A guide to fibromyalgia

If you literally ache all over, you may have fibromyalgia (FM) — one of the most vexing of all medical problems. One recent textbook described FM as a "chronic, poorly understood and disabling condition." It is all of that and perhaps more.

• FM is relatively common, affecting about 900,000 Canadians, or just under three per cent of the general population.
• The overwhelming majority of FM patients are women (by a 4-to-1 ratio) and the ailment typically strikes when a person is over 50.
• Fibro­myalgia is a significant health problem, accounting for one of every six visits that people make to rheumatologists.

FM's main features are severe and widespread muscle pain that is most pronounced in the neck and shoulders, extreme fatigue and — in most cases — poor sleep. Fibromyalgia can feel like a joint disease, but the pain actually occurs in nearby muscles, ligaments and tendons.

FM's pain and other symptoms may persist for years — even for life — but the intensity can vary from day to day. Both inactivity and unaccustomed physical activity can make symptoms worse, as can insomnia, humid weather and emotional stress.In addition to widespread persistent pain, fatigue and poor sleep, people with FM typically report many other problems including:

• Irritable bowel syndrome (present in up to 50 percent of cases)
• Tension headaches
• Problems concentrating or remembering
• A sense of swollen hands, though examination shows the hands to be normal
• Palpitations
• Depression

• Until about 20 years ago FM was known as fibrositis, a condition of inflamed ("-itis") muscles, tendons and other fibrous tissues.
• In 1979, Canadian physicians showed that fibrositis patients also suffered from extreme fatigue and, in almost all cases, problems with sleep. Studies also found that achy joints of fibrositis patients were not actually inflamed.
• So in 1981, Dr. Muhammad B. Yunus, professor of medicine at the University of Illinois College of Medicine at Peoria, specifically used the 1976 term "fibromyalgia," which roughly means achy muscles and other soft tissues.
• The World Health Organization recognized FM as a medical disorder in its Copenhagen Declaration of New Year's Day 1993.