There is no known cause, and no single treatment, which leaves doctors and their patients with no alternative other than to experiment with a variety of treatments.

What is fibromyalgia?

The cause of fibromyalgia is not known. It is a group of common nonarticular (non-joint) rheumatic disorders characterised by achy pain, tenderness and stiffness of muscles, tendon insertions and soft tissues around these areas.

Any of these tissues may be involved, but the lower back, neck, shoulders, chest and thighs are generally particularly affected.

Symptoms of fibromyalgia

There is a common pattern of symptoms which affect about 75% of those suffering from fibromyalgia. These include fatigue, disrupted sleep, stiffness on waking in the morning, and the presence of multiple tender spots in the neck, lower back, arms and legs.

Many women with fibromyalgia also have other medical conditions such as irritable bowel disease, Lyme Disease, arthritis and tension headaches.

In some patients muscle abnormalities have been seen, but most researchers think that these result from the muscles not being used because of chronic pain, rather than from the disease itself.

The diagnosis of fibromyalgia is based on a number of signs and symptoms and there is no one laboratory test or x-ray which will give the diagnosis. It tends to be a diagnosis which is made after other illnesses have been excluded.

Treatment

Fibromyalgia is difficult to treat. Only about 50% of those treated report adequate relief of their symptoms.

There is no one drug or treatment which works well in all people.

Drugs which have been used include pain killers, antidepressants and anti-inflammatories.

The most widely prescribed drug for fibromyalgia is the antidepressant amitriptyline, which is taken at night and has been found to consistently relieve symptoms in 25 to 30% of women. Another relatively effective antidepressant is venlafaxine. Newer anti-depressants such as fluoxetine have not been very successful.

Some women are helped by anti-anxiety drugs such as alprazolam. Local anaesthetics applied to the skin, and growth hormone have also been used with some success.

Nearly all the medications used to treat fibromyalgia have side effects and none are 100% effective.

Alternative therapies used in fibromyalgia

Approximately 90% of women with fibromyalgia have tried some type of alternative therapy, particularly dietary manipulation, chiropractic, and massage therapy.

Biofeedback, which is the control of unconscious or involuntary bodily function through thought processes, has been shown to decrease the number of tender spots, as well as the intensity of pain.

Some women have had success with hypnosis or acupuncture.

The last word

Fibromyalgia is a chronic, distressing condition which affects many women. Conventional medicine alone can rarely successfully treat this condition. Many doctors are now encouraging their patients to seek help from reputable alternative practitioners, an approach which offers women more control over the management of their care.

People with fibromyalgia should learn all they can about their condition, and find the mixture of therapies which works best for them. It is important to realise that in spite of the chronic pain, very few women with fibromyalgia end up being disabled by the disorder.