FIBROMYALGIA - A CLINICAL CHALLENGE

The syndrome of fibromyalgia includes an unusually large and heterogen eous number of symptoms apart from the core features of generalized pa in and widespread tenderness. Widespread tenderness is the only object ive criterion. There is no evidence that fibromyalgia is a disease of the muscles or a rheumatic syndrome. The experience from an Australian epidemic of fibromyalgia indicates that there is an important psychos omatic component in the pathogenesis. Probably, fibromyalgia is not a disease entity; rather, the symptoms reflect difficulties in coping wi th various types of environmental stress. Secondary to this, sleep dis turbances, fatigue, a low level of physical activity and poor physical fitness may develop, rendering the patients susceptible to muscle pai n and tenderness elicited by sleep disturbances. A vicious circle may be responsible for the chronicity of the syndrome. Identification of e nvironmental factors and early intervention should be given a high pri ority.