Fibromyalgia (FM) is a condition where widespread generalized pain limits a person's ability to function, sometimes to the point of complete disability. This month, we'll look at identifying markers that may be used to determine whether a patient has FM or not.
Chronic pain that arises from the muscles and joints affects nearly 20% of the adult population, with the highest percentages found among females and those in lower income brackets. It is very challenging to determine “the cause” of chronic pain, probably because it is influenced by and interacts with various physical, emotional, psychological, and social factors. Several studies have reportedly shown that the levels of certain neurotransmitters (chemicals that help our nerves transmit information) including serotonin, glutamate, lactate, and pyruvate are elevated in patients with localized chronic myalgias (like FM) and therefore may be potential biomarkers for various conditions causing chronic pain. Unfortunately, elevations in these potential markers are not specific or unique to FM.
However, researchers have identified muscle alterations in in fibromyalgia / chronic widespread pain patients. More studies are needed to confirm these findings before they have the potential for use as a diagnostic criteria for FM.
For the time being, in order to establish a diagnosis of FM, we must rely on the following:
1) The presence of widespread pain by using the “Widespread Pain Index” or WPI.
2) Determining the severity of the symptoms by using the “Symptom Severity Score” or SS score of which there are two parts:
• Scoring fatigue, waking un-refreshed, and cognitive symptoms using a 0-3 scale, 3 representing the most severe or disturbing of these daily functions.
• Adding up additional symptoms associated with FM, resulting in a 0-3 range depending on the number of the “other symptoms.”
Using the WPI and the SS scores, FM can be identified if one of the following two situations has been present for three or more months:
• WPI score > 7 and SS score > 5
• WPI score between 3 and 6 and SS score > 9
