MEpedia - User contributions [en]

Musculoskeletal system

2018-08-25T18:17:34Z

77.111.246.7:lowercase

The '''Musculoskeletal system''' "includes the bones of the skeleton and the cartilages, ligaments, and other connective tissue that stabilize or connect the bones. In addition to supporting the weight of the body, bones work together with muscles to maintain body position and to produce controlled, precise movements. Without the skeleton to pull against, contracting muscle fibers could not make us sit, stand, walk, or run."<ref name=":0">{{Cite web|url=http://my.clevelandclinic.org/health/articles/normal-structure-and-function-of-the-musculoskeletal-system|title=Musculoskeletal System {{!}} Cleveland Clinic|website=Cleveland Clinic|language=en|access-date=2018-08-25}}</ref>

== Bones ==
206 bones perform 5 functions:

<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*provide support for the body
*store minerals and lipids
*produce blood cells
*protect body organs
*provide leverage and movement<ref name=":0" />
</div>

== Other elements ==
<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*joints
*tendons
*ligaments
*skeletal muscles
*nerves
*cartilage
*hyaline cartilage
*elastic cartlilage
*fibrocartilage<ref name=":0" />
</div>

== Musculoskeletal disorders ==
Musculoskeletal disorders (MSDs) are conditions that can affect your muscles, bones, and joints. They include conditions such as:<ref>{{Cite news|url=http://www.healthline.com/health/musculoskeletal-disorders#Overview1|title=Musculoskeletal Disorders: Definition and Patient Education|last=Cherney|first=Kristeen|date=Mar 21, 2018|work=Healthline|access-date=2018-08-25|archive-url=|archive-date=|dead-url=|language=en}}</ref>

* tendinitis
* [[carpal tunnel syndrome]]
* osteoarthritis
* [[rheumatoid arthritis]]
* [[fibromyalgia]]
* bone fractures

== References ==

[[Category:Body systems]]
<references />

Musculoskeletal system

2018-08-25T18:15:48Z

77.111.246.7:/* Musculoskeletal disorders */ lowercase

The '''Musculoskeletal system''' "includes the bones of the skeleton and the cartilages, ligaments, and other connective tissue that stabilize or connect the bones. In addition to supporting the weight of the body, bones work together with muscles to maintain body position and to produce controlled, precise movements. Without the skeleton to pull against, contracting muscle fibers could not make us sit, stand, walk, or run."<ref name=":0">{{Cite web|url=http://my.clevelandclinic.org/health/articles/normal-structure-and-function-of-the-musculoskeletal-system|title=Musculoskeletal System {{!}} Cleveland Clinic|website=Cleveland Clinic|language=en|access-date=2018-08-25}}</ref>

== Bones ==
206 bones perform 5 functions:

<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*Provide support for the body
*Store minerals and lipids
*Produce blood cells
*Protect body organs
*Provide leverage and movement<ref name=":0" />
</div>

== Other elements ==
<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*Joints
*Tendons
*Ligaments
*Skeletal muscles
*Nerves
*Cartilage
*Hyaline Cartilage
*Elastic Cartlilage
*Fibrocartilage<ref name=":0" />
</div>

== Musculoskeletal disorders ==
Musculoskeletal disorders (MSDs) are conditions that can affect your muscles, bones, and joints. They include conditions such as:<ref>{{Cite news|url=http://www.healthline.com/health/musculoskeletal-disorders#Overview1|title=Musculoskeletal Disorders: Definition and Patient Education|last=Cherney|first=Kristeen|date=Mar 21, 2018|work=Healthline|access-date=2018-08-25|archive-url=|archive-date=|dead-url=|language=en}}</ref>

* tendinitis
* [[carpal tunnel syndrome]]
* osteoarthritis
* [[rheumatoid arthritis]]
* [[fibromyalgia]]
* bone fractures

== References ==

[[Category:Body systems]]
<references />

Musculoskeletal system

2018-08-25T18:12:52Z

77.111.246.7:convert citations

The '''Musculoskeletal system''' "includes the bones of the skeleton and the cartilages, ligaments, and other connective tissue that stabilize or connect the bones. In addition to supporting the weight of the body, bones work together with muscles to maintain body position and to produce controlled, precise movements. Without the skeleton to pull against, contracting muscle fibers could not make us sit, stand, walk, or run."<ref name=":0">{{Cite web|url=http://my.clevelandclinic.org/health/articles/normal-structure-and-function-of-the-musculoskeletal-system|title=Musculoskeletal System {{!}} Cleveland Clinic|website=Cleveland Clinic|language=en|access-date=2018-08-25}}</ref>

== Bones ==
206 bones perform 5 functions:

<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*Provide support for the body
*Store minerals and lipids
*Produce blood cells
*Protect body organs
*Provide leverage and movement<ref name=":0" />
</div>

== Other elements ==
<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*Joints
*Tendons
*Ligaments
*Skeletal muscles
*Nerves
*Cartilage
*Hyaline Cartilage
*Elastic Cartlilage
*Fibrocartilage<ref name=":0" />
</div>

== Musculoskeletal disorders ==
Musculoskeletal disorders (MSDs) are conditions that can affect your muscles, bones, and joints. They include conditions such as:<ref>{{Cite news|url=http://www.healthline.com/health/musculoskeletal-disorders#Overview1|title=Musculoskeletal Disorders: Definition and Patient Education|last=Cherney|first=Kristeen|date=Mar 21, 2018|work=Healthline|access-date=2018-08-25|archive-url=|archive-date=|dead-url=|language=en}}</ref>

* tendinitis
* [[Carpal tunnel syndrome]]
* osteoarthritis
* [[Rheumatoid arthritis]]
* [[Fibromyalgia]]
* bone fractures

== References ==

[[Category:Body systems]]
<references />

Musculoskeletal

2018-08-25T18:08:46Z

77.111.246.7:create

#REDIRECT [[Musculoskeletal system]]

Fibromyalgia

2018-08-25T18:08:11Z

77.111.246.7:internal links

[[Fibromyalgia]] (FM/FMS) is a chronic disorder characterized by widespread [[musculoskeletal]] pain, [[fatigue]], and tenderness in localized areas. [[Pain]] is widespread, on both sides of the body, and above and below the waist.

Sufferers are fatigued and tired even when sleeping for long periods of time, and sleep is often disrupted by pain. Many FM sufferers have sleep disorders like [https://en.wikipedia.org/wiki/Sleep_apnea sleep apnea] and [[restless leg syndrome]]. [[Cognitive impairment]], when one cannot focus or pay attention and the patient has difficulty concentrating on mental tasks, is known by FM sufferers as "[[fibro fog]]".<ref name=":17">{{Cite news|url=https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014|title=What Is Fibro Fog and ME/CFS Brain Fog?|last=Dellwo|first=Adrienne|date=|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Some experience [[depression]], [[headache]]s, and lower [[abdominal pain]] or cramping. Other symptoms include tingling or [[numbness]] in hands and feet, pain in jaw and disorders of the jaw such as [[temporomandibular joint disorder|temporomandibular joint disorder]] (TMJ), [[Menstrual cycle#Health effects in other conditions|menstrual cycle]] cramps, and digestive problems like i[[Irritable bowel syndrome|rritable bowel syndrome]] (IBS).<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms#1|title=Fibromyalgia Symptoms|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780|title=Fibromyalgia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref>

[[File:Fibro_Tender_Points.png|400px|thumb|right|1990 ACR Diagnostic Criteria: 18 Tender Points]]
[[File:Fibro_Widespread_Pain.png|400px|thumb|right|2010 ACR Preliminatry Diagnostic Criteria: Wisedpread Pain Index (WPI), 19 Tender Point Areas]]

==Prevalence==
FM is the second most common [https://en.wikipedia.org/wiki/Rheumatism rheumatic disorder] behind [[wikipedia:Osteoarthritis|osteoarthritis]] and is "now considered to be a lifelong [[Central nervous system]] disorder."<ref>{{Cite news|url=https://naidw.org/blog/members-myblogs/fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder|title=Fibromyalgia now considered as a lifelong central nervous system disorder|work=NAIDW.org®|access-date=2018-08-09|language=en-gb}}</ref> An estimated 10 million people in the US and 3-6% of the world population have fibromyalgia. It is seen in women, men, children, and all ethnic groups. It is often seen in families and diagnosed between the ages of 20 to 50 years; incidence increases with age.<ref>{{Cite news|url=http://www.fmaware.org/about-fibromyalgia/prevalence/|title=Prevalence - National Fibromyalgia Association (NFA)|work=National Fibromyalgia Association (NFA)|access-date=2018-08-09|language=en-US}}</ref>

FM has a female:male 7:1 ratio under the ''American College of Rheumatology (ACR) 1990 Diagnostic Criteria'' and 2:1 when the ''ACR 2010 Preliminary Diagnostic Criteria'' is used.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=|publisher=|editor-last=Diamond|editor-first=Herbert|at=Sex-related differences in incidence}}</ref> ''See'': [[Fibromyalgia#American College of Rheumatology (ACR) Criteria|Fibromyalgia (''American College of Rheumatology (ACR) Criteria'' section)]].

==Fibromyalgia in ME/CFS==
Dr. [[Jarred Younger]] has said that many patients that meet the criteria for FM also meet criteria for [[chronic fatigue syndrome]] (CFS) but the reverse is not necessarily true as a lot of people with [[CFS]] do not have [[chronic pain]].<ref>{{Cite web|url=https://www.youtube.com/watch?v=wJB95m4FLa0#t=57m27s|title=Webinar with Jarred Younger, Ph.D.|last=Younger|first=Jared|date=May 20, 2016|website=YouTube|at=57:27|via=|archive-url=|archive-date=|dead-url=|access-date=|publisher=SolveCFS|type=Video}}</ref> However, the [[Canadian Consensus Criteria]] (CCC) requires the symptom of pain to diagnose [[ME/CFS]]. It is the pattern and significant degree of [[chronic pain]] in FM that sets it apart from other diseases that have pain.

"The most common overlapping condition with ME/CFS is fibromyalgia."<ref name=":30">{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions - American Myalgic Encephalomyelitis and
Chronic Fatigue Syndrome Society|last=|first=|date=|website=ammes.org|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref><ref name=":31">{{Cite journal|last=Jason|first=Leonard|last2=Taylor|first2=R.R.|last3=Kennedy|first3=C.L.|last4=Song|first4=S|last5=Johnson|first5=D|last6=Torres|first6=S.R.|date=2001-01-01|title=Chronic fatigue syndrome: Comorbidity with fibromyalgia and psychiatric illness|url=https://www.researchgate.net/publication/285787383_Chronic_fatigue_syndrome_Comorbidity_with_fibromyalgia_and_psychiatric_illness|journal=Medicine and Psychiatry|volume=4|pages=29–34}}</ref>

==Health complications==
FM is not a [https://en.wikipedia.org/wiki/Progressive_disease progressive disease] but according to Dr. Dan Clauw the "slow gradual worsening of chronic pain patients over time is due to downstream consequences of poorly controlled pain and other symptoms, wherein individuals then progressively get less active, sleep worse, are under more stress and unknowingly develop bad habits which worsen pain and other symptoms."<ref>{{Cite news|url=http://nationalpainreport.com/ask-the-dctors-is-fibromyalgia-progressive-8831105.html|title=Ask the Doctors: Is Fibromyalgia Progressive?|date=2016-08-09|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*[https://www.sharecare.com/health/fibromyalgia-effects Fibromyalgia Complications]<ref name=":19" />

:<blockquote>People who have fibromyalgia frequently complain of a variety of symptoms that affect other parts of the body. Many people complain of [[gastrointestinal]] issues and restless legs syndrome (RLS). Additionally, the [[chronic pain]] and discomfort of fibromyalgia may lead to [[depression]].<ref name=":19">{{Cite news|url=https://www.sharecare.com/health/fibromyalgia-effects|title=Fibromyalgia Complications - Fibromyalgia - Joint Health|work=Sharecare|access-date=2018-08-09|language=en}}</ref></blockquote>

*[https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions Can fibromyalgia cause other medical conditions?]<ref name=":20" />

:<blockquote>Fibromyalgia is not known to cause other medical conditions. However, people who have fibromyalgia seem to be at high risk for developing other painful conditions, including [https://en.wikipedia.org/wiki/Osteoarthritis osteoarthritis] (the common type of arthritis caused by wear and tear on the joints) as well as other related conditions, such as [[rheumatoid arthritis]], [[lupus]], and [https://en.wikipedia.org/wiki/Ankylosing_spondylitis ankylosing spondylitis]. Also, people with fibromyalgia are frequently diagnosed with chronic fatigue syndrome, irritable bowel syndrome (IBS), and temporomandibular joint (TMJ) disorder.<ref name=":20">{{Cite web|url=https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions|title=Can fibromyalgia cause other medical conditions? {{!}} Fibromyalgia Complications|last=Honor Society of Nursing|first=|date=|website=Sharecare|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref></blockquote>

==Risk factors==
[[Lupus]] and [[rheumatoid arthritis]] (RA) are risk factors in developing FM. Car accidents, [[post-traumatic stress disorder]] (PTSD), [https://en.wikipedia.org/wiki/Repetitive_strain_injury repetitive injuries], illness such as a [https://en.wikipedia.org/wiki/Viral_disease viral infection], [https://en.wikipedia.org/wiki/Family_history_(medicine) family history], and [https://en.wikipedia.org/wiki/Obesity obesity] have all been linked to FM.<ref>{{Cite web|url=https://www.cdc.gov/arthritis/basics/fibromyalgia.htm|title=Fibromyalgia {{!}} Arthritis {{!}} CDC|date=2018-04-03|website=www.cdc.gov|language=en-us|access-date=2018-08-09}}</ref><ref>{{Cite news|url=https://www.niams.nih.gov/health_info/Fibromyalgia/|title=Fibromyalgia What Causes it?|last=Director|first=Nancy Garrick, Deputy|date=2017-04-05|work=National Institute of Arthritis and Musculoskeletal and Skin Diseases|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

==Diagnosis==
[https://www.verywellhealth.com/what-are-fibromyalgia-tender-points-189768 Tender points], not [https://en.wikipedia.org/wiki/Myofascial_trigger_point trigger points], are used to diagnose fibromyalgia.<ref>{{Cite web|url=http://www.healthcentral.com/chronic-pain/c/662034/176031/fibromyalgia-trigger/|title=The Difference Between Fibromyalgia Tender Points and Myofascial Trigger Points - Chronic Pain {{!}} HealthCentral|last=Cooper|first=Celeste|date=May 8, 2015|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> Tender points will be above and below the waist and on both sides of the body. (See: Illustrations of the 1990 and 2010 American College of Rheumatology (ACR) Criteria depicting tender points near the top of this page.) It is important to check for other conditions that could be causing pain such as hypothyroidism, rheumatoid arthritis or lupus, osteoarthritis, ankylosing spondylitis, and [[wikipedia:Polymyalgia_rheumatica|polymyalgia rheumatica]].<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>

===United States===
==== American College of Rheumatology (ACR) Criteria ====

*1990, [http://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf The American College Of Rheumatology 1990 Criteria For The Classification Of Fibromyalgia]<ref>{{Cite web|url=https://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf|title=The American College of Rheumatology Criteria for the Classification of Fibromyalgia|last=Wolfe|first=Frederick|last2=Smythe|first2=Hugh|date=1990|website=rheumatology.org|publisher=|others=Abeles, Micha; Clark, Patricia; Fam, Adel; Farber, Stephen; Fiechtner, Justus; Franklin, Michael; Gatter, Robert; Hamaty, Daniel; Lessard, James; Lightbroun, Alan; Masi, Alfonse; McCain, Glenn; Reynolds, W. John; Romano, Thomas; Russell, Jon; Sheon, Robert|archive-url=|archive-date=|dead-url=|access-date=|last3=Yunus|first3=Muhammad|last4=Bennett|first4=Robert|last5=Bombardier|first5=Claire|last6=Goldenberg|first6=Don|last7=Tugwell|first7=Peter|last8=Campbell|first8=Stephen}}</ref> "American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure."<ref>{{Cite news|url=http://www.health.com/health/gallery/0,,20345635,00.html|title=18 Points Used to Diagnose Fibromyalgia|last=|first=|date=Feb 4, 2011|work=Health.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> <ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2010, The [https://www.fibroknowledge.com/site/acr-2010 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview]<ref>{{Cite web|url=https://www.fibroknowledge.com/sites/default/files/downloads/file/2010_ACR_CRITERIA.pdf|title=American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia|last=|first=|date=2010|website=fibroknowledge.com|type=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref> was proposed and modified in 2011<ref>{{Cite news|url=http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria|title=New and Modified Fibromyalgia Diagnostic Criteria|last=Garg|first=Neha|date=Feb 9, 2012|work=Rheumatology Network|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=|last2=Deodhar|first2=Atul}}</ref> with the modification being validated in 2013 and published in 2014.<ref>{{Cite journal|last=Bennett|first=Robert M.|last2=Friend|first2=Ronald|last3=Marcus|first3=Dawn|last4=Bernstein|first4=Cheryl|last5=Han|first5=Bobby Kwanghoon|last6=Yachoui|first6=Ralph|last7=Deodhar|first7=Atul|last8=Kaell|first8=Alan|last9=Bonafede|first9=Peter|date=2014|title=Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/24497443|journal=Arthritis Care & Research|volume=66|issue=9|pages=1364–1373|doi=10.1002/acr.22301|issn=2151-4658|pmid=24497443|via=}}</ref> September of 2016, another revision has been made.<ref>{{Cite news|url=http://acrabstracts.org/abstract/2016-revisions-to-the-20102011-fibromyalgia-diagnostic-criteria/|title=2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria - ACR Meeting Abstracts|last=|first=|date=Sep 28, 2016|work=ACR Meeting Abstracts|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

:Men do not seem to form the tender points needed for diagnosis under the 1990 criteria,<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/features/how-fibromyalgia-affects-men#2|title=How Fibromyalgia Affects Men: Symptoms and Diagnosis|work=WebMD|access-date=2018-08-09|language=en-US}}</ref> the 2010 proposed criteria diagnoses more men with a F/M ratio of 2:1.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=}}</ref>
:Tender points were used to diagnose with the 1990 criteria, however "considerable skill is needed to correctly check for a patient’s tender points (i.e., digital palpation that is done with certain amount of applied pressure), yet this technique is not typically taught at most medical schools."<ref name=":0">{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 5, 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>
:The new standards were designed to:
:*eliminate the use of a tender point examination
:*include a severity scale by which to identify and measure characteristic FM symptoms
:*utilize an index by which to rate pain<ref name=":0" />
:*There are 19 tender point areas in the widespread pain index (WPI), whereas the 1990 criteria had 18 tender points.<ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose fibromyalgia.<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=Jul 25, 2012|website=www.ssa.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

==== Sleep study ====
[[Sleep dysfunction]] is often involved in fibromyalgia. Treating a sleep disorder can help with fibromyalgia symptoms. A diagnosed sleep disorder is also helpful if one needs to file for disability.

*[https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054 Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054|title=Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*[http://www.sciencedaily.com/releases/2008/09/080903134311.htm What A Sleep Study Can Reveal About Fibromyalgia]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2008/09/080903134311.htm|title=What A Sleep Study Can Reveal About Fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*[http://linkis.com/nationalpainreport.com/lzYea Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says]<ref>{{Cite news|url=http://linkis.com/nationalpainreport.com/lzYea|title=Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says|last=|first=|date=Mar 25, 2016|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== ICD Diagnostic code===
====World Health Organization====
'''ICD-10'''

The [[World Health Organization]] (WHO) International Classification of Diseases (ICD) lists fibromyalgia as a "disease of the [[musculoskeletal system]] and connective tissue", under the code M79.7 (WHO ICD-10 Version: 016).<ref>World Health Organization, [http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7 International Classification of Diseases - Fibromyalgia M79.7], ICD-10, 2016</ref>

*'''M79.7 Fibromyalgia'''
::Fibromyositis
::Fibrositis
::Myofibrositis<ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7|title=ICD-10 Version:2016|website=apps.who.int|language=en|access-date=2018-08-09}}</ref>

In 2015, the [[United States]] finally adopted ICD-10 and Fibromyalgia as a diagnosis.<ref>{{Cite web|url=http://www.icd10data.com/ICD10CM/Codes/M00-M99/M70-M79/M79-/M79.7|title=2018 ICD-10-CM Diagnosis Code M79.7: Fibromyalgia|website=www.icd10data.com|language=en|access-date=2018-08-09}}</ref> <ref>{{Cite news|url=http://nationalpainreport.com/the-health-care-industry-finally-recognizes-fibromyalgia-8827637.html|title=The Health Care Industry Finally Recognizes Fibromyalgia|last=Liptan|first=Ginevra|date=2015-09-30|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

'''ICD-11 (2019)'''

[https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504 ICD-11] (2019) has diagnostic code ''MG30.1 Chronic widespread pain''.<ref name=":18">{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504|title=ICD-11 - Mortality and Morbidity Statistics|website=icd.who.int|language=en|access-date=2018-08-09}}</ref>

*'''MG30.01 Chronic widespread pain'''

'''Parent'''
::MG30.0 Chronic primary pain

'''Description'''
<blockquote>Chronic widespread pain (CWP) is diffuse pain in at least 4 of 5 body regions and is associated with significant emotional distress (anxiety, anger/frustration or depressed mood) or functional disability (interference in daily life activities and reduced participation in social roles) [1]. CWP is multifactorial: biological, psychological and social factors contribute to the pain syndrome. The diagnosis is appropriate when the pain is not directly attributable to a nociceptive process in these regions and there are features consistent with nociplastic pain [2] and identified psychological and social contributors.<ref name=":18" /></blockquote>

'''Inclusions'''
:*Fibromyalgia
'''Exclusions'''
:*Acute pain (MG31)<ref name=":18" />

==Pathophysiology==
"Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology. There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or [[Lyme disease]], as well as emotional or physical trauma."<ref>{{Cite web|url=https://www.uptodate.com/contents/pathogenesis-of-fibromyalgia#!|title=UpToDate|last=Goldenberg|first=Don L|date=|website=www.uptodate.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> The widespread pain is severe, debilitating, and abnormal in processing its pain. There is also sleep disturbance and fatigue. Cause or causes are unproven.<ref>{{Cite news|url=https://www.omf.ngo/what-is-mecfs-old/fibromyalgia/|title=What is Fibromyalgia? {{!}} Open Medicine Foundation|work=Open Medicine Foundation|access-date=2018-08-09|language=en-US}}</ref>

*May 2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/ Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management]<ref name=":21">{{Cite journal|last=Jahan|first=Firdous|last2=Nanji|first2=Kashmira|last3=Qidwai|first3=Waris|last4=Qasim|first4=Rizwan|date=2012|title=Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/|journal=Oman Medical Journal|volume=27|issue=3|pages=192–195|doi=10.5001/omj.2012.44|issn=1999-768X|pmc=|pmid=22811766|via=}}</ref> ''See'' Table 1: "Conditions associated with fibromyalgia." Musculoskeletal, genitourianry, gastro intestinal, and miscellaneous conditions often exist among fibromyalgia patients.

<blockquote>Pathophysiology: Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as [[serotonin]], substance P, growth hormone and [[cortisol]] suggest that regulation of the autonomic and neuro-endocrine system appears to be the basis of the syndrome. Fibromyalgia is not a life-threatening, deforming, or [https://en.wikipedia.org/wiki/Progressive_disease progressive disease]. [[Anxiety]] and [[depression]] are the most common association. Aberrant pain processing, which can result in [[chronic pain]], may be the result of several interplaying mechanisms. [[Central sensitization]], blunting of inhibitory pain pathways and alterations in [[neurotransmitters]] lead to aberrant neuro-chemical processing of sensory signals in the CNS, thus lowering the threshold of pain and amplification of normal sensory signals causing constant pain.<ref name=":21" /></blockquote>

<blockquote>The frequent co-morbidity of fibromyalgia with mood disorders suggests a major role for the stress response and for neuroendocrine abnormalities. The [[hypothalamic pituitary axis]] (HPA) is a critical component of the stress-adaptation response. In FMS, stress adaptation response is disturbed leading to stress induce symptoms. Psychiatric co-morbidity has been associated with FMS and needs to be identified during the consultation process, as this requires special consideration during treatment.<ref name=":21" /></blockquote>

*May 2018, [https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management]<ref>{{Cite journal|last=Bourgaize|first=Sheryl|last2=Newton|first2=Genevieve|last3=Kumbhare|first3=Dinesh|last4=Srbely|first4=John|date=2018|title=A comparison of the clinical manifestation and
pathophysiology of myofascial pain syndrome
and fibromyalgia: implications for differential
diagnosis and management|url=https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf|format=PDF|journal=Journal of the Canadian Chiropractic Assoc.|volume=|pages=26-41|at=See Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)|via=}}</ref> (PDF) ''See'' Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)

*Jul 2018, [https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/ Primary and Secondary Fibromyalgia Share Same Symptom Burden, Study Suggests]<ref name=":22">{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/|title=Primary, Secondary Fibromyalgia Share Same Symptom Burden, Study Says|last=Carvalho|first=John|date=2018-07-31|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

<blockquote>Fibromyalgia can be considered either primary, or dominant, also known as idiopathic fibromyalgia, or secondary. In the primary form, the causes of the disorder are unknown, but in secondary fibromyalgia, the disorder usually occurs alongside other debilitating medical conditions, such as rheumatoid arthritis (RA), lupus, and multiple sclerosis.<ref name=":22" /></blockquote>

===Immune system research===

Dr. [[Jarred Younger]] believes an overactive [[immune system]] is the cause and will be conducting a study to test this hypothesis.<ref>{{Cite news|url=http://nationalpainreport.com/new-uab-study-could-radically-change-fibromyalgia-treatment-as-we-know-it-8833437.html|title=New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It|last=Gregory Burch|first=Donna|date=2017-04-24|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=https://www.youtube.com/watch?v=8e5xKX036bE|title=Testing the fibromyalgia immune system with lipopolysaccharide (LPS)|last=Younger|first=Jarred|date=May 24, 2017|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=|via=Younger Lab}}</ref> An overactive immune system is responsible for [[inflammation]] which causes [[chronic pain]].

Dr. William Pridgen's research of [[HSV-1]] (cold sore virus) as being involved in FM has conducted a successful Phase III clinical trial, which had been fast-tracked by the [[Food and Drug Administration]] (FDA), of a combination drug that suppresses this virus and also helps with pain. ''See'': [[Fibromyalgia#IMC-1|Fibromyalgia (''Drugs: Trials: IMC-1'' section)]].

[[ProHealth]] reports that an old [https://en.wikipedia.org/wiki/Tuberculosis Tuberculosis] vaccine, [https://en.wikipedia.org/wiki/BCG_vaccine Bacille Calmette-Guerin] (BCG), may be researched for treatment of Fibromyalgia spearheaded by [http://www.buzzfile.com/business/Epicgenetics,-Inc.-310-586-2929 EpicGenetics] and [http://www.massgeneral.org/ Massachusetts General Hospital].<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

EpicGenetics has a blood test that is identifying the presence of specific white blood cell abnormalities of patients diagnosed with FM and has partnered with two universities to offer [https://en.wikipedia.org/wiki/Disease_gene_identification#Whole_exome_sequencing whole exome sequencing] free of charge to those who test positive with their [http://fmtest.com/ FM/a® test].<ref>{{Cite news|url=http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> Concerns have been raised in regards to the FM/a® EpicGenetics Blood Test.<ref>{{Cite web|url=http://www.fmperplex.com/2013/02/25/junk-science-junk-ethics/|title=Junk Science – Junk Ethics – The Fibromyalgia Perplex|last=Wolfe|first=Fred|date=Feb 25, 2013|website=www.fmperplex.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> EpicGenetics is awaiting FDA approval to test the Bacille Calmette-Guerin (BCG) vaccine (an old Tuberculosis vaccine) on patients that tested positive with its FM/a® test.<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689#comment-2286|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=See Comments Section: CDW12 says: June 26, 2018 at 2:05 pm|language=en-US}}</ref><ref>{{Cite web|url=https://www.celestecooper.com/2018/07/the-fma-blood-test-and-participation-in.html#.Wz4nxdJKjIU|title=The FM/a® Blood Test and Participation in Fibromyalgia Vaccine Study|last=Cooper|first=Celeste|date=Jul 5, 2018|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

A June 2018 study found inflammatory genes CCL11, CCL4, and MEFV in a fibromyalgia family study.<ref>{{Cite journal|last=Zhang|first=Zhifang|last2=Feng|first2=Jinong|last3=Mao|first3=Allen|last4=Le|first4=Keith|last5=Placa|first5=Deirdre La|last6=Wu|first6=Xiwei|last7=Longmate|first7=Jeffrey|last8=Marek|first8=Claudia|last9=Amand|first9=R. Paul St|date=2018-06-21|title=SNPs in inflammatory genes CCL11, CCL4 and MEFV in a fibromyalgia family study|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198625|journal=PLOS ONE|language=en|volume=13|issue=6|pages=e0198625|doi=10.1371/journal.pone.0198625|issn=1932-6203|pmid=29927949|via=}}</ref>
<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/03/immune-system-may-play-role-fibromyalgia-study/|title=Fibromyalgia May Be Linked to Immune System, Study Suggests|last=Inacio|first=Patricia|date=2018-07-03|work=Fibromyalgia News Today|access-date=2018-08-22|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Comorbidities, overlapping conditions, and common symptoms ==
[[File:Fibromyalgia and comorbid conditions.JPG|700px|thumb|center|Comorbid conditions of Fibromyalgia (FMS) are ME/CFS which is the most common; autoimmune diseases; migraines; Multiple Chemical Sensitivities (MCS); and orthostatic intolerance (OI) / Postural Orthostatic Tachycardia Syndrome (POTS).<ref name=":30" /><ref name=":31" /><ref name=":33">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref> Depression and anxiety; digestive conditions and menstrual problems; GWI; nervous system disorders; low blood pressure (Low BP); other pain conditions and migraines; and sleep dysfunction/disturbance all overlap with FMS.<ref name=":30" /> <ref name=":33" />]]

*[[Allodynia]]
** [http://chronicfatigue.about.com/od/glossary/g/allodynia.htm Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS]<ref name=":1">{{Cite news|url=https://www.verywellhealth.com/allodynia-definition-and-types-fibromyalgia-715929|title=Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Feb 23, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Types of Allodynia: Tactile; Mechanical; and Thermal. "Type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain" <ref name=":1" />
*[[Autoimmune disease]]<nowiki/>s "Research suggests that RA and other inflammatory diseases may somehow increase the risk for fibromyalgia."<ref>{{Cite news|url=https://www.health.com/health/gallery/0,,20520705,00.html#restless-legs-0|title=7 Conditions Linked to Fibromyalgia|work=Health.com|access-date=2018-08-19|language=en}}</ref>

*[[Body temperature]]
**[https://www.verywell.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025 Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":2">{{Cite news|url=https://www.verywellhealth.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025|title=Temperature Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Mar 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

<blockquote>When you're exposed to heat, does it feel like you're burning up? Does it seem impossible for you to cool off? Or maybe it's cold that bothers you, chilling you to the bone, leaving you unable to warm up? Or are you one of those people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) who is cold all the time, or hot all the time, or alternately hot or cold while out of sync with the environment?<ref name=":2" /></blockquote>

[[File:Costal cartilages.JPG|200px|thumb|left|Costochonritus is inflammation of the costal cartliges (shown in red) causing chest and ribcage pain]]

:* [https://www.verywell.com/costochondritis-in-fibromyalgia-716178 Costochondritis in Fibromyalgia]<ref name=":10">{{Cite news|url=https://www.verywellhealth.com/costochondritis-in-fibromyalgia-716178|title=Costochondritis Chest Pain in Fibromyalgia|last=Dellow|first=Adrienne|date=Feb 14, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|date=2018-05-25|title=Costochondritis|url=https://en.wikipedia.org/w/index.php?title=Costochondritis&oldid=842926736|journal=Wikipedia|language=en}}</ref>

<blockquote>Costochondritis is inflammation of the cartilage that connects your ribs to your breastbone. Depending on how much inflammation there is, it can range from mildly annoying to intensely painful. People sometimes describe the pain as stabbing, aching, or burning.<ref name=":10" /></blockquote>

<blockquote>Costochondritis can make you think you're having heart problems, which is a scary thing. Even though costochondritis is common, you should get medical attention if you have unexplained chest pain. You don't want to assume that it's FMS-related and end up with permanent heart damage or worse.<ref name=":10" /></blockquote>

<blockquote>The pain can radiate to your shoulder and arms as well (another way the condition mimics a heart attack). Sometimes the pain is accompanied by redness and/or swelling in the most painful areas. When that's the case, it's called Tietze's Syndrome.<ref name=":10" /></blockquote>

* [[Depression]] and [[Anxiety]] Fibromyalgia sufferers are "up to three times more likely to have depression at the time of their diagnosis than someone without fibromyalgia."<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/fibromyalgia-and-depression#1|title=Fibromyalgia and Depression|work=WebMD|access-date=2018-08-19|language=en-US}}</ref> Up to 20 percent of Fibromyalgia patients will have either depression or anxiety.<ref>{{Cite web|url=https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/fibromyalgia|title=Fibromyalgia {{!}} Anxiety and Depression Association of America, ADAA|website=adaa.org|language=en|access-date=2018-08-19}}</ref>

*[[Fibro fog]]

:*[http://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction]<ref name=":3">{{Cite news|url=https://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx|title=What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction|last=Mandal|first=Ananya|date=2013-06-03|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> 'Mental confusion along with difficulty in concentration and loss of memory is often termed “[[fibro fog]]"'.<ref name=":3" />

:* [https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014 What Is Fibro Fog and ME/CFS Brain Fog?]<ref name=":17" />

*[[Gastrointestinal system]]
**[[Irritable bowel syndrome]]: [http://chronicfatigue.about.com/od/whyfmscfsarelinked/a/IBS.htm Irritable Bowel Syndrome in Fibromyalgia & Chronic Fatigue Syndrome - Why Do They Go Together?]<ref name=":4">{{Cite news|url=https://www.verywellhealth.com/irritable-bowel-syndrome-in-fibromyalgia-cfs-716167|title=Irritable Bowel Syndrome in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jan 28, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>Fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome (IBS) frequently go together. No one really knows why, but we do know that all three conditions can include imbalances of serotonin -- although in fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS or ME/CFS) it's an imbalance in the brain, while with IBS it's in the gut.<ref name=":4" /></blockquote>
* [[Gulf War Illness]]
**[https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp Fibromyalgia in Gulf War Veterans]<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp|title=Fibromyalgia in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-19}}</ref> GWI increases risk of developing Fibromyalgia.

*[https://en.wikipedia.org/wiki/Interstitial_cystitis Interstitial Cystitis]<ref>{{Cite journal|date=2018-07-11|title=Interstitial cystitis|url=https://en.wikipedia.org/w/index.php?title=Interstitial_cystitis&oldid=849828657|journal=Wikipedia|language=en}}</ref> (Painful bladder)
**[https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168 Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis]<ref name=":5">{{Cite news|url=https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168|title=Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "Fibromyalgia, chronic fatigue syndrome and interstitial cystitis (IC) -- a painful bladder condition -- frequently occur together. Women may be up to 10 times more likely than men to develop it."<ref name=":5" />

*Language Impairment
**[[Word-finding problems]] is a symptom of ME/CFS.
:*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome Impaired Language in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":6" /> "Searching their brains for simple words that they just can't remember. On other occasions, individuals with these diagnoses may find it hard to write or even understand language."<ref name=":6">{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:*"The diagnosis of [[Aphasia]] is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written"<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref> but with [[dysphasia]] you will have those symptoms and trouble listening and doing numeral calculations.<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-09}}</ref> ''See also'': [[Dyscalculia]].
* [[ME/CFS]]
:*[https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184 Comorbid Conditions in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>
* [[Migraine]]
:*[https://migrainecenters.com/blog/migraines-and-fibromyalgia/ Migraines and Fibromyalgia]<ref name=":32" />
<blockquote>Both fibromyalgia and migraine may reflect problems in the brain’s pain processing center. It is believed that both conditions are caused by excitation of the nervous system or an over-response to stimuli. Stress is usually cited as a trigger for both migraine and fibromyalgia attacks.<ref name=":32">{{Cite news|url=https://migrainecenters.com/blog/migraines-and-fibromyalgia/|title=Migraines and Fibromyalgia - Migraine Centers|date=2016-05-06|work=Migraine Centers|access-date=2018-08-19|language=en-US}}</ref></blockquote>
* [[Multiple chemical sensitivity|Multiple Chemical Sensitivity]] (MCS) It is thought that both Fibromyalgia and MCS are [[Central sensitisation|central sensitivity]] syndromes.<ref>{{Cite news|url=https://www.verywellhealth.com/chemical-sensitivity-in-fibromyalgia-716170|title=Multiple Chemical Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>

*OBGYN
**[https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596 Menstrual Periods with Fibromyalgia: Personal Stories]<ref>{{Cite news|url=https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596|title=Menstrual Periods with Fibromyalgia: Personal Stories|last=Dellwo|first=Adrienne|date=May 18, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>
**[https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626 Fibromyalgia Tied to Hysterectomy, Gynecologic Disease].<ref name=":7" />
:<blockquote>You may have heard about a possible link between gynecologic surgery (such as a hysterectomy) and the development of fibromyalgia, and doctors have long suspected that fibromyalgia has strong hormonal ties and triggers. This does not seem surprising as we've long suspected a link between endocrine disorders, gynecological conditions, and autoimmune conditions.<ref name=":7">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626|title=Fibromyalgia Tied to Hysterectomy, Gynecologic Disease|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref></blockquote>

*[[Orthostatic intolerance]] (OI) and [[Postural orthostatic tachycardia syndrome]] (POTS)<ref>{{Cite journal|last=Yun|first=Dong Joo|last2=Choi|first2=Han Na|last3=Oh|first3=Gun-Sei|date=2013|title=A Case of Postural Orthostatic Tachycardia Syndrome Associated with Migraine and Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710947/|journal=The Korean Journal of Pain|volume=26|issue=3|pages=303–306|doi=10.3344/kjp.2013.26.3.303|issn=2005-9159|pmid=23862007|via=}}</ref>

:*[http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM]<ref>{{Cite web|url=http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf|title=Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM|last=Lapp|first=Charles W.|last2=Black|first2=Laura|date=|website=drlapp.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Smith|first3=Rebekah S.}}</ref> (PDF) Symptoms can include low blood pressure and/or sudden high blood pressure, dizziness, fainting.

:*[https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/ An Overlooked Issue in Fibromyalgia? Study Highlights Problems Standing (Orthostatic Intolerance)]<ref>{{Cite news|url=https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/|title=An Overlooked Issue in Fibromyalgia? Study Highlights Orthostatic Intolerance - Problems Standing - Health Rising|last=Johnson|first=Cort|date=2017-09-21|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[[Sleep dysfunction]]
**[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia]<ref name=":23">{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}</ref>

:<blockquote>The present results of this study suggest that long-term, comorbid pain and sleep disturbance may be associated with increased activation in core default mode brain areas that is above and beyond long-term pain disturbance alone.<ref name=":23" /></blockquote>

:*[http://www.prohealth.com/library/showarticle.cfm?libid=22344 Fibromyalgia and Sleep]<ref name=":8">{{Cite news|url=https://www.prohealth.com/library/fibromyalgia-and-sleep-38954|title=Fibromyalgia and Sleep - Prohealth|date=2016-01-11|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref> "Most people with fibromyalgia have an associated sleep disorder that makes it difficult for them to get the deep, restorative sleep they need."<ref name=":8" />

[[File:TMJ_1.jpg|200px|thumb|right|TMJ/TMD is a condition that occurs in some fibromyalgia and ME/CFS patients]]
* [[Temporomandibular joint disorder]] (TMJ/TMD)

:* [https://www.sciencedirect.com/science/article/pii/S2255502114001758 Temporomandibular disorders in fibromyalgia syndrome: a short-communication]<ref>{{Cite journal|last=Soares Gui|first=Maisa|last2=Pimentel|first2=Marcele Jardim|last3=Rizzatti-Barbosa|first3=C'elia Marisa|date=2015-03-01|title=Temporomandibular disorders in fibromyalgia syndrome: a short-communication|url=https://www.sciencedirect.com/science/article/pii/S2255502114001758|journal=Revista Brasileira de Reumatologia (English Edition)|language=en|volume=55|issue=2|pages=189–194|doi=10.1016/j.rbre.2014.07.004|issn=2255-5021|via=ScienceDirect}}</ref><ref>{{Cite news|url=https://www.whitesmilesforlife.com/blog/study-probes-pain-link-between-tmj-fibromyalgia/|title=Study Probes Pain Link Between TMJ, Fibromyalgia|date=2016-05-03|work=Kent E. White, DDS|access-date=2018-08-19|language=en-US}}</ref>

::Other than headaches, the symptoms are quite distinct from symptoms of FMS and ME/CFS.

::They include:
::*Jaw pain
::*Discomfort or difficulty chewing
::*Painful clicking in the jaw
::*Difficulty opening or closing the mouth
::*Headaches
::*Locking jaw
::*Teeth that don't come together properly<ref>{{Cite news|url=https://www.verywellhealth.com/tmj-in-fibromyalgia-chronic-fatigue-syndrome-716175|title=TMJ in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Mar 31, 2018|work=Verywell Health|access-date=2018-08-22|archive-url=|archive-date=|dead-url=}}</ref>

*[[Thyroid disease]]
**[https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677 Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease]<ref name=":9">{{Cite news|url=https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677|title=A Comparison of Chronic Fatigue, Fibromyalgia, and Thyroid Disease|last=Shomon|first=Mary|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>People with Hashimoto's autoimmune thyroid disease often experience significant fatigue and body aches. While these symptoms are common in Hashimoto's, they can also be markers of other diseases, like chronic fatigue syndrome or fibromyalgia.<ref name=":9" /></blockquote>

*Other symptoms
**[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/fibrosymptoms.htm Symptoms of Fibromyalgia]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-symptoms-716139|title=Symptoms of Fibromyalgia|last=Dellwo|first=Adrienne|date=May 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> (A comprehensive all in one place list for the many symptoms of fibromyalgia.)

