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In 1990, the America College of Rheumatology developed standards for fibromyalgia that health care
practitioners can use to diagnose this condition. According to these standards, a person is thought to have
fibromyalgia if he or she has widespread pain in combination with tenderness in at least 11 of the 18 sites
known as trigger points. Trigger point sites include the base of the neck, along the backbone, in front of the
hip and elbow, and at the rear of the knee and shoulder.
Treatment
There is no known cure for fibromyalgia. Therefore, the goal of treatment is successful symptom
management. Treatment usually requires a combination of therapies, exercise, proper rest, and diet. A
patient's clear understanding of his or her role in the recovery process is imperative for successful
management of this condition. Treatments found to be helpful include heat and occasionally cold
applications. A regular stretching program is often useful. Aerobic activities focusing on increasing the
heart rate are the preferred forms of exercise over most other forms of exertion. Exercise programs need to
include good warm-up and cool-down sessions, with special attention given to avoiding exercises causing
joint pain. The diet should include a large variety of fruits and vegetables which provide the body with trace
elements and minerals that are necessary for healthy muscles.
Adequate rest is essential in the treatment of fibromyalgia. Avoidance of stimulating foods or drinks
(such as coffee) and medications like decongestants prior to bedtime is advised. If diet, exercise, and
adequate rest do not relieve the symptoms of fibromyalgia, medications may be prescribed. Medications
prescribed and found to have some benefit include antidepressant drugs, muscle relaxants, and
anti-inflammatory drugs. People with fibromyalgia often need a rheumatology consultation (a meeting with
a doctor who specializes in disorders of the joints, muscles, and soft tissue) to decide the cause of various
rheumatic symptoms, to be educated about fibromyalgia and its treatment, and to exclude other rheumatic
diseases. A treatment program must be individualized to meet the patient's needs. The rheumatologist, as
the team leader, enlists and coordinates the expertise of other health professionals in the care of the patient.
Alternative treatment
Massage therapy can be helpful, especially when a family member is instructed on specific massage
techniques to manage episodes of increased symptoms. Specific attention to mental health, including
psychological consultation, may also be important, since depression may precede or accompany
fibromyalgia. Other alternative therapies, including hellerwork, rolfing, homeopathic medicine, Chinese
traditional medicine (both acupuncture and herbs), polarity therapy, and Western botanical medicine, can
assist the person with fibromyalgia to function day to day and can contribute to healing.
Prognosis
Fibromyalgia is a chronic problem. The symptoms sometimes improve and at other times worsen, but they
often continue for months to years.
Prevention
There is no known or specific way to prevent fibromyalgia. However, similar to many other medical
conditions, remaining as healthy as possible with a good diet, safe exercise, and adequate rest is the best
prevention.
ORGANIZATIONS
Rheumatology
The study of disorders characterized by inflammation, degeneration of connective tissue, and related
structures of the body. These disorders are sometimes collectively referred to as rheumatism.
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