Fibromyalgia (FM) is a common chronic pain syndrome characterized by diffuse pain and the presence of abnormal tenderness in multiple specific anatomic locations or tender points. FM is the second most common rheumatoid condition seen by rheumatologists. FM is estimated to affect 5% of the general medical population and 10-20% of patients seen in rheumatology practice. The typical client is a female with the onset of symptoms between ages 25-55 with duration of symptoms at the time of diagnosis of at least 5 years. FM is not a deforming disease, but many patients may consider the pain of FM to be disabling. Symptoms tend to be unrelenting, with most clients reporting little change in a 3-year follow-up study.
A simple and effective criterion for FM has been established by the American College of Rheumatology. The criterion is as follows: a history of whole body pain (in all four quadrants) of greater than 3 months duration of inexplicable diagnosis, plus 11 or more of a possible 18 tender points. Other characteristics include persistent aching, nonrestorative sleep, fatigue, morning stiffness, subjective swelling, and variable parathesia mainly consisting of numbness or tingling in the extremities. In many instances, these symptoms may be worsened by weather change, anxiety, stress, and physical activity. Recent studies have shown the prevalence of hypermobility in the client with fibromyalgia and changes in the type II muscle fibers in the body.