==Treatment==

===United States===
'''Rheumatology and primary care providers: Diagnosing and treatment'''

*2012, [https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract A Framework for Fibromyalgia Management for Primary Care Providers]<ref>{{Cite journal|last=Arnold|first=Lesley M.|last2=Clauw|first2=Daniel J.|last3=Dunegan|first3=L. Jean|last4=Turk|first4=Dennis C.|date=2012|title=A Framework for Fibromyalgia Management for Primary Care Providers|url=https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract|journal=Mayo Clinic Proceedings|language=English|volume=87|issue=5|pages=488–496|doi=10.1016/j.mayocp.2012.02.010|issn=0025-6196|via=}}</ref> Rheumatologists stopped treating fibromyalgia patients and primary care providers began treatment managment although rheumatologists are most often the specialist to diagnose. (Please see [http://me-pedia.org/wiki/Fibromyalgia#Disability disability] heading about ''primary provider'' and ''specialists'' for disability cases.)

=== Drugs ===

{{Main article |page_name = Fibromyalgia drugs}}

=== Therapies ===

==== Exercise ====
''Please Note'': These recommendations are for fibromyalgia patients and '''not''' [[ME/CFS]] sufferers.
[[File:Warm water exercise.JPG|200px|thumb|left|Warm water exercise is best for fibromyalgia. Start slow and don't push through the pain<ref name=":11" />]]

*[https://www.verywellhealth.com/warm-water-exercise-for-fibromyalgia-716059 Warm Water Exercise for Fibromyalgia]<ref name=":11">{{Cite news|url=http://chronicfatigue.about.com/od/treatingfmscfs/a/warmwaterFMS.htm|title=Warm Water Exercise for Fibromyalgia|last=Dellwo|first=Adrienne|date=Nov 19, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|last=Munguía-Izquierdo|first=D.|last2=Legaz-Arrese|first2=A.|date=2007|title=Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/18173915|journal=Clinical and Experimental Rheumatology|volume=25|issue=6|pages=823–830|issn=0392-856X|pmid=18173915|via=}}</ref>

<blockquote>A warm-water pool is good for therapy because cold water can make muscles tense up. It's especially important in FMS because many people with the condition are intolerant of cold. A warm-water pool is one that's kept around 89.6 degrees Fahrenheit (32 Celsius), which is several degrees warmer than most heated pools.<ref name=":11" /></blockquote>

*Moderate aerobic exercise and weights with six to eight reps and then a day or two of rest in between. Do not start a program if you are in a flare.<ref>{{Cite web|url=http://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/fibromyalgia-questions/fibromyalgia-exercise.php|title=Fibromyalgia Exercise {{!}} Exercising with Fibromyalgia|last=Ronenn|first=Roubenoff|date=|website=www.arthritis.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[https://www.youtube.com/watch?v=BauJYuJwFsI Easy fibromyalgia exercises and motivation to keep you healthy!]<ref>{{Cite web|url=https://www.youtube.com/watch?v=BauJYuJwFsI|title=Easy Fibromyalgia exercises and motivation to keep you healthy!|last=Suarez|first=Eric|date=Jun 21, 2011|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=Aug 9, 2018}}</ref> Video

*[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/Fibromyalgia-Myth-Vs-Fact.htm Fibromyalgia Myth vs. Fact]<ref name=":15">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-myth-vs-fact-716131|title=Fibromyalgia: What's Myth, What's Fact?|last=Dellwo|first=Adrienne|date=Jun 8, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=Myth #3 People With Fibromyalgia Need More Exercise}}</ref> Heading: ''Myth #3: People With Fibromyalgia Need More Exercise''. Appropriate exercise, which each patient needs to gauge for themselves.<ref name=":15" />

==== Massage ====

*2014, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/ Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]<ref>{{Cite journal|last=Li|first=Yan-hui|last2=Wang|first2=Feng-yun|last3=Feng|first3=Chun-qing|last4=Yang|first4=Xia-feng|last5=Sun|first5=Yi-hua|date=2014-02-20|title=Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/|journal=PLoS ONE|volume=9|issue=2|doi=10.1371/journal.pone.0089304|issn=1932-6203|pmc=|pmid=24586677|pages=|via=}}</ref>

*2016, [http://chronicfatigue.about.com/od/alternativetreatments/a/bodywork.htm Massage, Rolfing & Other Bodywork - Are They Effective Fibromyalgia & Chronic Fatigue Syndrome Treatments?]<ref>{{Cite news|url=https://www.verywellhealth.com/massage-rolfing-other-bodywork-715645|title=Massage, Rolfing, Reiki: Do They Work for Fibromyalgia & ME/CFS?|last=Dellwo|first=Adrienne|date=Aug 10, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==== Acupuncture ====

*2004, [[U.S. Department of Health and Human Services]] (HHS) and [https://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services Centers for Medicare and Medicaid Services] (CMS) ruled April 16, 2004, a noncoverage determination for acupuncture.<ref>{{Cite web|url=https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R11NCD.pdf|title=CMS Manual System Pub. 100-03 Medicare
National Coverage Determinations|last=|first=|date=Apr 16, 2004|website=CMS.gov|format=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2005, [http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html Acupuncture Good for Fibromyalgia?] <ref name=":16">{{Cite web|url=http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html|title=Acupuncture Good for Fibromyalgia?|last=|first=|date=Oct 2, 2012|website=Acupuncture School Online|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> "Acupuncture gave no significant pain relief to fibromyalgia patients."<ref name=":16" />

*2016, [http://www.sciencedirect.com/science/article/pii/S2095496416602352 Short-term complementary and alternative medicine on quality of life in women with fibromyalgia] <ref name=":25">{{Cite journal|date=2016-01-01|title=Short-term complementary and alternative medicine on quality of life in women with fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S2095496416602352|journal=Journal of Integrative Medicine|language=en|volume=14|issue=1|pages=29–35|doi=10.1016/S2095-4964(16)60235-2|issn=2095-4964}}</ref> "There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session."<ref name=":25" />

*2016, [https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/ Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/|title=Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients - Fibromyalgia News Today|last=Semedo|first=Daniela|date=2016-02-01|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Disability ==
===United States===
''Please Note'': The following is NOT legal advice and it should not be relied upon in taking steps for a disability case. Only ''[https://www.ssa.gov/ Social Security]'' and a disability lawyer can provide the most up to date and the correct legal avenue for bringing a disability case.

In the[[ United States]], [https://www.ssa.gov/ssi/ Social Security Insurance] and [https://www.ssa.gov/disability/ Social Security Disability] (SSI) and (SSD) benefits are available for Fibromyalgia. Generally for SSI/SSD, notes and tests from a ''Primary Provider'' '''may''' be allowed for submission but ''Specialists'' such as a rheumatologist, neurologist, psychiatrist, etc. are required for diagnosis, ongoing treatment and completing SSI/SSD paperwork.

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose Fibromyalgia. (See: "Policy Interpretation" for the POLICY INTERPRETATION RULING.)<ref>[https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia]</ref>

*[http://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social Applying for Disability With Fibromyalgia]<ref>{{Cite news|url=https://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social|title=Fibromyalgia Disability: Applying for Disability Benefits With Fibromyalgia|date=2016-10-03|work=NewLifeOutlook {{!}} Fibromyalgia|access-date=2018-08-09|language=en-US}}</ref> One patient's success of applying, denial, successful appeal, and a breakdown of what SSI/SSD requires for the medical determination of a favorable decision of disability.

*[https://www.socialsecurity.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html Fibromyalgia: Policy Interpretation Ruling - Social Security]<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=|website=www.ssa.gov|at=Titles II and XVI: Evaluation of Fibromyalgia|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[http://www.disabilitysecrets.com/social_security_disability_fibromyalgia.html Social Security Disability (SSDI & SSI) for Fibromyalgia - Disability Secrets By NOLO]<ref>{{Cite news|url=https://www.disabilitysecrets.com/resources/social-security-disability-ssdi-ssi-fibromyalgia.htm|title=Social Security Disability (SSDI & SSI) for Fibromyalgia|last=Laurence|first=Bethany|date=|work=www.disabilitysecrets.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*[http://www.mdjunction.com/fibromyalgia/fibromyalgia-disability Fibromyalgia Disability Patient Support Forums]<ref>{{Cite web|url=https://www.mdjunction.com/fibromyalgia/fibromyalgia-disability|title=Fibromyalgia Disability|website=MDJunction|language=en|access-date=2018-08-09}}</ref> at [[MDJunction]]

==== Examinations and Tests ====
For documentation of symptoms and co-morbidities of a FM diagnosis, you and your doctor should consider the following examinations and tests:

:'''Fibromyaglia Diagnostic Examination'''
:*[http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist Rheumatologist] examination and diagnosis of FM. (Consider having a rheumatologist order tests and coordinate referrals for other specialists for examinations and testing. Only specialists can complete the paperwork for Social Security. A primary doctor cannot complete disability paperwork but ''may'' be able to forward test results they have ordered.)
[[File:Whole body bone scan.jpg|200px|thumb|right|A whole body bone scan (Bone scintigraphy) is a nuclear medicine test. '''Arthritis''', avascular necrosis, bone cancers, cancers that have spread to the bone, fibrous dysplasia, fractures, infection involving the bone, and Pagets disease can be diagnosed using this scan.<ref>{{Cite news|url=https://www.healthline.com/health/bone-scan#purpose|title=Bone Scan: Purpose, Procedure, and Risks|last=Krans|first=Brian|date=Dec 13, 2017|work=Healthline|access-date=2018-08-21|archive-url=|archive-date=|dead-url=|language=en}}</ref>]]
:'''Arthritis'''
:*[https://en.wikipedia.org/wiki/Bone_scintigraphy Whole body bone scan (Bone scintigraphy)]<ref>{{Cite journal|date=2018-05-22|title=Bone scintigraphy|url=https://en.wikipedia.org/wiki/Bone_scintigraphy|journal=Wikipedia|language=en}}</ref> to rule out treatable arthritis.
:'''Blood Tests'''
:*Routine blood tests for [[diabetes]] (fasting sugar, A1C) and a full [[Thyroid disease]] panel ([https://en.wikipedia.org/wiki/Thyroid_function_tests#Thyroid-stimulating_hormone TSH, T3, Free T3, T4 and Free T4]).
:*Rule out [[Rheumatoid arthritis]], lupus, [[Lyme disease]] and other diseases that can share some of the same symptoms of fibromyalgia and may be treatable.<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1-3|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>
:*Vitamin and mineral deficiencies such as [[B12]] and [[Vitamin D]] are treatable with over the counter supplements and prescription medications which can improve [[fatigue]] and [[pain]].
:'''Gastrointestinal'''
:*[[Irritable bowel syndrome]] diagnosis which may require blood, [http://www.mayoclinic.org/tests-procedures/endoscopy/basics/definition/PRC-20020363 upper endoscopy] to rule out [https://en.wikipedia.org/wiki/Coeliac_disease celiac disease] and [https://en.wikipedia.org/wiki/Stool_test fecal tests] to check for bacteria ([[SIBO]]) and [http://www.umm.edu/health/medical/altmed/condition/intestinal-parasites intestinal parasites].
:'''Mental Health and Cognition'''
:* Psychiatric evaluation as any [[depression]] and [[anxiety]] should be treated.
:* [[Cognitive dysfunction]] tests.
:'''Sleep dysfunction'''
:*Sleep study for [[Restless legs syndrome]], [[Sleep disturbance]] or [[Narcolepsy]].
:'''Orthostatic Intolerance'''
:*[[Tilt table test]] to diagnose [[Orthostatic intolerance]] or [[Postural orthostatic tachycardia syndrome|POTS]].
:'''TMJ, tinnitus, vertigo, and dizziness'''
:*An ear, nose, and throat specialist (ENT) ([http://www.mayoclinic.org/departments-centers/otorhinolaryngology-ent/overview Otorhinolaryngology]) examination and imaging may be ordered for [[Temporomandibular joint disorder]] (TMJ).
:*(Ear, sinus, throat/lymph infections, and [[tinnitus]] can also be documented.)
:*[https://en.wikipedia.org/wiki/Videonystagmography Videonystagmography] (VNG) testing if you experience [[vertigo]] and/or [[dizziness]].<ref>{{Cite news|url=https://www.everydayhearing.com/balance/articles/what-to-expect-at-your-vng-test/|title=What to Expect at Your VNG/ENG Test - Everyday Hearing|last=Banks|first=Lindsey|date=2014-05-07|work=Everyday Hearing|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

Of course, one can have arthritis, sleep apnea, [[Chronic lyme disease|chronic Lyme disease]] or other diseases and still have FM, but there may be a treatable condition where a patient's overall health, including their FM, improves.<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/guide/common-misdiagnoses-of-fibromyalgia#1|title=Common Misdiagnoses of Fibromyalgia|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite web|url=http://www.cfidsselfhelp.org/library/overlapping-and-related-conditions|title=Overlapping and Related Conditions {{!}} CFIDS & Fibromyalgia Self-Help|website=www.cfidsselfhelp.org|access-date=2018-08-09}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

There have been cases of [[Vitamin D]] deficiency being misdiagnosed as fibromyalgia as a D deficiency can cause pain. Supplementation or prescribed D treatments may alleviate this pain. However, it is possible to have both a D deficiency and fibromyalgia and correcting the deficiency will only resolve the pain stemming from it.<ref>{{Cite news|url=http://www.webmd.com/pain-management/features/vitamin-d-deficiency-and-chronic-pain-link#1|title=Does Vitamin D Deficiency Cause Chronic Pain?|last=Shaw|first=Gina|date=|work=WebMD|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

==== Blogs about navigating SSD process ====

*Resources for getting approved for disability include this [http://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/ Guide to Social Security Disability for People with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome],<ref>{{Cite web|url=https://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/|title=The Sleepy Girl Guide to Social Security Disability (U.S.) {{!}} #MEAction|last=Silver|first=Lily|date=Apr 17, 2017|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> available on the #[[MEAction]] website.

*[https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/ How Patty’s Lawyer Never Told Her What She Needed to Know]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/|title=How Patty’s Lawyer Never Told Her What She Needed to Know|last=Skelton Preston|first=Patty|date=2017-03-20|work=How to Get On|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/ Sample Doctor Letters for Disability]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/|title=21 Sample Doctor Letters for Disability|date=2017-05-01|work=How to Get On|access-date=2018-08-09|language=en-US}}</ref>

== Notable studies ==
{{Main article |page_name = Fibromyalgia notable studies}}

== Controversies ==
=== Dr. Frederick Wolfe ===
Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.<ref>{{Cite news|url=http://www.nytimes.com/2008/01/14/health/14pain.html?_r=0|title=Drug Approved. Is Disease Real?|last=Berenson|first=Alex|date=Jan 14, 2008|work=The Wall Street Journal|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>[http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf Fibromyalgia: A Short Commentary - iMedPub Journals - DOI: 10.4172/2472-1913.100027 - Frederick Wolfe and Brian Walitt - Sep. 23, 2016]</ref><ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|journal=Journal of Headache & Pain Management|volume=1|issue=3:27|pages=|via=iMedPub Journals}}</ref><ref>{{Cite news|url=https://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx|title=Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine|last=Cashin-Garbutt|first=April|date=2013-03-22|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Fibromyalgia vs Chiari malformation ===
Some individuals diagnosed with FMS were undergoing surgery for [[Chiari malformation]] (CM). These are two separate conditions; FMS cannot be resolved by undergoing a risky CM surgery.

*2011, [https://www.ncbi.nlm.nih.gov/pubmed/21135714 Is Chiari I malformation associated with fibromyalgia?]<ref>{{Cite journal|last=Watson|first=Nathaniel F.|last2=Buchwald|first2=Dedra|last3=Goldberg|first3=Jack|last4=Maravilla|first4=Kenneth R.|last5=Noonan|first5=Carolyn|last6=Guan|first6=Qingyan|last7=Ellenbogen|first7=Richard G.|date=2011|title=Is Chiari I malformation associated with fibromyalgia?|url=https://www.ncbi.nlm.nih.gov/pubmed/21135714|journal=Neurosurgery|volume=68|issue=2|pages=443–448; discussion 448–449|doi=10.1227/NEU.0b013e3182039a31|issn=1524-4040|pmid=21135714|via=}}</ref>
::Conclusion: Most patients with FM do not have [[CIM]] pathology. Future studies should focus on dynamic neuroimaging of craniocervical neuroanatomy in patients with FM.
*2015, [https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery CFS/FM and Chiari Malformation Surgery]<ref>{{Cite web|url=https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery|title=CFS/FM and Chiari Malformation Surgery|last=Casanova|first=Ken|date=Nov 15, 2015|website=www.massmecfs.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

== Learn more ==
*[https://www.s4me.info/forums/fibromyalgia-and-connective-tissue-disorders.35/ Forum: Fibromyalgia and Connective Tissue Disorders] at [[Science for ME]]
*[[Verywell FMS/CFS]]

=== Ongoing process of diagnosing and categorizing ===

*2014, [http://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114 Lyme Disease, Fibromyalgia Link Evaporates]<ref>{{Cite news|url=https://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114|title=Lyme Disease, Fibromylagia Link Evaporates|last=Kuznar|first=Wayne|date=2014-12-14|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> (See also: [[Chronic lyme disease]])

*2015, [http://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx Fibromyalgia now considered as a lifelong central nervous system disorder]<ref>{{Cite news|url=https://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx|title=Fibromyalgia now considered as a lifelong central nervous system disorder|date=2015-05-18|work=News-Medical.net|access-date=2018-08-09|language=en}}</ref>

*2015, [http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates]<ref>{{Cite news|url=http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html|title=Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates|date=2015-10-24|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2015, ''Question:'' [http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html 'Is Fibromyalgia a Psychosomatic Illness?'] via CelesteCooper.com ''Answer:'' "Fibromyalgia is NOT a psychosomatic illness."<ref>[http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html Is Fibromyalgia a Psychosomatic Illness? Med Student Asks Celeste Cooper by Celeste Cooper - CelesteCooper.com Sep 4, 2015]</ref>

*2016, [http://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination Diagnosing Fibromyalgia May Be Possible Using Noninvasive Eye Examination]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination|title=Diagnosing Fibromyalgia May Be Possible with Noninvasive Eye Exam|date=2016-09-09|work=Fibromyalgia News Today|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780 Microglia in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780|title=Microglia in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*2016, [http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/ Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders?]<ref>{{Cite news|url=http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/|title=Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders? - Simmaron Research|date=2016-03-21|work=Simmaron Research|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://consultqd.clevelandclinic.org/2016/03/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic Why Fibromyalgia Is Neuropathic]<ref>{{Cite news|url=https://consultqd.clevelandclinic.org/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic|title=Why Fibromyalgia Is Neuropathic|date=2016-03-08|work=Consult QD|access-date=2018-08-09|language=en-US}}</ref>

*2017, [http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain]<ref>{{Cite news|url=http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html|title=Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain|last=Liptan|first=Ginevra|date=2017-04-11|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
*2017, [https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947 AI can spot the pain from a disease some doctors still think is fake]<ref>{{Cite news|url=https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947|title=AI can spot the pain from a disease some doctors still think is fake|last=Goldhill|first=Olivia|date=Aug 9, 2018|work=Quartz|access-date=2018-08-15|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== Blood tests ===

*2013, [http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html New Fibromyalgia Blood Test is 99% Accurate]<ref>{{Cite news|url=http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html|title=New Fibromyalgia Blood Test is 99% Accurate|date=2013-07-31|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2014, [http://www.prohealth.com/library/showarticle.cfm?libid=18837 Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”]<ref>{{Cite news|url=https://www.prohealth.com/library/pridgen-reports-fibromyalgia-antiviral-trial-results-very-positive-predicts-new-approach-will-be-game-changer-32620|title=Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”|last=|first=|date=2014-03-25|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2016, [https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html Blood Test for Fibromyalgia: FM/a Test Ⓡ is now available, Q&A]<ref>{{Cite web|url=https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html|title=Blood Test for Fibromyalgia: FM/a Test ® Is Real, Q&A|last=Cooper|first=Celeste|date=May 3, 2016|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2016, [http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/ Fibromyalgia blood testing covered by rising number of insurance companies]<ref>{{Cite news|url=http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/|title=Fibromyalgia blood testing covered more of insurance companies|last=Campbell|first=Julie|date=2016-04-08|work=Live Insurance News|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2017, [http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches]<ref>{{Cite news|url=https://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=Business Wire|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Brain scans ===

*2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds]<ref>{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|publisher=ANAPSID|via=Chronic Neuroimmune Diseases|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2012, [https://www.sciencedaily.com/releases/2012/11/121111153426.htm Fibromyalgia and the brain: New clues reveal how pain and therapies are processed]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2012/11/121111153426.htm|title=Fibromyalgia and the brain: New clues reveal how pain and therapies are processed|last=|first=|date=Nov 11, 2012|work=ScienceDaily|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*2015, [https://www.verywell.com/unique-brain-connectivity-in-fibromyalgia-715630 Unique Brain Connectivity in Fibromyalgia - Increased Importance Assigned to Pain]<ref>{{Cite news|url=https://www.verywellhealth.com/how-lyrica-changes-the-fibromyalgia-brain-715767|title=How Lyrica Changes the Fibromyalgia Brain|last=Dellwo|first=Adrienne|date=Apr 30, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==See also==
* [[Fibromyalgia drugs]]

* [[Fibromyalgia notable studies]]
* [[Influenza vaccine]]

*[[Lady Gaga]]

==References==
<references />

[[Category:Diagnoses]]
[[Category:Comorbidities]]

Fibromyalgia

2018-08-25T17:55:49Z

77.111.246.7:/* Diagnosis */ x

[[Fibromyalgia]] (FM/FMS) is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Pain is widespread, on both sides of the body, and above and below the waist.

Sufferers are fatigued and tired even when sleeping for long periods of time, and sleep is often disrupted by pain. Many FM sufferers have sleep disorders like [https://en.wikipedia.org/wiki/Sleep_apnea sleep apnea] and [[restless leg syndrome]]. [[Cognitive impairment]], when one cannot focus or pay attention and the patient has difficulty concentrating on mental tasks, is known by FM sufferers as "[[fibro fog]]".<ref name=":17">{{Cite news|url=https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014|title=What Is Fibro Fog and ME/CFS Brain Fog?|last=Dellwo|first=Adrienne|date=|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Some experience [[depression]], [[headache]]s, and lower [[abdominal pain]] or cramping. Other symptoms include tingling or [[numbness]] in hands and feet, pain in jaw and disorders of the jaw such as [[temporomandibular joint disorder|temporomandibular joint disorder]] (TMJ), [[Menstrual cycle#Health effects in other conditions|menstrual cycle]] cramps, and digestive problems like i[[Irritable bowel syndrome|rritable bowel syndrome]] (IBS).<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms#1|title=Fibromyalgia Symptoms|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780|title=Fibromyalgia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref>

[[File:Fibro_Tender_Points.png|400px|thumb|right|1990 ACR Diagnostic Criteria: 18 Tender Points]]
[[File:Fibro_Widespread_Pain.png|400px|thumb|right|2010 ACR Preliminatry Diagnostic Criteria: Wisedpread Pain Index (WPI), 19 Tender Point Areas]]

==Prevalence==
FM is the second most common [https://en.wikipedia.org/wiki/Rheumatism rheumatic disorder] behind [[wikipedia:Osteoarthritis|osteoarthritis]] and is "now considered to be a lifelong [[Central nervous system]] disorder."<ref>{{Cite news|url=https://naidw.org/blog/members-myblogs/fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder|title=Fibromyalgia now considered as a lifelong central nervous system disorder|work=NAIDW.org®|access-date=2018-08-09|language=en-gb}}</ref> An estimated 10 million people in the US and 3-6% of the world population have fibromyalgia. It is seen in women, men, children, and all ethnic groups. It is often seen in families and diagnosed between the ages of 20 to 50 years; incidence increases with age.<ref>{{Cite news|url=http://www.fmaware.org/about-fibromyalgia/prevalence/|title=Prevalence - National Fibromyalgia Association (NFA)|work=National Fibromyalgia Association (NFA)|access-date=2018-08-09|language=en-US}}</ref>

FM has a female:male 7:1 ratio under the ''American College of Rheumatology (ACR) 1990 Diagnostic Criteria'' and 2:1 when the ''ACR 2010 Preliminary Diagnostic Criteria'' is used.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=|publisher=|editor-last=Diamond|editor-first=Herbert|at=Sex-related differences in incidence}}</ref> ''See'': [[Fibromyalgia#American College of Rheumatology (ACR) Criteria|Fibromyalgia (''American College of Rheumatology (ACR) Criteria'' section)]].

==Fibromyalgia in ME/CFS==
Dr. [[Jarred Younger]] has said that many patients that meet the criteria for FM also meet criteria for [[chronic fatigue syndrome]] (CFS) but the reverse is not necessarily true as a lot of people with [[CFS]] do not have [[chronic pain]].<ref>{{Cite web|url=https://www.youtube.com/watch?v=wJB95m4FLa0#t=57m27s|title=Webinar with Jarred Younger, Ph.D.|last=Younger|first=Jared|date=May 20, 2016|website=YouTube|at=57:27|via=|archive-url=|archive-date=|dead-url=|access-date=|publisher=SolveCFS|type=Video}}</ref> However, the [[Canadian Consensus Criteria]] (CCC) requires the symptom of pain to diagnose [[ME/CFS]]. It is the pattern and significant degree of [[chronic pain]] in FM that sets it apart from other diseases that have pain.

"The most common overlapping condition with ME/CFS is fibromyalgia."<ref name=":30">{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions - American Myalgic Encephalomyelitis and
Chronic Fatigue Syndrome Society|last=|first=|date=|website=ammes.org|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref><ref name=":31">{{Cite journal|last=Jason|first=Leonard|last2=Taylor|first2=R.R.|last3=Kennedy|first3=C.L.|last4=Song|first4=S|last5=Johnson|first5=D|last6=Torres|first6=S.R.|date=2001-01-01|title=Chronic fatigue syndrome: Comorbidity with fibromyalgia and psychiatric illness|url=https://www.researchgate.net/publication/285787383_Chronic_fatigue_syndrome_Comorbidity_with_fibromyalgia_and_psychiatric_illness|journal=Medicine and Psychiatry|volume=4|pages=29–34}}</ref>

==Health complications==
FM is not a [https://en.wikipedia.org/wiki/Progressive_disease progressive disease] but according to Dr. Dan Clauw the "slow gradual worsening of chronic pain patients over time is due to downstream consequences of poorly controlled pain and other symptoms, wherein individuals then progressively get less active, sleep worse, are under more stress and unknowingly develop bad habits which worsen pain and other symptoms."<ref>{{Cite news|url=http://nationalpainreport.com/ask-the-dctors-is-fibromyalgia-progressive-8831105.html|title=Ask the Doctors: Is Fibromyalgia Progressive?|date=2016-08-09|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*[https://www.sharecare.com/health/fibromyalgia-effects Fibromyalgia Complications]<ref name=":19" />

:<blockquote>People who have fibromyalgia frequently complain of a variety of symptoms that affect other parts of the body. Many people complain of [[gastrointestinal]] issues and restless legs syndrome (RLS). Additionally, the [[chronic pain]] and discomfort of fibromyalgia may lead to [[depression]].<ref name=":19">{{Cite news|url=https://www.sharecare.com/health/fibromyalgia-effects|title=Fibromyalgia Complications - Fibromyalgia - Joint Health|work=Sharecare|access-date=2018-08-09|language=en}}</ref></blockquote>

*[https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions Can fibromyalgia cause other medical conditions?]<ref name=":20" />

:<blockquote>Fibromyalgia is not known to cause other medical conditions. However, people who have fibromyalgia seem to be at high risk for developing other painful conditions, including [https://en.wikipedia.org/wiki/Osteoarthritis osteoarthritis] (the common type of arthritis caused by wear and tear on the joints) as well as other related conditions, such as [[rheumatoid arthritis]], [[lupus]], and [https://en.wikipedia.org/wiki/Ankylosing_spondylitis ankylosing spondylitis]. Also, people with fibromyalgia are frequently diagnosed with chronic fatigue syndrome, irritable bowel syndrome (IBS), and temporomandibular joint (TMJ) disorder.<ref name=":20">{{Cite web|url=https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions|title=Can fibromyalgia cause other medical conditions? {{!}} Fibromyalgia Complications|last=Honor Society of Nursing|first=|date=|website=Sharecare|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref></blockquote>

==Risk factors==
[[Lupus]] and [[rheumatoid arthritis]] (RA) are risk factors in developing FM. Car accidents, [[post-traumatic stress disorder]] (PTSD), [https://en.wikipedia.org/wiki/Repetitive_strain_injury repetitive injuries], illness such as a [https://en.wikipedia.org/wiki/Viral_disease viral infection], [https://en.wikipedia.org/wiki/Family_history_(medicine) family history], and [https://en.wikipedia.org/wiki/Obesity obesity] have all been linked to FM.<ref>{{Cite web|url=https://www.cdc.gov/arthritis/basics/fibromyalgia.htm|title=Fibromyalgia {{!}} Arthritis {{!}} CDC|date=2018-04-03|website=www.cdc.gov|language=en-us|access-date=2018-08-09}}</ref><ref>{{Cite news|url=https://www.niams.nih.gov/health_info/Fibromyalgia/|title=Fibromyalgia What Causes it?|last=Director|first=Nancy Garrick, Deputy|date=2017-04-05|work=National Institute of Arthritis and Musculoskeletal and Skin Diseases|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

==Diagnosis==
[https://www.verywellhealth.com/what-are-fibromyalgia-tender-points-189768 Tender points], not [https://en.wikipedia.org/wiki/Myofascial_trigger_point trigger points], are used to diagnose fibromyalgia.<ref>{{Cite web|url=http://www.healthcentral.com/chronic-pain/c/662034/176031/fibromyalgia-trigger/|title=The Difference Between Fibromyalgia Tender Points and Myofascial Trigger Points - Chronic Pain {{!}} HealthCentral|last=Cooper|first=Celeste|date=May 8, 2015|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> Tender points will be above and below the waist and on both sides of the body. (See: Illustrations of the 1990 and 2010 American College of Rheumatology (ACR) Criteria depicting tender points near the top of this page.) It is important to check for other conditions that could be causing pain such as hypothyroidism, rheumatoid arthritis or lupus, osteoarthritis, ankylosing spondylitis, and [[wikipedia:Polymyalgia_rheumatica|polymyalgia rheumatica]].<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>

===United States===
==== American College of Rheumatology (ACR) Criteria ====

*1990, [http://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf The American College Of Rheumatology 1990 Criteria For The Classification Of Fibromyalgia]<ref>{{Cite web|url=https://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf|title=The American College of Rheumatology Criteria for the Classification of Fibromyalgia|last=Wolfe|first=Frederick|last2=Smythe|first2=Hugh|date=1990|website=rheumatology.org|publisher=|others=Abeles, Micha; Clark, Patricia; Fam, Adel; Farber, Stephen; Fiechtner, Justus; Franklin, Michael; Gatter, Robert; Hamaty, Daniel; Lessard, James; Lightbroun, Alan; Masi, Alfonse; McCain, Glenn; Reynolds, W. John; Romano, Thomas; Russell, Jon; Sheon, Robert|archive-url=|archive-date=|dead-url=|access-date=|last3=Yunus|first3=Muhammad|last4=Bennett|first4=Robert|last5=Bombardier|first5=Claire|last6=Goldenberg|first6=Don|last7=Tugwell|first7=Peter|last8=Campbell|first8=Stephen}}</ref> "American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure."<ref>{{Cite news|url=http://www.health.com/health/gallery/0,,20345635,00.html|title=18 Points Used to Diagnose Fibromyalgia|last=|first=|date=Feb 4, 2011|work=Health.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> <ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2010, The [https://www.fibroknowledge.com/site/acr-2010 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview]<ref>{{Cite web|url=https://www.fibroknowledge.com/sites/default/files/downloads/file/2010_ACR_CRITERIA.pdf|title=American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia|last=|first=|date=2010|website=fibroknowledge.com|type=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref> was proposed and modified in 2011<ref>{{Cite news|url=http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria|title=New and Modified Fibromyalgia Diagnostic Criteria|last=Garg|first=Neha|date=Feb 9, 2012|work=Rheumatology Network|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=|last2=Deodhar|first2=Atul}}</ref> with the modification being validated in 2013 and published in 2014.<ref>{{Cite journal|last=Bennett|first=Robert M.|last2=Friend|first2=Ronald|last3=Marcus|first3=Dawn|last4=Bernstein|first4=Cheryl|last5=Han|first5=Bobby Kwanghoon|last6=Yachoui|first6=Ralph|last7=Deodhar|first7=Atul|last8=Kaell|first8=Alan|last9=Bonafede|first9=Peter|date=2014|title=Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/24497443|journal=Arthritis Care & Research|volume=66|issue=9|pages=1364–1373|doi=10.1002/acr.22301|issn=2151-4658|pmid=24497443|via=}}</ref> September of 2016, another revision has been made.<ref>{{Cite news|url=http://acrabstracts.org/abstract/2016-revisions-to-the-20102011-fibromyalgia-diagnostic-criteria/|title=2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria - ACR Meeting Abstracts|last=|first=|date=Sep 28, 2016|work=ACR Meeting Abstracts|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

:Men do not seem to form the tender points needed for diagnosis under the 1990 criteria,<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/features/how-fibromyalgia-affects-men#2|title=How Fibromyalgia Affects Men: Symptoms and Diagnosis|work=WebMD|access-date=2018-08-09|language=en-US}}</ref> the 2010 proposed criteria diagnoses more men with a F/M ratio of 2:1.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=}}</ref>
:Tender points were used to diagnose with the 1990 criteria, however "considerable skill is needed to correctly check for a patient’s tender points (i.e., digital palpation that is done with certain amount of applied pressure), yet this technique is not typically taught at most medical schools."<ref name=":0">{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 5, 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>
:The new standards were designed to:
:*eliminate the use of a tender point examination
:*include a severity scale by which to identify and measure characteristic FM symptoms
:*utilize an index by which to rate pain<ref name=":0" />
:*There are 19 tender point areas in the widespread pain index (WPI), whereas the 1990 criteria had 18 tender points.<ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose fibromyalgia.<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=Jul 25, 2012|website=www.ssa.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

==== Sleep study ====
[[Sleep dysfunction]] is often involved in fibromyalgia. Treating a sleep disorder can help with fibromyalgia symptoms. A diagnosed sleep disorder is also helpful if one needs to file for disability.

*[https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054 Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054|title=Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*[http://www.sciencedaily.com/releases/2008/09/080903134311.htm What A Sleep Study Can Reveal About Fibromyalgia]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2008/09/080903134311.htm|title=What A Sleep Study Can Reveal About Fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*[http://linkis.com/nationalpainreport.com/lzYea Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says]<ref>{{Cite news|url=http://linkis.com/nationalpainreport.com/lzYea|title=Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says|last=|first=|date=Mar 25, 2016|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== ICD Diagnostic code===
====World Health Organization====
'''ICD-10'''

The [[World Health Organization]] (WHO) International Classification of Diseases (ICD) lists fibromyalgia as a "disease of the [[musculoskeletal system]] and connective tissue", under the code M79.7 (WHO ICD-10 Version: 016).<ref>World Health Organization, [http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7 International Classification of Diseases - Fibromyalgia M79.7], ICD-10, 2016</ref>

*'''M79.7 Fibromyalgia'''
::Fibromyositis
::Fibrositis
::Myofibrositis<ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7|title=ICD-10 Version:2016|website=apps.who.int|language=en|access-date=2018-08-09}}</ref>

In 2015, the [[United States]] finally adopted ICD-10 and Fibromyalgia as a diagnosis.<ref>{{Cite web|url=http://www.icd10data.com/ICD10CM/Codes/M00-M99/M70-M79/M79-/M79.7|title=2018 ICD-10-CM Diagnosis Code M79.7: Fibromyalgia|website=www.icd10data.com|language=en|access-date=2018-08-09}}</ref> <ref>{{Cite news|url=http://nationalpainreport.com/the-health-care-industry-finally-recognizes-fibromyalgia-8827637.html|title=The Health Care Industry Finally Recognizes Fibromyalgia|last=Liptan|first=Ginevra|date=2015-09-30|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

'''ICD-11 (2019)'''

[https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504 ICD-11] (2019) has diagnostic code ''MG30.1 Chronic widespread pain''.<ref name=":18">{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504|title=ICD-11 - Mortality and Morbidity Statistics|website=icd.who.int|language=en|access-date=2018-08-09}}</ref>

*'''MG30.01 Chronic widespread pain'''

'''Parent'''
::MG30.0 Chronic primary pain

'''Description'''
<blockquote>Chronic widespread pain (CWP) is diffuse pain in at least 4 of 5 body regions and is associated with significant emotional distress (anxiety, anger/frustration or depressed mood) or functional disability (interference in daily life activities and reduced participation in social roles) [1]. CWP is multifactorial: biological, psychological and social factors contribute to the pain syndrome. The diagnosis is appropriate when the pain is not directly attributable to a nociceptive process in these regions and there are features consistent with nociplastic pain [2] and identified psychological and social contributors.<ref name=":18" /></blockquote>

'''Inclusions'''
:*Fibromyalgia
'''Exclusions'''
:*Acute pain (MG31)<ref name=":18" />

==Pathophysiology==
"Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology. There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or [[Lyme disease]], as well as emotional or physical trauma."<ref>{{Cite web|url=https://www.uptodate.com/contents/pathogenesis-of-fibromyalgia#!|title=UpToDate|last=Goldenberg|first=Don L|date=|website=www.uptodate.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> The widespread pain is severe, debilitating, and abnormal in processing its pain. There is also sleep disturbance and fatigue. Cause or causes are unproven.<ref>{{Cite news|url=https://www.omf.ngo/what-is-mecfs-old/fibromyalgia/|title=What is Fibromyalgia? {{!}} Open Medicine Foundation|work=Open Medicine Foundation|access-date=2018-08-09|language=en-US}}</ref>

*May 2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/ Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management]<ref name=":21">{{Cite journal|last=Jahan|first=Firdous|last2=Nanji|first2=Kashmira|last3=Qidwai|first3=Waris|last4=Qasim|first4=Rizwan|date=2012|title=Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/|journal=Oman Medical Journal|volume=27|issue=3|pages=192–195|doi=10.5001/omj.2012.44|issn=1999-768X|pmc=|pmid=22811766|via=}}</ref> ''See'' Table 1: "Conditions associated with fibromyalgia." Musculoskeletal, genitourianry, gastro intestinal, and miscellaneous conditions often exist among fibromyalgia patients.

<blockquote>Pathophysiology: Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as [[serotonin]], substance P, growth hormone and [[cortisol]] suggest that regulation of the autonomic and neuro-endocrine system appears to be the basis of the syndrome. Fibromyalgia is not a life-threatening, deforming, or [https://en.wikipedia.org/wiki/Progressive_disease progressive disease]. [[Anxiety]] and [[depression]] are the most common association. Aberrant pain processing, which can result in [[chronic pain]], may be the result of several interplaying mechanisms. [[Central sensitization]], blunting of inhibitory pain pathways and alterations in [[neurotransmitters]] lead to aberrant neuro-chemical processing of sensory signals in the CNS, thus lowering the threshold of pain and amplification of normal sensory signals causing constant pain.<ref name=":21" /></blockquote>

<blockquote>The frequent co-morbidity of fibromyalgia with mood disorders suggests a major role for the stress response and for neuroendocrine abnormalities. The [[hypothalamic pituitary axis]] (HPA) is a critical component of the stress-adaptation response. In FMS, stress adaptation response is disturbed leading to stress induce symptoms. Psychiatric co-morbidity has been associated with FMS and needs to be identified during the consultation process, as this requires special consideration during treatment.<ref name=":21" /></blockquote>

*May 2018, [https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management]<ref>{{Cite journal|last=Bourgaize|first=Sheryl|last2=Newton|first2=Genevieve|last3=Kumbhare|first3=Dinesh|last4=Srbely|first4=John|date=2018|title=A comparison of the clinical manifestation and
pathophysiology of myofascial pain syndrome
and fibromyalgia: implications for differential
diagnosis and management|url=https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf|format=PDF|journal=Journal of the Canadian Chiropractic Assoc.|volume=|pages=26-41|at=See Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)|via=}}</ref> (PDF) ''See'' Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)

*Jul 2018, [https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/ Primary and Secondary Fibromyalgia Share Same Symptom Burden, Study Suggests]<ref name=":22">{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/|title=Primary, Secondary Fibromyalgia Share Same Symptom Burden, Study Says|last=Carvalho|first=John|date=2018-07-31|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

<blockquote>Fibromyalgia can be considered either primary, or dominant, also known as idiopathic fibromyalgia, or secondary. In the primary form, the causes of the disorder are unknown, but in secondary fibromyalgia, the disorder usually occurs alongside other debilitating medical conditions, such as rheumatoid arthritis (RA), lupus, and multiple sclerosis.<ref name=":22" /></blockquote>

===Immune system research===

Dr. [[Jarred Younger]] believes an overactive [[immune system]] is the cause and will be conducting a study to test this hypothesis.<ref>{{Cite news|url=http://nationalpainreport.com/new-uab-study-could-radically-change-fibromyalgia-treatment-as-we-know-it-8833437.html|title=New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It|last=Gregory Burch|first=Donna|date=2017-04-24|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=https://www.youtube.com/watch?v=8e5xKX036bE|title=Testing the fibromyalgia immune system with lipopolysaccharide (LPS)|last=Younger|first=Jarred|date=May 24, 2017|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=|via=Younger Lab}}</ref> An overactive immune system is responsible for [[inflammation]] which causes [[chronic pain]].

Dr. William Pridgen's research of [[HSV-1]] (cold sore virus) as being involved in FM has conducted a successful Phase III clinical trial, which had been fast-tracked by the [[Food and Drug Administration]] (FDA), of a combination drug that suppresses this virus and also helps with pain. ''See'': [[Fibromyalgia#IMC-1|Fibromyalgia (''Drugs: Trials: IMC-1'' section)]].

