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CFS/FMS |
Chronic Fatigue Syndrome and Fibromyalgia Syndrome I first learned about Chronic Fatigue Syndrome (CFS) and Fibromyalgia Syndrome (FMS) when my coworker was diagnosed with both CFS and FMS 1994. We were working in the Housing Office at Ellsworth AFB. I watched her health deteriorate to the point where she could no longer function and had to retire on a medical disability. In January 1995 we established Black Hills CFS/FMS Support Group. Being involved with the support group has been a very rewarding experience for me. I have gotten back ten fold what I have given. What is Chronic Fatigue Syndrome? What is Fibromyalgia Syndrome? What is Chronic Fatigue Syndrome? From the Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) Association of America: Although its name trivializes the illness as little more than mere tiredness, Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) brings with it a constellation of debilitating symptoms. CFIDS is characterized by incapacitating fatigue (experienced as profound exhaustion and extremely poor stamina) and problems with concentration and short-term memory. It is also accompanied by flu-like symptoms such as pain in the joints and muscles, unrefreshing sleep, tender lymph nodes, sore throat, and headache. Persons with CFIDS (PWCs) have symptoms that vary from person to person and fluctuate in severity. Specific symptoms may come and go, complicating treatment and the PWC's ability to cope with the illness. Most symptoms are invisible, which makes it difficult for others to understand the vast array of debilitating symptoms with which PWCs contend. Other Common Symptoms: For more information, contact the CFIDS Association of America. From the Center for Disease Control (CDC): In order to receive a diagnosis of Chronic Fatigue Syndrome, a patient must satisfy two criteria: (1) Have severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis, and (2) Concurrently have four or more of the following symptoms: substantial impairment in short-term memory or concentration, sore throat, tender lymph nodes, muscle pain, multi-joint pain without swelling or redness, headaches of a new type, pattern or severity, unrefreshing sleep, and post-exertional malaise lasting more than 24 hours. The symptoms must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue. For more information, contact the Center for Disease Control.
What is Fibromyalgia Syndrome? From the Arthritis Foundation Fibromyalgia syndrome is a common form of generalized muscular pain and fatigue that is believed to affect approximately 2 percent of the U.S. population, or 5 million people. The word fibromyalgia means pain in the muscles and in the tissues that connect bones, ligaments and tendons. The cause of fibromyalgia is unknown. Although people with fibromyalgia may ache like people with a joint disease, fibromyalgia does not cause inflammation, and so it is not a form of arthritis (which is characterized by joint inflammation). Instead, fibromyalgia is a form of soft tissue rheumatism. Fibromyalgia syndrome cannot be diagnosed with laboratory tests. The results of X-rays, blood tests and muscle biopsies look normal. Therefore, the diagnosis is based on a clinical examination by a doctor of a person’s symptoms. In 1990, the American College of Rheumatology (ACR), an association of approximately 5,000 rheumatologists (specialists in musculoskeletal diseases and immune disorders), developed guidelines to help doctors diagnose fibromyalgia. According to the ACR criteria, a person has fibromyalgia if he or she has a history of widespread pain (of at least three months’ duration), and pain in 11 of the body’s 18 specific tender point sites. Symptoms and Signs: Widespread musculoskeletal pain is the most prominent symptom of fibromyalgia. The pain generally occurs throughout the body, although it may start in one region, such as the neck and shoulders, and may spread over a period of time. Fibromyalgia pain has been described in a variety of ways, such as burning, gnawing, aching, or as stiffness or soreness. It often varies according to time of the day, activity level, weather, sleep patterns and stress. Most people with fibromyalgia say that some degree of pain always is present. They feel the pain mainly in their muscles. For some people with fibromyalgia, the pain may be quite severe. Although the results of a general physical examination usually are normal, and individuals may look healthy, a specific examination of the muscles of people with fibromyalgia reveals especially tender areas at locations known as tender points. Tender points are areas of the body that are painful when pressed. The presence and pattern of these characteristic tender points separate fibromyalgia from other conditions. Not all physicians know how to check for tender points, but most rheumatologists can perform a tender point evaluation. Fatigue and Sleep Disturbances: About 90 percent of people with fibromyalgia describe moderate or severe fatigue, decreased endurance, or the kind of exhaustion felt with the flu or lack of sleep. Sometimes the fatigue is a greater problem than pain for people with fibromyalgia. Most people with fibromyalgia experience sleeping problems. Although they may be able to fall asleep without major difficulty, they may sleep lightly and wake up frequently during the night. They often wake up feeling tired, even after sleeping through the night. The resulting fatigue can range from listlessness and decreased endurance to exhaustion. The level of fatigue experienced may vary during the day and from one day to the next. Nervous System Symptoms: Changes in mood are common symptoms of fibromyalgia. Many individuals feel sad or down, although only about 25 percent are considered clinically depressed. People with fibromyalgia also may feel anxious. Some researchers think there is a link between fibromyalgia and certain forms of depression and chronic anxiety. However, any person with a chronic illness – not just fibromyalgia – may feel depressed at times while struggling with their pain and fatigue. People with fibromyalgia may report difficulty concentrating or performing simple mental tasks. There is no evidence that these problems become more serious over time, and they tend to come and go. Similar problems have been noted in many people with mood changes, sleep disturbances or other chronic illnesses. Other Problems: Headaches, especially tension headaches and migraine headaches, are common symptoms of fibromyalgia, as are abdominal pain, bloating and alternating constipation and diarrhea (irritable bowel syndrome or spastic colon). Bladder spasms and irritability may cause urinary urgency or frequency. Some studies of people with fibromyalgia have reported other problems, such as cramps, dizziness and pain in the temporomandibular joint (TMJ), which attaches the lower jaw to the skull on each side of the face. Contact the Arthritis Foundation for more information on Fibromyalgia. From the Fibromyalgia Network: For the most part, routine laboratory testing reveals nothing about Fibromyalgia 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: (1) Widespread pain in all four quadrants of their body for a minimum of three months (2) At least 11 of the 18 specified tender points. 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. While many chronic pain syndromes display symptoms that overlap with Fibromyalgia, the 1990 ACR multi-center criteria study (published in the February 1990 issue of Arthritis and Rheumatism) evaluated a total of 558 patients, of which 265 were classified as controls. These control individuals weren't your typical healthy "normals." They were age and sex matched patients with neck pain syndrome, low back pain, local tendonitis, trauma-related pain syndromes, rheumatoid arthritis, lupus, osteoarthritis of the knee or hand, and other painful disorders. These patients all had some symptoms that mimic FMS, but the trained examiners were not foiled--they hand-picked the FMS patients out of the "chronically ill" melting pot with an accuracy of 88%. FMS is not a wastebasket diagnosis! Although 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. Commonly associated symptoms include fatigue, irritable bowel (e.g., diarrhea, constipation, etc.), sleep disorder (or sleep that is unrefreshing), chronic headaches (tension-type or migraines), jaw pain (including TMJ dysfunction), cognitive or memory impairment, post-exertional malaise and muscle pain, morning stiffness (waking up stiff and achy), menstrual cramping, numbness and tingling sensations, dizziness or lightheadedness, skin and chemical sensitivities. For more information, contact the Fibromyalgia Network .
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