Understanding fibromyalgia syndrome.

Fibromyalgia syndrome (FMS) is characterized by generalized pain and musculoskeletal tenderness, fatigue, nonrestorative sleep, and morning stiffness. People with FMS often report that they "hurt all over." Many describe the pain as aching, exhausting, or nagging. Pain is most commonly associated with tender points in the suboccipital area of the neck, shoulders, chest wall, elbows, knees, hips, and back (see illustration at right). Muscle cramping and spasms are common. Although classified as a chronic pain syndrome, FMS may produce "flares" of acute pain. In fact, pain may become so severe that it limits range of motion and functional ability. Often denied or misunderstood, FMS has been described as an invisible illness. Because people with the syndrome don't look sick, their clinicians, family, and friends may fail to respond empathetically. Over time, such insensitivity may produce selfdoubt and diminished self-worth. The condition often is mislabeled as rheumatism, fibromyositis, and myositis. Unlike stiffness associated with arthritis, pain from FMS doesn't diminish with activity. In addition to pain, signs and symptoms of FMS include dry eyes and mouth, swelling, sleep myoclonus, paresthesias, poor posture, weight gain, cold sensitivity, exercise intolerance, difficulty concentrating, visual deficits, balance disturbances, and anxiety. Febrile Low cervic Occiput