[[ProHealth]] reports that an old [https://en.wikipedia.org/wiki/Tuberculosis Tuberculosis] vaccine, [https://en.wikipedia.org/wiki/BCG_vaccine Bacille Calmette-Guerin] (BCG), may be researched for treatment of Fibromyalgia spearheaded by [http://www.buzzfile.com/business/Epicgenetics,-Inc.-310-586-2929 EpicGenetics] and [http://www.massgeneral.org/ Massachusetts General Hospital].<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

EpicGenetics has a blood test that is identifying the presence of specific white blood cell abnormalities of patients diagnosed with FM and has partnered with two universities to offer [https://en.wikipedia.org/wiki/Disease_gene_identification#Whole_exome_sequencing whole exome sequencing] free of charge to those who test positive with their [http://fmtest.com/ FM/a® test].<ref>{{Cite news|url=http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> Concerns have been raised in regards to the FM/a® EpicGenetics Blood Test.<ref>{{Cite web|url=http://www.fmperplex.com/2013/02/25/junk-science-junk-ethics/|title=Junk Science – Junk Ethics – The Fibromyalgia Perplex|last=Wolfe|first=Fred|date=Feb 25, 2013|website=www.fmperplex.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> EpicGenetics is awaiting FDA approval to test the Bacille Calmette-Guerin (BCG) vaccine (an old Tuberculosis vaccine) on patients that tested positive with its FM/a® test.<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689#comment-2286|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=See Comments Section: CDW12 says: June 26, 2018 at 2:05 pm|language=en-US}}</ref><ref>{{Cite web|url=https://www.celestecooper.com/2018/07/the-fma-blood-test-and-participation-in.html#.Wz4nxdJKjIU|title=The FM/a® Blood Test and Participation in Fibromyalgia Vaccine Study|last=Cooper|first=Celeste|date=Jul 5, 2018|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

A June 2018 study found inflammatory genes CCL11, CCL4, and MEFV in a fibromyalgia family study.<ref>{{Cite journal|last=Zhang|first=Zhifang|last2=Feng|first2=Jinong|last3=Mao|first3=Allen|last4=Le|first4=Keith|last5=Placa|first5=Deirdre La|last6=Wu|first6=Xiwei|last7=Longmate|first7=Jeffrey|last8=Marek|first8=Claudia|last9=Amand|first9=R. Paul St|date=2018-06-21|title=SNPs in inflammatory genes CCL11, CCL4 and MEFV in a fibromyalgia family study|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198625|journal=PLOS ONE|language=en|volume=13|issue=6|pages=e0198625|doi=10.1371/journal.pone.0198625|issn=1932-6203|pmid=29927949|via=}}</ref>
<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/03/immune-system-may-play-role-fibromyalgia-study/|title=Fibromyalgia May Be Linked to Immune System, Study Suggests|last=Inacio|first=Patricia|date=2018-07-03|work=Fibromyalgia News Today|access-date=2018-08-22|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Comorbidities, overlapping conditions, and common symptoms ==
[[File:Fibromyalgia and comorbid conditions.JPG|700px|thumb|center|Comorbid conditions of Fibromyalgia (FMS) are ME/CFS which is the most common; autoimmune diseases; migraines; Multiple Chemical Sensitivities (MCS); and orthostatic intolerance (OI) / Postural Orthostatic Tachycardia Syndrome (POTS).<ref name=":30" /><ref name=":31" /><ref name=":33">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref> Depression and anxiety; digestive conditions and menstrual problems; GWI; nervous system disorders; low blood pressure (Low BP); other pain conditions and migraines; and sleep dysfunction/disturbance all overlap with FMS.<ref name=":30" /> <ref name=":33" />]]

*[[Allodynia]]
** [http://chronicfatigue.about.com/od/glossary/g/allodynia.htm Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS]<ref name=":1">{{Cite news|url=https://www.verywellhealth.com/allodynia-definition-and-types-fibromyalgia-715929|title=Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Feb 23, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Types of Allodynia: Tactile; Mechanical; and Thermal. "Type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain" <ref name=":1" />
*[[Autoimmune disease]]<nowiki/>s "Research suggests that RA and other inflammatory diseases may somehow increase the risk for fibromyalgia."<ref>{{Cite news|url=https://www.health.com/health/gallery/0,,20520705,00.html#restless-legs-0|title=7 Conditions Linked to Fibromyalgia|work=Health.com|access-date=2018-08-19|language=en}}</ref>

*[[Body temperature]]
**[https://www.verywell.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025 Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":2">{{Cite news|url=https://www.verywellhealth.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025|title=Temperature Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Mar 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

<blockquote>When you're exposed to heat, does it feel like you're burning up? Does it seem impossible for you to cool off? Or maybe it's cold that bothers you, chilling you to the bone, leaving you unable to warm up? Or are you one of those people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) who is cold all the time, or hot all the time, or alternately hot or cold while out of sync with the environment?<ref name=":2" /></blockquote>

[[File:Costal cartilages.JPG|200px|thumb|left|Costochonritus is inflammation of the costal cartliges (shown in red) causing chest and ribcage pain]]

:* [https://www.verywell.com/costochondritis-in-fibromyalgia-716178 Costochondritis in Fibromyalgia]<ref name=":10">{{Cite news|url=https://www.verywellhealth.com/costochondritis-in-fibromyalgia-716178|title=Costochondritis Chest Pain in Fibromyalgia|last=Dellow|first=Adrienne|date=Feb 14, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|date=2018-05-25|title=Costochondritis|url=https://en.wikipedia.org/w/index.php?title=Costochondritis&oldid=842926736|journal=Wikipedia|language=en}}</ref>

<blockquote>Costochondritis is inflammation of the cartilage that connects your ribs to your breastbone. Depending on how much inflammation there is, it can range from mildly annoying to intensely painful. People sometimes describe the pain as stabbing, aching, or burning.<ref name=":10" /></blockquote>

<blockquote>Costochondritis can make you think you're having heart problems, which is a scary thing. Even though costochondritis is common, you should get medical attention if you have unexplained chest pain. You don't want to assume that it's FMS-related and end up with permanent heart damage or worse.<ref name=":10" /></blockquote>

<blockquote>The pain can radiate to your shoulder and arms as well (another way the condition mimics a heart attack). Sometimes the pain is accompanied by redness and/or swelling in the most painful areas. When that's the case, it's called Tietze's Syndrome.<ref name=":10" /></blockquote>

* [[Depression]] and [[Anxiety]] Fibromyalgia sufferers are "up to three times more likely to have depression at the time of their diagnosis than someone without fibromyalgia."<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/fibromyalgia-and-depression#1|title=Fibromyalgia and Depression|work=WebMD|access-date=2018-08-19|language=en-US}}</ref> Up to 20 percent of Fibromyalgia patients will have either depression or anxiety.<ref>{{Cite web|url=https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/fibromyalgia|title=Fibromyalgia {{!}} Anxiety and Depression Association of America, ADAA|website=adaa.org|language=en|access-date=2018-08-19}}</ref>

*[[Fibro fog]]

:*[http://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction]<ref name=":3">{{Cite news|url=https://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx|title=What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction|last=Mandal|first=Ananya|date=2013-06-03|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> 'Mental confusion along with difficulty in concentration and loss of memory is often termed “[[fibro fog]]"'.<ref name=":3" />

:* [https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014 What Is Fibro Fog and ME/CFS Brain Fog?]<ref name=":17" />

*[[Gastrointestinal system]]
**[[Irritable bowel syndrome]]: [http://chronicfatigue.about.com/od/whyfmscfsarelinked/a/IBS.htm Irritable Bowel Syndrome in Fibromyalgia & Chronic Fatigue Syndrome - Why Do They Go Together?]<ref name=":4">{{Cite news|url=https://www.verywellhealth.com/irritable-bowel-syndrome-in-fibromyalgia-cfs-716167|title=Irritable Bowel Syndrome in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jan 28, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>Fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome (IBS) frequently go together. No one really knows why, but we do know that all three conditions can include imbalances of serotonin -- although in fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS or ME/CFS) it's an imbalance in the brain, while with IBS it's in the gut.<ref name=":4" /></blockquote>
* [[Gulf War Illness]]
**[https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp Fibromyalgia in Gulf War Veterans]<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp|title=Fibromyalgia in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-19}}</ref> GWI increases risk of developing Fibromyalgia.

*[https://en.wikipedia.org/wiki/Interstitial_cystitis Interstitial Cystitis]<ref>{{Cite journal|date=2018-07-11|title=Interstitial cystitis|url=https://en.wikipedia.org/w/index.php?title=Interstitial_cystitis&oldid=849828657|journal=Wikipedia|language=en}}</ref> (Painful bladder)
**[https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168 Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis]<ref name=":5">{{Cite news|url=https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168|title=Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "Fibromyalgia, chronic fatigue syndrome and interstitial cystitis (IC) -- a painful bladder condition -- frequently occur together. Women may be up to 10 times more likely than men to develop it."<ref name=":5" />

*Language Impairment
**[[Word-finding problems]] is a symptom of ME/CFS.
:*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome Impaired Language in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":6" /> "Searching their brains for simple words that they just can't remember. On other occasions, individuals with these diagnoses may find it hard to write or even understand language."<ref name=":6">{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:*"The diagnosis of [[Aphasia]] is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written"<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref> but with [[dysphasia]] you will have those symptoms and trouble listening and doing numeral calculations.<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-09}}</ref> ''See also'': [[Dyscalculia]].
* [[ME/CFS]]
:*[https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184 Comorbid Conditions in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>
* [[Migraine]]
:*[https://migrainecenters.com/blog/migraines-and-fibromyalgia/ Migraines and Fibromyalgia]<ref name=":32" />
<blockquote>Both fibromyalgia and migraine may reflect problems in the brain’s pain processing center. It is believed that both conditions are caused by excitation of the nervous system or an over-response to stimuli. Stress is usually cited as a trigger for both migraine and fibromyalgia attacks.<ref name=":32">{{Cite news|url=https://migrainecenters.com/blog/migraines-and-fibromyalgia/|title=Migraines and Fibromyalgia - Migraine Centers|date=2016-05-06|work=Migraine Centers|access-date=2018-08-19|language=en-US}}</ref></blockquote>
* [[Multiple chemical sensitivity|Multiple Chemical Sensitivity]] (MCS) It is thought that both Fibromyalgia and MCS are [[Central sensitisation|central sensitivity]] syndromes.<ref>{{Cite news|url=https://www.verywellhealth.com/chemical-sensitivity-in-fibromyalgia-716170|title=Multiple Chemical Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>

*OBGYN
**[https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596 Menstrual Periods with Fibromyalgia: Personal Stories]<ref>{{Cite news|url=https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596|title=Menstrual Periods with Fibromyalgia: Personal Stories|last=Dellwo|first=Adrienne|date=May 18, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>
**[https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626 Fibromyalgia Tied to Hysterectomy, Gynecologic Disease].<ref name=":7" />
:<blockquote>You may have heard about a possible link between gynecologic surgery (such as a hysterectomy) and the development of fibromyalgia, and doctors have long suspected that fibromyalgia has strong hormonal ties and triggers. This does not seem surprising as we've long suspected a link between endocrine disorders, gynecological conditions, and autoimmune conditions.<ref name=":7">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626|title=Fibromyalgia Tied to Hysterectomy, Gynecologic Disease|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref></blockquote>

*[[Orthostatic intolerance]] (OI) and [[Postural orthostatic tachycardia syndrome]] (POTS)<ref>{{Cite journal|last=Yun|first=Dong Joo|last2=Choi|first2=Han Na|last3=Oh|first3=Gun-Sei|date=2013|title=A Case of Postural Orthostatic Tachycardia Syndrome Associated with Migraine and Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710947/|journal=The Korean Journal of Pain|volume=26|issue=3|pages=303–306|doi=10.3344/kjp.2013.26.3.303|issn=2005-9159|pmid=23862007|via=}}</ref>

:*[http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM]<ref>{{Cite web|url=http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf|title=Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM|last=Lapp|first=Charles W.|last2=Black|first2=Laura|date=|website=drlapp.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Smith|first3=Rebekah S.}}</ref> (PDF) Symptoms can include low blood pressure and/or sudden high blood pressure, dizziness, fainting.

:*[https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/ An Overlooked Issue in Fibromyalgia? Study Highlights Problems Standing (Orthostatic Intolerance)]<ref>{{Cite news|url=https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/|title=An Overlooked Issue in Fibromyalgia? Study Highlights Orthostatic Intolerance - Problems Standing - Health Rising|last=Johnson|first=Cort|date=2017-09-21|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[[Sleep dysfunction]]
**[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia]<ref name=":23">{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}</ref>

:<blockquote>The present results of this study suggest that long-term, comorbid pain and sleep disturbance may be associated with increased activation in core default mode brain areas that is above and beyond long-term pain disturbance alone.<ref name=":23" /></blockquote>

:*[http://www.prohealth.com/library/showarticle.cfm?libid=22344 Fibromyalgia and Sleep]<ref name=":8">{{Cite news|url=https://www.prohealth.com/library/fibromyalgia-and-sleep-38954|title=Fibromyalgia and Sleep - Prohealth|date=2016-01-11|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref> "Most people with fibromyalgia have an associated sleep disorder that makes it difficult for them to get the deep, restorative sleep they need."<ref name=":8" />

[[File:TMJ_1.jpg|200px|thumb|right|TMJ/TMD is a condition that occurs in some fibromyalgia and ME/CFS patients]]
* [[Temporomandibular joint disorder]] (TMJ/TMD)

:* [https://www.sciencedirect.com/science/article/pii/S2255502114001758 Temporomandibular disorders in fibromyalgia syndrome: a short-communication]<ref>{{Cite journal|last=Soares Gui|first=Maisa|last2=Pimentel|first2=Marcele Jardim|last3=Rizzatti-Barbosa|first3=C'elia Marisa|date=2015-03-01|title=Temporomandibular disorders in fibromyalgia syndrome: a short-communication|url=https://www.sciencedirect.com/science/article/pii/S2255502114001758|journal=Revista Brasileira de Reumatologia (English Edition)|language=en|volume=55|issue=2|pages=189–194|doi=10.1016/j.rbre.2014.07.004|issn=2255-5021|via=ScienceDirect}}</ref><ref>{{Cite news|url=https://www.whitesmilesforlife.com/blog/study-probes-pain-link-between-tmj-fibromyalgia/|title=Study Probes Pain Link Between TMJ, Fibromyalgia|date=2016-05-03|work=Kent E. White, DDS|access-date=2018-08-19|language=en-US}}</ref>

::Other than headaches, the symptoms are quite distinct from symptoms of FMS and ME/CFS.

::They include:
::*Jaw pain
::*Discomfort or difficulty chewing
::*Painful clicking in the jaw
::*Difficulty opening or closing the mouth
::*Headaches
::*Locking jaw
::*Teeth that don't come together properly<ref>{{Cite news|url=https://www.verywellhealth.com/tmj-in-fibromyalgia-chronic-fatigue-syndrome-716175|title=TMJ in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Mar 31, 2018|work=Verywell Health|access-date=2018-08-22|archive-url=|archive-date=|dead-url=}}</ref>

*[[Thyroid disease]]
**[https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677 Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease]<ref name=":9">{{Cite news|url=https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677|title=A Comparison of Chronic Fatigue, Fibromyalgia, and Thyroid Disease|last=Shomon|first=Mary|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>People with Hashimoto's autoimmune thyroid disease often experience significant fatigue and body aches. While these symptoms are common in Hashimoto's, they can also be markers of other diseases, like chronic fatigue syndrome or fibromyalgia.<ref name=":9" /></blockquote>

*Other symptoms
**[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/fibrosymptoms.htm Symptoms of Fibromyalgia]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-symptoms-716139|title=Symptoms of Fibromyalgia|last=Dellwo|first=Adrienne|date=May 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> (A comprehensive all in one place list for the many symptoms of fibromyalgia.)

==Treatment==

===United States===
'''Rheumatology and primary care providers: Diagnosing and treatment'''

*2012, [https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract A Framework for Fibromyalgia Management for Primary Care Providers]<ref>{{Cite journal|last=Arnold|first=Lesley M.|last2=Clauw|first2=Daniel J.|last3=Dunegan|first3=L. Jean|last4=Turk|first4=Dennis C.|date=2012|title=A Framework for Fibromyalgia Management for Primary Care Providers|url=https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract|journal=Mayo Clinic Proceedings|language=English|volume=87|issue=5|pages=488–496|doi=10.1016/j.mayocp.2012.02.010|issn=0025-6196|via=}}</ref> Rheumatologists stopped treating fibromyalgia patients and primary care providers began treatment managment although rheumatologists are most often the specialist to diagnose. (Please see [http://me-pedia.org/wiki/Fibromyalgia#Disability disability] heading about ''primary provider'' and ''specialists'' for disability cases.)

=== Drugs ===

{{Main article |page_name = Fibromyalgia drugs}}

=== Therapies ===

==== Exercise ====
''Please Note'': These recommendations are for fibromyalgia patients and '''not''' [[ME/CFS]] sufferers.
[[File:Warm water exercise.JPG|200px|thumb|left|Warm water exercise is best for fibromyalgia. Start slow and don't push through the pain<ref name=":11" />]]

*[https://www.verywellhealth.com/warm-water-exercise-for-fibromyalgia-716059 Warm Water Exercise for Fibromyalgia]<ref name=":11">{{Cite news|url=http://chronicfatigue.about.com/od/treatingfmscfs/a/warmwaterFMS.htm|title=Warm Water Exercise for Fibromyalgia|last=Dellwo|first=Adrienne|date=Nov 19, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|last=Munguía-Izquierdo|first=D.|last2=Legaz-Arrese|first2=A.|date=2007|title=Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/18173915|journal=Clinical and Experimental Rheumatology|volume=25|issue=6|pages=823–830|issn=0392-856X|pmid=18173915|via=}}</ref>

<blockquote>A warm-water pool is good for therapy because cold water can make muscles tense up. It's especially important in FMS because many people with the condition are intolerant of cold. A warm-water pool is one that's kept around 89.6 degrees Fahrenheit (32 Celsius), which is several degrees warmer than most heated pools.<ref name=":11" /></blockquote>

*Moderate aerobic exercise and weights with six to eight reps and then a day or two of rest in between. Do not start a program if you are in a flare.<ref>{{Cite web|url=http://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/fibromyalgia-questions/fibromyalgia-exercise.php|title=Fibromyalgia Exercise {{!}} Exercising with Fibromyalgia|last=Ronenn|first=Roubenoff|date=|website=www.arthritis.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[https://www.youtube.com/watch?v=BauJYuJwFsI Easy fibromyalgia exercises and motivation to keep you healthy!]<ref>{{Cite web|url=https://www.youtube.com/watch?v=BauJYuJwFsI|title=Easy Fibromyalgia exercises and motivation to keep you healthy!|last=Suarez|first=Eric|date=Jun 21, 2011|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=Aug 9, 2018}}</ref> Video

*[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/Fibromyalgia-Myth-Vs-Fact.htm Fibromyalgia Myth vs. Fact]<ref name=":15">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-myth-vs-fact-716131|title=Fibromyalgia: What's Myth, What's Fact?|last=Dellwo|first=Adrienne|date=Jun 8, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=Myth #3 People With Fibromyalgia Need More Exercise}}</ref> Heading: ''Myth #3: People With Fibromyalgia Need More Exercise''. Appropriate exercise, which each patient needs to gauge for themselves.<ref name=":15" />

==== Massage ====

*2014, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/ Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]<ref>{{Cite journal|last=Li|first=Yan-hui|last2=Wang|first2=Feng-yun|last3=Feng|first3=Chun-qing|last4=Yang|first4=Xia-feng|last5=Sun|first5=Yi-hua|date=2014-02-20|title=Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/|journal=PLoS ONE|volume=9|issue=2|doi=10.1371/journal.pone.0089304|issn=1932-6203|pmc=|pmid=24586677|pages=|via=}}</ref>

*2016, [http://chronicfatigue.about.com/od/alternativetreatments/a/bodywork.htm Massage, Rolfing & Other Bodywork - Are They Effective Fibromyalgia & Chronic Fatigue Syndrome Treatments?]<ref>{{Cite news|url=https://www.verywellhealth.com/massage-rolfing-other-bodywork-715645|title=Massage, Rolfing, Reiki: Do They Work for Fibromyalgia & ME/CFS?|last=Dellwo|first=Adrienne|date=Aug 10, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==== Acupuncture ====

*2004, [[U.S. Department of Health and Human Services]] (HHS) and [https://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services Centers for Medicare and Medicaid Services] (CMS) ruled April 16, 2004, a noncoverage determination for acupuncture.<ref>{{Cite web|url=https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R11NCD.pdf|title=CMS Manual System Pub. 100-03 Medicare
National Coverage Determinations|last=|first=|date=Apr 16, 2004|website=CMS.gov|format=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2005, [http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html Acupuncture Good for Fibromyalgia?] <ref name=":16">{{Cite web|url=http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html|title=Acupuncture Good for Fibromyalgia?|last=|first=|date=Oct 2, 2012|website=Acupuncture School Online|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> "Acupuncture gave no significant pain relief to fibromyalgia patients."<ref name=":16" />

*2016, [http://www.sciencedirect.com/science/article/pii/S2095496416602352 Short-term complementary and alternative medicine on quality of life in women with fibromyalgia] <ref name=":25">{{Cite journal|date=2016-01-01|title=Short-term complementary and alternative medicine on quality of life in women with fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S2095496416602352|journal=Journal of Integrative Medicine|language=en|volume=14|issue=1|pages=29–35|doi=10.1016/S2095-4964(16)60235-2|issn=2095-4964}}</ref> "There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session."<ref name=":25" />

*2016, [https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/ Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/|title=Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients - Fibromyalgia News Today|last=Semedo|first=Daniela|date=2016-02-01|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Disability ==
===United States===
''Please Note'': The following is NOT legal advice and it should not be relied upon in taking steps for a disability case. Only ''[https://www.ssa.gov/ Social Security]'' and a disability lawyer can provide the most up to date and the correct legal avenue for bringing a disability case.

In the[[ United States]], [https://www.ssa.gov/ssi/ Social Security Insurance] and [https://www.ssa.gov/disability/ Social Security Disability] (SSI) and (SSD) benefits are available for Fibromyalgia. Generally for SSI/SSD, notes and tests from a ''Primary Provider'' '''may''' be allowed for submission but ''Specialists'' such as a rheumatologist, neurologist, psychiatrist, etc. are required for diagnosis, ongoing treatment and completing SSI/SSD paperwork.

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose Fibromyalgia. (See: "Policy Interpretation" for the POLICY INTERPRETATION RULING.)<ref>[https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia]</ref>

*[http://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social Applying for Disability With Fibromyalgia]<ref>{{Cite news|url=https://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social|title=Fibromyalgia Disability: Applying for Disability Benefits With Fibromyalgia|date=2016-10-03|work=NewLifeOutlook {{!}} Fibromyalgia|access-date=2018-08-09|language=en-US}}</ref> One patient's success of applying, denial, successful appeal, and a breakdown of what SSI/SSD requires for the medical determination of a favorable decision of disability.

*[https://www.socialsecurity.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html Fibromyalgia: Policy Interpretation Ruling - Social Security]<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=|website=www.ssa.gov|at=Titles II and XVI: Evaluation of Fibromyalgia|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[http://www.disabilitysecrets.com/social_security_disability_fibromyalgia.html Social Security Disability (SSDI & SSI) for Fibromyalgia - Disability Secrets By NOLO]<ref>{{Cite news|url=https://www.disabilitysecrets.com/resources/social-security-disability-ssdi-ssi-fibromyalgia.htm|title=Social Security Disability (SSDI & SSI) for Fibromyalgia|last=Laurence|first=Bethany|date=|work=www.disabilitysecrets.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*[http://www.mdjunction.com/fibromyalgia/fibromyalgia-disability Fibromyalgia Disability Patient Support Forums]<ref>{{Cite web|url=https://www.mdjunction.com/fibromyalgia/fibromyalgia-disability|title=Fibromyalgia Disability|website=MDJunction|language=en|access-date=2018-08-09}}</ref> at [[MDJunction]]

==== Examinations and Tests ====
For documentation of symptoms and co-morbidities of a FM diagnosis, you and your doctor should consider the following examinations and tests:

:'''Fibromyaglia Diagnostic Examination'''
:*[http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist Rheumatologist] examination and diagnosis of FM. (Consider having a rheumatologist order tests and coordinate referrals for other specialists for examinations and testing. Only specialists can complete the paperwork for Social Security. A primary doctor cannot complete disability paperwork but ''may'' be able to forward test results they have ordered.)
[[File:Whole body bone scan.jpg|200px|thumb|right|A whole body bone scan (Bone scintigraphy) is a nuclear medicine test. '''Arthritis''', avascular necrosis, bone cancers, cancers that have spread to the bone, fibrous dysplasia, fractures, infection involving the bone, and Pagets disease can be diagnosed using this scan.<ref>{{Cite news|url=https://www.healthline.com/health/bone-scan#purpose|title=Bone Scan: Purpose, Procedure, and Risks|last=Krans|first=Brian|date=Dec 13, 2017|work=Healthline|access-date=2018-08-21|archive-url=|archive-date=|dead-url=|language=en}}</ref>]]
:'''Arthritis'''
:*[https://en.wikipedia.org/wiki/Bone_scintigraphy Whole body bone scan (Bone scintigraphy)]<ref>{{Cite journal|date=2018-05-22|title=Bone scintigraphy|url=https://en.wikipedia.org/wiki/Bone_scintigraphy|journal=Wikipedia|language=en}}</ref> to rule out treatable arthritis.
:'''Blood Tests'''
:*Routine blood tests for [[diabetes]] (fasting sugar, A1C) and a full [[Thyroid disease]] panel ([https://en.wikipedia.org/wiki/Thyroid_function_tests#Thyroid-stimulating_hormone TSH, T3, Free T3, T4 and Free T4]).
:*Rule out [[Rheumatoid arthritis]], lupus, [[Lyme disease]] and other diseases that can share some of the same symptoms of fibromyalgia and may be treatable.<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1-3|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>
:*Vitamin and mineral deficiencies such as [[B12]] and [[Vitamin D]] are treatable with over the counter supplements and prescription medications which can improve [[fatigue]] and [[pain]].
:'''Gastrointestinal'''
:*[[Irritable bowel syndrome]] diagnosis which may require blood, [http://www.mayoclinic.org/tests-procedures/endoscopy/basics/definition/PRC-20020363 upper endoscopy] to rule out [https://en.wikipedia.org/wiki/Coeliac_disease celiac disease] and [https://en.wikipedia.org/wiki/Stool_test fecal tests] to check for bacteria ([[SIBO]]) and [http://www.umm.edu/health/medical/altmed/condition/intestinal-parasites intestinal parasites].
:'''Mental Health and Cognition'''
:* Psychiatric evaluation as any [[depression]] and [[anxiety]] should be treated.
:* [[Cognitive dysfunction]] tests.
:'''Sleep dysfunction'''
:*Sleep study for [[Restless legs syndrome]], [[Sleep disturbance]] or [[Narcolepsy]].
:'''Orthostatic Intolerance'''
:*[[Tilt table test]] to diagnose [[Orthostatic intolerance]] or [[Postural orthostatic tachycardia syndrome|POTS]].
:'''TMJ, tinnitus, vertigo, and dizziness'''
:*An ear, nose, and throat specialist (ENT) ([http://www.mayoclinic.org/departments-centers/otorhinolaryngology-ent/overview Otorhinolaryngology]) examination and imaging may be ordered for [[Temporomandibular joint disorder]] (TMJ).
:*(Ear, sinus, throat/lymph infections, and [[tinnitus]] can also be documented.)
:*[https://en.wikipedia.org/wiki/Videonystagmography Videonystagmography] (VNG) testing if you experience [[vertigo]] and/or [[dizziness]].<ref>{{Cite news|url=https://www.everydayhearing.com/balance/articles/what-to-expect-at-your-vng-test/|title=What to Expect at Your VNG/ENG Test - Everyday Hearing|last=Banks|first=Lindsey|date=2014-05-07|work=Everyday Hearing|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

Of course, one can have arthritis, sleep apnea, [[Chronic lyme disease|chronic Lyme disease]] or other diseases and still have FM, but there may be a treatable condition where a patient's overall health, including their FM, improves.<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/guide/common-misdiagnoses-of-fibromyalgia#1|title=Common Misdiagnoses of Fibromyalgia|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite web|url=http://www.cfidsselfhelp.org/library/overlapping-and-related-conditions|title=Overlapping and Related Conditions {{!}} CFIDS & Fibromyalgia Self-Help|website=www.cfidsselfhelp.org|access-date=2018-08-09}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

There have been cases of [[Vitamin D]] deficiency being misdiagnosed as fibromyalgia as a D deficiency can cause pain. Supplementation or prescribed D treatments may alleviate this pain. However, it is possible to have both a D deficiency and fibromyalgia and correcting the deficiency will only resolve the pain stemming from it.<ref>{{Cite news|url=http://www.webmd.com/pain-management/features/vitamin-d-deficiency-and-chronic-pain-link#1|title=Does Vitamin D Deficiency Cause Chronic Pain?|last=Shaw|first=Gina|date=|work=WebMD|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

==== Blogs about navigating SSD process ====

*Resources for getting approved for disability include this [http://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/ Guide to Social Security Disability for People with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome],<ref>{{Cite web|url=https://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/|title=The Sleepy Girl Guide to Social Security Disability (U.S.) {{!}} #MEAction|last=Silver|first=Lily|date=Apr 17, 2017|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> available on the #[[MEAction]] website.

*[https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/ How Patty’s Lawyer Never Told Her What She Needed to Know]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/|title=How Patty’s Lawyer Never Told Her What She Needed to Know|last=Skelton Preston|first=Patty|date=2017-03-20|work=How to Get On|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/ Sample Doctor Letters for Disability]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/|title=21 Sample Doctor Letters for Disability|date=2017-05-01|work=How to Get On|access-date=2018-08-09|language=en-US}}</ref>

== Notable studies ==
{{Main article |page_name = Fibromyalgia notable studies}}

== Controversies ==
=== Dr. Frederick Wolfe ===
Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.<ref>{{Cite news|url=http://www.nytimes.com/2008/01/14/health/14pain.html?_r=0|title=Drug Approved. Is Disease Real?|last=Berenson|first=Alex|date=Jan 14, 2008|work=The Wall Street Journal|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>[http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf Fibromyalgia: A Short Commentary - iMedPub Journals - DOI: 10.4172/2472-1913.100027 - Frederick Wolfe and Brian Walitt - Sep. 23, 2016]</ref><ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|journal=Journal of Headache & Pain Management|volume=1|issue=3:27|pages=|via=iMedPub Journals}}</ref><ref>{{Cite news|url=https://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx|title=Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine|last=Cashin-Garbutt|first=April|date=2013-03-22|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Fibromyalgia vs Chiari malformation ===
Some individuals diagnosed with FMS were undergoing surgery for [[Chiari malformation]] (CM). These are two separate conditions; FMS cannot be resolved by undergoing a risky CM surgery.

*2011, [https://www.ncbi.nlm.nih.gov/pubmed/21135714 Is Chiari I malformation associated with fibromyalgia?]<ref>{{Cite journal|last=Watson|first=Nathaniel F.|last2=Buchwald|first2=Dedra|last3=Goldberg|first3=Jack|last4=Maravilla|first4=Kenneth R.|last5=Noonan|first5=Carolyn|last6=Guan|first6=Qingyan|last7=Ellenbogen|first7=Richard G.|date=2011|title=Is Chiari I malformation associated with fibromyalgia?|url=https://www.ncbi.nlm.nih.gov/pubmed/21135714|journal=Neurosurgery|volume=68|issue=2|pages=443–448; discussion 448–449|doi=10.1227/NEU.0b013e3182039a31|issn=1524-4040|pmid=21135714|via=}}</ref>
::Conclusion: Most patients with FM do not have [[CIM]] pathology. Future studies should focus on dynamic neuroimaging of craniocervical neuroanatomy in patients with FM.
*2015, [https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery CFS/FM and Chiari Malformation Surgery]<ref>{{Cite web|url=https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery|title=CFS/FM and Chiari Malformation Surgery|last=Casanova|first=Ken|date=Nov 15, 2015|website=www.massmecfs.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

== Learn more ==
*[https://www.s4me.info/forums/fibromyalgia-and-connective-tissue-disorders.35/ Forum: Fibromyalgia and Connective Tissue Disorders] at [[Science for ME]]
*[[Verywell FMS/CFS]]

=== Ongoing process of diagnosing and categorizing ===

*2014, [http://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114 Lyme Disease, Fibromyalgia Link Evaporates]<ref>{{Cite news|url=https://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114|title=Lyme Disease, Fibromylagia Link Evaporates|last=Kuznar|first=Wayne|date=2014-12-14|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> (See also: [[Chronic lyme disease]])

*2015, [http://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx Fibromyalgia now considered as a lifelong central nervous system disorder]<ref>{{Cite news|url=https://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx|title=Fibromyalgia now considered as a lifelong central nervous system disorder|date=2015-05-18|work=News-Medical.net|access-date=2018-08-09|language=en}}</ref>

*2015, [http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates]<ref>{{Cite news|url=http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html|title=Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates|date=2015-10-24|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2015, ''Question:'' [http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html 'Is Fibromyalgia a Psychosomatic Illness?'] via CelesteCooper.com ''Answer:'' "Fibromyalgia is NOT a psychosomatic illness."<ref>[http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html Is Fibromyalgia a Psychosomatic Illness? Med Student Asks Celeste Cooper by Celeste Cooper - CelesteCooper.com Sep 4, 2015]</ref>

*2016, [http://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination Diagnosing Fibromyalgia May Be Possible Using Noninvasive Eye Examination]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination|title=Diagnosing Fibromyalgia May Be Possible with Noninvasive Eye Exam|date=2016-09-09|work=Fibromyalgia News Today|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780 Microglia in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780|title=Microglia in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*2016, [http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/ Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders?]<ref>{{Cite news|url=http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/|title=Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders? - Simmaron Research|date=2016-03-21|work=Simmaron Research|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://consultqd.clevelandclinic.org/2016/03/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic Why Fibromyalgia Is Neuropathic]<ref>{{Cite news|url=https://consultqd.clevelandclinic.org/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic|title=Why Fibromyalgia Is Neuropathic|date=2016-03-08|work=Consult QD|access-date=2018-08-09|language=en-US}}</ref>

*2017, [http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain]<ref>{{Cite news|url=http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html|title=Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain|last=Liptan|first=Ginevra|date=2017-04-11|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
*2017, [https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947 AI can spot the pain from a disease some doctors still think is fake]<ref>{{Cite news|url=https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947|title=AI can spot the pain from a disease some doctors still think is fake|last=Goldhill|first=Olivia|date=Aug 9, 2018|work=Quartz|access-date=2018-08-15|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== Blood tests ===

*2013, [http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html New Fibromyalgia Blood Test is 99% Accurate]<ref>{{Cite news|url=http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html|title=New Fibromyalgia Blood Test is 99% Accurate|date=2013-07-31|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2014, [http://www.prohealth.com/library/showarticle.cfm?libid=18837 Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”]<ref>{{Cite news|url=https://www.prohealth.com/library/pridgen-reports-fibromyalgia-antiviral-trial-results-very-positive-predicts-new-approach-will-be-game-changer-32620|title=Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”|last=|first=|date=2014-03-25|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2016, [https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html Blood Test for Fibromyalgia: FM/a Test Ⓡ is now available, Q&A]<ref>{{Cite web|url=https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html|title=Blood Test for Fibromyalgia: FM/a Test ® Is Real, Q&A|last=Cooper|first=Celeste|date=May 3, 2016|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2016, [http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/ Fibromyalgia blood testing covered by rising number of insurance companies]<ref>{{Cite news|url=http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/|title=Fibromyalgia blood testing covered more of insurance companies|last=Campbell|first=Julie|date=2016-04-08|work=Live Insurance News|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2017, [http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches]<ref>{{Cite news|url=https://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=Business Wire|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Brain scans ===

*2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds]<ref>{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|publisher=ANAPSID|via=Chronic Neuroimmune Diseases|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2012, [https://www.sciencedaily.com/releases/2012/11/121111153426.htm Fibromyalgia and the brain: New clues reveal how pain and therapies are processed]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2012/11/121111153426.htm|title=Fibromyalgia and the brain: New clues reveal how pain and therapies are processed|last=|first=|date=Nov 11, 2012|work=ScienceDaily|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*2015, [https://www.verywell.com/unique-brain-connectivity-in-fibromyalgia-715630 Unique Brain Connectivity in Fibromyalgia - Increased Importance Assigned to Pain]<ref>{{Cite news|url=https://www.verywellhealth.com/how-lyrica-changes-the-fibromyalgia-brain-715767|title=How Lyrica Changes the Fibromyalgia Brain|last=Dellwo|first=Adrienne|date=Apr 30, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==See also==
* [[Fibromyalgia drugs]]

* [[Fibromyalgia notable studies]]
* [[Influenza vaccine]]

*[[Lady Gaga]]

==References==
<references />

[[Category:Diagnoses]]
[[Category:Comorbidities]]

Influenza

2018-08-25T17:53:57Z

77.111.246.7:x

'''Influenza''', commonly known as "'''the flu'''", is an infectious disease caused by an influenza virus. There are four types of influenza virus, types A and B (seasonal), C which is less frequent causing mild infections and not a public health threat, and D which primarily affect cattle and not known to infect or cause illness in people. Seasonal influenza is characterized by a sudden onset fever, a cough (usually dry), [[headache]], [[muscle pain]] and [[joint pain]], severe malaise (feeling unwell), [[sore throat]] and runny nose.<ref name=":0">{{Cite web|url=http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal)|title=Influenza (Seasonal)|website=World Health Organization|language=en-US|access-date=2018-08-25}}</ref>

A subtype of influenza A is [[H1N1]].

== Epidemiology ==
All age groups can be effected but there are groups that are at more risk than others.
* children under 59 months
* health care workers
* elderly
* pregnant women
* individuals with chronic medical conditions
** cardiac
** hematologic
** pulmonary
** renal
** liver
** [[metabolic]]
** neurodevelopment
* individuals with immunosuppressive conditions
** HIV/AIDS
** receiving chemotherapy or steroids
** malignancy<ref name=":0" />
Influenza spreads easily with rapid transmission in crowded areas such as schools and nursing homes. Sneezing and coughing spreads droplets containing [[Virus|viruses]] which can spread over three feet. Persons within range can become infected by breathing in these droplets. The virus also spreads by hands contaminated with influenza. From time of infection to illness is about 2 days but can be one to four days.<ref name=":0" />

== Learn more ==
* [https://blausen.com/en/video/influenza/ Influenza]<ref>{{Cite web|url=https://blausen.com/en/video/influenza/|title=Influenza|website=blausen.com|access-date=2018-08-25}}</ref> Video short
* [http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal) Influenza (Seasonal)]<ref name=":0" /> Fact Sheet
* [[wikipedia:Wikipedia|Wikipedia]]

== See also ==
* [[Influenza A virus subtype H1N1]]

* [[Influenza vaccine]]

* [[Vaccine]]

== References ==
<references />
[[Category:Infectious agents]]

Influenza

2018-08-25T17:44:34Z

77.111.246.7:internal links

'''Influenza''', commonly known as "'''the flu'''", is an infectious disease caused by an influenza virus. There are four types of influenza virus, types A and B (seasonal), C which is less frequent causing mild infections and not a public health threat, and D which primarily affect cattle and not known to infect or cause illness in people. Seasonal influenza is characterized by a sudden on fever, a cough (usually dry), [[headache]], [[muscle pain]] and [[joint pain]], severe malaise (feeling unwell), [[sore throat]] and runny nose.<ref name=":0">{{Cite web|url=http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal)|title=Influenza (Seasonal)|website=World Health Organization|language=en-US|access-date=2018-08-25}}</ref>

A subtype of influenza A is [[H1N1]].

== Epidemiology ==
All age groups can be effected but there are groups that are at more risk than others.
* children under 59 months
* health care workers
* elderly
* pregnant women
* individuals with chronic medical conditions
** cardiac
** hematologic
** pulmonary
** renal
** liver
** [[metabolic]]
** neurodevelopment
* individuals with immunosuppressive conditions
** HIV/AIDS
** receiving chemotherapy or steroids
** malignancy<ref name=":0" />
Influenza spreads easily with rapid transmission in crowded areas such as schools and nursing homes. Sneezing and coughing spreads droplets containing [[Virus|viruses]] which can spread over three feet. Persons within range can become infected by breathing in these droplets. The virus also spreads by hands contaminated with influenza. From time of infection to illness is about 2 days but can be one to four days.<ref name=":0" />

== Learn more ==
* [https://blausen.com/en/video/influenza/ Influenza]<ref>{{Cite web|url=https://blausen.com/en/video/influenza/|title=Influenza|website=blausen.com|access-date=2018-08-25}}</ref> Video short
* [http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal) Influenza (Seasonal)]<ref name=":0" /> Fact Sheet
* [[wikipedia:Wikipedia|Wikipedia]]

== See also ==
* [[Influenza A virus subtype H1N1]]

* [[Influenza vaccine]]

* [[Vaccine]]

== References ==
<references />
[[Category:Infectious agents]]

Dysphasia

2018-08-25T17:24:39Z

77.111.246.7:bold

[[Dysphasia]] is a partial or complete impairment of the ability to communicate resulting from brain injury. There are several types of dysphasia: Expressive (Broca's and Transcortical); Receptive (Wernicke's, Anomic, and Conduction); and Global.<ref name=":0">{{Cite web|url=https://www.encyclopedia.com/medicine/diseases-and-conditions/pathology/dysphasia|title=Dysphasia {{!}} Encyclopedia.com|last=Gale|first=Thomson|date=2006|website=www.encyclopedia.com|publisher=Gale Encyclopedia of Medicine, 3rd ed.|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref>

In order to distinguish [[Dysphagia|dyspha'''g'''ia]] (trouble with swallowing) and dyspha'''s'''ia (language disorder) the medical world often calls dyspha'''s'''ia by the name [[Aphasia]].<ref name=":1">{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-10}}</ref> However, while aphasia tends to "affect your ability to speak, write and understand language, both verbal and written",<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-10|language=en}}</ref> with Dysphasia you will have those symptoms and trouble listening and doing numeral calculations."<ref name=":1" />

==Dysphasia and ME/CFS==
Aphasia, dysphasia, and [[word-finding problems]] in general are reported symptoms of [[ME/CFS]] and [[fibromyalgia]]. However, neither ME/CFS or fibromyalgia patients have been researched for this language impairment.

