# Defination please?



## LML (Jul 17, 2001)

Is there a precise defination for fibromyalgia?Or a definative test for it that I can ask my MD to give me? I'm finally getting my IBS more or less under control, but within the last year my legs (from hips to ankles) have become much more stiff and achy and and sometimes painful. RLS is more pronounced as well. I'm wondering if this stiffness and pain is related to the IBS, or might be fibro or some other new treat for me. Also have GERD. What are the possible relationship with these conditions?I'd appreciate any info.Thanks!


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## Susan Purry (Nov 6, 2001)

Hi LML







Here is a definition: * What is Fibromyalgia Syndrome? * http://www.fmnetnews.com/pages/basics.html#causes


> quote: FMS (fibromyalgia syndrome) is a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. Fibromyalgia means pain in the muscles, ligaments and tendons--the fibrous tissues in the body. FMS used to be called fibrositis, implying that there was inflammation in the muscles, but research later proved that inflammation did not exist.


Here is some info about diagnosis (you mentioned a definitive test):*Diagnostic Criteria for Fibromyalgia * http://www.fmnetnews.com/pages/criteria.html


> quote: For the most part, routine laboratory testing reveals nothing about fibromylagia or chronic fatigue syndrome. However, upon physical examination, the fibromyalgia patient will be sensitive to pressure in certain areas of the body called tender points. To meet the diagnostic criteria, patients must have: A. Widespread pain in all four quadrants of their body for a minimum of three monthsB. At least 11 of the 18 specified tender points(see diagram)These 18 sites used for diagnosis cluster around the neck, shoulder, chest, hip, knee and elbow regions. Over 75 other tender points have been found to exist, but are not used for diagnostic purposes. ï¿½Although the above criteria focuses on tender point count, a consensus of 35 FMS experts published a report in 1996 saying that a person does not need to have the required 11 tender points to be diagnosed and treated for FMS. This criteria was created for research purposes and many people may still have FMS with less than 11 of the required tender points as long as they have widespread pain and many of the common symptoms associated with FMS


About testing - there is no diagnostic blood test for Fibromyalgia, but your doctor will probably take bloods to rule out other conditions which may be causing your symptoms. Here is a map of those tender points: http://www.fibromyalgia.com/tender_points.htm Here is some further info which covers a few points: *The Scientific Basis for Understanding Pain in Fibromyalgia * by Robert Bennett MD, FRCP http://www.myalgia.com/Scientific%20basis.htm


> quote:*Clincal Features*PainThe core symptom of the FM syndrome is chronic widespread painï¿½Fatigue Easy fatigability from physical exertion, mental exertion and psychological stressors are typical of fibromyalgia. The etiology of fatigue in fibromyalgia is multifaceted and is thought to include non-restorative sleep, deconditioning, depression, poor coping mechanisms and secondary endocrine dysfunction involving the hypothalamic pituitary adrenal axis and growth hormone deficiencyï¿½Disordered sleep Fibromyalgia patients invariably report disturbed sleep ï¿½*Pathogenesis *Fibromyalgia articles commonly begin with the admonition that "the cause of fibromyalgia is not known". This assertion is no longer justified. Impressive advances have been made in understanding the neurobiology of chronic pain. As fibromyalgia is now considered part of the spectrum of chronic pain, these advances are relevant to understanding pain in fibromyalgia patientsï¿½*Central Pain Mechanisms *There are several lines of evidence to suggest that the pain experience of fibromyalgia patients is in part the result of disordered sensory processing at a central level.ï¿½*Management* The current treatment modalities for fibromyalgia seldom lead to long term relief. Basically the current management philosophy is to help the patient constructively adapt to an existence plagued by pain, fatigue and other symptoms


Hope this helps..?IBS is quite common in people with Fibro and/or CFS. Probably because there are some things involved with Fibro and/or CFS which effect the gut, such as serotonin (only 5% is in the brain, the rest is in the gut), overproduction of cytokines and dysregulation of the autonomic nervous system. RLS is a pain isn't it! It may be worth reviewing with your doctor the strategy you're using to manage it. Best wishes,


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## Feisty (Aug 14, 2000)

LML,Sorry, but don't know what the RLS is, could you explain?Thanks.


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## LML (Jul 17, 2001)

Thanks so much Susan for such a good definitive response. Shoot ... one more thing that's not easily treated or specifically diagnosed. How lucky can I get?! But you gave me some good things to ask my doctor about. Is this related enough to IBS to talk to my GI about it or should I talk to someone else?Feisty, RLS is restless leg symdrome. It's an uncontrolable twitchy sometimes crampy feeling in your legs. Makes you almost involuntarily need to move them. Happens mostly to me at night or in the day time if I have to sit still too long in one spot. Had it for more than 40 yrs but only recently learned that it had a name! I take klonapin at night to help.


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