Fibrositis (also called fibromyalgia) affects about 3–10% of the population, making it one of the most common rheumatic syndromes in general medicine. It shares many features with the chronic fatigue syndrome, namely, an increased frequency among women aged 20–50, absence of objective findings, and absence of diagnostic laboratory tests. While many of the clinical features of the two conditions overlap, musculoskeletal pain predominates in fibrositis whereas lassitude dominates the chronic fatigue syndrome.
The cause is unknown, but sleep disorders, depression, viral infections, and aberrant perception of normal stimuli have all been proposed. Fibrositis can be a complication of hypothyroidism, rheumatoid arthritis, or, in men, sleep apnea.
The patient complains of chronic aching pain and stiffness, frequently involving the entire body but with prominence of pain around the neck, shoulders, low back, and hips. Fatigue, sleep disorders, subjective numbness, chronic headaches, and irritable bowel symptoms are common. The patient feels incapable of performing normal activities, and even minor exertion aggravates pain and increases fatigue. Patients occasionally trace the onset of symptoms to an acute event or viral-like illness. Physical examination is normal except for “trigger points” of pain produced by palpation of various areas such as the trapezius, the medial fat pad of the knee, and the lateral epicondyle of the elbow. Read the rest of this entry »