==Presentation==
Dysphasia can affect comprehension (understanding spoken language), naming (identifying items with words), repetition (repeating words or phrases), and speech.<ref name=":2">{{Cite news|url=https://medical-dictionary.thefreedictionary.com/dysphasia|title=dysphasia|work=TheFreeDictionary.com|access-date=2018-08-10}}</ref>

==Prevalence==
"Approximately one million Americans currently suffer from one of the various forms of dysphasia, and an additional 80,000 new cases occur annually."<ref name=":2" />

==Presentation==
Sufferers can think clearly and understand their feelings. However, they will have difficulty in:
<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*Talking
*Understanding
*Listening
*Writing or doing [[Dyscalculia|numeral calculations]]
*Everyday tasks like shopping or answering the phone
*Comprehension
*Reading comprehension
*Language comprehension
*Abstractions (verbal)
*Semantic Meaning
*Hierarchical Classification Language
*Complex Grammatical Structure
*Word Problems in Math
*Verbal Association
*Language Delay
*Receptive and Expressive Language
*Language Output
*Meta-linguistic Function<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-10}}</ref>
</div>

==Symptom recognition==

==Notable studies==

==Possible causes==
Damage or trauma to the [[brain]], most commonly stroke, can cause dysphasia. Infection, direct trauma, transient ischemic attack (TIA), brain tumors, and degeneration can also instigate its onset which will quickly manifest itself after damage to the brain. "Expressive dysphasias can be accompanied by noticeable motor impairment."<ref name=":2" />

29 causes of Dysphasia:
<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*[[Alzheimer's]] disease
*Bell's palsy
*Brain abscess
*Brain failure
*Brain tumour
*Cerebral tumours
*Cerebrovascular accident
*Creutzfeldt-Jakob disease
*Dialysis encephalopathy syndrome
*[[Encephalitis]] head trauma
*Food Additive Adverse reaction - chocolate
*Food Additive Adverse reaction - sulphite a
*Gerstmann-Badal syndrome
*Gonionemus poisoning
*Hallervorden-Spatz disease
*Hallervorden-Spatz Syndrome
*Hemiplegic migraine, familial type 1
*Hemiplegic migraine, familial type 2
*[[Herpes simplex]] encephalitis
*Intracranial space-occupying lesion
*Landau-Kleffner syndrome
*Neurosyphilis - dysphasia
*Neurosyphilis - meningovascular
*Pantothenate kinase-associated neurodegeneration
*Progressive Multifocal Leukoencephalopathy
*[[Seizure]] disorder
*Stroke
*Stroke affecting Broca's and Wernicke's area
*[[Transient ischemic attack]]<ref>{{Cite web|url=http://www.rightdiagnosis.com/symptoms/dysphasia/causes.htm|title=Causes of Dysphasia - RightDiagnosis.com|website=www.rightdiagnosis.com|access-date=2018-08-10}}</ref> (TIA)
</div>

==Potential treatments==
Treating and stabilizing the injury underlying the development of the patient's dysphasia must take place immediately. When damage is caused by TIA a full recovery can happen within a few days. However, most dysphasias can take months or years to recover from and even after prolonged therapy, many patients never achieve a full recovery. Treatment depends on speech therapies by a trained speech therapist.<ref name=":0" /> Patients can also use techniques such as talking slowly and repeating things, using gestures and drawings, and avoiding noisy areas can all help in dealing with dysphasia. "Dysphasic people need a lot of emotional support."<ref name=":1" />

==Learn more==
*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Do Fibromyalgia and Chronic Fatigue Syndrome Cause Language Problems?|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-10|archive-url=|archive-date=|dead-url=}}</ref>

==See also==
*[[Aphasia]]
*[[Cognitive dysfunction]]
*[[Dyscalculia]]
*[[Memory problems]]
*[[Word-finding problems]]

=References=
<references />

[[Category:Signs and symptoms]]
[[Category:Cognitive signs and symptoms]]
[[Category:Language disorders]]

Aphasia

2018-08-25T17:23:59Z

77.111.246.7:lower case and bolding

[[File:Types_of_Aphasia.png|600px|thumb|right|Source: National Aphasia Association]]
[[Aphasia]] is a communication disorder. It results from damage or injury to language parts of the brain. It affects the ability to speak, read, or write. It is more common among older adults, in particular, and those who have suffered a stroke. Head trauma, brain tumors, or infections can also impact these same language parts of the brain.

The Types of aphasia are Global aphasia;<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/global-aphasia/|title=Global Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref> Broca's aphasia ('non-fluent aphasia');<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/brocas-aphasia/|title=Broca's (Expressive) Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref> Mixed non-fluent aphasia;<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/mixed-non-fluent-aphasia/|title=Mixed Non-fluent Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref>Wernicke's aphasia ('fluent aphasia');<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/wernickes-aphasia/|title=Wernicke's (Receptive) Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref> Anomic aphasia;<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/anomic-aphasia/|title=Anomic Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref> Primary Progressive Aphasia;<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/primary-progressive-aphasia/|title=Primary Progressive Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref> and other varieties that "do not exactly fit into these categories."<ref name=":0">{{Cite news|url=https://www.aphasia.org/aphasia-definitions/|title=Aphasia Definitions - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref>

In order to distinguish [[Dysphagia|dyspha'''g'''ia]] (trouble with swallowing) and [[Dysphasia|dyspha'''s'''ia]] (language disorder), the medical world often calls dyspha'''s'''ia by the name aphasia.<ref name=":1">{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-10}}</ref> However, while aphasia tends to "affect your ability to speak, write and understand language, both verbal and written",<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-10|language=en}}</ref> with dysphasia you will have those symptoms and trouble listening and doing numeral calculations.<ref name=":1" />

==Aphasia and ME/CFS==
Aphasia and dysphasia symptoms, and [[word-finding problems]] in general are patient reported comorbidities of [[ME/CFS]] and [[fibromyalgia]]. However, neither ME/CFS or fibromyalgia has any research for these language impairments.

==Presentation==
Communication can be nearly impossible or very mild. The ability to retrieve names or objects, to put words together into sentences, or to read can all be affected. "More commonly, however, multiple aspects of communication are impaired, while some channels remain accessible for a limited exchange of information."<ref name=":0" />

==Prevalence==
Approximately 1 million people, 1 in 250 in the United States in 2015, are living with Aphasia. There are 180,000 new cases annually. There are no significant differences in incidence in men and women. However, there may be differences by type and severity of aphasia as "Wernicke’s aphasia and global aphasia occur more commonly in women, and Broca's aphasia occurs more commonly in men."<ref name=":2">{{Cite web|url=https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934663&section=Incidence_and_Prevalence|title=Aphasia: Incidence & Prevalence|website=American Speech-Language-Hearing Association|language=en|access-date=2018-08-10}}</ref> Fifteen percent under the age of 65 experience aphasia after their first ischemic stroke but 43% for individuals age 85 and older.<ref name=":2" />

==Presentation==
The main symptoms of aphasia include

*Trouble speaking
*Struggling with finding the appropriate term or word.
*Using strange or inappropriate words in a conversation.<ref name=":3">{{Cite news|url=https://www.webmd.com/brain/aphasia-causes-symptoms-types-treatments#2-4|title=An Overview of Aphasia|work=WebMD|access-date=2018-08-10|language=en-US}}</ref>

It can also present when a patient has trouble understanding what others are saying, particularly when the person is tired or in a crowded or loud environment. Although thinking skills are not affected, the patient may have problems understanding written material and have difficulties with handwriting. Using numbers and doing simple calculations can also be a problem.<ref name=":3" />

==Symptom recognition==
[[File:Broca Wernicke.JPG|200px|thumb|right|Cortex]]
[[The Hummingbirds' Foundation for ME]] recognizes the patient reported symptoms of aphasia, Broca's due to "a complete inability to express language" and Wernicke's due to having "difficulty or an inability to understand speech" as part of their list of cognitive and neurological dysfunctions. <ref>[http://www.hfme.org/themesymptomlist.htm Overview: Cognitive signs and symptoms - What is M.E.? What are the main M.E. symptoms? - The Hummingbird Foundation]</ref> They also note [[word-finding difficulties]] under cognitive signs and symptoms.<ref>[http://www.hfme.org/mesymptoms.htm Cognitive signs and symptoms - M.E. symptoms - The Hummingbird Foundation]</ref>

The [[Canadian Consensus Criteria]] lists difficulties with "[[Word-finding problems|word retrieval]]" under ''Neurological/Cognitive Manifestations'' as an optional symptom.

==Notable studies==

==Possible causes==
Some possible causes are:

*[[brain]] injury and stroke are usually the cause of aphasia.
*brain tumors
*brain infection
*dementia such as Alzheimer's
*epilepsy or other [[neurological]] disorder.<ref name=":3" />

Other causes:

*degenerative process
*[[memory problems]] or [[confusion]]<ref name=":4">{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/aphasia/symptoms-causes/syc-20369518|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-10|language=en}}</ref>

Temporary episodes can occur due to:

*[[migraine]]<nowiki/>s
*[[seizure]]<nowiki/>s
*transient ischemic attack (TIA)<ref name=":4" />

==Potential treatments==
Speech and language rehabilitation is usually a relatively slow process and although progress can be significant, "few people regain full pre-injury communication levels."<ref name=":4" />

It is important the therapy start early. Groups settings let patients try out their communication skills. Conversations, speaking in turn, clarifying misunderstandings, and fixing conversations are practiced in a safe setting.<ref name=":4" />

Currently, there are no medications to treat Aphasia but there are some studies looking into their use.

==Learn more==
*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Do Fibromyalgia and Chronic Fatigue Syndrome Cause Language Problems?|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-10|archive-url=|archive-date=|dead-url=}}</ref>
*[https://en.wikipedia.org/wiki/Aphasia Wikipedia]

==See also==
*[[Cognitive dysfunction]]
*[[Dyscalculia]]
*[[Dysphasia]]
*[[Memory problems]]
*[[Word-finding problems]]

==References==
<references />

[[Category:Signs and symptoms]]
[[Category:Cognitive signs and symptoms]]
[[Category:Language disorders]]

Dysphasia

2018-08-25T17:09:46Z

77.111.246.7:/* Dysphasia and ME/CFS */ wording

[[Dysphasia]] is a partial or complete impairment of the ability to communicate resulting from brain injury. There are several types of dysphasia: Expressive (Broca's and Transcortical); Receptive (Wernicke's, Anomic, and Conduction); and Global.<ref name=":0">{{Cite web|url=https://www.encyclopedia.com/medicine/diseases-and-conditions/pathology/dysphasia|title=Dysphasia {{!}} Encyclopedia.com|last=Gale|first=Thomson|date=2006|website=www.encyclopedia.com|publisher=Gale Encyclopedia of Medicine, 3rd ed.|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref>

In order to distinguish [[Dysphagia|dyspha'''g'''ia]] (trouble with swallowing) and dyspha'''s'''ia (language disorder) the medical world often calls dysphasia by the name [[Aphasia]].<ref name=":1">{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-10}}</ref> However, while aphasia tends to "affect your ability to speak, write and understand language, both verbal and written",<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-10|language=en}}</ref> with Dysphasia you will have those symptoms and trouble listening and doing numeral calculations."<ref name=":1" />

==Dysphasia and ME/CFS==
Aphasia, dysphasia, and [[word-finding problems]] in general are reported symptoms of [[ME/CFS]] and [[fibromyalgia]]. However, neither ME/CFS or fibromyalgia patients have been researched for this language impairment.

==Presentation==
Dysphasia can affect comprehension (understanding spoken language), naming (identifying items with words), repetition (repeating words or phrases), and speech.<ref name=":2">{{Cite news|url=https://medical-dictionary.thefreedictionary.com/dysphasia|title=dysphasia|work=TheFreeDictionary.com|access-date=2018-08-10}}</ref>

==Prevalence==
"Approximately one million Americans currently suffer from one of the various forms of dysphasia, and an additional 80,000 new cases occur annually."<ref name=":2" />

==Presentation==
Sufferers can think clearly and understand their feelings. However, they will have difficulty in:
<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*Talking
*Understanding
*Listening
*Writing or doing [[Dyscalculia|numeral calculations]]
*Everyday tasks like shopping or answering the phone
*Comprehension
*Reading comprehension
*Language comprehension
*Abstractions (verbal)
*Semantic Meaning
*Hierarchical Classification Language
*Complex Grammatical Structure
*Word Problems in Math
*Verbal Association
*Language Delay
*Receptive and Expressive Language
*Language Output
*Meta-linguistic Function<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-10}}</ref>
</div>

==Symptom recognition==

==Notable studies==

==Possible causes==
Damage or trauma to the [[brain]], most commonly stroke, can cause dysphasia. Infection, direct trauma, transient ischemic attack (TIA), brain tumors, and degeneration can also instigate its onset which will quickly manifest itself after damage to the brain. "Expressive dysphasias can be accompanied by noticeable motor impairment."<ref name=":2" />

29 causes of Dysphasia:
<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*[[Alzheimer's]] disease
*Bell's palsy
*Brain abscess
*Brain failure
*Brain tumour
*Cerebral tumours
*Cerebrovascular accident
*Creutzfeldt-Jakob disease
*Dialysis encephalopathy syndrome
*[[Encephalitis]] head trauma
*Food Additive Adverse reaction - chocolate
*Food Additive Adverse reaction - sulphite a
*Gerstmann-Badal syndrome
*Gonionemus poisoning
*Hallervorden-Spatz disease
*Hallervorden-Spatz Syndrome
*Hemiplegic migraine, familial type 1
*Hemiplegic migraine, familial type 2
*[[Herpes simplex]] encephalitis
*Intracranial space-occupying lesion
*Landau-Kleffner syndrome
*Neurosyphilis - dysphasia
*Neurosyphilis - meningovascular
*Pantothenate kinase-associated neurodegeneration
*Progressive Multifocal Leukoencephalopathy
*[[Seizure]] disorder
*Stroke
*Stroke affecting Broca's and Wernicke's area
*[[Transient ischemic attack]]<ref>{{Cite web|url=http://www.rightdiagnosis.com/symptoms/dysphasia/causes.htm|title=Causes of Dysphasia - RightDiagnosis.com|website=www.rightdiagnosis.com|access-date=2018-08-10}}</ref> (TIA)
</div>

==Potential treatments==
Treating and stabilizing the injury underlying the development of the patient's dysphasia must take place immediately. When damage is caused by TIA a full recovery can happen within a few days. However, most dysphasias can take months or years to recover from and even after prolonged therapy, many patients never achieve a full recovery. Treatment depends on speech therapies by a trained speech therapist.<ref name=":0" /> Patients can also use techniques such as talking slowly and repeating things, using gestures and drawings, and avoiding noisy areas can all help in dealing with dysphasia. "Dysphasic people need a lot of emotional support."<ref name=":1" />

==Learn more==
*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Do Fibromyalgia and Chronic Fatigue Syndrome Cause Language Problems?|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-10|archive-url=|archive-date=|dead-url=}}</ref>

==See also==
*[[Aphasia]]
*[[Cognitive dysfunction]]
*[[Dyscalculia]]
*[[Memory problems]]
*[[Word-finding problems]]

=References=
<references />

[[Category:Signs and symptoms]]
[[Category:Cognitive signs and symptoms]]
[[Category:Language disorders]]

Dysphasia

2018-08-25T17:05:38Z

77.111.246.7:/* Possible causes */ x

[[Dysphasia]] is a partial or complete impairment of the ability to communicate resulting from brain injury. There are several types of dysphasia: Expressive (Broca's and Transcortical); Receptive (Wernicke's, Anomic, and Conduction); and Global.<ref name=":0">{{Cite web|url=https://www.encyclopedia.com/medicine/diseases-and-conditions/pathology/dysphasia|title=Dysphasia {{!}} Encyclopedia.com|last=Gale|first=Thomson|date=2006|website=www.encyclopedia.com|publisher=Gale Encyclopedia of Medicine, 3rd ed.|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref>

In order to distinguish [[Dysphagia|dyspha'''g'''ia]] (trouble with swallowing) and dyspha'''s'''ia (language disorder) the medical world often calls dysphasia by the name [[Aphasia]].<ref name=":1">{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-10}}</ref> However, while aphasia tends to "affect your ability to speak, write and understand language, both verbal and written",<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-10|language=en}}</ref> with Dysphasia you will have those symptoms and trouble listening and doing numeral calculations."<ref name=":1" />

==Dysphasia and ME/CFS==
Aphasia, dysphasia, and [[word-finding problems]] in general are also comorbidities of [[ME/CFS]] and [[fibromyalgia]]. However, neither ME/CFS or fibromyalgia patients have been researched for this language impairment.

==Presentation==
Dysphasia can affect comprehension (understanding spoken language), naming (identifying items with words), repetition (repeating words or phrases), and speech.<ref name=":2">{{Cite news|url=https://medical-dictionary.thefreedictionary.com/dysphasia|title=dysphasia|work=TheFreeDictionary.com|access-date=2018-08-10}}</ref>

==Prevalence==
"Approximately one million Americans currently suffer from one of the various forms of dysphasia, and an additional 80,000 new cases occur annually."<ref name=":2" />

==Presentation==
Sufferers can think clearly and understand their feelings. However, they will have difficulty in:
<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*Talking
*Understanding
*Listening
*Writing or doing [[Dyscalculia|numeral calculations]]
*Everyday tasks like shopping or answering the phone
*Comprehension
*Reading comprehension
*Language comprehension
*Abstractions (verbal)
*Semantic Meaning
*Hierarchical Classification Language
*Complex Grammatical Structure
*Word Problems in Math
*Verbal Association
*Language Delay
*Receptive and Expressive Language
*Language Output
*Meta-linguistic Function<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-10}}</ref>
</div>

==Symptom recognition==

==Notable studies==

==Possible causes==
Damage or trauma to the [[brain]], most commonly stroke, can cause dysphasia. Infection, direct trauma, transient ischemic attack (TIA), brain tumors, and degeneration can also instigate its onset which will quickly manifest itself after damage to the brain. "Expressive dysphasias can be accompanied by noticeable motor impairment."<ref name=":2" />

29 causes of Dysphasia:
<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*[[Alzheimer's]] disease
*Bell's palsy
*Brain abscess
*Brain failure
*Brain tumour
*Cerebral tumours
*Cerebrovascular accident
*Creutzfeldt-Jakob disease
*Dialysis encephalopathy syndrome
*[[Encephalitis]] head trauma
*Food Additive Adverse reaction - chocolate
*Food Additive Adverse reaction - sulphite a
*Gerstmann-Badal syndrome
*Gonionemus poisoning
*Hallervorden-Spatz disease
*Hallervorden-Spatz Syndrome
*Hemiplegic migraine, familial type 1
*Hemiplegic migraine, familial type 2
*[[Herpes simplex]] encephalitis
*Intracranial space-occupying lesion
*Landau-Kleffner syndrome
*Neurosyphilis - dysphasia
*Neurosyphilis - meningovascular
*Pantothenate kinase-associated neurodegeneration
*Progressive Multifocal Leukoencephalopathy
*[[Seizure]] disorder
*Stroke
*Stroke affecting Broca's and Wernicke's area
*[[Transient ischemic attack]]<ref>{{Cite web|url=http://www.rightdiagnosis.com/symptoms/dysphasia/causes.htm|title=Causes of Dysphasia - RightDiagnosis.com|website=www.rightdiagnosis.com|access-date=2018-08-10}}</ref> (TIA)
</div>

==Potential treatments==
Treating and stabilizing the injury underlying the development of the patient's dysphasia must take place immediately. When damage is caused by TIA a full recovery can happen within a few days. However, most dysphasias can take months or years to recover from and even after prolonged therapy, many patients never achieve a full recovery. Treatment depends on speech therapies by a trained speech therapist.<ref name=":0" /> Patients can also use techniques such as talking slowly and repeating things, using gestures and drawings, and avoiding noisy areas can all help in dealing with dysphasia. "Dysphasic people need a lot of emotional support."<ref name=":1" />

==Learn more==
*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Do Fibromyalgia and Chronic Fatigue Syndrome Cause Language Problems?|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-10|archive-url=|archive-date=|dead-url=}}</ref>

==See also==
*[[Aphasia]]
*[[Cognitive dysfunction]]
*[[Dyscalculia]]
*[[Memory problems]]
*[[Word-finding problems]]

=References=
<references />

[[Category:Signs and symptoms]]
[[Category:Cognitive signs and symptoms]]
[[Category:Language disorders]]

Dysphasia

2018-08-25T17:04:37Z

77.111.246.7:lowercase

[[Dysphasia]] is a partial or complete impairment of the ability to communicate resulting from brain injury. There are several types of dysphasia: Expressive (Broca's and Transcortical); Receptive (Wernicke's, Anomic, and Conduction); and Global.<ref name=":0">{{Cite web|url=https://www.encyclopedia.com/medicine/diseases-and-conditions/pathology/dysphasia|title=Dysphasia {{!}} Encyclopedia.com|last=Gale|first=Thomson|date=2006|website=www.encyclopedia.com|publisher=Gale Encyclopedia of Medicine, 3rd ed.|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref>

In order to distinguish [[Dysphagia|dyspha'''g'''ia]] (trouble with swallowing) and dyspha'''s'''ia (language disorder) the medical world often calls dysphasia by the name [[Aphasia]].<ref name=":1">{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-10}}</ref> However, while aphasia tends to "affect your ability to speak, write and understand language, both verbal and written",<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-10|language=en}}</ref> with Dysphasia you will have those symptoms and trouble listening and doing numeral calculations."<ref name=":1" />

==Dysphasia and ME/CFS==
Aphasia, dysphasia, and [[word-finding problems]] in general are also comorbidities of [[ME/CFS]] and [[fibromyalgia]]. However, neither ME/CFS or fibromyalgia patients have been researched for this language impairment.

==Presentation==
Dysphasia can affect comprehension (understanding spoken language), naming (identifying items with words), repetition (repeating words or phrases), and speech.<ref name=":2">{{Cite news|url=https://medical-dictionary.thefreedictionary.com/dysphasia|title=dysphasia|work=TheFreeDictionary.com|access-date=2018-08-10}}</ref>

==Prevalence==
"Approximately one million Americans currently suffer from one of the various forms of dysphasia, and an additional 80,000 new cases occur annually."<ref name=":2" />

==Presentation==
Sufferers can think clearly and understand their feelings. However, they will have difficulty in:
<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*Talking
*Understanding
*Listening
*Writing or doing [[Dyscalculia|numeral calculations]]
*Everyday tasks like shopping or answering the phone
*Comprehension
*Reading comprehension
*Language comprehension
*Abstractions (verbal)
*Semantic Meaning
*Hierarchical Classification Language
*Complex Grammatical Structure
*Word Problems in Math
*Verbal Association
*Language Delay
*Receptive and Expressive Language
*Language Output
*Meta-linguistic Function<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-10}}</ref>
</div>

==Symptom recognition==

==Notable studies==

==Possible causes==
Damage or trauma to the brain, most commonly stroke, can cause dysphasia. Infection, direct trauma, transient ischemic attack (TIA), [[brain]] tumors, and degeneration can also instigate its onset which will quickly manifest itself after damage to the brain. "Expressive dysphasias can be accompanied by noticeable motor impairment."<ref name=":2" />

29 causes of Dysphasia:
<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*[[Alzheimer's]] disease
*Bell's palsy
*Brain abscess
*Brain failure
*Brain tumour
*Cerebral tumours
*Cerebrovascular accident
*Creutzfeldt-Jakob disease
*Dialysis encephalopathy syndrome
*[[Encephalitis]] head trauma
*Food Additive Adverse reaction - chocolate
*Food Additive Adverse reaction - sulphite a
*Gerstmann-Badal syndrome
*Gonionemus poisoning
*Hallervorden-Spatz disease
*Hallervorden-Spatz Syndrome
*Hemiplegic migraine, familial type 1
*Hemiplegic migraine, familial type 2
*[[Herpes simplex]] encephalitis
*Intracranial space-occupying lesion
*Landau-Kleffner syndrome
*Neurosyphilis - dysphasia
*Neurosyphilis - meningovascular
*Pantothenate kinase-associated neurodegeneration
*Progressive Multifocal Leukoencephalopathy
*[[Seizure]] disorder
*Stroke
*Stroke affecting Broca's and Wernicke's area
*[[Transient ischemic attack]]<ref>{{Cite web|url=http://www.rightdiagnosis.com/symptoms/dysphasia/causes.htm|title=Causes of Dysphasia - RightDiagnosis.com|website=www.rightdiagnosis.com|access-date=2018-08-10}}</ref> (TIA)
</div>

==Potential treatments==
Treating and stabilizing the injury underlying the development of the patient's dysphasia must take place immediately. When damage is caused by TIA a full recovery can happen within a few days. However, most dysphasias can take months or years to recover from and even after prolonged therapy, many patients never achieve a full recovery. Treatment depends on speech therapies by a trained speech therapist.<ref name=":0" /> Patients can also use techniques such as talking slowly and repeating things, using gestures and drawings, and avoiding noisy areas can all help in dealing with dysphasia. "Dysphasic people need a lot of emotional support."<ref name=":1" />

==Learn more==
*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Do Fibromyalgia and Chronic Fatigue Syndrome Cause Language Problems?|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-10|archive-url=|archive-date=|dead-url=}}</ref>

==See also==
*[[Aphasia]]
*[[Cognitive dysfunction]]
*[[Dyscalculia]]
*[[Memory problems]]
*[[Word-finding problems]]

=References=
<references />

[[Category:Signs and symptoms]]
[[Category:Cognitive signs and symptoms]]
[[Category:Language disorders]]

Aphasia

2018-08-25T15:55:50Z

77.111.246.7:/* Symptom recognition */ CCC

[[File:Types_of_Aphasia.png|600px|thumb|right|Source: National Aphasia Association]]
[[Aphasia]] is a communication disorder. It results from damage or injury to language parts of the brain. It affects the ability to speak, read, or write. It is more common among older adults, in particular, and those who have suffered a stroke. Head trauma, brain tumors, or infections can also impact these same language parts of the brain.

The Types of Aphasia are Global aphasia;<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/global-aphasia/|title=Global Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref> Broca's aphasia ('non-fluent aphasia');<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/brocas-aphasia/|title=Broca's (Expressive) Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref> Mixed non-fluent aphasia;<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/mixed-non-fluent-aphasia/|title=Mixed Non-fluent Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref>Wernicke's aphasia ('fluent aphasia');<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/wernickes-aphasia/|title=Wernicke's (Receptive) Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref> Anomic aphasia;<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/anomic-aphasia/|title=Anomic Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref> Primary Progressive Aphasia;<ref>{{Cite news|url=https://www.aphasia.org/aphasia-resources/primary-progressive-aphasia/|title=Primary Progressive Aphasia - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref> and other varieties that "do not exactly fit into these categories."<ref name=":0">{{Cite news|url=https://www.aphasia.org/aphasia-definitions/|title=Aphasia Definitions - National Aphasia Association|work=National Aphasia Association|access-date=2018-08-10|language=en-US}}</ref>

In order to distinguish [[Dysphagia]] (trouble with swallowing) and [[Dysphasia]] (language disorder), the medical world often calls Dysphasia by the name Aphasia.<ref name=":1">{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-10}}</ref> However, while Aphasia tends to "affect your ability to speak, write and understand language, both verbal and written",<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-10|language=en}}</ref> with Dysphasia you will have those symptoms and trouble listening and doing numeral calculations.<ref name=":1" />

==Aphasia and ME/CFS==
Aphasia and dysphasia symptoms, and [[word-finding problems]] in general are patient reported comorbidities of [[ME/CFS]] and [[Fibromyalgia]]. However, neither ME/CFS or Fibromyalgia has any research for these language impairments.

==Presentation==
Communication can be nearly impossible or very mild. The ability to retrieve names or objects, to put words together into sentences, or to read can all be affected. "More commonly, however, multiple aspects of communication are impaired, while some channels remain accessible for a limited exchange of information."<ref name=":0" />

==Prevalence==
Approximately 1 million people, 1 in 250 in the United States in 2015, are living with Aphasia. There are 180,000 new cases annually. There are no significant differences in incidence in men and women. However, there may be differences by type and severity of aphasia as "Wernicke’s aphasia and global aphasia occur more commonly in women, and Broca's aphasia occurs more commonly in men."<ref name=":2">{{Cite web|url=https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934663&section=Incidence_and_Prevalence|title=Aphasia: Incidence & Prevalence|website=American Speech-Language-Hearing Association|language=en|access-date=2018-08-10}}</ref> Fifteen percent under the age of 65 experience aphasia after their first ischemic stroke but 43% for individuals age 85 and older.<ref name=":2" />

==Presentation==
The main symptoms of aphasia include

*Trouble speaking
*Struggling with finding the appropriate term or word.
*Using strange or inappropriate words in a conversation.<ref name=":3">{{Cite news|url=https://www.webmd.com/brain/aphasia-causes-symptoms-types-treatments#2-4|title=An Overview of Aphasia|work=WebMD|access-date=2018-08-10|language=en-US}}</ref>

It can also present when a patient has trouble understanding what others are saying, particularly when the person is tired or in a crowded or loud environment. Although thinking skills are not affected, the patient may have problems understanding written material and have difficulties with handwriting. Using numbers and doing simple calculations can also be a problem.<ref name=":3" />

==Symptom recognition==
[[File:Broca Wernicke.JPG|200px|thumb|right|Cortex]]
[[The Hummingbirds' Foundation for ME]] recognizes the patient reported symptoms of aphasia, Broca's due to "a complete inability to express language" and Wernicke's due to having "difficulty or an inability to understand speech" as part of their list of cognitive and neurological dysfunctions. <ref>[http://www.hfme.org/themesymptomlist.htm Overview: Cognitive signs and symptoms - What is M.E.? What are the main M.E. symptoms? - The Hummingbird Foundation]</ref> They also note [[word-finding difficulties]] under cognitive signs and symptoms.<ref>[http://www.hfme.org/mesymptoms.htm Cognitive signs and symptoms - M.E. symptoms - The Hummingbird Foundation]</ref>

The [[Canadian Consensus Criteria]] lists difficulties with "word retrieval" under "Neurological/Cognitive Manifestations" as an optional symptom.

==Notable studies==

==Possible causes==
Some possible causes are:

*Brain injury and stroke are usually the cause of aphasia.
*Brain tumors
*Brain infection
*Dementia such as Alzheimer's
*Epilepsy or other neurological disorder.<ref name=":3" />

Other causes:

*Degenerative process
*Memory problems or confusion<ref name=":4">{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/aphasia/symptoms-causes/syc-20369518|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-10|language=en}}</ref>

Temporary episodes can occur due to:

*Migraines
*Seizures
*Transient ischemic attack (TIA)<ref name=":4" />

==Potential treatments==
Speech and language rehabilitation is usually a relatively slow process and although progress can be significant, "few people regain full pre-injury communication levels."<ref name=":4" />

It is important the therapy start early. Groups settings let patients try out their communication skills. Conversations, speaking in turn, clarifying misunderstandings, and fixing conversations are practiced in a safe setting.<ref name=":4" />

Currently, there are no medications to treat Aphasia but there are some studies looking into their use.

==Learn more==
*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Do Fibromyalgia and Chronic Fatigue Syndrome Cause Language Problems?|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-10|archive-url=|archive-date=|dead-url=}}</ref>
*[https://en.wikipedia.org/wiki/Aphasia Wikipedia]

==See also==
*[[Cognitive dysfunction]]
*[[Dyscalculia]]
*[[Dysphasia]]
*[[Memory problems]]
*[[Word-finding problems]]

==References==
<references />

[[Category:Signs and symptoms]]
[[Category:Cognitive signs and symptoms]]
[[Category:Language disorders]]

Influenza

2018-08-25T15:41:55Z

77.111.246.7:removed stub

'''Influenza''', commonly known as "'''the flu'''", is an infectious disease caused by an influenza virus. There are four types of influenza virus, types A and B (seasonal), C which is less frequent causing mild infections and not a public health threat, and D which primarily affect cattle and not known to infect or cause illness in people. Seasonal influenza is characterized by a sudden on fever, a cough (usually dry), headache, muscle pain and joint pain, severe malaise (feeling unwell), sore throat and runny nose.<ref name=":0">{{Cite web|url=http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal)|title=Influenza (Seasonal)|website=World Health Organization|language=en-US|access-date=2018-08-25}}</ref>

A subtype of influenza A is [[H1N1]].

== Epidemiology ==
All age groups can be effected but there are groups that are at more risk than others.
* children under 59 months
* health care workers
* elderly
* pregnant women
* individuals with chronic medical conditions
** cardiac
** hematologic
** pulmonary
** renal
** liver
** metabolic
** neurodevelopment
* individuals with immunosuppressive conditions
** HIV/AIDS
** receiving chemotherapy or steroids
** malignancy<ref name=":0" />
Influenza spreads easily with rapid transmission in crowded areas such as schools and nursing homes. Sneezing and coughing spreads droplets containing viruses which can spread over three feet. Persons within range can become infected by breathing in these droplets. The virus also spreads by hands contaminated with influenza. From time of infection to illness is about 2 days but can be one to four days.<ref name=":0" />

== Learn more ==
* [https://blausen.com/en/video/influenza/ Influenza]<ref>{{Cite web|url=https://blausen.com/en/video/influenza/|title=Influenza|website=blausen.com|access-date=2018-08-25}}</ref> Video short
* [http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal) Influenza (Seasonal)]<ref name=":0" /> Fact Sheet
* [[wikipedia:Wikipedia|Wikipedia]]

== See also ==
* [[Influenza A virus subtype H1N1]]

* [[Influenza vaccine]]

* [[Vaccine]]

== References ==
<references />
[[Category:Infectious agents]]

Influenza

2018-08-25T15:40:40Z

77.111.246.7:/* Learn more */ organize

'''Influenza''', commonly known as "'''the flu'''", is an infectious disease caused by an influenza virus. There are four types of influenza virus, types A and B (seasonal), C which is less frequent causing mild infections and not a public health threat, and D which primarily affect cattle and not known to infect or cause illness in people. Seasonal influenza is characterized by a sudden on fever, a cough (usually dry), headache, muscle pain and joint pain, severe malaise (feeling unwell), sore throat and runny nose.<ref name=":0">{{Cite web|url=http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal)|title=Influenza (Seasonal)|website=World Health Organization|language=en-US|access-date=2018-08-25}}</ref>

A subtype of influenza A is [[H1N1]].{{Stub}}

[[Category:Infectious agents]]

== Epidemiology ==
All age groups can be effected but there are groups that are at more risk than others.
* children under 59 months
* health care workers
* elderly
* pregnant women
* individuals with chronic medical conditions
** cardiac
** hematologic
** pulmonary
** renal
** liver
** metabolic
** neurodevelopment
* individuals with immunosuppressive conditions
** HIV/AIDS
** receiving chemotherapy or steroids
** malignancy<ref name=":0" />
Influenza spreads easily with rapid transmission in crowded areas such as schools and nursing homes. Sneezing and coughing spreads droplets containing viruses which can spread over three feet. Persons within range can become infected by breathing in these droplets. The virus also spreads by hands contaminated with influenza. From time of infection to illness is about 2 days but can be one to four days.<ref name=":0" />

== Learn more ==
* [https://blausen.com/en/video/influenza/ Influenza]<ref>{{Cite web|url=https://blausen.com/en/video/influenza/|title=Influenza|website=blausen.com|access-date=2018-08-25}}</ref> Video short
* [http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal) Influenza (Seasonal)]<ref name=":0" /> Fact Sheet
* [[wikipedia:Wikipedia|Wikipedia]]

== See also ==
* [[Influenza A virus subtype H1N1]]

* [[Influenza vaccine]]

* [[Vaccine]]

== References ==
<references />

Influenza

2018-08-25T15:37:19Z

77.111.246.7:/* Learn more */ citation

'''Influenza''', commonly known as "'''the flu'''", is an infectious disease caused by an influenza virus. There are four types of influenza virus, types A and B (seasonal), C which is less frequent causing mild infections and not a public health threat, and D which primarily affect cattle and not known to infect or cause illness in people. Seasonal influenza is characterized by a sudden on fever, a cough (usually dry), headache, muscle pain and joint pain, severe malaise (feeling unwell), sore throat and runny nose.<ref name=":0">{{Cite web|url=http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal)|title=Influenza (Seasonal)|website=World Health Organization|language=en-US|access-date=2018-08-25}}</ref>

A subtype of influenza A is [[H1N1]].{{Stub}}

[[Category:Infectious agents]]

== Epidemiology ==
All age groups can be effected but there are groups that are at more risk than others.
* children under 59 months
* health care workers
* elderly
* pregnant women
* individuals with chronic medical conditions
** cardiac
** hematologic
** pulmonary
** renal
** liver
** metabolic
** neurodevelopment
* individuals with immunosuppressive conditions
** HIV/AIDS
** receiving chemotherapy or steroids
** malignancy<ref name=":0" />
Influenza spreads easily with rapid transmission in crowded areas such as schools and nursing homes. Sneezing and coughing spreads droplets containing viruses which can spread over three feet. Persons within range can become infected by breathing in these droplets. The virus also spreads by hands contaminated with influenza. From time of infection to illness is about 2 days but can be one to four days.<ref name=":0" />

== Learn more ==
* [https://blausen.com/en/video/influenza/ Influenza]<ref>{{Cite web|url=https://blausen.com/en/video/influenza/|title=Influenza|website=blausen.com|access-date=2018-08-25}}</ref> Video short
* [[Influenza A virus subtype H1N1]]
* [http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal) Influenza (Seasonal)]<ref name=":0" /> Fact Sheet
* [[Influenza vaccine]]
* [[wikipedia:Wikipedia|Wikipedia]]

== See also ==
* [[Vaccine]]

== References ==
<references />

Influenza

2018-08-25T15:34:39Z

77.111.246.7:x

'''Influenza''', commonly known as "'''the flu'''", is an infectious disease caused by an influenza virus. There are four types of influenza virus, types A and B (seasonal), C which is less frequent causing mild infections and not a public health threat, and D which primarily affect cattle and not known to infect or cause illness in people. Seasonal influenza is characterized by a sudden on fever, a cough (usually dry), headache, muscle pain and joint pain, severe malaise (feeling unwell), sore throat and runny nose.<ref name=":0">{{Cite web|url=http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal)|title=Influenza (Seasonal)|website=World Health Organization|language=en-US|access-date=2018-08-25}}</ref>

A subtype of influenza A is [[H1N1]].{{Stub}}

[[Category:Infectious agents]]

== Epidemiology ==
All age groups can be effected but there are groups that are at more risk than others.
* children under 59 months
* health care workers
* elderly
* pregnant women
* individuals with chronic medical conditions
** cardiac
** hematologic
** pulmonary
** renal
** liver
** metabolic
** neurodevelopment
* individuals with immunosuppressive conditions
** HIV/AIDS
** receiving chemotherapy or steroids
** malignancy<ref name=":0" />
Influenza spreads easily with rapid transmission in crowded areas such as schools and nursing homes. Sneezing and coughing spreads droplets containing viruses which can spread over three feet. Persons within range can become infected by breathing in these droplets. The virus also spreads by hands contaminated with influenza. From time of infection to illness is about 2 days but can be one to four days.<ref name=":0" />

== Learn more ==
* [https://blausen.com/en/video/influenza/ Influenza]<ref>{{Cite web|url=https://blausen.com/en/video/influenza/|title=Influenza|website=blausen.com|access-date=2018-08-25}}</ref> Video short
* [[Influenza A virus subtype H1N1]]
* [http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal) Influenza (Seasonal)] Fact Sheet
* [[Influenza vaccine]]
* [[wikipedia:Wikipedia|Wikipedia]]

== See also ==
* [[Vaccine]]

== References ==
<references />

Influenza

2018-08-25T15:33:05Z

77.111.246.7:/* Epidemiology */ populate

'''Influenza''', commonly known as "'''the flu'''", is an infectious disease caused by an influenza virus. There are four types of influenza virus, types A and B (seasonal), C which is less frequent causing mild infections and not a public health threat, and D which primarily affect cattle and not known to infect or cause illness in people. Seasonal influenza is characterized by a sudden on fever, a cough (usually dry), headache, muscle pain and joint pain, severe malaise (feeling unwell), sore throat and runny nose.<ref name=":0">{{Cite web|url=http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal)|title=Influenza (Seasonal)|website=World Health Organization|language=en-US|access-date=2018-08-25}}</ref>

A subtype of influenza A is [[H1N1]].{{Stub}}

[[Category:Infectious agents]]

== Epidemiology ==
All age groups can be effected but there are groups that are at more risk than others.
* children under 59 months
* health care workers
* elderly
* pregnant women
* individuals with chronic medical conditions
** cardiac
** hematologic
** pulmonary
** renal
** liver
** metabolic
** neurodevelopment
* individuals with immunosuppressive conditions
** HIV/AIDS
** receiving chemotherapy or steroids
** malignancy<ref name=":0" />
Influenza spreads easily with rapid transmission in crowded areas such as schools and nursing homes. Sneezing and coughing spreads droplets containing viruses which can spread over three feet. Persons within range can become infected by breathing in these droplets. The virus also spreads by hands contaminated with influenza. From time of infection to illness is about 2 days but can be one to four days.<ref name=":0" />
*
*
== Learn more ==
* [https://blausen.com/en/video/influenza/ Influenza]<ref>{{Cite web|url=https://blausen.com/en/video/influenza/|title=Influenza|website=blausen.com|access-date=2018-08-25}}</ref> Video short
* [[Influenza A virus subtype H1N1]]
* [http://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal) Influenza (Seasonal)] Fact Sheet
* [[Influenza vaccine]]
* [[wikipedia:Wikipedia|Wikipedia]]

== See also ==
* [[Vaccine]]

== References ==
<references />

Influenza

2018-08-25T15:19:05Z

77.111.246.7:populating

Fibromyalgia

2018-08-25T14:47:29Z

77.111.246.7:lowercase

[[Fibromyalgia]] (FM/FMS) is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Pain is widespread, on both sides of the body, and above and below the waist.

Sufferers are fatigued and tired even when sleeping for long periods of time, and sleep is often disrupted by pain. Many FM sufferers have sleep disorders like [https://en.wikipedia.org/wiki/Sleep_apnea sleep apnea] and [[restless leg syndrome]]. [[Cognitive impairment]], when one cannot focus or pay attention and the patient has difficulty concentrating on mental tasks, is known by FM sufferers as "[[fibro fog]]".<ref name=":17">{{Cite news|url=https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014|title=What Is Fibro Fog and ME/CFS Brain Fog?|last=Dellwo|first=Adrienne|date=|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Some experience [[depression]], [[headache]]s, and lower [[abdominal pain]] or cramping. Other symptoms include tingling or [[numbness]] in hands and feet, pain in jaw and disorders of the jaw such as [[temporomandibular joint disorder|temporomandibular joint disorder]] (TMJ), [[Menstrual cycle#Health effects in other conditions|menstrual cycle]] cramps, and digestive problems like i[[Irritable bowel syndrome|rritable bowel syndrome]] (IBS).<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms#1|title=Fibromyalgia Symptoms|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780|title=Fibromyalgia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref>

[[File:Fibro_Tender_Points.png|400px|thumb|right|1990 ACR Diagnostic Criteria: 18 Tender Points]]
[[File:Fibro_Widespread_Pain.png|400px|thumb|right|2010 ACR Preliminatry Diagnostic Criteria: Wisedpread Pain Index (WPI), 19 Tender Point Areas]]

==Prevalence==
FM is the second most common [https://en.wikipedia.org/wiki/Rheumatism rheumatic disorder] behind [[wikipedia:Osteoarthritis|osteoarthritis]] and is "now considered to be a lifelong [[Central nervous system]] disorder."<ref>{{Cite news|url=https://naidw.org/blog/members-myblogs/fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder|title=Fibromyalgia now considered as a lifelong central nervous system disorder|work=NAIDW.org®|access-date=2018-08-09|language=en-gb}}</ref> An estimated 10 million people in the US and 3-6% of the world population have fibromyalgia. It is seen in women, men, children, and all ethnic groups. It is often seen in families and diagnosed between the ages of 20 to 50 years; incidence increases with age.<ref>{{Cite news|url=http://www.fmaware.org/about-fibromyalgia/prevalence/|title=Prevalence - National Fibromyalgia Association (NFA)|work=National Fibromyalgia Association (NFA)|access-date=2018-08-09|language=en-US}}</ref>

FM has a female:male 7:1 ratio under the ''American College of Rheumatology (ACR) 1990 Diagnostic Criteria'' and 2:1 when the ''ACR 2010 Preliminary Diagnostic Criteria'' is used.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=|publisher=|editor-last=Diamond|editor-first=Herbert|at=Sex-related differences in incidence}}</ref> ''See'': [[Fibromyalgia#American College of Rheumatology (ACR) Criteria|Fibromyalgia (''American College of Rheumatology (ACR) Criteria'' section)]].

==Fibromyalgia in ME/CFS==
Dr. [[Jarred Younger]] has said that many patients that meet the criteria for FM also meet criteria for [[chronic fatigue syndrome]] (CFS) but the reverse is not necessarily true as a lot of people with [[CFS]] do not have [[chronic pain]].<ref>{{Cite web|url=https://www.youtube.com/watch?v=wJB95m4FLa0#t=57m27s|title=Webinar with Jarred Younger, Ph.D.|last=Younger|first=Jared|date=May 20, 2016|website=YouTube|at=57:27|via=|archive-url=|archive-date=|dead-url=|access-date=|publisher=SolveCFS|type=Video}}</ref> However, the [[Canadian Consensus Criteria]] (CCC) requires the symptom of pain to diagnose [[ME/CFS]]. It is the pattern and significant degree of [[chronic pain]] in FM that sets it apart from other diseases that have pain.

"The most common overlapping condition with ME/CFS is fibromyalgia."<ref name=":30">{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions - American Myalgic Encephalomyelitis and
Chronic Fatigue Syndrome Society|last=|first=|date=|website=ammes.org|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref><ref name=":31">{{Cite journal|last=Jason|first=Leonard|last2=Taylor|first2=R.R.|last3=Kennedy|first3=C.L.|last4=Song|first4=S|last5=Johnson|first5=D|last6=Torres|first6=S.R.|date=2001-01-01|title=Chronic fatigue syndrome: Comorbidity with fibromyalgia and psychiatric illness|url=https://www.researchgate.net/publication/285787383_Chronic_fatigue_syndrome_Comorbidity_with_fibromyalgia_and_psychiatric_illness|journal=Medicine and Psychiatry|volume=4|pages=29–34}}</ref>

==Health complications==
FM is not a [https://en.wikipedia.org/wiki/Progressive_disease progressive disease] but according to Dr. Dan Clauw the "slow gradual worsening of chronic pain patients over time is due to downstream consequences of poorly controlled pain and other symptoms, wherein individuals then progressively get less active, sleep worse, are under more stress and unknowingly develop bad habits which worsen pain and other symptoms."<ref>{{Cite news|url=http://nationalpainreport.com/ask-the-dctors-is-fibromyalgia-progressive-8831105.html|title=Ask the Doctors: Is Fibromyalgia Progressive?|date=2016-08-09|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*[https://www.sharecare.com/health/fibromyalgia-effects Fibromyalgia Complications]<ref name=":19" />

:<blockquote>People who have fibromyalgia frequently complain of a variety of symptoms that affect other parts of the body. Many people complain of [[gastrointestinal]] issues and restless legs syndrome (RLS). Additionally, the [[chronic pain]] and discomfort of fibromyalgia may lead to [[depression]].<ref name=":19">{{Cite news|url=https://www.sharecare.com/health/fibromyalgia-effects|title=Fibromyalgia Complications - Fibromyalgia - Joint Health|work=Sharecare|access-date=2018-08-09|language=en}}</ref></blockquote>

*[https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions Can fibromyalgia cause other medical conditions?]<ref name=":20" />

:<blockquote>Fibromyalgia is not known to cause other medical conditions. However, people who have fibromyalgia seem to be at high risk for developing other painful conditions, including [https://en.wikipedia.org/wiki/Osteoarthritis osteoarthritis] (the common type of arthritis caused by wear and tear on the joints) as well as other related conditions, such as [[rheumatoid arthritis]], [[lupus]], and [https://en.wikipedia.org/wiki/Ankylosing_spondylitis ankylosing spondylitis]. Also, people with fibromyalgia are frequently diagnosed with chronic fatigue syndrome, irritable bowel syndrome (IBS), and temporomandibular joint (TMJ) disorder.<ref name=":20">{{Cite web|url=https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions|title=Can fibromyalgia cause other medical conditions? {{!}} Fibromyalgia Complications|last=Honor Society of Nursing|first=|date=|website=Sharecare|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref></blockquote>

==Risk factors==
[[Lupus]] and [[rheumatoid arthritis]] (RA) are risk factors in developing FM. Car accidents, [[post-traumatic stress disorder]] (PTSD), [https://en.wikipedia.org/wiki/Repetitive_strain_injury repetitive injuries], illness such as a [https://en.wikipedia.org/wiki/Viral_disease viral infection], [https://en.wikipedia.org/wiki/Family_history_(medicine) family history], and [https://en.wikipedia.org/wiki/Obesity obesity] have all been linked to FM.<ref>{{Cite web|url=https://www.cdc.gov/arthritis/basics/fibromyalgia.htm|title=Fibromyalgia {{!}} Arthritis {{!}} CDC|date=2018-04-03|website=www.cdc.gov|language=en-us|access-date=2018-08-09}}</ref><ref>{{Cite news|url=https://www.niams.nih.gov/health_info/Fibromyalgia/|title=Fibromyalgia What Causes it?|last=Director|first=Nancy Garrick, Deputy|date=2017-04-05|work=National Institute of Arthritis and Musculoskeletal and Skin Diseases|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

==Diagnosis==
[https://www.verywellhealth.com/what-are-fibromyalgia-tender-points-189768 Tender points], not [https://en.wikipedia.org/wiki/Myofascial_trigger_point trigger points], are used to diagnose Fibromyalgia.<ref>{{Cite web|url=http://www.healthcentral.com/chronic-pain/c/662034/176031/fibromyalgia-trigger/|title=The Difference Between Fibromyalgia Tender Points and Myofascial Trigger Points - Chronic Pain {{!}} HealthCentral|last=Cooper|first=Celeste|date=May 8, 2015|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> Tender points will be above and below the waist and on both sides of the body. (See: Illustrations of the 1990 and 2010 American College of Rheumatology (ACR) Criteria depicting tender points near the top of this page.) It is important to check for other conditions that could be causing pain such as hypothyroidism, rheumatoid arthritis or lupus, osteoarthritis, ankylosing spondylitis, and [[wikipedia:Polymyalgia_rheumatica|polymyalgia rheumatica]].<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>

===United States===
==== American College of Rheumatology (ACR) Criteria ====

*1990, [http://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf The American College Of Rheumatology 1990 Criteria For The Classification Of Fibromyalgia]<ref>{{Cite web|url=https://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf|title=The American College of Rheumatology Criteria for the Classification of Fibromyalgia|last=Wolfe|first=Frederick|last2=Smythe|first2=Hugh|date=1990|website=rheumatology.org|publisher=|others=Abeles, Micha; Clark, Patricia; Fam, Adel; Farber, Stephen; Fiechtner, Justus; Franklin, Michael; Gatter, Robert; Hamaty, Daniel; Lessard, James; Lightbroun, Alan; Masi, Alfonse; McCain, Glenn; Reynolds, W. John; Romano, Thomas; Russell, Jon; Sheon, Robert|archive-url=|archive-date=|dead-url=|access-date=|last3=Yunus|first3=Muhammad|last4=Bennett|first4=Robert|last5=Bombardier|first5=Claire|last6=Goldenberg|first6=Don|last7=Tugwell|first7=Peter|last8=Campbell|first8=Stephen}}</ref> "American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure."<ref>{{Cite news|url=http://www.health.com/health/gallery/0,,20345635,00.html|title=18 Points Used to Diagnose Fibromyalgia|last=|first=|date=Feb 4, 2011|work=Health.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> <ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2010, The [https://www.fibroknowledge.com/site/acr-2010 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview]<ref>{{Cite web|url=https://www.fibroknowledge.com/sites/default/files/downloads/file/2010_ACR_CRITERIA.pdf|title=American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia|last=|first=|date=2010|website=fibroknowledge.com|type=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref> was proposed and modified in 2011<ref>{{Cite news|url=http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria|title=New and Modified Fibromyalgia Diagnostic Criteria|last=Garg|first=Neha|date=Feb 9, 2012|work=Rheumatology Network|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=|last2=Deodhar|first2=Atul}}</ref> with the modification being validated in 2013 and published in 2014.<ref>{{Cite journal|last=Bennett|first=Robert M.|last2=Friend|first2=Ronald|last3=Marcus|first3=Dawn|last4=Bernstein|first4=Cheryl|last5=Han|first5=Bobby Kwanghoon|last6=Yachoui|first6=Ralph|last7=Deodhar|first7=Atul|last8=Kaell|first8=Alan|last9=Bonafede|first9=Peter|date=2014|title=Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/24497443|journal=Arthritis Care & Research|volume=66|issue=9|pages=1364–1373|doi=10.1002/acr.22301|issn=2151-4658|pmid=24497443|via=}}</ref> September of 2016, another revision has been made.<ref>{{Cite news|url=http://acrabstracts.org/abstract/2016-revisions-to-the-20102011-fibromyalgia-diagnostic-criteria/|title=2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria - ACR Meeting Abstracts|last=|first=|date=Sep 28, 2016|work=ACR Meeting Abstracts|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

:Men do not seem to form the tender points needed for diagnosis under the 1990 criteria,<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/features/how-fibromyalgia-affects-men#2|title=How Fibromyalgia Affects Men: Symptoms and Diagnosis|work=WebMD|access-date=2018-08-09|language=en-US}}</ref> the 2010 proposed criteria diagnoses more men with a F/M ratio of 2:1.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=}}</ref>
:Tender points were used to diagnose with the 1990 criteria, however "considerable skill is needed to correctly check for a patient’s tender points (i.e., digital palpation that is done with certain amount of applied pressure), yet this technique is not typically taught at most medical schools."<ref name=":0">{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 5, 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>
:The new standards were designed to:
:*eliminate the use of a tender point examination
:*include a severity scale by which to identify and measure characteristic FM symptoms
:*utilize an index by which to rate pain<ref name=":0" />
:*There are 19 tender point areas in the widespread pain index (WPI), whereas the 1990 criteria had 18 tender points.<ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose fibromyalgia.<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=Jul 25, 2012|website=www.ssa.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

==== Sleep study ====
[[Sleep dysfunction]] is often involved in fibromyalgia. Treating a sleep disorder can help with fibromyalgia symptoms. A diagnosed sleep disorder is also helpful if one needs to file for disability.

*[https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054 Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054|title=Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*[http://www.sciencedaily.com/releases/2008/09/080903134311.htm What A Sleep Study Can Reveal About Fibromyalgia]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2008/09/080903134311.htm|title=What A Sleep Study Can Reveal About Fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*[http://linkis.com/nationalpainreport.com/lzYea Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says]<ref>{{Cite news|url=http://linkis.com/nationalpainreport.com/lzYea|title=Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says|last=|first=|date=Mar 25, 2016|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== ICD Diagnostic code===
====World Health Organization====
'''ICD-10'''

The [[World Health Organization]] (WHO) International Classification of Diseases (ICD) lists fibromyalgia as a "disease of the [[musculoskeletal system]] and connective tissue", under the code M79.7 (WHO ICD-10 Version: 016).<ref>World Health Organization, [http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7 International Classification of Diseases - Fibromyalgia M79.7], ICD-10, 2016</ref>

*'''M79.7 Fibromyalgia'''
::Fibromyositis
::Fibrositis
::Myofibrositis<ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7|title=ICD-10 Version:2016|website=apps.who.int|language=en|access-date=2018-08-09}}</ref>

In 2015, the [[United States]] finally adopted ICD-10 and Fibromyalgia as a diagnosis.<ref>{{Cite web|url=http://www.icd10data.com/ICD10CM/Codes/M00-M99/M70-M79/M79-/M79.7|title=2018 ICD-10-CM Diagnosis Code M79.7: Fibromyalgia|website=www.icd10data.com|language=en|access-date=2018-08-09}}</ref> <ref>{{Cite news|url=http://nationalpainreport.com/the-health-care-industry-finally-recognizes-fibromyalgia-8827637.html|title=The Health Care Industry Finally Recognizes Fibromyalgia|last=Liptan|first=Ginevra|date=2015-09-30|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

'''ICD-11 (2019)'''

[https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504 ICD-11] (2019) has diagnostic code ''MG30.1 Chronic widespread pain''.<ref name=":18">{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504|title=ICD-11 - Mortality and Morbidity Statistics|website=icd.who.int|language=en|access-date=2018-08-09}}</ref>

*'''MG30.01 Chronic widespread pain'''

'''Parent'''
::MG30.0 Chronic primary pain

'''Description'''
<blockquote>Chronic widespread pain (CWP) is diffuse pain in at least 4 of 5 body regions and is associated with significant emotional distress (anxiety, anger/frustration or depressed mood) or functional disability (interference in daily life activities and reduced participation in social roles) [1]. CWP is multifactorial: biological, psychological and social factors contribute to the pain syndrome. The diagnosis is appropriate when the pain is not directly attributable to a nociceptive process in these regions and there are features consistent with nociplastic pain [2] and identified psychological and social contributors.<ref name=":18" /></blockquote>

'''Inclusions'''
:*Fibromyalgia
'''Exclusions'''
:*Acute pain (MG31)<ref name=":18" />

==Pathophysiology==
"Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology. There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or [[Lyme disease]], as well as emotional or physical trauma."<ref>{{Cite web|url=https://www.uptodate.com/contents/pathogenesis-of-fibromyalgia#!|title=UpToDate|last=Goldenberg|first=Don L|date=|website=www.uptodate.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> The widespread pain is severe, debilitating, and abnormal in processing its pain. There is also sleep disturbance and fatigue. Cause or causes are unproven.<ref>{{Cite news|url=https://www.omf.ngo/what-is-mecfs-old/fibromyalgia/|title=What is Fibromyalgia? {{!}} Open Medicine Foundation|work=Open Medicine Foundation|access-date=2018-08-09|language=en-US}}</ref>

*May 2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/ Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management]<ref name=":21">{{Cite journal|last=Jahan|first=Firdous|last2=Nanji|first2=Kashmira|last3=Qidwai|first3=Waris|last4=Qasim|first4=Rizwan|date=2012|title=Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/|journal=Oman Medical Journal|volume=27|issue=3|pages=192–195|doi=10.5001/omj.2012.44|issn=1999-768X|pmc=|pmid=22811766|via=}}</ref> ''See'' Table 1: "Conditions associated with fibromyalgia." Musculoskeletal, genitourianry, gastro intestinal, and miscellaneous conditions often exist among fibromyalgia patients.

<blockquote>Pathophysiology: Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as [[serotonin]], substance P, growth hormone and [[cortisol]] suggest that regulation of the autonomic and neuro-endocrine system appears to be the basis of the syndrome. Fibromyalgia is not a life-threatening, deforming, or [https://en.wikipedia.org/wiki/Progressive_disease progressive disease]. [[Anxiety]] and [[depression]] are the most common association. Aberrant pain processing, which can result in [[chronic pain]], may be the result of several interplaying mechanisms. [[Central sensitization]], blunting of inhibitory pain pathways and alterations in [[neurotransmitters]] lead to aberrant neuro-chemical processing of sensory signals in the CNS, thus lowering the threshold of pain and amplification of normal sensory signals causing constant pain.<ref name=":21" /></blockquote>

<blockquote>The frequent co-morbidity of fibromyalgia with mood disorders suggests a major role for the stress response and for neuroendocrine abnormalities. The [[hypothalamic pituitary axis]] (HPA) is a critical component of the stress-adaptation response. In FMS, stress adaptation response is disturbed leading to stress induce symptoms. Psychiatric co-morbidity has been associated with FMS and needs to be identified during the consultation process, as this requires special consideration during treatment.<ref name=":21" /></blockquote>

*May 2018, [https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management]<ref>{{Cite journal|last=Bourgaize|first=Sheryl|last2=Newton|first2=Genevieve|last3=Kumbhare|first3=Dinesh|last4=Srbely|first4=John|date=2018|title=A comparison of the clinical manifestation and
pathophysiology of myofascial pain syndrome
and fibromyalgia: implications for differential
diagnosis and management|url=https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf|format=PDF|journal=Journal of the Canadian Chiropractic Assoc.|volume=|pages=26-41|at=See Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)|via=}}</ref> (PDF) ''See'' Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)

*Jul 2018, [https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/ Primary and Secondary Fibromyalgia Share Same Symptom Burden, Study Suggests]<ref name=":22">{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/|title=Primary, Secondary Fibromyalgia Share Same Symptom Burden, Study Says|last=Carvalho|first=John|date=2018-07-31|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

<blockquote>Fibromyalgia can be considered either primary, or dominant, also known as idiopathic fibromyalgia, or secondary. In the primary form, the causes of the disorder are unknown, but in secondary fibromyalgia, the disorder usually occurs alongside other debilitating medical conditions, such as rheumatoid arthritis (RA), lupus, and multiple sclerosis.<ref name=":22" /></blockquote>

===Immune system research===

Dr. [[Jarred Younger]] believes an overactive [[immune system]] is the cause and will be conducting a study to test this hypothesis.<ref>{{Cite news|url=http://nationalpainreport.com/new-uab-study-could-radically-change-fibromyalgia-treatment-as-we-know-it-8833437.html|title=New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It|last=Gregory Burch|first=Donna|date=2017-04-24|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=https://www.youtube.com/watch?v=8e5xKX036bE|title=Testing the fibromyalgia immune system with lipopolysaccharide (LPS)|last=Younger|first=Jarred|date=May 24, 2017|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=|via=Younger Lab}}</ref> An overactive immune system is responsible for [[inflammation]] which causes [[chronic pain]].

Dr. William Pridgen's research of [[HSV-1]] (cold sore virus) as being involved in FM has conducted a successful Phase III clinical trial, which had been fast-tracked by the [[Food and Drug Administration]] (FDA), of a combination drug that suppresses this virus and also helps with pain. ''See'': [[Fibromyalgia#IMC-1|Fibromyalgia (''Drugs: Trials: IMC-1'' section)]].

[[ProHealth]] reports that an old [https://en.wikipedia.org/wiki/Tuberculosis Tuberculosis] vaccine, [https://en.wikipedia.org/wiki/BCG_vaccine Bacille Calmette-Guerin] (BCG), may be researched for treatment of Fibromyalgia spearheaded by [http://www.buzzfile.com/business/Epicgenetics,-Inc.-310-586-2929 EpicGenetics] and [http://www.massgeneral.org/ Massachusetts General Hospital].<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

EpicGenetics has a blood test that is identifying the presence of specific white blood cell abnormalities of patients diagnosed with FM and has partnered with two universities to offer [https://en.wikipedia.org/wiki/Disease_gene_identification#Whole_exome_sequencing whole exome sequencing] free of charge to those who test positive with their [http://fmtest.com/ FM/a® test].<ref>{{Cite news|url=http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> Concerns have been raised in regards to the FM/a® EpicGenetics Blood Test.<ref>{{Cite web|url=http://www.fmperplex.com/2013/02/25/junk-science-junk-ethics/|title=Junk Science – Junk Ethics – The Fibromyalgia Perplex|last=Wolfe|first=Fred|date=Feb 25, 2013|website=www.fmperplex.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> EpicGenetics is awaiting FDA approval to test the Bacille Calmette-Guerin (BCG) vaccine (an old Tuberculosis vaccine) on patients that tested positive with its FM/a® test.<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689#comment-2286|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=See Comments Section: CDW12 says: June 26, 2018 at 2:05 pm|language=en-US}}</ref><ref>{{Cite web|url=https://www.celestecooper.com/2018/07/the-fma-blood-test-and-participation-in.html#.Wz4nxdJKjIU|title=The FM/a® Blood Test and Participation in Fibromyalgia Vaccine Study|last=Cooper|first=Celeste|date=Jul 5, 2018|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

A June 2018 study found inflammatory genes CCL11, CCL4, and MEFV in a fibromyalgia family study.<ref>{{Cite journal|last=Zhang|first=Zhifang|last2=Feng|first2=Jinong|last3=Mao|first3=Allen|last4=Le|first4=Keith|last5=Placa|first5=Deirdre La|last6=Wu|first6=Xiwei|last7=Longmate|first7=Jeffrey|last8=Marek|first8=Claudia|last9=Amand|first9=R. Paul St|date=2018-06-21|title=SNPs in inflammatory genes CCL11, CCL4 and MEFV in a fibromyalgia family study|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198625|journal=PLOS ONE|language=en|volume=13|issue=6|pages=e0198625|doi=10.1371/journal.pone.0198625|issn=1932-6203|pmid=29927949|via=}}</ref>
<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/03/immune-system-may-play-role-fibromyalgia-study/|title=Fibromyalgia May Be Linked to Immune System, Study Suggests|last=Inacio|first=Patricia|date=2018-07-03|work=Fibromyalgia News Today|access-date=2018-08-22|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Comorbidities, overlapping conditions, and common symptoms ==
[[File:Fibromyalgia and comorbid conditions.JPG|700px|thumb|center|Comorbid conditions of Fibromyalgia (FMS) are ME/CFS which is the most common; autoimmune diseases; migraines; Multiple Chemical Sensitivities (MCS); and orthostatic intolerance (OI) / Postural Orthostatic Tachycardia Syndrome (POTS).<ref name=":30" /><ref name=":31" /><ref name=":33">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref> Depression and anxiety; digestive conditions and menstrual problems; GWI; nervous system disorders; low blood pressure (Low BP); other pain conditions and migraines; and sleep dysfunction/disturbance all overlap with FMS.<ref name=":30" /> <ref name=":33" />]]

*[[Allodynia]]
** [http://chronicfatigue.about.com/od/glossary/g/allodynia.htm Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS]<ref name=":1">{{Cite news|url=https://www.verywellhealth.com/allodynia-definition-and-types-fibromyalgia-715929|title=Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Feb 23, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Types of Allodynia: Tactile; Mechanical; and Thermal. "Type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain" <ref name=":1" />
*[[Autoimmune disease]]<nowiki/>s "Research suggests that RA and other inflammatory diseases may somehow increase the risk for fibromyalgia."<ref>{{Cite news|url=https://www.health.com/health/gallery/0,,20520705,00.html#restless-legs-0|title=7 Conditions Linked to Fibromyalgia|work=Health.com|access-date=2018-08-19|language=en}}</ref>

*[[Body temperature]]
**[https://www.verywell.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025 Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":2">{{Cite news|url=https://www.verywellhealth.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025|title=Temperature Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Mar 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

<blockquote>When you're exposed to heat, does it feel like you're burning up? Does it seem impossible for you to cool off? Or maybe it's cold that bothers you, chilling you to the bone, leaving you unable to warm up? Or are you one of those people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) who is cold all the time, or hot all the time, or alternately hot or cold while out of sync with the environment?<ref name=":2" /></blockquote>

[[File:Costal cartilages.JPG|200px|thumb|left|Costochonritus is inflammation of the costal cartliges (shown in red) causing chest and ribcage pain]]

:* [https://www.verywell.com/costochondritis-in-fibromyalgia-716178 Costochondritis in Fibromyalgia]<ref name=":10">{{Cite news|url=https://www.verywellhealth.com/costochondritis-in-fibromyalgia-716178|title=Costochondritis Chest Pain in Fibromyalgia|last=Dellow|first=Adrienne|date=Feb 14, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|date=2018-05-25|title=Costochondritis|url=https://en.wikipedia.org/w/index.php?title=Costochondritis&oldid=842926736|journal=Wikipedia|language=en}}</ref>

<blockquote>Costochondritis is inflammation of the cartilage that connects your ribs to your breastbone. Depending on how much inflammation there is, it can range from mildly annoying to intensely painful. People sometimes describe the pain as stabbing, aching, or burning.<ref name=":10" /></blockquote>

<blockquote>Costochondritis can make you think you're having heart problems, which is a scary thing. Even though costochondritis is common, you should get medical attention if you have unexplained chest pain. You don't want to assume that it's FMS-related and end up with permanent heart damage or worse.<ref name=":10" /></blockquote>

<blockquote>The pain can radiate to your shoulder and arms as well (another way the condition mimics a heart attack). Sometimes the pain is accompanied by redness and/or swelling in the most painful areas. When that's the case, it's called Tietze's Syndrome.<ref name=":10" /></blockquote>

* [[Depression]] and [[Anxiety]] Fibromyalgia sufferers are "up to three times more likely to have depression at the time of their diagnosis than someone without fibromyalgia."<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/fibromyalgia-and-depression#1|title=Fibromyalgia and Depression|work=WebMD|access-date=2018-08-19|language=en-US}}</ref> Up to 20 percent of Fibromyalgia patients will have either depression or anxiety.<ref>{{Cite web|url=https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/fibromyalgia|title=Fibromyalgia {{!}} Anxiety and Depression Association of America, ADAA|website=adaa.org|language=en|access-date=2018-08-19}}</ref>

*[[Fibro fog]]

:*[http://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction]<ref name=":3">{{Cite news|url=https://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx|title=What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction|last=Mandal|first=Ananya|date=2013-06-03|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> 'Mental confusion along with difficulty in concentration and loss of memory is often termed “[[fibro fog]]"'.<ref name=":3" />

:* [https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014 What Is Fibro Fog and ME/CFS Brain Fog?]<ref name=":17" />

*[[Gastrointestinal system]]
**[[Irritable bowel syndrome]]: [http://chronicfatigue.about.com/od/whyfmscfsarelinked/a/IBS.htm Irritable Bowel Syndrome in Fibromyalgia & Chronic Fatigue Syndrome - Why Do They Go Together?]<ref name=":4">{{Cite news|url=https://www.verywellhealth.com/irritable-bowel-syndrome-in-fibromyalgia-cfs-716167|title=Irritable Bowel Syndrome in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jan 28, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>Fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome (IBS) frequently go together. No one really knows why, but we do know that all three conditions can include imbalances of serotonin -- although in fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS or ME/CFS) it's an imbalance in the brain, while with IBS it's in the gut.<ref name=":4" /></blockquote>
* [[Gulf War Illness]]
**[https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp Fibromyalgia in Gulf War Veterans]<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp|title=Fibromyalgia in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-19}}</ref> GWI increases risk of developing Fibromyalgia.

*[https://en.wikipedia.org/wiki/Interstitial_cystitis Interstitial Cystitis]<ref>{{Cite journal|date=2018-07-11|title=Interstitial cystitis|url=https://en.wikipedia.org/w/index.php?title=Interstitial_cystitis&oldid=849828657|journal=Wikipedia|language=en}}</ref> (Painful bladder)
**[https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168 Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis]<ref name=":5">{{Cite news|url=https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168|title=Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "Fibromyalgia, chronic fatigue syndrome and interstitial cystitis (IC) -- a painful bladder condition -- frequently occur together. Women may be up to 10 times more likely than men to develop it."<ref name=":5" />

*Language Impairment
**[[Word-finding problems]] is a symptom of ME/CFS.
:*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome Impaired Language in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":6" /> "Searching their brains for simple words that they just can't remember. On other occasions, individuals with these diagnoses may find it hard to write or even understand language."<ref name=":6">{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:*"The diagnosis of [[Aphasia]] is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written"<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref> but with [[dysphasia]] you will have those symptoms and trouble listening and doing numeral calculations.<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-09}}</ref> ''See also'': [[Dyscalculia]].
* [[ME/CFS]]
:*[https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184 Comorbid Conditions in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>
* [[Migraine]]
:*[https://migrainecenters.com/blog/migraines-and-fibromyalgia/ Migraines and Fibromyalgia]<ref name=":32" />
<blockquote>Both fibromyalgia and migraine may reflect problems in the brain’s pain processing center. It is believed that both conditions are caused by excitation of the nervous system or an over-response to stimuli. Stress is usually cited as a trigger for both migraine and fibromyalgia attacks.<ref name=":32">{{Cite news|url=https://migrainecenters.com/blog/migraines-and-fibromyalgia/|title=Migraines and Fibromyalgia - Migraine Centers|date=2016-05-06|work=Migraine Centers|access-date=2018-08-19|language=en-US}}</ref></blockquote>
* [[Multiple chemical sensitivity|Multiple Chemical Sensitivity]] (MCS) It is thought that both Fibromyalgia and MCS are [[Central sensitisation|central sensitivity]] syndromes.<ref>{{Cite news|url=https://www.verywellhealth.com/chemical-sensitivity-in-fibromyalgia-716170|title=Multiple Chemical Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>

*OBGYN
**[https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596 Menstrual Periods with Fibromyalgia: Personal Stories]<ref>{{Cite news|url=https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596|title=Menstrual Periods with Fibromyalgia: Personal Stories|last=Dellwo|first=Adrienne|date=May 18, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>
**[https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626 Fibromyalgia Tied to Hysterectomy, Gynecologic Disease].<ref name=":7" />
:<blockquote>You may have heard about a possible link between gynecologic surgery (such as a hysterectomy) and the development of fibromyalgia, and doctors have long suspected that fibromyalgia has strong hormonal ties and triggers. This does not seem surprising as we've long suspected a link between endocrine disorders, gynecological conditions, and autoimmune conditions.<ref name=":7">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626|title=Fibromyalgia Tied to Hysterectomy, Gynecologic Disease|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref></blockquote>

*[[Orthostatic intolerance]] (OI) and [[Postural orthostatic tachycardia syndrome]] (POTS)<ref>{{Cite journal|last=Yun|first=Dong Joo|last2=Choi|first2=Han Na|last3=Oh|first3=Gun-Sei|date=2013|title=A Case of Postural Orthostatic Tachycardia Syndrome Associated with Migraine and Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710947/|journal=The Korean Journal of Pain|volume=26|issue=3|pages=303–306|doi=10.3344/kjp.2013.26.3.303|issn=2005-9159|pmid=23862007|via=}}</ref>

:*[http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM]<ref>{{Cite web|url=http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf|title=Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM|last=Lapp|first=Charles W.|last2=Black|first2=Laura|date=|website=drlapp.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Smith|first3=Rebekah S.}}</ref> (PDF) Symptoms can include low blood pressure and/or sudden high blood pressure, dizziness, fainting.

:*[https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/ An Overlooked Issue in Fibromyalgia? Study Highlights Problems Standing (Orthostatic Intolerance)]<ref>{{Cite news|url=https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/|title=An Overlooked Issue in Fibromyalgia? Study Highlights Orthostatic Intolerance - Problems Standing - Health Rising|last=Johnson|first=Cort|date=2017-09-21|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[[Sleep dysfunction]]
**[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia]<ref name=":23">{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}</ref>

:<blockquote>The present results of this study suggest that long-term, comorbid pain and sleep disturbance may be associated with increased activation in core default mode brain areas that is above and beyond long-term pain disturbance alone.<ref name=":23" /></blockquote>

:*[http://www.prohealth.com/library/showarticle.cfm?libid=22344 Fibromyalgia and Sleep]<ref name=":8">{{Cite news|url=https://www.prohealth.com/library/fibromyalgia-and-sleep-38954|title=Fibromyalgia and Sleep - Prohealth|date=2016-01-11|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref> "Most people with fibromyalgia have an associated sleep disorder that makes it difficult for them to get the deep, restorative sleep they need."<ref name=":8" />

[[File:TMJ_1.jpg|200px|thumb|right|TMJ/TMD is a condition that occurs in some fibromyalgia and ME/CFS patients]]
* [[Temporomandibular joint disorder]] (TMJ/TMD)

:* [https://www.sciencedirect.com/science/article/pii/S2255502114001758 Temporomandibular disorders in fibromyalgia syndrome: a short-communication]<ref>{{Cite journal|last=Soares Gui|first=Maisa|last2=Pimentel|first2=Marcele Jardim|last3=Rizzatti-Barbosa|first3=C'elia Marisa|date=2015-03-01|title=Temporomandibular disorders in fibromyalgia syndrome: a short-communication|url=https://www.sciencedirect.com/science/article/pii/S2255502114001758|journal=Revista Brasileira de Reumatologia (English Edition)|language=en|volume=55|issue=2|pages=189–194|doi=10.1016/j.rbre.2014.07.004|issn=2255-5021|via=ScienceDirect}}</ref><ref>{{Cite news|url=https://www.whitesmilesforlife.com/blog/study-probes-pain-link-between-tmj-fibromyalgia/|title=Study Probes Pain Link Between TMJ, Fibromyalgia|date=2016-05-03|work=Kent E. White, DDS|access-date=2018-08-19|language=en-US}}</ref>

::Other than headaches, the symptoms are quite distinct from symptoms of FMS and ME/CFS.

::They include:
::*Jaw pain
::*Discomfort or difficulty chewing
::*Painful clicking in the jaw
::*Difficulty opening or closing the mouth
::*Headaches
::*Locking jaw
::*Teeth that don't come together properly<ref>{{Cite news|url=https://www.verywellhealth.com/tmj-in-fibromyalgia-chronic-fatigue-syndrome-716175|title=TMJ in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Mar 31, 2018|work=Verywell Health|access-date=2018-08-22|archive-url=|archive-date=|dead-url=}}</ref>

*[[Thyroid disease]]
**[https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677 Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease]<ref name=":9">{{Cite news|url=https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677|title=A Comparison of Chronic Fatigue, Fibromyalgia, and Thyroid Disease|last=Shomon|first=Mary|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>People with Hashimoto's autoimmune thyroid disease often experience significant fatigue and body aches. While these symptoms are common in Hashimoto's, they can also be markers of other diseases, like chronic fatigue syndrome or fibromyalgia.<ref name=":9" /></blockquote>

*Other symptoms
**[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/fibrosymptoms.htm Symptoms of Fibromyalgia]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-symptoms-716139|title=Symptoms of Fibromyalgia|last=Dellwo|first=Adrienne|date=May 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> (A comprehensive all in one place list for the many symptoms of fibromyalgia.)

==Treatment==

===United States===
'''Rheumatology and primary care providers: Diagnosing and treatment'''

*2012, [https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract A Framework for Fibromyalgia Management for Primary Care Providers]<ref>{{Cite journal|last=Arnold|first=Lesley M.|last2=Clauw|first2=Daniel J.|last3=Dunegan|first3=L. Jean|last4=Turk|first4=Dennis C.|date=2012|title=A Framework for Fibromyalgia Management for Primary Care Providers|url=https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract|journal=Mayo Clinic Proceedings|language=English|volume=87|issue=5|pages=488–496|doi=10.1016/j.mayocp.2012.02.010|issn=0025-6196|via=}}</ref> Rheumatologists stopped treating fibromyalgia patients and primary care providers began treatment managment although rheumatologists are most often the specialist to diagnose. (Please see [http://me-pedia.org/wiki/Fibromyalgia#Disability disability] heading about ''primary provider'' and ''specialists'' for disability cases.)

=== Drugs ===

{{Main article |page_name = Fibromyalgia drugs}}

=== Therapies ===

==== Exercise ====
''Please Note'': These recommendations are for fibromyalgia patients and '''not''' [[ME/CFS]] sufferers.
[[File:Warm water exercise.JPG|200px|thumb|left|Warm water exercise is best for fibromyalgia. Start slow and don't push through the pain<ref name=":11" />]]

*[https://www.verywellhealth.com/warm-water-exercise-for-fibromyalgia-716059 Warm Water Exercise for Fibromyalgia]<ref name=":11">{{Cite news|url=http://chronicfatigue.about.com/od/treatingfmscfs/a/warmwaterFMS.htm|title=Warm Water Exercise for Fibromyalgia|last=Dellwo|first=Adrienne|date=Nov 19, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|last=Munguía-Izquierdo|first=D.|last2=Legaz-Arrese|first2=A.|date=2007|title=Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/18173915|journal=Clinical and Experimental Rheumatology|volume=25|issue=6|pages=823–830|issn=0392-856X|pmid=18173915|via=}}</ref>

<blockquote>A warm-water pool is good for therapy because cold water can make muscles tense up. It's especially important in FMS because many people with the condition are intolerant of cold. A warm-water pool is one that's kept around 89.6 degrees Fahrenheit (32 Celsius), which is several degrees warmer than most heated pools.<ref name=":11" /></blockquote>

*Moderate aerobic exercise and weights with six to eight reps and then a day or two of rest in between. Do not start a program if you are in a flare.<ref>{{Cite web|url=http://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/fibromyalgia-questions/fibromyalgia-exercise.php|title=Fibromyalgia Exercise {{!}} Exercising with Fibromyalgia|last=Ronenn|first=Roubenoff|date=|website=www.arthritis.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[https://www.youtube.com/watch?v=BauJYuJwFsI Easy fibromyalgia exercises and motivation to keep you healthy!]<ref>{{Cite web|url=https://www.youtube.com/watch?v=BauJYuJwFsI|title=Easy Fibromyalgia exercises and motivation to keep you healthy!|last=Suarez|first=Eric|date=Jun 21, 2011|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=Aug 9, 2018}}</ref> Video

*[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/Fibromyalgia-Myth-Vs-Fact.htm Fibromyalgia Myth vs. Fact]<ref name=":15">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-myth-vs-fact-716131|title=Fibromyalgia: What's Myth, What's Fact?|last=Dellwo|first=Adrienne|date=Jun 8, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=Myth #3 People With Fibromyalgia Need More Exercise}}</ref> Heading: ''Myth #3: People With Fibromyalgia Need More Exercise''. Appropriate exercise, which each patient needs to gauge for themselves.<ref name=":15" />

==== Massage ====

*2014, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/ Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]<ref>{{Cite journal|last=Li|first=Yan-hui|last2=Wang|first2=Feng-yun|last3=Feng|first3=Chun-qing|last4=Yang|first4=Xia-feng|last5=Sun|first5=Yi-hua|date=2014-02-20|title=Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/|journal=PLoS ONE|volume=9|issue=2|doi=10.1371/journal.pone.0089304|issn=1932-6203|pmc=|pmid=24586677|pages=|via=}}</ref>

*2016, [http://chronicfatigue.about.com/od/alternativetreatments/a/bodywork.htm Massage, Rolfing & Other Bodywork - Are They Effective Fibromyalgia & Chronic Fatigue Syndrome Treatments?]<ref>{{Cite news|url=https://www.verywellhealth.com/massage-rolfing-other-bodywork-715645|title=Massage, Rolfing, Reiki: Do They Work for Fibromyalgia & ME/CFS?|last=Dellwo|first=Adrienne|date=Aug 10, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==== Acupuncture ====

*2004, [[U.S. Department of Health and Human Services]] (HHS) and [https://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services Centers for Medicare and Medicaid Services] (CMS) ruled April 16, 2004, a noncoverage determination for acupuncture.<ref>{{Cite web|url=https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R11NCD.pdf|title=CMS Manual System Pub. 100-03 Medicare
National Coverage Determinations|last=|first=|date=Apr 16, 2004|website=CMS.gov|format=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2005, [http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html Acupuncture Good for Fibromyalgia?] <ref name=":16">{{Cite web|url=http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html|title=Acupuncture Good for Fibromyalgia?|last=|first=|date=Oct 2, 2012|website=Acupuncture School Online|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> "Acupuncture gave no significant pain relief to fibromyalgia patients."<ref name=":16" />

*2016, [http://www.sciencedirect.com/science/article/pii/S2095496416602352 Short-term complementary and alternative medicine on quality of life in women with fibromyalgia] <ref name=":25">{{Cite journal|date=2016-01-01|title=Short-term complementary and alternative medicine on quality of life in women with fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S2095496416602352|journal=Journal of Integrative Medicine|language=en|volume=14|issue=1|pages=29–35|doi=10.1016/S2095-4964(16)60235-2|issn=2095-4964}}</ref> "There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session."<ref name=":25" />

*2016, [https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/ Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/|title=Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients - Fibromyalgia News Today|last=Semedo|first=Daniela|date=2016-02-01|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Disability ==
===United States===
''Please Note'': The following is NOT legal advice and it should not be relied upon in taking steps for a disability case. Only ''[https://www.ssa.gov/ Social Security]'' and a disability lawyer can provide the most up to date and the correct legal avenue for bringing a disability case.

In the[[ United States]], [https://www.ssa.gov/ssi/ Social Security Insurance] and [https://www.ssa.gov/disability/ Social Security Disability] (SSI) and (SSD) benefits are available for Fibromyalgia. Generally for SSI/SSD, notes and tests from a ''Primary Provider'' '''may''' be allowed for submission but ''Specialists'' such as a rheumatologist, neurologist, psychiatrist, etc. are required for diagnosis, ongoing treatment and completing SSI/SSD paperwork.

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose Fibromyalgia. (See: "Policy Interpretation" for the POLICY INTERPRETATION RULING.)<ref>[https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia]</ref>

*[http://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social Applying for Disability With Fibromyalgia]<ref>{{Cite news|url=https://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social|title=Fibromyalgia Disability: Applying for Disability Benefits With Fibromyalgia|date=2016-10-03|work=NewLifeOutlook {{!}} Fibromyalgia|access-date=2018-08-09|language=en-US}}</ref> One patient's success of applying, denial, successful appeal, and a breakdown of what SSI/SSD requires for the medical determination of a favorable decision of disability.

*[https://www.socialsecurity.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html Fibromyalgia: Policy Interpretation Ruling - Social Security]<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=|website=www.ssa.gov|at=Titles II and XVI: Evaluation of Fibromyalgia|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[http://www.disabilitysecrets.com/social_security_disability_fibromyalgia.html Social Security Disability (SSDI & SSI) for Fibromyalgia - Disability Secrets By NOLO]<ref>{{Cite news|url=https://www.disabilitysecrets.com/resources/social-security-disability-ssdi-ssi-fibromyalgia.htm|title=Social Security Disability (SSDI & SSI) for Fibromyalgia|last=Laurence|first=Bethany|date=|work=www.disabilitysecrets.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*[http://www.mdjunction.com/fibromyalgia/fibromyalgia-disability Fibromyalgia Disability Patient Support Forums]<ref>{{Cite web|url=https://www.mdjunction.com/fibromyalgia/fibromyalgia-disability|title=Fibromyalgia Disability|website=MDJunction|language=en|access-date=2018-08-09}}</ref> at [[MDJunction]]

==== Examinations and Tests ====
For documentation of symptoms and co-morbidities of a FM diagnosis, you and your doctor should consider the following examinations and tests:

:'''Fibromyaglia Diagnostic Examination'''
:*[http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist Rheumatologist] examination and diagnosis of FM. (Consider having a rheumatologist order tests and coordinate referrals for other specialists for examinations and testing. Only specialists can complete the paperwork for Social Security. A primary doctor cannot complete disability paperwork but ''may'' be able to forward test results they have ordered.)
[[File:Whole body bone scan.jpg|200px|thumb|right|A whole body bone scan (Bone scintigraphy) is a nuclear medicine test. '''Arthritis''', avascular necrosis, bone cancers, cancers that have spread to the bone, fibrous dysplasia, fractures, infection involving the bone, and Pagets disease can be diagnosed using this scan.<ref>{{Cite news|url=https://www.healthline.com/health/bone-scan#purpose|title=Bone Scan: Purpose, Procedure, and Risks|last=Krans|first=Brian|date=Dec 13, 2017|work=Healthline|access-date=2018-08-21|archive-url=|archive-date=|dead-url=|language=en}}</ref>]]
:'''Arthritis'''
:*[https://en.wikipedia.org/wiki/Bone_scintigraphy Whole body bone scan (Bone scintigraphy)]<ref>{{Cite journal|date=2018-05-22|title=Bone scintigraphy|url=https://en.wikipedia.org/wiki/Bone_scintigraphy|journal=Wikipedia|language=en}}</ref> to rule out treatable arthritis.
:'''Blood Tests'''
:*Routine blood tests for [[diabetes]] (fasting sugar, A1C) and a full [[Thyroid disease]] panel ([https://en.wikipedia.org/wiki/Thyroid_function_tests#Thyroid-stimulating_hormone TSH, T3, Free T3, T4 and Free T4]).
:*Rule out [[Rheumatoid arthritis]], lupus, [[Lyme disease]] and other diseases that can share some of the same symptoms of fibromyalgia and may be treatable.<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1-3|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>
:*Vitamin and mineral deficiencies such as [[B12]] and [[Vitamin D]] are treatable with over the counter supplements and prescription medications which can improve [[fatigue]] and [[pain]].
:'''Gastrointestinal'''
:*[[Irritable bowel syndrome]] diagnosis which may require blood, [http://www.mayoclinic.org/tests-procedures/endoscopy/basics/definition/PRC-20020363 upper endoscopy] to rule out [https://en.wikipedia.org/wiki/Coeliac_disease celiac disease] and [https://en.wikipedia.org/wiki/Stool_test fecal tests] to check for bacteria ([[SIBO]]) and [http://www.umm.edu/health/medical/altmed/condition/intestinal-parasites intestinal parasites].
:'''Mental Health and Cognition'''
:* Psychiatric evaluation as any [[depression]] and [[anxiety]] should be treated.
:* [[Cognitive dysfunction]] tests.
:'''Sleep dysfunction'''
:*Sleep study for [[Restless legs syndrome]], [[Sleep disturbance]] or [[Narcolepsy]].
:'''Orthostatic Intolerance'''
:*[[Tilt table test]] to diagnose [[Orthostatic intolerance]] or [[Postural orthostatic tachycardia syndrome|POTS]].
:'''TMJ, tinnitus, vertigo, and dizziness'''
:*An ear, nose, and throat specialist (ENT) ([http://www.mayoclinic.org/departments-centers/otorhinolaryngology-ent/overview Otorhinolaryngology]) examination and imaging may be ordered for [[Temporomandibular joint disorder]] (TMJ).
:*(Ear, sinus, throat/lymph infections, and [[tinnitus]] can also be documented.)
:*[https://en.wikipedia.org/wiki/Videonystagmography Videonystagmography] (VNG) testing if you experience [[vertigo]] and/or [[dizziness]].<ref>{{Cite news|url=https://www.everydayhearing.com/balance/articles/what-to-expect-at-your-vng-test/|title=What to Expect at Your VNG/ENG Test - Everyday Hearing|last=Banks|first=Lindsey|date=2014-05-07|work=Everyday Hearing|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

Of course, one can have arthritis, sleep apnea, [[Chronic lyme disease|chronic Lyme disease]] or other diseases and still have FM, but there may be a treatable condition where a patient's overall health, including their FM, improves.<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/guide/common-misdiagnoses-of-fibromyalgia#1|title=Common Misdiagnoses of Fibromyalgia|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite web|url=http://www.cfidsselfhelp.org/library/overlapping-and-related-conditions|title=Overlapping and Related Conditions {{!}} CFIDS & Fibromyalgia Self-Help|website=www.cfidsselfhelp.org|access-date=2018-08-09}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

There have been cases of [[Vitamin D]] deficiency being misdiagnosed as fibromyalgia as a D deficiency can cause pain. Supplementation or prescribed D treatments may alleviate this pain. However, it is possible to have both a D deficiency and fibromyalgia and correcting the deficiency will only resolve the pain stemming from it.<ref>{{Cite news|url=http://www.webmd.com/pain-management/features/vitamin-d-deficiency-and-chronic-pain-link#1|title=Does Vitamin D Deficiency Cause Chronic Pain?|last=Shaw|first=Gina|date=|work=WebMD|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

==== Blogs about navigating SSD process ====

*Resources for getting approved for disability include this [http://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/ Guide to Social Security Disability for People with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome],<ref>{{Cite web|url=https://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/|title=The Sleepy Girl Guide to Social Security Disability (U.S.) {{!}} #MEAction|last=Silver|first=Lily|date=Apr 17, 2017|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> available on the #[[MEAction]] website.

*[https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/ How Patty’s Lawyer Never Told Her What She Needed to Know]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/|title=How Patty’s Lawyer Never Told Her What She Needed to Know|last=Skelton Preston|first=Patty|date=2017-03-20|work=How to Get On|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/ Sample Doctor Letters for Disability]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/|title=21 Sample Doctor Letters for Disability|date=2017-05-01|work=How to Get On|access-date=2018-08-09|language=en-US}}</ref>

== Notable studies ==
{{Main article |page_name = Fibromyalgia notable studies}}

== Controversies ==
=== Dr. Frederick Wolfe ===
Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.<ref>{{Cite news|url=http://www.nytimes.com/2008/01/14/health/14pain.html?_r=0|title=Drug Approved. Is Disease Real?|last=Berenson|first=Alex|date=Jan 14, 2008|work=The Wall Street Journal|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>[http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf Fibromyalgia: A Short Commentary - iMedPub Journals - DOI: 10.4172/2472-1913.100027 - Frederick Wolfe and Brian Walitt - Sep. 23, 2016]</ref><ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|journal=Journal of Headache & Pain Management|volume=1|issue=3:27|pages=|via=iMedPub Journals}}</ref><ref>{{Cite news|url=https://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx|title=Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine|last=Cashin-Garbutt|first=April|date=2013-03-22|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Fibromyalgia vs Chiari malformation ===
Some individuals diagnosed with FMS were undergoing surgery for [[Chiari malformation]] (CM). These are two separate conditions; FMS cannot be resolved by undergoing a risky CM surgery.

*2011, [https://www.ncbi.nlm.nih.gov/pubmed/21135714 Is Chiari I malformation associated with fibromyalgia?]<ref>{{Cite journal|last=Watson|first=Nathaniel F.|last2=Buchwald|first2=Dedra|last3=Goldberg|first3=Jack|last4=Maravilla|first4=Kenneth R.|last5=Noonan|first5=Carolyn|last6=Guan|first6=Qingyan|last7=Ellenbogen|first7=Richard G.|date=2011|title=Is Chiari I malformation associated with fibromyalgia?|url=https://www.ncbi.nlm.nih.gov/pubmed/21135714|journal=Neurosurgery|volume=68|issue=2|pages=443–448; discussion 448–449|doi=10.1227/NEU.0b013e3182039a31|issn=1524-4040|pmid=21135714|via=}}</ref>
::Conclusion: Most patients with FM do not have [[CIM]] pathology. Future studies should focus on dynamic neuroimaging of craniocervical neuroanatomy in patients with FM.
*2015, [https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery CFS/FM and Chiari Malformation Surgery]<ref>{{Cite web|url=https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery|title=CFS/FM and Chiari Malformation Surgery|last=Casanova|first=Ken|date=Nov 15, 2015|website=www.massmecfs.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

== Learn more ==
*[https://www.s4me.info/forums/fibromyalgia-and-connective-tissue-disorders.35/ Forum: Fibromyalgia and Connective Tissue Disorders] at [[Science for ME]]
*[[Verywell FMS/CFS]]

=== Ongoing process of diagnosing and categorizing ===

*2014, [http://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114 Lyme Disease, Fibromyalgia Link Evaporates]<ref>{{Cite news|url=https://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114|title=Lyme Disease, Fibromylagia Link Evaporates|last=Kuznar|first=Wayne|date=2014-12-14|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> (See also: [[Chronic lyme disease]])

*2015, [http://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx Fibromyalgia now considered as a lifelong central nervous system disorder]<ref>{{Cite news|url=https://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx|title=Fibromyalgia now considered as a lifelong central nervous system disorder|date=2015-05-18|work=News-Medical.net|access-date=2018-08-09|language=en}}</ref>

*2015, [http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates]<ref>{{Cite news|url=http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html|title=Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates|date=2015-10-24|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2015, ''Question:'' [http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html 'Is Fibromyalgia a Psychosomatic Illness?'] via CelesteCooper.com ''Answer:'' "Fibromyalgia is NOT a psychosomatic illness."<ref>[http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html Is Fibromyalgia a Psychosomatic Illness? Med Student Asks Celeste Cooper by Celeste Cooper - CelesteCooper.com Sep 4, 2015]</ref>

*2016, [http://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination Diagnosing Fibromyalgia May Be Possible Using Noninvasive Eye Examination]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination|title=Diagnosing Fibromyalgia May Be Possible with Noninvasive Eye Exam|date=2016-09-09|work=Fibromyalgia News Today|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780 Microglia in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780|title=Microglia in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*2016, [http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/ Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders?]<ref>{{Cite news|url=http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/|title=Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders? - Simmaron Research|date=2016-03-21|work=Simmaron Research|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://consultqd.clevelandclinic.org/2016/03/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic Why Fibromyalgia Is Neuropathic]<ref>{{Cite news|url=https://consultqd.clevelandclinic.org/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic|title=Why Fibromyalgia Is Neuropathic|date=2016-03-08|work=Consult QD|access-date=2018-08-09|language=en-US}}</ref>

*2017, [http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain]<ref>{{Cite news|url=http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html|title=Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain|last=Liptan|first=Ginevra|date=2017-04-11|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
*2017, [https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947 AI can spot the pain from a disease some doctors still think is fake]<ref>{{Cite news|url=https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947|title=AI can spot the pain from a disease some doctors still think is fake|last=Goldhill|first=Olivia|date=Aug 9, 2018|work=Quartz|access-date=2018-08-15|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== Blood tests ===

*2013, [http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html New Fibromyalgia Blood Test is 99% Accurate]<ref>{{Cite news|url=http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html|title=New Fibromyalgia Blood Test is 99% Accurate|date=2013-07-31|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2014, [http://www.prohealth.com/library/showarticle.cfm?libid=18837 Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”]<ref>{{Cite news|url=https://www.prohealth.com/library/pridgen-reports-fibromyalgia-antiviral-trial-results-very-positive-predicts-new-approach-will-be-game-changer-32620|title=Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”|last=|first=|date=2014-03-25|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2016, [https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html Blood Test for Fibromyalgia: FM/a Test Ⓡ is now available, Q&A]<ref>{{Cite web|url=https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html|title=Blood Test for Fibromyalgia: FM/a Test ® Is Real, Q&A|last=Cooper|first=Celeste|date=May 3, 2016|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2016, [http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/ Fibromyalgia blood testing covered by rising number of insurance companies]<ref>{{Cite news|url=http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/|title=Fibromyalgia blood testing covered more of insurance companies|last=Campbell|first=Julie|date=2016-04-08|work=Live Insurance News|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2017, [http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches]<ref>{{Cite news|url=https://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=Business Wire|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Brain scans ===

*2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds]<ref>{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|publisher=ANAPSID|via=Chronic Neuroimmune Diseases|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2012, [https://www.sciencedaily.com/releases/2012/11/121111153426.htm Fibromyalgia and the brain: New clues reveal how pain and therapies are processed]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2012/11/121111153426.htm|title=Fibromyalgia and the brain: New clues reveal how pain and therapies are processed|last=|first=|date=Nov 11, 2012|work=ScienceDaily|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*2015, [https://www.verywell.com/unique-brain-connectivity-in-fibromyalgia-715630 Unique Brain Connectivity in Fibromyalgia - Increased Importance Assigned to Pain]<ref>{{Cite news|url=https://www.verywellhealth.com/how-lyrica-changes-the-fibromyalgia-brain-715767|title=How Lyrica Changes the Fibromyalgia Brain|last=Dellwo|first=Adrienne|date=Apr 30, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==See also==
* [[Fibromyalgia drugs]]

* [[Fibromyalgia notable studies]]
* [[Influenza vaccine]]

*[[Lady Gaga]]

==References==
<references />

[[Category:Diagnoses]]
[[Category:Comorbidities]]

Fibromyalgia

2018-08-25T14:38:00Z

77.111.246.7:/* Exercise */ spacing (visual edits seem to knock off spacing on this page

[[Fibromyalgia]] (FM/FMS) is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Pain is widespread, on both sides of the body, and above and below the waist.

Sufferers are fatigued and tired even when sleeping for long periods of time, and sleep is often disrupted by pain. Many FM sufferers have sleep disorders like [https://en.wikipedia.org/wiki/Sleep_apnea sleep apnea] and [[restless leg syndrome]]. [[Cognitive impairment]], when one cannot focus or pay attention and the patient has difficulty concentrating on mental tasks, is known by FM sufferers as "[[fibro fog]]".<ref name=":17">{{Cite news|url=https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014|title=What Is Fibro Fog and ME/CFS Brain Fog?|last=Dellwo|first=Adrienne|date=|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Some experience [[depression]], [[headache]]s, and lower [[abdominal pain]] or cramping. Other symptoms include tingling or [[numbness]] in hands and feet, pain in jaw and disorders of the jaw such as [[temporomandibular joint disorder|temporomandibular joint disorder]] (TMJ), [[Menstrual cycle#Health effects in other conditions|menstrual cycle]] cramps, and digestive problems like i[[Irritable bowel syndrome|rritable bowel syndrome]] (IBS).<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms#1|title=Fibromyalgia Symptoms|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780|title=Fibromyalgia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref>

[[File:Fibro_Tender_Points.png|400px|thumb|right|1990 ACR Diagnostic Criteria: 18 Tender Points]]
[[File:Fibro_Widespread_Pain.png|400px|thumb|right|2010 ACR Preliminatry Diagnostic Criteria: Wisedpread Pain Index (WPI), 19 Tender Point Areas]]

==Prevalence==
FM is the second most common [https://en.wikipedia.org/wiki/Rheumatism rheumatic disorder] behind [[wikipedia:Osteoarthritis|osteoarthritis]] and is "now considered to be a lifelong [[Central nervous system]] disorder."<ref>{{Cite news|url=https://naidw.org/blog/members-myblogs/fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder|title=Fibromyalgia now considered as a lifelong central nervous system disorder|work=NAIDW.org®|access-date=2018-08-09|language=en-gb}}</ref> An estimated 10 million people in the US and 3-6% of the world population have fibromyalgia. It is seen in women, men, children, and all ethnic groups. It is often seen in families and diagnosed between the ages of 20 to 50 years; incidence increases with age.<ref>{{Cite news|url=http://www.fmaware.org/about-fibromyalgia/prevalence/|title=Prevalence - National Fibromyalgia Association (NFA)|work=National Fibromyalgia Association (NFA)|access-date=2018-08-09|language=en-US}}</ref>

FM has a female:male 7:1 ratio under the ''American College of Rheumatology (ACR) 1990 Diagnostic Criteria'' and 2:1 when the ''ACR 2010 Preliminary Diagnostic Criteria'' is used.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=|publisher=|editor-last=Diamond|editor-first=Herbert|at=Sex-related differences in incidence}}</ref> ''See'': [[Fibromyalgia#American College of Rheumatology (ACR) Criteria|Fibromyalgia (''American College of Rheumatology (ACR) Criteria'' section)]].

==Fibromyalgia in ME/CFS==
Dr. [[Jarred Younger]] has said that many patients that meet the criteria for FM also meet criteria for [[chronic fatigue syndrome]] (CFS) but the reverse is not necessarily true as a lot of people with [[CFS]] do not have [[chronic pain]].<ref>{{Cite web|url=https://www.youtube.com/watch?v=wJB95m4FLa0#t=57m27s|title=Webinar with Jarred Younger, Ph.D.|last=Younger|first=Jared|date=May 20, 2016|website=YouTube|at=57:27|via=|archive-url=|archive-date=|dead-url=|access-date=|publisher=SolveCFS|type=Video}}</ref> However, the [[Canadian Consensus Criteria]] (CCC) requires the symptom of pain to diagnose [[ME/CFS]]. It is the pattern and significant degree of [[chronic pain]] in FM that sets it apart from other diseases that have pain.

"The most common overlapping condition with ME/CFS is fibromyalgia."<ref name=":30">{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions - American Myalgic Encephalomyelitis and
Chronic Fatigue Syndrome Society|last=|first=|date=|website=ammes.org|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref><ref name=":31">{{Cite journal|last=Jason|first=Leonard|last2=Taylor|first2=R.R.|last3=Kennedy|first3=C.L.|last4=Song|first4=S|last5=Johnson|first5=D|last6=Torres|first6=S.R.|date=2001-01-01|title=Chronic fatigue syndrome: Comorbidity with fibromyalgia and psychiatric illness|url=https://www.researchgate.net/publication/285787383_Chronic_fatigue_syndrome_Comorbidity_with_fibromyalgia_and_psychiatric_illness|journal=Medicine and Psychiatry|volume=4|pages=29–34}}</ref>

==Health complications==
FM is not a [https://en.wikipedia.org/wiki/Progressive_disease progressive disease] but according to Dr. Dan Clauw the "slow gradual worsening of chronic pain patients over time is due to downstream consequences of poorly controlled pain and other symptoms, wherein individuals then progressively get less active, sleep worse, are under more stress and unknowingly develop bad habits which worsen pain and other symptoms."<ref>{{Cite news|url=http://nationalpainreport.com/ask-the-dctors-is-fibromyalgia-progressive-8831105.html|title=Ask the Doctors: Is Fibromyalgia Progressive?|date=2016-08-09|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*[https://www.sharecare.com/health/fibromyalgia-effects Fibromyalgia Complications]<ref name=":19" />

:<blockquote>People who have fibromyalgia frequently complain of a variety of symptoms that affect other parts of the body. Many people complain of [[gastrointestinal]] issues and restless legs syndrome (RLS). Additionally, the [[chronic pain]] and discomfort of fibromyalgia may lead to [[depression]].<ref name=":19">{{Cite news|url=https://www.sharecare.com/health/fibromyalgia-effects|title=Fibromyalgia Complications - Fibromyalgia - Joint Health|work=Sharecare|access-date=2018-08-09|language=en}}</ref></blockquote>

*[https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions Can fibromyalgia cause other medical conditions?]<ref name=":20" />

:<blockquote>Fibromyalgia is not known to cause other medical conditions. However, people who have fibromyalgia seem to be at high risk for developing other painful conditions, including [https://en.wikipedia.org/wiki/Osteoarthritis osteoarthritis] (the common type of arthritis caused by wear and tear on the joints) as well as other related conditions, such as [[rheumatoid arthritis]], [[lupus]], and [https://en.wikipedia.org/wiki/Ankylosing_spondylitis ankylosing spondylitis]. Also, people with fibromyalgia are frequently diagnosed with chronic fatigue syndrome, irritable bowel syndrome (IBS), and temporomandibular joint (TMJ) disorder.<ref name=":20">{{Cite web|url=https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions|title=Can fibromyalgia cause other medical conditions? {{!}} Fibromyalgia Complications|last=Honor Society of Nursing|first=|date=|website=Sharecare|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref></blockquote>

==Risk factors==
[[Lupus]] and [[Rheumatoid arthritis]] (RA) are risk factors in developing FM. Car accidents, [[Post-traumatic stress disorder]] (PTSD), [https://en.wikipedia.org/wiki/Repetitive_strain_injury repetitive injuries], illness such as a [https://en.wikipedia.org/wiki/Viral_disease viral infection], [https://en.wikipedia.org/wiki/Family_history_(medicine) family history], and [https://en.wikipedia.org/wiki/Obesity obesity] have all been linked to FM.<ref>{{Cite web|url=https://www.cdc.gov/arthritis/basics/fibromyalgia.htm|title=Fibromyalgia {{!}} Arthritis {{!}} CDC|date=2018-04-03|website=www.cdc.gov|language=en-us|access-date=2018-08-09}}</ref><ref>{{Cite news|url=https://www.niams.nih.gov/health_info/Fibromyalgia/|title=Fibromyalgia What Causes it?|last=Director|first=Nancy Garrick, Deputy|date=2017-04-05|work=National Institute of Arthritis and Musculoskeletal and Skin Diseases|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

==Diagnosis==
[https://www.verywellhealth.com/what-are-fibromyalgia-tender-points-189768 Tender points], not [https://en.wikipedia.org/wiki/Myofascial_trigger_point trigger points], are used to diagnose Fibromyalgia.<ref>{{Cite web|url=http://www.healthcentral.com/chronic-pain/c/662034/176031/fibromyalgia-trigger/|title=The Difference Between Fibromyalgia Tender Points and Myofascial Trigger Points - Chronic Pain {{!}} HealthCentral|last=Cooper|first=Celeste|date=May 8, 2015|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> Tender points will be above and below the waist and on both sides of the body. (See: Illustrations of the 1990 and 2010 American College of Rheumatology (ACR) Criteria depicting tender points near the top of this page.) It is important to check for other conditions that could be causing pain such as hypothyroidism, Rheumatoid arthritis or lupus, osteoarthritis, Ankylosing spondylitis, and [[wikipedia:Polymyalgia_rheumatica|Polymyalgia rheumatica]].<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>

===United States===
==== American College of Rheumatology (ACR) Criteria ====

*1990, [http://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf The American College Of Rheumatology 1990 Criteria For The Classification Of Fibromyalgia]<ref>{{Cite web|url=https://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf|title=The American College of Rheumatology Criteria for the Classification of Fibromyalgia|last=Wolfe|first=Frederick|last2=Smythe|first2=Hugh|date=1990|website=rheumatology.org|publisher=|others=Abeles, Micha; Clark, Patricia; Fam, Adel; Farber, Stephen; Fiechtner, Justus; Franklin, Michael; Gatter, Robert; Hamaty, Daniel; Lessard, James; Lightbroun, Alan; Masi, Alfonse; McCain, Glenn; Reynolds, W. John; Romano, Thomas; Russell, Jon; Sheon, Robert|archive-url=|archive-date=|dead-url=|access-date=|last3=Yunus|first3=Muhammad|last4=Bennett|first4=Robert|last5=Bombardier|first5=Claire|last6=Goldenberg|first6=Don|last7=Tugwell|first7=Peter|last8=Campbell|first8=Stephen}}</ref> "American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure."<ref>{{Cite news|url=http://www.health.com/health/gallery/0,,20345635,00.html|title=18 Points Used to Diagnose Fibromyalgia|last=|first=|date=Feb 4, 2011|work=Health.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> <ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2010, The [https://www.fibroknowledge.com/site/acr-2010 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview]<ref>{{Cite web|url=https://www.fibroknowledge.com/sites/default/files/downloads/file/2010_ACR_CRITERIA.pdf|title=American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia|last=|first=|date=2010|website=fibroknowledge.com|type=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref> was proposed and modified in 2011<ref>{{Cite news|url=http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria|title=New and Modified Fibromyalgia Diagnostic Criteria|last=Garg|first=Neha|date=Feb 9, 2012|work=Rheumatology Network|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=|last2=Deodhar|first2=Atul}}</ref> with the modification being validated in 2013 and published in 2014.<ref>{{Cite journal|last=Bennett|first=Robert M.|last2=Friend|first2=Ronald|last3=Marcus|first3=Dawn|last4=Bernstein|first4=Cheryl|last5=Han|first5=Bobby Kwanghoon|last6=Yachoui|first6=Ralph|last7=Deodhar|first7=Atul|last8=Kaell|first8=Alan|last9=Bonafede|first9=Peter|date=2014|title=Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/24497443|journal=Arthritis Care & Research|volume=66|issue=9|pages=1364–1373|doi=10.1002/acr.22301|issn=2151-4658|pmid=24497443|via=}}</ref> September of 2016, another revision has been made.<ref>{{Cite news|url=http://acrabstracts.org/abstract/2016-revisions-to-the-20102011-fibromyalgia-diagnostic-criteria/|title=2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria - ACR Meeting Abstracts|last=|first=|date=Sep 28, 2016|work=ACR Meeting Abstracts|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

:Men do not seem to form the tender points needed for diagnosis under the 1990 criteria,<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/features/how-fibromyalgia-affects-men#2|title=How Fibromyalgia Affects Men: Symptoms and Diagnosis|work=WebMD|access-date=2018-08-09|language=en-US}}</ref> the 2010 proposed criteria diagnoses more men with a F/M ratio of 2:1.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=}}</ref>
:Tender points were used to diagnose with the 1990 criteria, however "considerable skill is needed to correctly check for a patient’s tender points (i.e., digital palpation that is done with certain amount of applied pressure), yet this technique is not typically taught at most medical schools."<ref name=":0">{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 5, 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>
:The new standards were designed to:
:*eliminate the use of a tender point examination
:*include a severity scale by which to identify and measure characteristic FM symptoms
:*utilize an index by which to rate pain<ref name=":0" />
:*There are 19 tender point areas in the widespread pain index (WPI), whereas the 1990 criteria had 18 tender points.<ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose fibromyalgia.<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=Jul 25, 2012|website=www.ssa.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

==== Sleep study ====
[[Sleep dysfunction]] is often involved in fibromyalgia. Treating a sleep disorder can help with fibromyalgia symptoms. A diagnosed sleep disorder is also helpful if one needs to file for disability.

*[https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054 Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054|title=Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*[http://www.sciencedaily.com/releases/2008/09/080903134311.htm What A Sleep Study Can Reveal About Fibromyalgia]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2008/09/080903134311.htm|title=What A Sleep Study Can Reveal About Fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*[http://linkis.com/nationalpainreport.com/lzYea Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says]<ref>{{Cite news|url=http://linkis.com/nationalpainreport.com/lzYea|title=Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says|last=|first=|date=Mar 25, 2016|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== ICD Diagnostic code===
====World Health Organization====
'''ICD-10'''

The [[World Health Organization]] (WHO) International Classification of Diseases (ICD) lists fibromyalgia as a "disease of the [[musculoskeletal system]] and connective tissue", under the code M79.7 (WHO ICD-10 Version: 016).<ref>World Health Organization, [http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7 International Classification of Diseases - Fibromyalgia M79.7], ICD-10, 2016</ref>

*'''M79.7 Fibromyalgia'''
::Fibromyositis
::Fibrositis
::Myofibrositis<ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7|title=ICD-10 Version:2016|website=apps.who.int|language=en|access-date=2018-08-09}}</ref>

In 2015, the [[United States]] finally adopted ICD-10 and Fibromyalgia as a diagnosis.<ref>{{Cite web|url=http://www.icd10data.com/ICD10CM/Codes/M00-M99/M70-M79/M79-/M79.7|title=2018 ICD-10-CM Diagnosis Code M79.7: Fibromyalgia|website=www.icd10data.com|language=en|access-date=2018-08-09}}</ref> <ref>{{Cite news|url=http://nationalpainreport.com/the-health-care-industry-finally-recognizes-fibromyalgia-8827637.html|title=The Health Care Industry Finally Recognizes Fibromyalgia|last=Liptan|first=Ginevra|date=2015-09-30|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

'''ICD-11 (2019)'''

[https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504 ICD-11] (2019) has diagnostic code ''MG30.1 Chronic widespread pain''.<ref name=":18">{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504|title=ICD-11 - Mortality and Morbidity Statistics|website=icd.who.int|language=en|access-date=2018-08-09}}</ref>

*'''MG30.01 Chronic widespread pain'''

'''Parent'''
::MG30.0 Chronic primary pain

'''Description'''
<blockquote>Chronic widespread pain (CWP) is diffuse pain in at least 4 of 5 body regions and is associated with significant emotional distress (anxiety, anger/frustration or depressed mood) or functional disability (interference in daily life activities and reduced participation in social roles) [1]. CWP is multifactorial: biological, psychological and social factors contribute to the pain syndrome. The diagnosis is appropriate when the pain is not directly attributable to a nociceptive process in these regions and there are features consistent with nociplastic pain [2] and identified psychological and social contributors.<ref name=":18" /></blockquote>

'''Inclusions'''
:*Fibromyalgia
'''Exclusions'''
:*Acute pain (MG31)<ref name=":18" />

==Pathophysiology==
"Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology. There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or [[Lyme disease]], as well as emotional or physical trauma."<ref>{{Cite web|url=https://www.uptodate.com/contents/pathogenesis-of-fibromyalgia#!|title=UpToDate|last=Goldenberg|first=Don L|date=|website=www.uptodate.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> The widespread pain is severe, debilitating, and abnormal in processing its pain. There is also sleep disturbance and fatigue. Cause or causes are unproven.<ref>{{Cite news|url=https://www.omf.ngo/what-is-mecfs-old/fibromyalgia/|title=What is Fibromyalgia? {{!}} Open Medicine Foundation|work=Open Medicine Foundation|access-date=2018-08-09|language=en-US}}</ref>

*May 2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/ Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management]<ref name=":21">{{Cite journal|last=Jahan|first=Firdous|last2=Nanji|first2=Kashmira|last3=Qidwai|first3=Waris|last4=Qasim|first4=Rizwan|date=2012|title=Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/|journal=Oman Medical Journal|volume=27|issue=3|pages=192–195|doi=10.5001/omj.2012.44|issn=1999-768X|pmc=|pmid=22811766|via=}}</ref> ''See'' Table 1: "Conditions associated with fibromyalgia." Musculoskeletal, genitourianry, gastro intestinal, and miscellaneous conditions often exist among fibromyalgia patients.

<blockquote>Pathophysiology: Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as [[serotonin]], substance P, growth hormone and [[cortisol]] suggest that regulation of the autonomic and neuro-endocrine system appears to be the basis of the syndrome. Fibromyalgia is not a life-threatening, deforming, or [https://en.wikipedia.org/wiki/Progressive_disease progressive disease]. [[Anxiety]] and [[depression]] are the most common association. Aberrant pain processing, which can result in [[chronic pain]], may be the result of several interplaying mechanisms. [[Central sensitization]], blunting of inhibitory pain pathways and alterations in [[neurotransmitters]] lead to aberrant neuro-chemical processing of sensory signals in the CNS, thus lowering the threshold of pain and amplification of normal sensory signals causing constant pain.<ref name=":21" /></blockquote>

<blockquote>The frequent co-morbidity of fibromyalgia with mood disorders suggests a major role for the stress response and for neuroendocrine abnormalities. The [[hypothalamic pituitary axis]] (HPA) is a critical component of the stress-adaptation response. In FMS, stress adaptation response is disturbed leading to stress induce symptoms. Psychiatric co-morbidity has been associated with FMS and needs to be identified during the consultation process, as this requires special consideration during treatment.<ref name=":21" /></blockquote>

*May 2018, [https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management]<ref>{{Cite journal|last=Bourgaize|first=Sheryl|last2=Newton|first2=Genevieve|last3=Kumbhare|first3=Dinesh|last4=Srbely|first4=John|date=2018|title=A comparison of the clinical manifestation and
pathophysiology of myofascial pain syndrome
and fibromyalgia: implications for differential
diagnosis and management|url=https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf|format=PDF|journal=Journal of the Canadian Chiropractic Assoc.|volume=|pages=26-41|at=See Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)|via=}}</ref> (PDF) ''See'' Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)

*Jul 2018, [https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/ Primary and Secondary Fibromyalgia Share Same Symptom Burden, Study Suggests]<ref name=":22">{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/|title=Primary, Secondary Fibromyalgia Share Same Symptom Burden, Study Says|last=Carvalho|first=John|date=2018-07-31|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

<blockquote>Fibromyalgia can be considered either primary, or dominant, also known as idiopathic fibromyalgia, or secondary. In the primary form, the causes of the disorder are unknown, but in secondary fibromyalgia, the disorder usually occurs alongside other debilitating medical conditions, such as rheumatoid arthritis (RA), lupus, and multiple sclerosis.<ref name=":22" /></blockquote>

===Immune system research===

Dr. [[Jarred Younger]] believes an overactive [[immune system]] is the cause and will be conducting a study to test this hypothesis.<ref>{{Cite news|url=http://nationalpainreport.com/new-uab-study-could-radically-change-fibromyalgia-treatment-as-we-know-it-8833437.html|title=New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It|last=Gregory Burch|first=Donna|date=2017-04-24|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=https://www.youtube.com/watch?v=8e5xKX036bE|title=Testing the fibromyalgia immune system with lipopolysaccharide (LPS)|last=Younger|first=Jarred|date=May 24, 2017|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=|via=Younger Lab}}</ref> An overactive immune system is responsible for [[inflammation]] which causes [[chronic pain]].

Dr. William Pridgen's research of [[HSV-1]] (cold sore virus) as being involved in FM has conducted a successful Phase III clinical trial, which had been fast-tracked by the [[Food and Drug Administration]] (FDA), of a combination drug that suppresses this virus and also helps with pain. ''See'': [[Fibromyalgia#IMC-1|Fibromyalgia (''Drugs: Trials: IMC-1'' section)]].

[[ProHealth]] reports that an old [https://en.wikipedia.org/wiki/Tuberculosis Tuberculosis] vaccine, [https://en.wikipedia.org/wiki/BCG_vaccine Bacille Calmette-Guerin] (BCG), may be researched for treatment of Fibromyalgia spearheaded by [http://www.buzzfile.com/business/Epicgenetics,-Inc.-310-586-2929 EpicGenetics] and [http://www.massgeneral.org/ Massachusetts General Hospital].<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

EpicGenetics has a blood test that is identifying the presence of specific white blood cell abnormalities of patients diagnosed with FM and has partnered with two universities to offer [https://en.wikipedia.org/wiki/Disease_gene_identification#Whole_exome_sequencing whole exome sequencing] free of charge to those who test positive with their [http://fmtest.com/ FM/a® test].<ref>{{Cite news|url=http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> Concerns have been raised in regards to the FM/a® EpicGenetics Blood Test.<ref>{{Cite web|url=http://www.fmperplex.com/2013/02/25/junk-science-junk-ethics/|title=Junk Science – Junk Ethics – The Fibromyalgia Perplex|last=Wolfe|first=Fred|date=Feb 25, 2013|website=www.fmperplex.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> EpicGenetics is awaiting FDA approval to test the Bacille Calmette-Guerin (BCG) vaccine (an old Tuberculosis vaccine) on patients that tested positive with its FM/a® test.<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689#comment-2286|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=See Comments Section: CDW12 says: June 26, 2018 at 2:05 pm|language=en-US}}</ref><ref>{{Cite web|url=https://www.celestecooper.com/2018/07/the-fma-blood-test-and-participation-in.html#.Wz4nxdJKjIU|title=The FM/a® Blood Test and Participation in Fibromyalgia Vaccine Study|last=Cooper|first=Celeste|date=Jul 5, 2018|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

A June 2018 study found inflammatory genes CCL11, CCL4, and MEFV in a fibromyalgia family study.<ref>{{Cite journal|last=Zhang|first=Zhifang|last2=Feng|first2=Jinong|last3=Mao|first3=Allen|last4=Le|first4=Keith|last5=Placa|first5=Deirdre La|last6=Wu|first6=Xiwei|last7=Longmate|first7=Jeffrey|last8=Marek|first8=Claudia|last9=Amand|first9=R. Paul St|date=2018-06-21|title=SNPs in inflammatory genes CCL11, CCL4 and MEFV in a fibromyalgia family study|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198625|journal=PLOS ONE|language=en|volume=13|issue=6|pages=e0198625|doi=10.1371/journal.pone.0198625|issn=1932-6203|pmid=29927949|via=}}</ref>
<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/03/immune-system-may-play-role-fibromyalgia-study/|title=Fibromyalgia May Be Linked to Immune System, Study Suggests|last=Inacio|first=Patricia|date=2018-07-03|work=Fibromyalgia News Today|access-date=2018-08-22|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Comorbidities, overlapping conditions, and common symptoms ==
[[File:Fibromyalgia and comorbid conditions.JPG|700px|thumb|center|Comorbid conditions of Fibromyalgia (FMS) are ME/CFS which is the most common; autoimmune diseases; migraines; Multiple Chemical Sensitivities (MCS); and orthostatic intolerance (OI) / Postural Orthostatic Tachycardia Syndrome (POTS).<ref name=":30" /><ref name=":31" /><ref name=":33">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref> Depression and anxiety; digestive conditions and menstrual problems; GWI; nervous system disorders; low blood pressure (Low BP); other pain conditions and migraines; and sleep dysfunction/disturbance all overlap with FMS.<ref name=":30" /> <ref name=":33" />]]

*[[Allodynia]]
** [http://chronicfatigue.about.com/od/glossary/g/allodynia.htm Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS]<ref name=":1">{{Cite news|url=https://www.verywellhealth.com/allodynia-definition-and-types-fibromyalgia-715929|title=Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Feb 23, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Types of Allodynia: Tactile; Mechanical; and Thermal. "Type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain" <ref name=":1" />
*[[Autoimmune disease]]<nowiki/>s "Research suggests that RA and other inflammatory diseases may somehow increase the risk for fibromyalgia."<ref>{{Cite news|url=https://www.health.com/health/gallery/0,,20520705,00.html#restless-legs-0|title=7 Conditions Linked to Fibromyalgia|work=Health.com|access-date=2018-08-19|language=en}}</ref>

*[[Body temperature]]
**[https://www.verywell.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025 Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":2">{{Cite news|url=https://www.verywellhealth.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025|title=Temperature Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Mar 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

<blockquote>When you're exposed to heat, does it feel like you're burning up? Does it seem impossible for you to cool off? Or maybe it's cold that bothers you, chilling you to the bone, leaving you unable to warm up? Or are you one of those people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) who is cold all the time, or hot all the time, or alternately hot or cold while out of sync with the environment?<ref name=":2" /></blockquote>

[[File:Costal cartilages.JPG|200px|thumb|left|Costochonritus is inflammation of the costal cartliges (shown in red) causing chest and ribcage pain]]

:* [https://www.verywell.com/costochondritis-in-fibromyalgia-716178 Costochondritis in Fibromyalgia]<ref name=":10">{{Cite news|url=https://www.verywellhealth.com/costochondritis-in-fibromyalgia-716178|title=Costochondritis Chest Pain in Fibromyalgia|last=Dellow|first=Adrienne|date=Feb 14, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|date=2018-05-25|title=Costochondritis|url=https://en.wikipedia.org/w/index.php?title=Costochondritis&oldid=842926736|journal=Wikipedia|language=en}}</ref>

<blockquote>Costochondritis is inflammation of the cartilage that connects your ribs to your breastbone. Depending on how much inflammation there is, it can range from mildly annoying to intensely painful. People sometimes describe the pain as stabbing, aching, or burning.<ref name=":10" /></blockquote>

<blockquote>Costochondritis can make you think you're having heart problems, which is a scary thing. Even though costochondritis is common, you should get medical attention if you have unexplained chest pain. You don't want to assume that it's FMS-related and end up with permanent heart damage or worse.<ref name=":10" /></blockquote>

<blockquote>The pain can radiate to your shoulder and arms as well (another way the condition mimics a heart attack). Sometimes the pain is accompanied by redness and/or swelling in the most painful areas. When that's the case, it's called Tietze's Syndrome.<ref name=":10" /></blockquote>

* [[Depression]] and [[Anxiety]] Fibromyalgia sufferers are "up to three times more likely to have depression at the time of their diagnosis than someone without fibromyalgia."<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/fibromyalgia-and-depression#1|title=Fibromyalgia and Depression|work=WebMD|access-date=2018-08-19|language=en-US}}</ref> Up to 20 percent of Fibromyalgia patients will have either depression or anxiety.<ref>{{Cite web|url=https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/fibromyalgia|title=Fibromyalgia {{!}} Anxiety and Depression Association of America, ADAA|website=adaa.org|language=en|access-date=2018-08-19}}</ref>

*[[Fibro fog]]

:*[http://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction]<ref name=":3">{{Cite news|url=https://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx|title=What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction|last=Mandal|first=Ananya|date=2013-06-03|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> 'Mental confusion along with difficulty in concentration and loss of memory is often termed “[[fibro fog]]"'.<ref name=":3" />

:* [https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014 What Is Fibro Fog and ME/CFS Brain Fog?]<ref name=":17" />

*[[Gastrointestinal system]]
**[[Irritable bowel syndrome]]: [http://chronicfatigue.about.com/od/whyfmscfsarelinked/a/IBS.htm Irritable Bowel Syndrome in Fibromyalgia & Chronic Fatigue Syndrome - Why Do They Go Together?]<ref name=":4">{{Cite news|url=https://www.verywellhealth.com/irritable-bowel-syndrome-in-fibromyalgia-cfs-716167|title=Irritable Bowel Syndrome in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jan 28, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>Fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome (IBS) frequently go together. No one really knows why, but we do know that all three conditions can include imbalances of serotonin -- although in fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS or ME/CFS) it's an imbalance in the brain, while with IBS it's in the gut.<ref name=":4" /></blockquote>
* [[Gulf War Illness]]
**[https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp Fibromyalgia in Gulf War Veterans]<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp|title=Fibromyalgia in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-19}}</ref> GWI increases risk of developing Fibromyalgia.

*[https://en.wikipedia.org/wiki/Interstitial_cystitis Interstitial Cystitis]<ref>{{Cite journal|date=2018-07-11|title=Interstitial cystitis|url=https://en.wikipedia.org/w/index.php?title=Interstitial_cystitis&oldid=849828657|journal=Wikipedia|language=en}}</ref> (Painful bladder)
**[https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168 Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis]<ref name=":5">{{Cite news|url=https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168|title=Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "Fibromyalgia, chronic fatigue syndrome and interstitial cystitis (IC) -- a painful bladder condition -- frequently occur together. Women may be up to 10 times more likely than men to develop it."<ref name=":5" />

*Language Impairment
**[[Word-finding problems]] is a symptom of ME/CFS.
:*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome Impaired Language in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":6" /> "Searching their brains for simple words that they just can't remember. On other occasions, individuals with these diagnoses may find it hard to write or even understand language."<ref name=":6">{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:*"The diagnosis of [[Aphasia]] is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written"<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref> but with [[dysphasia]] you will have those symptoms and trouble listening and doing numeral calculations.<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-09}}</ref> ''See also'': [[Dyscalculia]].
* [[ME/CFS]]
:*[https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184 Comorbid Conditions in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>
* [[Migraine]]
:*[https://migrainecenters.com/blog/migraines-and-fibromyalgia/ Migraines and Fibromyalgia]<ref name=":32" />
<blockquote>Both fibromyalgia and migraine may reflect problems in the brain’s pain processing center. It is believed that both conditions are caused by excitation of the nervous system or an over-response to stimuli. Stress is usually cited as a trigger for both migraine and fibromyalgia attacks.<ref name=":32">{{Cite news|url=https://migrainecenters.com/blog/migraines-and-fibromyalgia/|title=Migraines and Fibromyalgia - Migraine Centers|date=2016-05-06|work=Migraine Centers|access-date=2018-08-19|language=en-US}}</ref></blockquote>
* [[Multiple chemical sensitivity|Multiple Chemical Sensitivity]] (MCS) It is thought that both Fibromyalgia and MCS are [[Central sensitisation|central sensitivity]] syndromes.<ref>{{Cite news|url=https://www.verywellhealth.com/chemical-sensitivity-in-fibromyalgia-716170|title=Multiple Chemical Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>

*OBGYN
**[https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596 Menstrual Periods with Fibromyalgia: Personal Stories]<ref>{{Cite news|url=https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596|title=Menstrual Periods with Fibromyalgia: Personal Stories|last=Dellwo|first=Adrienne|date=May 18, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>
**[https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626 Fibromyalgia Tied to Hysterectomy, Gynecologic Disease].<ref name=":7" />
:<blockquote>You may have heard about a possible link between gynecologic surgery (such as a hysterectomy) and the development of fibromyalgia, and doctors have long suspected that fibromyalgia has strong hormonal ties and triggers. This does not seem surprising as we've long suspected a link between endocrine disorders, gynecological conditions, and autoimmune conditions.<ref name=":7">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626|title=Fibromyalgia Tied to Hysterectomy, Gynecologic Disease|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref></blockquote>

*[[Orthostatic intolerance]] (OI) and [[Postural orthostatic tachycardia syndrome]] (POTS)<ref>{{Cite journal|last=Yun|first=Dong Joo|last2=Choi|first2=Han Na|last3=Oh|first3=Gun-Sei|date=2013|title=A Case of Postural Orthostatic Tachycardia Syndrome Associated with Migraine and Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710947/|journal=The Korean Journal of Pain|volume=26|issue=3|pages=303–306|doi=10.3344/kjp.2013.26.3.303|issn=2005-9159|pmid=23862007|via=}}</ref>

:*[http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM]<ref>{{Cite web|url=http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf|title=Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM|last=Lapp|first=Charles W.|last2=Black|first2=Laura|date=|website=drlapp.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Smith|first3=Rebekah S.}}</ref> (PDF) Symptoms can include low blood pressure and/or sudden high blood pressure, dizziness, fainting.

:*[https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/ An Overlooked Issue in Fibromyalgia? Study Highlights Problems Standing (Orthostatic Intolerance)]<ref>{{Cite news|url=https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/|title=An Overlooked Issue in Fibromyalgia? Study Highlights Orthostatic Intolerance - Problems Standing - Health Rising|last=Johnson|first=Cort|date=2017-09-21|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[[Sleep dysfunction]]
**[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia]<ref name=":23">{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}</ref>

:<blockquote>The present results of this study suggest that long-term, comorbid pain and sleep disturbance may be associated with increased activation in core default mode brain areas that is above and beyond long-term pain disturbance alone.<ref name=":23" /></blockquote>

:*[http://www.prohealth.com/library/showarticle.cfm?libid=22344 Fibromyalgia and Sleep]<ref name=":8">{{Cite news|url=https://www.prohealth.com/library/fibromyalgia-and-sleep-38954|title=Fibromyalgia and Sleep - Prohealth|date=2016-01-11|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref> "Most people with fibromyalgia have an associated sleep disorder that makes it difficult for them to get the deep, restorative sleep they need."<ref name=":8" />

[[File:TMJ_1.jpg|200px|thumb|right|TMJ/TMD is a condition that occurs in some fibromyalgia and ME/CFS patients]]
* [[Temporomandibular joint disorder]] (TMJ/TMD)

:* [https://www.sciencedirect.com/science/article/pii/S2255502114001758 Temporomandibular disorders in fibromyalgia syndrome: a short-communication]<ref>{{Cite journal|last=Soares Gui|first=Maisa|last2=Pimentel|first2=Marcele Jardim|last3=Rizzatti-Barbosa|first3=C'elia Marisa|date=2015-03-01|title=Temporomandibular disorders in fibromyalgia syndrome: a short-communication|url=https://www.sciencedirect.com/science/article/pii/S2255502114001758|journal=Revista Brasileira de Reumatologia (English Edition)|language=en|volume=55|issue=2|pages=189–194|doi=10.1016/j.rbre.2014.07.004|issn=2255-5021|via=ScienceDirect}}</ref><ref>{{Cite news|url=https://www.whitesmilesforlife.com/blog/study-probes-pain-link-between-tmj-fibromyalgia/|title=Study Probes Pain Link Between TMJ, Fibromyalgia|date=2016-05-03|work=Kent E. White, DDS|access-date=2018-08-19|language=en-US}}</ref>

::Other than headaches, the symptoms are quite distinct from symptoms of FMS and ME/CFS.

::They include:
::*Jaw pain
::*Discomfort or difficulty chewing
::*Painful clicking in the jaw
::*Difficulty opening or closing the mouth
::*Headaches
::*Locking jaw
::*Teeth that don't come together properly<ref>{{Cite news|url=https://www.verywellhealth.com/tmj-in-fibromyalgia-chronic-fatigue-syndrome-716175|title=TMJ in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Mar 31, 2018|work=Verywell Health|access-date=2018-08-22|archive-url=|archive-date=|dead-url=}}</ref>

*[[Thyroid disease]]
**[https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677 Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease]<ref name=":9">{{Cite news|url=https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677|title=A Comparison of Chronic Fatigue, Fibromyalgia, and Thyroid Disease|last=Shomon|first=Mary|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>People with Hashimoto's autoimmune thyroid disease often experience significant fatigue and body aches. While these symptoms are common in Hashimoto's, they can also be markers of other diseases, like chronic fatigue syndrome or fibromyalgia.<ref name=":9" /></blockquote>

*Other symptoms
**[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/fibrosymptoms.htm Symptoms of Fibromyalgia]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-symptoms-716139|title=Symptoms of Fibromyalgia|last=Dellwo|first=Adrienne|date=May 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> (A comprehensive all in one place list for the many symptoms of fibromyalgia.)

==Treatment==

===United States===
'''Rheumatology and primary care providers: Diagnosing and treatment'''

*2012, [https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract A Framework for Fibromyalgia Management for Primary Care Providers]<ref>{{Cite journal|last=Arnold|first=Lesley M.|last2=Clauw|first2=Daniel J.|last3=Dunegan|first3=L. Jean|last4=Turk|first4=Dennis C.|date=2012|title=A Framework for Fibromyalgia Management for Primary Care Providers|url=https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract|journal=Mayo Clinic Proceedings|language=English|volume=87|issue=5|pages=488–496|doi=10.1016/j.mayocp.2012.02.010|issn=0025-6196|via=}}</ref> Rheumatologists stopped treating fibromyalgia patients and primary care providers began treatment managment although rheumatologists are most often the specialist to diagnose. (Please see [http://me-pedia.org/wiki/Fibromyalgia#Disability disability] heading about ''primary provider'' and ''specialists'' for disability cases.)

=== Drugs ===

{{Main article |page_name = Fibromyalgia drugs}}

=== Therapies ===

==== Exercise ====
''Please Note'': These recommendations are for fibromyalgia patients and '''not''' [[ME/CFS]] sufferers.
[[File:Warm water exercise.JPG|200px|thumb|left|Warm water exercise is best for fibromyalgia. Start slow and don't push through the pain<ref name=":11" />]]

*[https://www.verywellhealth.com/warm-water-exercise-for-fibromyalgia-716059 Warm Water Exercise for Fibromyalgia]<ref name=":11">{{Cite news|url=http://chronicfatigue.about.com/od/treatingfmscfs/a/warmwaterFMS.htm|title=Warm Water Exercise for Fibromyalgia|last=Dellwo|first=Adrienne|date=Nov 19, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|last=Munguía-Izquierdo|first=D.|last2=Legaz-Arrese|first2=A.|date=2007|title=Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/18173915|journal=Clinical and Experimental Rheumatology|volume=25|issue=6|pages=823–830|issn=0392-856X|pmid=18173915|via=}}</ref>

<blockquote>A warm-water pool is good for therapy because cold water can make muscles tense up. It's especially important in FMS because many people with the condition are intolerant of cold. A warm-water pool is one that's kept around 89.6 degrees Fahrenheit (32 Celsius), which is several degrees warmer than most heated pools.<ref name=":11" /></blockquote>

*Moderate aerobic exercise and weights with six to eight reps and then a day or two of rest in between. Do not start a program if you are in a flare.<ref>{{Cite web|url=http://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/fibromyalgia-questions/fibromyalgia-exercise.php|title=Fibromyalgia Exercise {{!}} Exercising with Fibromyalgia|last=Ronenn|first=Roubenoff|date=|website=www.arthritis.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[https://www.youtube.com/watch?v=BauJYuJwFsI Easy fibromyalgia exercises and motivation to keep you healthy!]<ref>{{Cite web|url=https://www.youtube.com/watch?v=BauJYuJwFsI|title=Easy Fibromyalgia exercises and motivation to keep you healthy!|last=Suarez|first=Eric|date=Jun 21, 2011|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=Aug 9, 2018}}</ref> Video

*[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/Fibromyalgia-Myth-Vs-Fact.htm Fibromyalgia Myth vs. Fact]<ref name=":15">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-myth-vs-fact-716131|title=Fibromyalgia: What's Myth, What's Fact?|last=Dellwo|first=Adrienne|date=Jun 8, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=Myth #3 People With Fibromyalgia Need More Exercise}}</ref> Heading: ''Myth #3: People With Fibromyalgia Need More Exercise''. Appropriate exercise, which each patient needs to gauge for themselves.<ref name=":15" />

==== Massage ====

*2014, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/ Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]<ref>{{Cite journal|last=Li|first=Yan-hui|last2=Wang|first2=Feng-yun|last3=Feng|first3=Chun-qing|last4=Yang|first4=Xia-feng|last5=Sun|first5=Yi-hua|date=2014-02-20|title=Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/|journal=PLoS ONE|volume=9|issue=2|doi=10.1371/journal.pone.0089304|issn=1932-6203|pmc=|pmid=24586677|pages=|via=}}</ref>

*2016, [http://chronicfatigue.about.com/od/alternativetreatments/a/bodywork.htm Massage, Rolfing & Other Bodywork - Are They Effective Fibromyalgia & Chronic Fatigue Syndrome Treatments?]<ref>{{Cite news|url=https://www.verywellhealth.com/massage-rolfing-other-bodywork-715645|title=Massage, Rolfing, Reiki: Do They Work for Fibromyalgia & ME/CFS?|last=Dellwo|first=Adrienne|date=Aug 10, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==== Acupuncture ====

*2004, [[U.S. Department of Health and Human Services]] (HHS) and [https://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services Centers for Medicare and Medicaid Services] (CMS) ruled April 16, 2004, a noncoverage determination for acupuncture.<ref>{{Cite web|url=https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R11NCD.pdf|title=CMS Manual System Pub. 100-03 Medicare
National Coverage Determinations|last=|first=|date=Apr 16, 2004|website=CMS.gov|format=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2005, [http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html Acupuncture Good for Fibromyalgia?] <ref name=":16">{{Cite web|url=http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html|title=Acupuncture Good for Fibromyalgia?|last=|first=|date=Oct 2, 2012|website=Acupuncture School Online|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> "Acupuncture gave no significant pain relief to fibromyalgia patients."<ref name=":16" />

*2016, [http://www.sciencedirect.com/science/article/pii/S2095496416602352 Short-term complementary and alternative medicine on quality of life in women with fibromyalgia] <ref name=":25">{{Cite journal|date=2016-01-01|title=Short-term complementary and alternative medicine on quality of life in women with fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S2095496416602352|journal=Journal of Integrative Medicine|language=en|volume=14|issue=1|pages=29–35|doi=10.1016/S2095-4964(16)60235-2|issn=2095-4964}}</ref> "There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session."<ref name=":25" />

*2016, [https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/ Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/|title=Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients - Fibromyalgia News Today|last=Semedo|first=Daniela|date=2016-02-01|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Disability ==
===United States===
''Please Note'': The following is NOT legal advice and it should not be relied upon in taking steps for a disability case. Only ''[https://www.ssa.gov/ Social Security]'' and a disability lawyer can provide the most up to date and the correct legal avenue for bringing a disability case.

In the[[ United States]], [https://www.ssa.gov/ssi/ Social Security Insurance] and [https://www.ssa.gov/disability/ Social Security Disability] (SSI) and (SSD) benefits are available for Fibromyalgia. Generally for SSI/SSD, notes and tests from a ''Primary Provider'' '''may''' be allowed for submission but ''Specialists'' such as a rheumatologist, neurologist, psychiatrist, etc. are required for diagnosis, ongoing treatment and completing SSI/SSD paperwork.

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose Fibromyalgia. (See: "Policy Interpretation" for the POLICY INTERPRETATION RULING.)<ref>[https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia]</ref>

*[http://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social Applying for Disability With Fibromyalgia]<ref>{{Cite news|url=https://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social|title=Fibromyalgia Disability: Applying for Disability Benefits With Fibromyalgia|date=2016-10-03|work=NewLifeOutlook {{!}} Fibromyalgia|access-date=2018-08-09|language=en-US}}</ref> One patient's success of applying, denial, successful appeal, and a breakdown of what SSI/SSD requires for the medical determination of a favorable decision of disability.

*[https://www.socialsecurity.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html Fibromyalgia: Policy Interpretation Ruling - Social Security]<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=|website=www.ssa.gov|at=Titles II and XVI: Evaluation of Fibromyalgia|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[http://www.disabilitysecrets.com/social_security_disability_fibromyalgia.html Social Security Disability (SSDI & SSI) for Fibromyalgia - Disability Secrets By NOLO]<ref>{{Cite news|url=https://www.disabilitysecrets.com/resources/social-security-disability-ssdi-ssi-fibromyalgia.htm|title=Social Security Disability (SSDI & SSI) for Fibromyalgia|last=Laurence|first=Bethany|date=|work=www.disabilitysecrets.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*[http://www.mdjunction.com/fibromyalgia/fibromyalgia-disability Fibromyalgia Disability Patient Support Forums]<ref>{{Cite web|url=https://www.mdjunction.com/fibromyalgia/fibromyalgia-disability|title=Fibromyalgia Disability|website=MDJunction|language=en|access-date=2018-08-09}}</ref> at [[MDJunction]]

==== Examinations and Tests ====
For documentation of symptoms and co-morbidities of a FM diagnosis, you and your doctor should consider the following examinations and tests:

:'''Fibromyaglia Diagnostic Examination'''
:*[http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist Rheumatologist] examination and diagnosis of FM. (Consider having a rheumatologist order tests and coordinate referrals for other specialists for examinations and testing. Only specialists can complete the paperwork for Social Security. A primary doctor cannot complete disability paperwork but ''may'' be able to forward test results they have ordered.)
[[File:Whole body bone scan.jpg|200px|thumb|right|A whole body bone scan (Bone scintigraphy) is a nuclear medicine test. '''Arthritis''', avascular necrosis, bone cancers, cancers that have spread to the bone, fibrous dysplasia, fractures, infection involving the bone, and Pagets disease can be diagnosed using this scan.<ref>{{Cite news|url=https://www.healthline.com/health/bone-scan#purpose|title=Bone Scan: Purpose, Procedure, and Risks|last=Krans|first=Brian|date=Dec 13, 2017|work=Healthline|access-date=2018-08-21|archive-url=|archive-date=|dead-url=|language=en}}</ref>]]
:'''Arthritis'''
:*[https://en.wikipedia.org/wiki/Bone_scintigraphy Whole body bone scan (Bone scintigraphy)]<ref>{{Cite journal|date=2018-05-22|title=Bone scintigraphy|url=https://en.wikipedia.org/wiki/Bone_scintigraphy|journal=Wikipedia|language=en}}</ref> to rule out treatable arthritis.
:'''Blood Tests'''
:*Routine blood tests for [[diabetes]] (fasting sugar, A1C) and a full [[Thyroid disease]] panel ([https://en.wikipedia.org/wiki/Thyroid_function_tests#Thyroid-stimulating_hormone TSH, T3, Free T3, T4 and Free T4]).
:*Rule out [[Rheumatoid arthritis]], lupus, [[Lyme disease]] and other diseases that can share some of the same symptoms of fibromyalgia and may be treatable.<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1-3|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>
:*Vitamin and mineral deficiencies such as [[B12]] and [[Vitamin D]] are treatable with over the counter supplements and prescription medications which can improve [[fatigue]] and [[pain]].
:'''Gastrointestinal'''
:*[[Irritable bowel syndrome]] diagnosis which may require blood, [http://www.mayoclinic.org/tests-procedures/endoscopy/basics/definition/PRC-20020363 upper endoscopy] to rule out [https://en.wikipedia.org/wiki/Coeliac_disease celiac disease] and [https://en.wikipedia.org/wiki/Stool_test fecal tests] to check for bacteria ([[SIBO]]) and [http://www.umm.edu/health/medical/altmed/condition/intestinal-parasites intestinal parasites].
:'''Mental Health and Cognition'''
:* Psychiatric evaluation as any [[depression]] and [[anxiety]] should be treated.
:* [[Cognitive dysfunction]] tests.
:'''Sleep dysfunction'''
:*Sleep study for [[Restless legs syndrome]], [[Sleep disturbance]] or [[Narcolepsy]].
:'''Orthostatic Intolerance'''
:*[[Tilt table test]] to diagnose [[Orthostatic intolerance]] or [[Postural orthostatic tachycardia syndrome|POTS]].
:'''TMJ, tinnitus, vertigo, and dizziness'''
:*An ear, nose, and throat specialist (ENT) ([http://www.mayoclinic.org/departments-centers/otorhinolaryngology-ent/overview Otorhinolaryngology]) examination and imaging may be ordered for [[Temporomandibular joint disorder]] (TMJ).
:*(Ear, sinus, throat/lymph infections, and [[tinnitus]] can also be documented.)
:*[https://en.wikipedia.org/wiki/Videonystagmography Videonystagmography] (VNG) testing if you experience [[vertigo]] and/or [[dizziness]].<ref>{{Cite news|url=https://www.everydayhearing.com/balance/articles/what-to-expect-at-your-vng-test/|title=What to Expect at Your VNG/ENG Test - Everyday Hearing|last=Banks|first=Lindsey|date=2014-05-07|work=Everyday Hearing|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

Of course, one can have arthritis, sleep apnea, [[Chronic lyme disease|chronic Lyme disease]] or other diseases and still have FM, but there may be a treatable condition where a patient's overall health, including their FM, improves.<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/guide/common-misdiagnoses-of-fibromyalgia#1|title=Common Misdiagnoses of Fibromyalgia|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite web|url=http://www.cfidsselfhelp.org/library/overlapping-and-related-conditions|title=Overlapping and Related Conditions {{!}} CFIDS & Fibromyalgia Self-Help|website=www.cfidsselfhelp.org|access-date=2018-08-09}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

There have been cases of [[Vitamin D]] deficiency being misdiagnosed as fibromyalgia as a D deficiency can cause pain. Supplementation or prescribed D treatments may alleviate this pain. However, it is possible to have both a D deficiency and fibromyalgia and correcting the deficiency will only resolve the pain stemming from it.<ref>{{Cite news|url=http://www.webmd.com/pain-management/features/vitamin-d-deficiency-and-chronic-pain-link#1|title=Does Vitamin D Deficiency Cause Chronic Pain?|last=Shaw|first=Gina|date=|work=WebMD|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

==== Blogs about navigating SSD process ====

*Resources for getting approved for disability include this [http://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/ Guide to Social Security Disability for People with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome],<ref>{{Cite web|url=https://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/|title=The Sleepy Girl Guide to Social Security Disability (U.S.) {{!}} #MEAction|last=Silver|first=Lily|date=Apr 17, 2017|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> available on the #[[MEAction]] website.

*[https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/ How Patty’s Lawyer Never Told Her What She Needed to Know]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/|title=How Patty’s Lawyer Never Told Her What She Needed to Know|last=Skelton Preston|first=Patty|date=2017-03-20|work=How to Get On|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/ Sample Doctor Letters for Disability]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/|title=21 Sample Doctor Letters for Disability|date=2017-05-01|work=How to Get On|access-date=2018-08-09|language=en-US}}</ref>

== Notable studies ==
{{Main article |page_name = Fibromyalgia notable studies}}

== Controversies ==
=== Dr. Frederick Wolfe ===
Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.<ref>{{Cite news|url=http://www.nytimes.com/2008/01/14/health/14pain.html?_r=0|title=Drug Approved. Is Disease Real?|last=Berenson|first=Alex|date=Jan 14, 2008|work=The Wall Street Journal|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>[http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf Fibromyalgia: A Short Commentary - iMedPub Journals - DOI: 10.4172/2472-1913.100027 - Frederick Wolfe and Brian Walitt - Sep. 23, 2016]</ref><ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|journal=Journal of Headache & Pain Management|volume=1|issue=3:27|pages=|via=iMedPub Journals}}</ref><ref>{{Cite news|url=https://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx|title=Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine|last=Cashin-Garbutt|first=April|date=2013-03-22|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Fibromyalgia vs Chiari malformation ===
Some individuals diagnosed with FMS were undergoing surgery for [[Chiari malformation]] (CM). These are two separate conditions; FMS cannot be resolved by undergoing a risky CM surgery.

*2011, [https://www.ncbi.nlm.nih.gov/pubmed/21135714 Is Chiari I malformation associated with fibromyalgia?]<ref>{{Cite journal|last=Watson|first=Nathaniel F.|last2=Buchwald|first2=Dedra|last3=Goldberg|first3=Jack|last4=Maravilla|first4=Kenneth R.|last5=Noonan|first5=Carolyn|last6=Guan|first6=Qingyan|last7=Ellenbogen|first7=Richard G.|date=2011|title=Is Chiari I malformation associated with fibromyalgia?|url=https://www.ncbi.nlm.nih.gov/pubmed/21135714|journal=Neurosurgery|volume=68|issue=2|pages=443–448; discussion 448–449|doi=10.1227/NEU.0b013e3182039a31|issn=1524-4040|pmid=21135714|via=}}</ref>
::Conclusion: Most patients with FM do not have [[CIM]] pathology. Future studies should focus on dynamic neuroimaging of craniocervical neuroanatomy in patients with FM.
*2015, [https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery CFS/FM and Chiari Malformation Surgery]<ref>{{Cite web|url=https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery|title=CFS/FM and Chiari Malformation Surgery|last=Casanova|first=Ken|date=Nov 15, 2015|website=www.massmecfs.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

== Learn more ==
*[https://www.s4me.info/forums/fibromyalgia-and-connective-tissue-disorders.35/ Forum: Fibromyalgia and Connective Tissue Disorders] at [[Science for ME]]
*[[Verywell FMS/CFS]]

=== Ongoing process of diagnosing and categorizing ===

*2014, [http://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114 Lyme Disease, Fibromyalgia Link Evaporates]<ref>{{Cite news|url=https://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114|title=Lyme Disease, Fibromylagia Link Evaporates|last=Kuznar|first=Wayne|date=2014-12-14|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> (See also: [[Chronic lyme disease]])

*2015, [http://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx Fibromyalgia now considered as a lifelong central nervous system disorder]<ref>{{Cite news|url=https://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx|title=Fibromyalgia now considered as a lifelong central nervous system disorder|date=2015-05-18|work=News-Medical.net|access-date=2018-08-09|language=en}}</ref>

*2015, [http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates]<ref>{{Cite news|url=http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html|title=Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates|date=2015-10-24|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2015, ''Question:'' [http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html 'Is Fibromyalgia a Psychosomatic Illness?'] via CelesteCooper.com ''Answer:'' "Fibromyalgia is NOT a psychosomatic illness."<ref>[http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html Is Fibromyalgia a Psychosomatic Illness? Med Student Asks Celeste Cooper by Celeste Cooper - CelesteCooper.com Sep 4, 2015]</ref>

*2016, [http://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination Diagnosing Fibromyalgia May Be Possible Using Noninvasive Eye Examination]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination|title=Diagnosing Fibromyalgia May Be Possible with Noninvasive Eye Exam|date=2016-09-09|work=Fibromyalgia News Today|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780 Microglia in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780|title=Microglia in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*2016, [http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/ Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders?]<ref>{{Cite news|url=http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/|title=Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders? - Simmaron Research|date=2016-03-21|work=Simmaron Research|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://consultqd.clevelandclinic.org/2016/03/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic Why Fibromyalgia Is Neuropathic]<ref>{{Cite news|url=https://consultqd.clevelandclinic.org/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic|title=Why Fibromyalgia Is Neuropathic|date=2016-03-08|work=Consult QD|access-date=2018-08-09|language=en-US}}</ref>

*2017, [http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain]<ref>{{Cite news|url=http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html|title=Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain|last=Liptan|first=Ginevra|date=2017-04-11|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
*2017, [https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947 AI can spot the pain from a disease some doctors still think is fake]<ref>{{Cite news|url=https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947|title=AI can spot the pain from a disease some doctors still think is fake|last=Goldhill|first=Olivia|date=Aug 9, 2018|work=Quartz|access-date=2018-08-15|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== Blood tests ===

*2013, [http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html New Fibromyalgia Blood Test is 99% Accurate]<ref>{{Cite news|url=http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html|title=New Fibromyalgia Blood Test is 99% Accurate|date=2013-07-31|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2014, [http://www.prohealth.com/library/showarticle.cfm?libid=18837 Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”]<ref>{{Cite news|url=https://www.prohealth.com/library/pridgen-reports-fibromyalgia-antiviral-trial-results-very-positive-predicts-new-approach-will-be-game-changer-32620|title=Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”|last=|first=|date=2014-03-25|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2016, [https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html Blood Test for Fibromyalgia: FM/a Test Ⓡ is now available, Q&A]<ref>{{Cite web|url=https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html|title=Blood Test for Fibromyalgia: FM/a Test ® Is Real, Q&A|last=Cooper|first=Celeste|date=May 3, 2016|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2016, [http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/ Fibromyalgia blood testing covered by rising number of insurance companies]<ref>{{Cite news|url=http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/|title=Fibromyalgia blood testing covered more of insurance companies|last=Campbell|first=Julie|date=2016-04-08|work=Live Insurance News|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2017, [http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches]<ref>{{Cite news|url=https://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=Business Wire|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Brain scans ===

*2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds]<ref>{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|publisher=ANAPSID|via=Chronic Neuroimmune Diseases|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2012, [https://www.sciencedaily.com/releases/2012/11/121111153426.htm Fibromyalgia and the brain: New clues reveal how pain and therapies are processed]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2012/11/121111153426.htm|title=Fibromyalgia and the brain: New clues reveal how pain and therapies are processed|last=|first=|date=Nov 11, 2012|work=ScienceDaily|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*2015, [https://www.verywell.com/unique-brain-connectivity-in-fibromyalgia-715630 Unique Brain Connectivity in Fibromyalgia - Increased Importance Assigned to Pain]<ref>{{Cite news|url=https://www.verywellhealth.com/how-lyrica-changes-the-fibromyalgia-brain-715767|title=How Lyrica Changes the Fibromyalgia Brain|last=Dellwo|first=Adrienne|date=Apr 30, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==See also==
* [[Fibromyalgia drugs]]

* [[Fibromyalgia notable studies]]
* [[Influenza vaccine]]

*[[Lady Gaga]]

==References==
<references />

[[Category:Diagnoses]]
[[Category:Comorbidities]]

Fibromyalgia

2018-08-25T14:34:39Z

77.111.246.7:/* Comorbidities, overlapping conditions, and common symptoms */ internal link

[[Fibromyalgia]] (FM/FMS) is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Pain is widespread, on both sides of the body, and above and below the waist.

Sufferers are fatigued and tired even when sleeping for long periods of time, and sleep is often disrupted by pain. Many FM sufferers have sleep disorders like [https://en.wikipedia.org/wiki/Sleep_apnea sleep apnea] and [[restless leg syndrome]]. [[Cognitive impairment]], when one cannot focus or pay attention and the patient has difficulty concentrating on mental tasks, is known by FM sufferers as "[[fibro fog]]".<ref name=":17">{{Cite news|url=https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014|title=What Is Fibro Fog and ME/CFS Brain Fog?|last=Dellwo|first=Adrienne|date=|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Some experience [[depression]], [[headache]]s, and lower [[abdominal pain]] or cramping. Other symptoms include tingling or [[numbness]] in hands and feet, pain in jaw and disorders of the jaw such as [[temporomandibular joint disorder|temporomandibular joint disorder]] (TMJ), [[Menstrual cycle#Health effects in other conditions|menstrual cycle]] cramps, and digestive problems like i[[Irritable bowel syndrome|rritable bowel syndrome]] (IBS).<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms#1|title=Fibromyalgia Symptoms|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780|title=Fibromyalgia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref>

[[File:Fibro_Tender_Points.png|400px|thumb|right|1990 ACR Diagnostic Criteria: 18 Tender Points]]
[[File:Fibro_Widespread_Pain.png|400px|thumb|right|2010 ACR Preliminatry Diagnostic Criteria: Wisedpread Pain Index (WPI), 19 Tender Point Areas]]

==Prevalence==
FM is the second most common [https://en.wikipedia.org/wiki/Rheumatism rheumatic disorder] behind [[wikipedia:Osteoarthritis|osteoarthritis]] and is "now considered to be a lifelong [[Central nervous system]] disorder."<ref>{{Cite news|url=https://naidw.org/blog/members-myblogs/fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder|title=Fibromyalgia now considered as a lifelong central nervous system disorder|work=NAIDW.org®|access-date=2018-08-09|language=en-gb}}</ref> An estimated 10 million people in the US and 3-6% of the world population have fibromyalgia. It is seen in women, men, children, and all ethnic groups. It is often seen in families and diagnosed between the ages of 20 to 50 years; incidence increases with age.<ref>{{Cite news|url=http://www.fmaware.org/about-fibromyalgia/prevalence/|title=Prevalence - National Fibromyalgia Association (NFA)|work=National Fibromyalgia Association (NFA)|access-date=2018-08-09|language=en-US}}</ref>

FM has a female:male 7:1 ratio under the ''American College of Rheumatology (ACR) 1990 Diagnostic Criteria'' and 2:1 when the ''ACR 2010 Preliminary Diagnostic Criteria'' is used.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=|publisher=|editor-last=Diamond|editor-first=Herbert|at=Sex-related differences in incidence}}</ref> ''See'': [[Fibromyalgia#American College of Rheumatology (ACR) Criteria|Fibromyalgia (''American College of Rheumatology (ACR) Criteria'' section)]].

==Fibromyalgia in ME/CFS==
Dr. [[Jarred Younger]] has said that many patients that meet the criteria for FM also meet criteria for [[chronic fatigue syndrome]] (CFS) but the reverse is not necessarily true as a lot of people with [[CFS]] do not have [[chronic pain]].<ref>{{Cite web|url=https://www.youtube.com/watch?v=wJB95m4FLa0#t=57m27s|title=Webinar with Jarred Younger, Ph.D.|last=Younger|first=Jared|date=May 20, 2016|website=YouTube|at=57:27|via=|archive-url=|archive-date=|dead-url=|access-date=|publisher=SolveCFS|type=Video}}</ref> However, the [[Canadian Consensus Criteria]] (CCC) requires the symptom of pain to diagnose [[ME/CFS]]. It is the pattern and significant degree of [[chronic pain]] in FM that sets it apart from other diseases that have pain.

"The most common overlapping condition with ME/CFS is fibromyalgia."<ref name=":30">{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions - American Myalgic Encephalomyelitis and
Chronic Fatigue Syndrome Society|last=|first=|date=|website=ammes.org|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref><ref name=":31">{{Cite journal|last=Jason|first=Leonard|last2=Taylor|first2=R.R.|last3=Kennedy|first3=C.L.|last4=Song|first4=S|last5=Johnson|first5=D|last6=Torres|first6=S.R.|date=2001-01-01|title=Chronic fatigue syndrome: Comorbidity with fibromyalgia and psychiatric illness|url=https://www.researchgate.net/publication/285787383_Chronic_fatigue_syndrome_Comorbidity_with_fibromyalgia_and_psychiatric_illness|journal=Medicine and Psychiatry|volume=4|pages=29–34}}</ref>

==Health complications==
FM is not a [https://en.wikipedia.org/wiki/Progressive_disease progressive disease] but according to Dr. Dan Clauw the "slow gradual worsening of chronic pain patients over time is due to downstream consequences of poorly controlled pain and other symptoms, wherein individuals then progressively get less active, sleep worse, are under more stress and unknowingly develop bad habits which worsen pain and other symptoms."<ref>{{Cite news|url=http://nationalpainreport.com/ask-the-dctors-is-fibromyalgia-progressive-8831105.html|title=Ask the Doctors: Is Fibromyalgia Progressive?|date=2016-08-09|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*[https://www.sharecare.com/health/fibromyalgia-effects Fibromyalgia Complications]<ref name=":19" />

:<blockquote>People who have fibromyalgia frequently complain of a variety of symptoms that affect other parts of the body. Many people complain of [[gastrointestinal]] issues and restless legs syndrome (RLS). Additionally, the [[chronic pain]] and discomfort of fibromyalgia may lead to [[depression]].<ref name=":19">{{Cite news|url=https://www.sharecare.com/health/fibromyalgia-effects|title=Fibromyalgia Complications - Fibromyalgia - Joint Health|work=Sharecare|access-date=2018-08-09|language=en}}</ref></blockquote>

*[https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions Can fibromyalgia cause other medical conditions?]<ref name=":20" />

:<blockquote>Fibromyalgia is not known to cause other medical conditions. However, people who have fibromyalgia seem to be at high risk for developing other painful conditions, including [https://en.wikipedia.org/wiki/Osteoarthritis osteoarthritis] (the common type of arthritis caused by wear and tear on the joints) as well as other related conditions, such as [[rheumatoid arthritis]], [[lupus]], and [https://en.wikipedia.org/wiki/Ankylosing_spondylitis ankylosing spondylitis]. Also, people with fibromyalgia are frequently diagnosed with chronic fatigue syndrome, irritable bowel syndrome (IBS), and temporomandibular joint (TMJ) disorder.<ref name=":20">{{Cite web|url=https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions|title=Can fibromyalgia cause other medical conditions? {{!}} Fibromyalgia Complications|last=Honor Society of Nursing|first=|date=|website=Sharecare|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref></blockquote>

==Risk factors==
[[Lupus]] and [[Rheumatoid arthritis]] (RA) are risk factors in developing FM. Car accidents, [[Post-traumatic stress disorder]] (PTSD), [https://en.wikipedia.org/wiki/Repetitive_strain_injury repetitive injuries], illness such as a [https://en.wikipedia.org/wiki/Viral_disease viral infection], [https://en.wikipedia.org/wiki/Family_history_(medicine) family history], and [https://en.wikipedia.org/wiki/Obesity obesity] have all been linked to FM.<ref>{{Cite web|url=https://www.cdc.gov/arthritis/basics/fibromyalgia.htm|title=Fibromyalgia {{!}} Arthritis {{!}} CDC|date=2018-04-03|website=www.cdc.gov|language=en-us|access-date=2018-08-09}}</ref><ref>{{Cite news|url=https://www.niams.nih.gov/health_info/Fibromyalgia/|title=Fibromyalgia What Causes it?|last=Director|first=Nancy Garrick, Deputy|date=2017-04-05|work=National Institute of Arthritis and Musculoskeletal and Skin Diseases|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

==Diagnosis==
[https://www.verywellhealth.com/what-are-fibromyalgia-tender-points-189768 Tender points], not [https://en.wikipedia.org/wiki/Myofascial_trigger_point trigger points], are used to diagnose Fibromyalgia.<ref>{{Cite web|url=http://www.healthcentral.com/chronic-pain/c/662034/176031/fibromyalgia-trigger/|title=The Difference Between Fibromyalgia Tender Points and Myofascial Trigger Points - Chronic Pain {{!}} HealthCentral|last=Cooper|first=Celeste|date=May 8, 2015|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> Tender points will be above and below the waist and on both sides of the body. (See: Illustrations of the 1990 and 2010 American College of Rheumatology (ACR) Criteria depicting tender points near the top of this page.) It is important to check for other conditions that could be causing pain such as hypothyroidism, Rheumatoid arthritis or lupus, osteoarthritis, Ankylosing spondylitis, and [[wikipedia:Polymyalgia_rheumatica|Polymyalgia rheumatica]].<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>

===United States===
==== American College of Rheumatology (ACR) Criteria ====

*1990, [http://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf The American College Of Rheumatology 1990 Criteria For The Classification Of Fibromyalgia]<ref>{{Cite web|url=https://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf|title=The American College of Rheumatology Criteria for the Classification of Fibromyalgia|last=Wolfe|first=Frederick|last2=Smythe|first2=Hugh|date=1990|website=rheumatology.org|publisher=|others=Abeles, Micha; Clark, Patricia; Fam, Adel; Farber, Stephen; Fiechtner, Justus; Franklin, Michael; Gatter, Robert; Hamaty, Daniel; Lessard, James; Lightbroun, Alan; Masi, Alfonse; McCain, Glenn; Reynolds, W. John; Romano, Thomas; Russell, Jon; Sheon, Robert|archive-url=|archive-date=|dead-url=|access-date=|last3=Yunus|first3=Muhammad|last4=Bennett|first4=Robert|last5=Bombardier|first5=Claire|last6=Goldenberg|first6=Don|last7=Tugwell|first7=Peter|last8=Campbell|first8=Stephen}}</ref> "American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure."<ref>{{Cite news|url=http://www.health.com/health/gallery/0,,20345635,00.html|title=18 Points Used to Diagnose Fibromyalgia|last=|first=|date=Feb 4, 2011|work=Health.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> <ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2010, The [https://www.fibroknowledge.com/site/acr-2010 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview]<ref>{{Cite web|url=https://www.fibroknowledge.com/sites/default/files/downloads/file/2010_ACR_CRITERIA.pdf|title=American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia|last=|first=|date=2010|website=fibroknowledge.com|type=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref> was proposed and modified in 2011<ref>{{Cite news|url=http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria|title=New and Modified Fibromyalgia Diagnostic Criteria|last=Garg|first=Neha|date=Feb 9, 2012|work=Rheumatology Network|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=|last2=Deodhar|first2=Atul}}</ref> with the modification being validated in 2013 and published in 2014.<ref>{{Cite journal|last=Bennett|first=Robert M.|last2=Friend|first2=Ronald|last3=Marcus|first3=Dawn|last4=Bernstein|first4=Cheryl|last5=Han|first5=Bobby Kwanghoon|last6=Yachoui|first6=Ralph|last7=Deodhar|first7=Atul|last8=Kaell|first8=Alan|last9=Bonafede|first9=Peter|date=2014|title=Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/24497443|journal=Arthritis Care & Research|volume=66|issue=9|pages=1364–1373|doi=10.1002/acr.22301|issn=2151-4658|pmid=24497443|via=}}</ref> September of 2016, another revision has been made.<ref>{{Cite news|url=http://acrabstracts.org/abstract/2016-revisions-to-the-20102011-fibromyalgia-diagnostic-criteria/|title=2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria - ACR Meeting Abstracts|last=|first=|date=Sep 28, 2016|work=ACR Meeting Abstracts|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

:Men do not seem to form the tender points needed for diagnosis under the 1990 criteria,<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/features/how-fibromyalgia-affects-men#2|title=How Fibromyalgia Affects Men: Symptoms and Diagnosis|work=WebMD|access-date=2018-08-09|language=en-US}}</ref> the 2010 proposed criteria diagnoses more men with a F/M ratio of 2:1.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=}}</ref>
:Tender points were used to diagnose with the 1990 criteria, however "considerable skill is needed to correctly check for a patient’s tender points (i.e., digital palpation that is done with certain amount of applied pressure), yet this technique is not typically taught at most medical schools."<ref name=":0">{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 5, 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>
:The new standards were designed to:
:*eliminate the use of a tender point examination
:*include a severity scale by which to identify and measure characteristic FM symptoms
:*utilize an index by which to rate pain<ref name=":0" />
:*There are 19 tender point areas in the widespread pain index (WPI), whereas the 1990 criteria had 18 tender points.<ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose fibromyalgia.<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=Jul 25, 2012|website=www.ssa.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

==== Sleep study ====
[[Sleep dysfunction]] is often involved in fibromyalgia. Treating a sleep disorder can help with fibromyalgia symptoms. A diagnosed sleep disorder is also helpful if one needs to file for disability.

*[https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054 Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054|title=Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*[http://www.sciencedaily.com/releases/2008/09/080903134311.htm What A Sleep Study Can Reveal About Fibromyalgia]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2008/09/080903134311.htm|title=What A Sleep Study Can Reveal About Fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*[http://linkis.com/nationalpainreport.com/lzYea Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says]<ref>{{Cite news|url=http://linkis.com/nationalpainreport.com/lzYea|title=Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says|last=|first=|date=Mar 25, 2016|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== ICD Diagnostic code===
====World Health Organization====
'''ICD-10'''

The [[World Health Organization]] (WHO) International Classification of Diseases (ICD) lists fibromyalgia as a "disease of the [[musculoskeletal system]] and connective tissue", under the code M79.7 (WHO ICD-10 Version: 016).<ref>World Health Organization, [http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7 International Classification of Diseases - Fibromyalgia M79.7], ICD-10, 2016</ref>

*'''M79.7 Fibromyalgia'''
::Fibromyositis
::Fibrositis
::Myofibrositis<ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7|title=ICD-10 Version:2016|website=apps.who.int|language=en|access-date=2018-08-09}}</ref>

In 2015, the [[United States]] finally adopted ICD-10 and Fibromyalgia as a diagnosis.<ref>{{Cite web|url=http://www.icd10data.com/ICD10CM/Codes/M00-M99/M70-M79/M79-/M79.7|title=2018 ICD-10-CM Diagnosis Code M79.7: Fibromyalgia|website=www.icd10data.com|language=en|access-date=2018-08-09}}</ref> <ref>{{Cite news|url=http://nationalpainreport.com/the-health-care-industry-finally-recognizes-fibromyalgia-8827637.html|title=The Health Care Industry Finally Recognizes Fibromyalgia|last=Liptan|first=Ginevra|date=2015-09-30|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

'''ICD-11 (2019)'''

[https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504 ICD-11] (2019) has diagnostic code ''MG30.1 Chronic widespread pain''.<ref name=":18">{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504|title=ICD-11 - Mortality and Morbidity Statistics|website=icd.who.int|language=en|access-date=2018-08-09}}</ref>

*'''MG30.01 Chronic widespread pain'''

'''Parent'''
::MG30.0 Chronic primary pain

'''Description'''
<blockquote>Chronic widespread pain (CWP) is diffuse pain in at least 4 of 5 body regions and is associated with significant emotional distress (anxiety, anger/frustration or depressed mood) or functional disability (interference in daily life activities and reduced participation in social roles) [1]. CWP is multifactorial: biological, psychological and social factors contribute to the pain syndrome. The diagnosis is appropriate when the pain is not directly attributable to a nociceptive process in these regions and there are features consistent with nociplastic pain [2] and identified psychological and social contributors.<ref name=":18" /></blockquote>

'''Inclusions'''
:*Fibromyalgia
'''Exclusions'''
:*Acute pain (MG31)<ref name=":18" />

==Pathophysiology==
"Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology. There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or [[Lyme disease]], as well as emotional or physical trauma."<ref>{{Cite web|url=https://www.uptodate.com/contents/pathogenesis-of-fibromyalgia#!|title=UpToDate|last=Goldenberg|first=Don L|date=|website=www.uptodate.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> The widespread pain is severe, debilitating, and abnormal in processing its pain. There is also sleep disturbance and fatigue. Cause or causes are unproven.<ref>{{Cite news|url=https://www.omf.ngo/what-is-mecfs-old/fibromyalgia/|title=What is Fibromyalgia? {{!}} Open Medicine Foundation|work=Open Medicine Foundation|access-date=2018-08-09|language=en-US}}</ref>

*May 2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/ Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management]<ref name=":21">{{Cite journal|last=Jahan|first=Firdous|last2=Nanji|first2=Kashmira|last3=Qidwai|first3=Waris|last4=Qasim|first4=Rizwan|date=2012|title=Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/|journal=Oman Medical Journal|volume=27|issue=3|pages=192–195|doi=10.5001/omj.2012.44|issn=1999-768X|pmc=|pmid=22811766|via=}}</ref> ''See'' Table 1: "Conditions associated with fibromyalgia." Musculoskeletal, genitourianry, gastro intestinal, and miscellaneous conditions often exist among fibromyalgia patients.

<blockquote>Pathophysiology: Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as [[serotonin]], substance P, growth hormone and [[cortisol]] suggest that regulation of the autonomic and neuro-endocrine system appears to be the basis of the syndrome. Fibromyalgia is not a life-threatening, deforming, or [https://en.wikipedia.org/wiki/Progressive_disease progressive disease]. [[Anxiety]] and [[depression]] are the most common association. Aberrant pain processing, which can result in [[chronic pain]], may be the result of several interplaying mechanisms. [[Central sensitization]], blunting of inhibitory pain pathways and alterations in [[neurotransmitters]] lead to aberrant neuro-chemical processing of sensory signals in the CNS, thus lowering the threshold of pain and amplification of normal sensory signals causing constant pain.<ref name=":21" /></blockquote>

<blockquote>The frequent co-morbidity of fibromyalgia with mood disorders suggests a major role for the stress response and for neuroendocrine abnormalities. The [[hypothalamic pituitary axis]] (HPA) is a critical component of the stress-adaptation response. In FMS, stress adaptation response is disturbed leading to stress induce symptoms. Psychiatric co-morbidity has been associated with FMS and needs to be identified during the consultation process, as this requires special consideration during treatment.<ref name=":21" /></blockquote>

*May 2018, [https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management]<ref>{{Cite journal|last=Bourgaize|first=Sheryl|last2=Newton|first2=Genevieve|last3=Kumbhare|first3=Dinesh|last4=Srbely|first4=John|date=2018|title=A comparison of the clinical manifestation and
pathophysiology of myofascial pain syndrome
and fibromyalgia: implications for differential
diagnosis and management|url=https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf|format=PDF|journal=Journal of the Canadian Chiropractic Assoc.|volume=|pages=26-41|at=See Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)|via=}}</ref> (PDF) ''See'' Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)

*Jul 2018, [https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/ Primary and Secondary Fibromyalgia Share Same Symptom Burden, Study Suggests]<ref name=":22">{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/|title=Primary, Secondary Fibromyalgia Share Same Symptom Burden, Study Says|last=Carvalho|first=John|date=2018-07-31|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

<blockquote>Fibromyalgia can be considered either primary, or dominant, also known as idiopathic fibromyalgia, or secondary. In the primary form, the causes of the disorder are unknown, but in secondary fibromyalgia, the disorder usually occurs alongside other debilitating medical conditions, such as rheumatoid arthritis (RA), lupus, and multiple sclerosis.<ref name=":22" /></blockquote>

===Immune system research===

Dr. [[Jarred Younger]] believes an overactive [[immune system]] is the cause and will be conducting a study to test this hypothesis.<ref>{{Cite news|url=http://nationalpainreport.com/new-uab-study-could-radically-change-fibromyalgia-treatment-as-we-know-it-8833437.html|title=New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It|last=Gregory Burch|first=Donna|date=2017-04-24|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=https://www.youtube.com/watch?v=8e5xKX036bE|title=Testing the fibromyalgia immune system with lipopolysaccharide (LPS)|last=Younger|first=Jarred|date=May 24, 2017|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=|via=Younger Lab}}</ref> An overactive immune system is responsible for [[inflammation]] which causes [[chronic pain]].

Dr. William Pridgen's research of [[HSV-1]] (cold sore virus) as being involved in FM has conducted a successful Phase III clinical trial, which had been fast-tracked by the [[Food and Drug Administration]] (FDA), of a combination drug that suppresses this virus and also helps with pain. ''See'': [[Fibromyalgia#IMC-1|Fibromyalgia (''Drugs: Trials: IMC-1'' section)]].

[[ProHealth]] reports that an old [https://en.wikipedia.org/wiki/Tuberculosis Tuberculosis] vaccine, [https://en.wikipedia.org/wiki/BCG_vaccine Bacille Calmette-Guerin] (BCG), may be researched for treatment of Fibromyalgia spearheaded by [http://www.buzzfile.com/business/Epicgenetics,-Inc.-310-586-2929 EpicGenetics] and [http://www.massgeneral.org/ Massachusetts General Hospital].<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

EpicGenetics has a blood test that is identifying the presence of specific white blood cell abnormalities of patients diagnosed with FM and has partnered with two universities to offer [https://en.wikipedia.org/wiki/Disease_gene_identification#Whole_exome_sequencing whole exome sequencing] free of charge to those who test positive with their [http://fmtest.com/ FM/a® test].<ref>{{Cite news|url=http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> Concerns have been raised in regards to the FM/a® EpicGenetics Blood Test.<ref>{{Cite web|url=http://www.fmperplex.com/2013/02/25/junk-science-junk-ethics/|title=Junk Science – Junk Ethics – The Fibromyalgia Perplex|last=Wolfe|first=Fred|date=Feb 25, 2013|website=www.fmperplex.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> EpicGenetics is awaiting FDA approval to test the Bacille Calmette-Guerin (BCG) vaccine (an old Tuberculosis vaccine) on patients that tested positive with its FM/a® test.<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689#comment-2286|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=See Comments Section: CDW12 says: June 26, 2018 at 2:05 pm|language=en-US}}</ref><ref>{{Cite web|url=https://www.celestecooper.com/2018/07/the-fma-blood-test-and-participation-in.html#.Wz4nxdJKjIU|title=The FM/a® Blood Test and Participation in Fibromyalgia Vaccine Study|last=Cooper|first=Celeste|date=Jul 5, 2018|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

A June 2018 study found inflammatory genes CCL11, CCL4, and MEFV in a fibromyalgia family study.<ref>{{Cite journal|last=Zhang|first=Zhifang|last2=Feng|first2=Jinong|last3=Mao|first3=Allen|last4=Le|first4=Keith|last5=Placa|first5=Deirdre La|last6=Wu|first6=Xiwei|last7=Longmate|first7=Jeffrey|last8=Marek|first8=Claudia|last9=Amand|first9=R. Paul St|date=2018-06-21|title=SNPs in inflammatory genes CCL11, CCL4 and MEFV in a fibromyalgia family study|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198625|journal=PLOS ONE|language=en|volume=13|issue=6|pages=e0198625|doi=10.1371/journal.pone.0198625|issn=1932-6203|pmid=29927949|via=}}</ref>
<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/03/immune-system-may-play-role-fibromyalgia-study/|title=Fibromyalgia May Be Linked to Immune System, Study Suggests|last=Inacio|first=Patricia|date=2018-07-03|work=Fibromyalgia News Today|access-date=2018-08-22|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Comorbidities, overlapping conditions, and common symptoms ==
[[File:Fibromyalgia and comorbid conditions.JPG|700px|thumb|center|Comorbid conditions of Fibromyalgia (FMS) are ME/CFS which is the most common; autoimmune diseases; migraines; Multiple Chemical Sensitivities (MCS); and orthostatic intolerance (OI) / Postural Orthostatic Tachycardia Syndrome (POTS).<ref name=":30" /><ref name=":31" /><ref name=":33">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref> Depression and anxiety; digestive conditions and menstrual problems; GWI; nervous system disorders; low blood pressure (Low BP); other pain conditions and migraines; and sleep dysfunction/disturbance all overlap with FMS.<ref name=":30" /> <ref name=":33" />]]

*[[Allodynia]]
** [http://chronicfatigue.about.com/od/glossary/g/allodynia.htm Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS]<ref name=":1">{{Cite news|url=https://www.verywellhealth.com/allodynia-definition-and-types-fibromyalgia-715929|title=Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Feb 23, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Types of Allodynia: Tactile; Mechanical; and Thermal. "Type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain" <ref name=":1" />
*[[Autoimmune disease]]<nowiki/>s "Research suggests that RA and other inflammatory diseases may somehow increase the risk for fibromyalgia."<ref>{{Cite news|url=https://www.health.com/health/gallery/0,,20520705,00.html#restless-legs-0|title=7 Conditions Linked to Fibromyalgia|work=Health.com|access-date=2018-08-19|language=en}}</ref>

*[[Body temperature]]
**[https://www.verywell.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025 Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":2">{{Cite news|url=https://www.verywellhealth.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025|title=Temperature Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Mar 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

<blockquote>When you're exposed to heat, does it feel like you're burning up? Does it seem impossible for you to cool off? Or maybe it's cold that bothers you, chilling you to the bone, leaving you unable to warm up? Or are you one of those people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) who is cold all the time, or hot all the time, or alternately hot or cold while out of sync with the environment?<ref name=":2" /></blockquote>

[[File:Costal cartilages.JPG|200px|thumb|left|Costochonritus is inflammation of the costal cartliges (shown in red) causing chest and ribcage pain]]

:* [https://www.verywell.com/costochondritis-in-fibromyalgia-716178 Costochondritis in Fibromyalgia]<ref name=":10">{{Cite news|url=https://www.verywellhealth.com/costochondritis-in-fibromyalgia-716178|title=Costochondritis Chest Pain in Fibromyalgia|last=Dellow|first=Adrienne|date=Feb 14, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|date=2018-05-25|title=Costochondritis|url=https://en.wikipedia.org/w/index.php?title=Costochondritis&oldid=842926736|journal=Wikipedia|language=en}}</ref>

<blockquote>Costochondritis is inflammation of the cartilage that connects your ribs to your breastbone. Depending on how much inflammation there is, it can range from mildly annoying to intensely painful. People sometimes describe the pain as stabbing, aching, or burning.<ref name=":10" /></blockquote>

<blockquote>Costochondritis can make you think you're having heart problems, which is a scary thing. Even though costochondritis is common, you should get medical attention if you have unexplained chest pain. You don't want to assume that it's FMS-related and end up with permanent heart damage or worse.<ref name=":10" /></blockquote>

<blockquote>The pain can radiate to your shoulder and arms as well (another way the condition mimics a heart attack). Sometimes the pain is accompanied by redness and/or swelling in the most painful areas. When that's the case, it's called Tietze's Syndrome.<ref name=":10" /></blockquote>

* [[Depression]] and [[Anxiety]] Fibromyalgia sufferers are "up to three times more likely to have depression at the time of their diagnosis than someone without fibromyalgia."<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/fibromyalgia-and-depression#1|title=Fibromyalgia and Depression|work=WebMD|access-date=2018-08-19|language=en-US}}</ref> Up to 20 percent of Fibromyalgia patients will have either depression or anxiety.<ref>{{Cite web|url=https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/fibromyalgia|title=Fibromyalgia {{!}} Anxiety and Depression Association of America, ADAA|website=adaa.org|language=en|access-date=2018-08-19}}</ref>

*[[Fibro fog]]

:*[http://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction]<ref name=":3">{{Cite news|url=https://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx|title=What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction|last=Mandal|first=Ananya|date=2013-06-03|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> 'Mental confusion along with difficulty in concentration and loss of memory is often termed “[[fibro fog]]"'.<ref name=":3" />

:* [https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014 What Is Fibro Fog and ME/CFS Brain Fog?]<ref name=":17" />

*[[Gastrointestinal system]]
**[[Irritable bowel syndrome]]: [http://chronicfatigue.about.com/od/whyfmscfsarelinked/a/IBS.htm Irritable Bowel Syndrome in Fibromyalgia & Chronic Fatigue Syndrome - Why Do They Go Together?]<ref name=":4">{{Cite news|url=https://www.verywellhealth.com/irritable-bowel-syndrome-in-fibromyalgia-cfs-716167|title=Irritable Bowel Syndrome in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jan 28, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>Fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome (IBS) frequently go together. No one really knows why, but we do know that all three conditions can include imbalances of serotonin -- although in fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS or ME/CFS) it's an imbalance in the brain, while with IBS it's in the gut.<ref name=":4" /></blockquote>
* [[Gulf War Illness]]
**[https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp Fibromyalgia in Gulf War Veterans]<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp|title=Fibromyalgia in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-19}}</ref> GWI increases risk of developing Fibromyalgia.

*[https://en.wikipedia.org/wiki/Interstitial_cystitis Interstitial Cystitis]<ref>{{Cite journal|date=2018-07-11|title=Interstitial cystitis|url=https://en.wikipedia.org/w/index.php?title=Interstitial_cystitis&oldid=849828657|journal=Wikipedia|language=en}}</ref> (Painful bladder)
**[https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168 Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis]<ref name=":5">{{Cite news|url=https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168|title=Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "Fibromyalgia, chronic fatigue syndrome and interstitial cystitis (IC) -- a painful bladder condition -- frequently occur together. Women may be up to 10 times more likely than men to develop it."<ref name=":5" />

*Language Impairment
**[[Word-finding problems]] is a symptom of ME/CFS.
:*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome Impaired Language in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":6" /> "Searching their brains for simple words that they just can't remember. On other occasions, individuals with these diagnoses may find it hard to write or even understand language."<ref name=":6">{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:*"The diagnosis of [[Aphasia]] is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written"<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref> but with [[dysphasia]] you will have those symptoms and trouble listening and doing numeral calculations.<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-09}}</ref> ''See also'': [[Dyscalculia]].
* [[ME/CFS]]
:*[https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184 Comorbid Conditions in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>
* [[Migraine]]
:*[https://migrainecenters.com/blog/migraines-and-fibromyalgia/ Migraines and Fibromyalgia]<ref name=":32" />
<blockquote>Both fibromyalgia and migraine may reflect problems in the brain’s pain processing center. It is believed that both conditions are caused by excitation of the nervous system or an over-response to stimuli. Stress is usually cited as a trigger for both migraine and fibromyalgia attacks.<ref name=":32">{{Cite news|url=https://migrainecenters.com/blog/migraines-and-fibromyalgia/|title=Migraines and Fibromyalgia - Migraine Centers|date=2016-05-06|work=Migraine Centers|access-date=2018-08-19|language=en-US}}</ref></blockquote>
* [[Multiple chemical sensitivity|Multiple Chemical Sensitivity]] (MCS) It is thought that both Fibromyalgia and MCS are [[Central sensitisation|central sensitivity]] syndromes.<ref>{{Cite news|url=https://www.verywellhealth.com/chemical-sensitivity-in-fibromyalgia-716170|title=Multiple Chemical Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>

*OBGYN
**[https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596 Menstrual Periods with Fibromyalgia: Personal Stories]<ref>{{Cite news|url=https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596|title=Menstrual Periods with Fibromyalgia: Personal Stories|last=Dellwo|first=Adrienne|date=May 18, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>
**[https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626 Fibromyalgia Tied to Hysterectomy, Gynecologic Disease].<ref name=":7" />
:<blockquote>You may have heard about a possible link between gynecologic surgery (such as a hysterectomy) and the development of fibromyalgia, and doctors have long suspected that fibromyalgia has strong hormonal ties and triggers. This does not seem surprising as we've long suspected a link between endocrine disorders, gynecological conditions, and autoimmune conditions.<ref name=":7">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626|title=Fibromyalgia Tied to Hysterectomy, Gynecologic Disease|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref></blockquote>

*[[Orthostatic intolerance]] (OI) and [[Postural orthostatic tachycardia syndrome]] (POTS)<ref>{{Cite journal|last=Yun|first=Dong Joo|last2=Choi|first2=Han Na|last3=Oh|first3=Gun-Sei|date=2013|title=A Case of Postural Orthostatic Tachycardia Syndrome Associated with Migraine and Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710947/|journal=The Korean Journal of Pain|volume=26|issue=3|pages=303–306|doi=10.3344/kjp.2013.26.3.303|issn=2005-9159|pmid=23862007|via=}}</ref>

:*[http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM]<ref>{{Cite web|url=http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf|title=Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM|last=Lapp|first=Charles W.|last2=Black|first2=Laura|date=|website=drlapp.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Smith|first3=Rebekah S.}}</ref> (PDF) Symptoms can include low blood pressure and/or sudden high blood pressure, dizziness, fainting.

:*[https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/ An Overlooked Issue in Fibromyalgia? Study Highlights Problems Standing (Orthostatic Intolerance)]<ref>{{Cite news|url=https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/|title=An Overlooked Issue in Fibromyalgia? Study Highlights Orthostatic Intolerance - Problems Standing - Health Rising|last=Johnson|first=Cort|date=2017-09-21|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[[Sleep dysfunction]]
**[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia]<ref name=":23">{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}</ref>

:<blockquote>The present results of this study suggest that long-term, comorbid pain and sleep disturbance may be associated with increased activation in core default mode brain areas that is above and beyond long-term pain disturbance alone.<ref name=":23" /></blockquote>

:*[http://www.prohealth.com/library/showarticle.cfm?libid=22344 Fibromyalgia and Sleep]<ref name=":8">{{Cite news|url=https://www.prohealth.com/library/fibromyalgia-and-sleep-38954|title=Fibromyalgia and Sleep - Prohealth|date=2016-01-11|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref> "Most people with fibromyalgia have an associated sleep disorder that makes it difficult for them to get the deep, restorative sleep they need."<ref name=":8" />

[[File:TMJ_1.jpg|200px|thumb|right|TMJ/TMD is a condition that occurs in some fibromyalgia and ME/CFS patients]]
* [[Temporomandibular joint disorder]] (TMJ/TMD)

:* [https://www.sciencedirect.com/science/article/pii/S2255502114001758 Temporomandibular disorders in fibromyalgia syndrome: a short-communication]<ref>{{Cite journal|last=Soares Gui|first=Maisa|last2=Pimentel|first2=Marcele Jardim|last3=Rizzatti-Barbosa|first3=C'elia Marisa|date=2015-03-01|title=Temporomandibular disorders in fibromyalgia syndrome: a short-communication|url=https://www.sciencedirect.com/science/article/pii/S2255502114001758|journal=Revista Brasileira de Reumatologia (English Edition)|language=en|volume=55|issue=2|pages=189–194|doi=10.1016/j.rbre.2014.07.004|issn=2255-5021|via=ScienceDirect}}</ref><ref>{{Cite news|url=https://www.whitesmilesforlife.com/blog/study-probes-pain-link-between-tmj-fibromyalgia/|title=Study Probes Pain Link Between TMJ, Fibromyalgia|date=2016-05-03|work=Kent E. White, DDS|access-date=2018-08-19|language=en-US}}</ref>

::Other than headaches, the symptoms are quite distinct from symptoms of FMS and ME/CFS.

::They include:
::*Jaw pain
::*Discomfort or difficulty chewing
::*Painful clicking in the jaw
::*Difficulty opening or closing the mouth
::*Headaches
::*Locking jaw
::*Teeth that don't come together properly<ref>{{Cite news|url=https://www.verywellhealth.com/tmj-in-fibromyalgia-chronic-fatigue-syndrome-716175|title=TMJ in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Mar 31, 2018|work=Verywell Health|access-date=2018-08-22|archive-url=|archive-date=|dead-url=}}</ref>

*[[Thyroid disease]]
**[https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677 Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease]<ref name=":9">{{Cite news|url=https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677|title=A Comparison of Chronic Fatigue, Fibromyalgia, and Thyroid Disease|last=Shomon|first=Mary|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>People with Hashimoto's autoimmune thyroid disease often experience significant fatigue and body aches. While these symptoms are common in Hashimoto's, they can also be markers of other diseases, like chronic fatigue syndrome or fibromyalgia.<ref name=":9" /></blockquote>

*Other symptoms
**[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/fibrosymptoms.htm Symptoms of Fibromyalgia]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-symptoms-716139|title=Symptoms of Fibromyalgia|last=Dellwo|first=Adrienne|date=May 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> (A comprehensive all in one place list for the many symptoms of fibromyalgia.)

==Treatment==

===United States===
'''Rheumatology and primary care providers: Diagnosing and treatment'''

*2012, [https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract A Framework for Fibromyalgia Management for Primary Care Providers]<ref>{{Cite journal|last=Arnold|first=Lesley M.|last2=Clauw|first2=Daniel J.|last3=Dunegan|first3=L. Jean|last4=Turk|first4=Dennis C.|date=2012|title=A Framework for Fibromyalgia Management for Primary Care Providers|url=https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract|journal=Mayo Clinic Proceedings|language=English|volume=87|issue=5|pages=488–496|doi=10.1016/j.mayocp.2012.02.010|issn=0025-6196|via=}}</ref> Rheumatologists stopped treating fibromyalgia patients and primary care providers began treatment managment although rheumatologists are most often the specialist to diagnose. (Please see [http://me-pedia.org/wiki/Fibromyalgia#Disability disability] heading about ''primary provider'' and ''specialists'' for disability cases.)

=== Drugs ===

{{Main article |page_name = Fibromyalgia drugs}}

=== Therapies ===

==== Exercise ====
''Please Note'': These recommendations are for fibromyalgia patients and '''not''' [[ME/CFS]] sufferers.
[[File:Warm water exercise.JPG|200px|thumb|left|Warm water exercise is best for fibromyalgia. Start slow and don't push through the pain<ref name=":11" />]]

*[https://www.verywellhealth.com/warm-water-exercise-for-fibromyalgia-716059 Warm Water Exercise for Fibromyalgia]<ref name=":11">{{Cite news|url=http://chronicfatigue.about.com/od/treatingfmscfs/a/warmwaterFMS.htm|title=Warm Water Exercise for Fibromyalgia|last=Dellwo|first=Adrienne|date=Nov 19, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|last=Munguía-Izquierdo|first=D.|last2=Legaz-Arrese|first2=A.|date=2007|title=Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/18173915|journal=Clinical and Experimental Rheumatology|volume=25|issue=6|pages=823–830|issn=0392-856X|pmid=18173915|via=}}</ref>

<blockquote>A warm-water pool is good for therapy because cold water can make muscles tense up. It's especially important in FMS because many people with the condition are intolerant of cold. A warm-water pool is one that's kept around 89.6 degrees Fahrenheit (32 Celsius), which is several degrees warmer than most heated pools.<ref name=":11" /></blockquote>

*Moderate aerobic exercise and weights with six to eight reps and then a day or two of rest in between. Do not start a program if you are in a flare.<ref>{{Cite web|url=http://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/fibromyalgia-questions/fibromyalgia-exercise.php|title=Fibromyalgia Exercise {{!}} Exercising with Fibromyalgia|last=Ronenn|first=Roubenoff|date=|website=www.arthritis.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[https://www.youtube.com/watch?v=BauJYuJwFsI Easy fibromyalgia exercises and motivation to keep you healthy!]<ref>{{Cite web|url=https://www.youtube.com/watch?v=BauJYuJwFsI|title=Easy Fibromyalgia exercises and motivation to keep you healthy!|last=Suarez|first=Eric|date=Jun 21, 2011|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=Aug 9, 2018}}</ref> Video

*[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/Fibromyalgia-Myth-Vs-Fact.htm Fibromyalgia Myth vs. Fact]<ref name=":15">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-myth-vs-fact-716131|title=Fibromyalgia: What's Myth, What's Fact?|last=Dellwo|first=Adrienne|date=Jun 8, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=Myth #3 People With Fibromyalgia Need More Exercise}}</ref> Heading: ''Myth #3: People With Fibromyalgia Need More Exercise''. Appropriate exercise, which each patient needs to gauge for themselves.<ref name=":15" />

==== Massage ====

*2014, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/ Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]<ref>{{Cite journal|last=Li|first=Yan-hui|last2=Wang|first2=Feng-yun|last3=Feng|first3=Chun-qing|last4=Yang|first4=Xia-feng|last5=Sun|first5=Yi-hua|date=2014-02-20|title=Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/|journal=PLoS ONE|volume=9|issue=2|doi=10.1371/journal.pone.0089304|issn=1932-6203|pmc=|pmid=24586677|pages=|via=}}</ref>

*2016, [http://chronicfatigue.about.com/od/alternativetreatments/a/bodywork.htm Massage, Rolfing & Other Bodywork - Are They Effective Fibromyalgia & Chronic Fatigue Syndrome Treatments?]<ref>{{Cite news|url=https://www.verywellhealth.com/massage-rolfing-other-bodywork-715645|title=Massage, Rolfing, Reiki: Do They Work for Fibromyalgia & ME/CFS?|last=Dellwo|first=Adrienne|date=Aug 10, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==== Acupuncture ====

*2004, [[U.S. Department of Health and Human Services]] (HHS) and [https://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services Centers for Medicare and Medicaid Services] (CMS) ruled April 16, 2004, a noncoverage determination for acupuncture.<ref>{{Cite web|url=https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R11NCD.pdf|title=CMS Manual System Pub. 100-03 Medicare
National Coverage Determinations|last=|first=|date=Apr 16, 2004|website=CMS.gov|format=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2005, [http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html Acupuncture Good for Fibromyalgia?] <ref name=":16">{{Cite web|url=http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html|title=Acupuncture Good for Fibromyalgia?|last=|first=|date=Oct 2, 2012|website=Acupuncture School Online|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> "Acupuncture gave no significant pain relief to fibromyalgia patients."<ref name=":16" />

*2016, [http://www.sciencedirect.com/science/article/pii/S2095496416602352 Short-term complementary and alternative medicine on quality of life in women with fibromyalgia] <ref name=":25">{{Cite journal|date=2016-01-01|title=Short-term complementary and alternative medicine on quality of life in women with fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S2095496416602352|journal=Journal of Integrative Medicine|language=en|volume=14|issue=1|pages=29–35|doi=10.1016/S2095-4964(16)60235-2|issn=2095-4964}}</ref> "There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session."<ref name=":25" />

*2016, [https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/ Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/|title=Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients - Fibromyalgia News Today|last=Semedo|first=Daniela|date=2016-02-01|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Disability ==
===United States===
''Please Note'': The following is NOT legal advice and it should not be relied upon in taking steps for a disability case. Only ''[https://www.ssa.gov/ Social Security]'' and a disability lawyer can provide the most up to date and the correct legal avenue for bringing a disability case.

In the[[ United States]], [https://www.ssa.gov/ssi/ Social Security Insurance] and [https://www.ssa.gov/disability/ Social Security Disability] (SSI) and (SSD) benefits are available for Fibromyalgia. Generally for SSI/SSD, notes and tests from a ''Primary Provider'' '''may''' be allowed for submission but ''Specialists'' such as a rheumatologist, neurologist, psychiatrist, etc. are required for diagnosis, ongoing treatment and completing SSI/SSD paperwork.

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose Fibromyalgia. (See: "Policy Interpretation" for the POLICY INTERPRETATION RULING.)<ref>[https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia]</ref>

*[http://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social Applying for Disability With Fibromyalgia]<ref>{{Cite news|url=https://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social|title=Fibromyalgia Disability: Applying for Disability Benefits With Fibromyalgia|date=2016-10-03|work=NewLifeOutlook {{!}} Fibromyalgia|access-date=2018-08-09|language=en-US}}</ref> One patient's success of applying, denial, successful appeal, and a breakdown of what SSI/SSD requires for the medical determination of a favorable decision of disability.

*[https://www.socialsecurity.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html Fibromyalgia: Policy Interpretation Ruling - Social Security]<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=|website=www.ssa.gov|at=Titles II and XVI: Evaluation of Fibromyalgia|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[http://www.disabilitysecrets.com/social_security_disability_fibromyalgia.html Social Security Disability (SSDI & SSI) for Fibromyalgia - Disability Secrets By NOLO]<ref>{{Cite news|url=https://www.disabilitysecrets.com/resources/social-security-disability-ssdi-ssi-fibromyalgia.htm|title=Social Security Disability (SSDI & SSI) for Fibromyalgia|last=Laurence|first=Bethany|date=|work=www.disabilitysecrets.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*[http://www.mdjunction.com/fibromyalgia/fibromyalgia-disability Fibromyalgia Disability Patient Support Forums]<ref>{{Cite web|url=https://www.mdjunction.com/fibromyalgia/fibromyalgia-disability|title=Fibromyalgia Disability|website=MDJunction|language=en|access-date=2018-08-09}}</ref> at [[MDJunction]]

==== Examinations and Tests ====
For documentation of symptoms and co-morbidities of a FM diagnosis, you and your doctor should consider the following examinations and tests:

:'''Fibromyaglia Diagnostic Examination'''
:*[http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist Rheumatologist] examination and diagnosis of FM. (Consider having a rheumatologist order tests and coordinate referrals for other specialists for examinations and testing. Only specialists can complete the paperwork for Social Security. A primary doctor cannot complete disability paperwork but ''may'' be able to forward test results they have ordered.)
[[File:Whole body bone scan.jpg|200px|thumb|right|A whole body bone scan (Bone scintigraphy) is a nuclear medicine test. '''Arthritis''', avascular necrosis, bone cancers, cancers that have spread to the bone, fibrous dysplasia, fractures, infection involving the bone, and Pagets disease can be diagnosed using this scan.<ref>{{Cite news|url=https://www.healthline.com/health/bone-scan#purpose|title=Bone Scan: Purpose, Procedure, and Risks|last=Krans|first=Brian|date=Dec 13, 2017|work=Healthline|access-date=2018-08-21|archive-url=|archive-date=|dead-url=|language=en}}</ref>]]
:'''Arthritis'''
:*[https://en.wikipedia.org/wiki/Bone_scintigraphy Whole body bone scan (Bone scintigraphy)]<ref>{{Cite journal|date=2018-05-22|title=Bone scintigraphy|url=https://en.wikipedia.org/wiki/Bone_scintigraphy|journal=Wikipedia|language=en}}</ref> to rule out treatable arthritis.
:'''Blood Tests'''
:*Routine blood tests for [[diabetes]] (fasting sugar, A1C) and a full [[Thyroid disease]] panel ([https://en.wikipedia.org/wiki/Thyroid_function_tests#Thyroid-stimulating_hormone TSH, T3, Free T3, T4 and Free T4]).
:*Rule out [[Rheumatoid arthritis]], lupus, [[Lyme disease]] and other diseases that can share some of the same symptoms of fibromyalgia and may be treatable.<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1-3|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>
:*Vitamin and mineral deficiencies such as [[B12]] and [[Vitamin D]] are treatable with over the counter supplements and prescription medications which can improve [[fatigue]] and [[pain]].
:'''Gastrointestinal'''
:*[[Irritable bowel syndrome]] diagnosis which may require blood, [http://www.mayoclinic.org/tests-procedures/endoscopy/basics/definition/PRC-20020363 upper endoscopy] to rule out [https://en.wikipedia.org/wiki/Coeliac_disease celiac disease] and [https://en.wikipedia.org/wiki/Stool_test fecal tests] to check for bacteria ([[SIBO]]) and [http://www.umm.edu/health/medical/altmed/condition/intestinal-parasites intestinal parasites].
:'''Mental Health and Cognition'''
:* Psychiatric evaluation as any [[depression]] and [[anxiety]] should be treated.
:* [[Cognitive dysfunction]] tests.
:'''Sleep dysfunction'''
:*Sleep study for [[Restless legs syndrome]], [[Sleep disturbance]] or [[Narcolepsy]].
:'''Orthostatic Intolerance'''
:*[[Tilt table test]] to diagnose [[Orthostatic intolerance]] or [[Postural orthostatic tachycardia syndrome|POTS]].
:'''TMJ, tinnitus, vertigo, and dizziness'''
:*An ear, nose, and throat specialist (ENT) ([http://www.mayoclinic.org/departments-centers/otorhinolaryngology-ent/overview Otorhinolaryngology]) examination and imaging may be ordered for [[Temporomandibular joint disorder]] (TMJ).
:*(Ear, sinus, throat/lymph infections, and [[tinnitus]] can also be documented.)
:*[https://en.wikipedia.org/wiki/Videonystagmography Videonystagmography] (VNG) testing if you experience [[vertigo]] and/or [[dizziness]].<ref>{{Cite news|url=https://www.everydayhearing.com/balance/articles/what-to-expect-at-your-vng-test/|title=What to Expect at Your VNG/ENG Test - Everyday Hearing|last=Banks|first=Lindsey|date=2014-05-07|work=Everyday Hearing|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

Of course, one can have arthritis, sleep apnea, [[Chronic lyme disease|chronic Lyme disease]] or other diseases and still have FM, but there may be a treatable condition where a patient's overall health, including their FM, improves.<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/guide/common-misdiagnoses-of-fibromyalgia#1|title=Common Misdiagnoses of Fibromyalgia|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite web|url=http://www.cfidsselfhelp.org/library/overlapping-and-related-conditions|title=Overlapping and Related Conditions {{!}} CFIDS & Fibromyalgia Self-Help|website=www.cfidsselfhelp.org|access-date=2018-08-09}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

There have been cases of [[Vitamin D]] deficiency being misdiagnosed as fibromyalgia as a D deficiency can cause pain. Supplementation or prescribed D treatments may alleviate this pain. However, it is possible to have both a D deficiency and fibromyalgia and correcting the deficiency will only resolve the pain stemming from it.<ref>{{Cite news|url=http://www.webmd.com/pain-management/features/vitamin-d-deficiency-and-chronic-pain-link#1|title=Does Vitamin D Deficiency Cause Chronic Pain?|last=Shaw|first=Gina|date=|work=WebMD|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

==== Blogs about navigating SSD process ====

*Resources for getting approved for disability include this [http://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/ Guide to Social Security Disability for People with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome],<ref>{{Cite web|url=https://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/|title=The Sleepy Girl Guide to Social Security Disability (U.S.) {{!}} #MEAction|last=Silver|first=Lily|date=Apr 17, 2017|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> available on the #[[MEAction]] website.

*[https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/ How Patty’s Lawyer Never Told Her What She Needed to Know]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/|title=How Patty’s Lawyer Never Told Her What She Needed to Know|last=Skelton Preston|first=Patty|date=2017-03-20|work=How to Get On|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/ Sample Doctor Letters for Disability]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/|title=21 Sample Doctor Letters for Disability|date=2017-05-01|work=How to Get On|access-date=2018-08-09|language=en-US}}</ref>

== Notable studies ==
{{Main article |page_name = Fibromyalgia notable studies}}

== Controversies ==
=== Dr. Frederick Wolfe ===
Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.<ref>{{Cite news|url=http://www.nytimes.com/2008/01/14/health/14pain.html?_r=0|title=Drug Approved. Is Disease Real?|last=Berenson|first=Alex|date=Jan 14, 2008|work=The Wall Street Journal|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>[http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf Fibromyalgia: A Short Commentary - iMedPub Journals - DOI: 10.4172/2472-1913.100027 - Frederick Wolfe and Brian Walitt - Sep. 23, 2016]</ref><ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|journal=Journal of Headache & Pain Management|volume=1|issue=3:27|pages=|via=iMedPub Journals}}</ref><ref>{{Cite news|url=https://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx|title=Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine|last=Cashin-Garbutt|first=April|date=2013-03-22|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Fibromyalgia vs Chiari malformation ===
Some individuals diagnosed with FMS were undergoing surgery for [[Chiari malformation]] (CM). These are two separate conditions; FMS cannot be resolved by undergoing a risky CM surgery.

*2011, [https://www.ncbi.nlm.nih.gov/pubmed/21135714 Is Chiari I malformation associated with fibromyalgia?]<ref>{{Cite journal|last=Watson|first=Nathaniel F.|last2=Buchwald|first2=Dedra|last3=Goldberg|first3=Jack|last4=Maravilla|first4=Kenneth R.|last5=Noonan|first5=Carolyn|last6=Guan|first6=Qingyan|last7=Ellenbogen|first7=Richard G.|date=2011|title=Is Chiari I malformation associated with fibromyalgia?|url=https://www.ncbi.nlm.nih.gov/pubmed/21135714|journal=Neurosurgery|volume=68|issue=2|pages=443–448; discussion 448–449|doi=10.1227/NEU.0b013e3182039a31|issn=1524-4040|pmid=21135714|via=}}</ref>
::Conclusion: Most patients with FM do not have [[CIM]] pathology. Future studies should focus on dynamic neuroimaging of craniocervical neuroanatomy in patients with FM.
*2015, [https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery CFS/FM and Chiari Malformation Surgery]<ref>{{Cite web|url=https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery|title=CFS/FM and Chiari Malformation Surgery|last=Casanova|first=Ken|date=Nov 15, 2015|website=www.massmecfs.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

== Learn more ==
*[https://www.s4me.info/forums/fibromyalgia-and-connective-tissue-disorders.35/ Forum: Fibromyalgia and Connective Tissue Disorders] at [[Science for ME]]
*[[Verywell FMS/CFS]]

=== Ongoing process of diagnosing and categorizing ===

*2014, [http://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114 Lyme Disease, Fibromyalgia Link Evaporates]<ref>{{Cite news|url=https://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114|title=Lyme Disease, Fibromylagia Link Evaporates|last=Kuznar|first=Wayne|date=2014-12-14|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> (See also: [[Chronic lyme disease]])

*2015, [http://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx Fibromyalgia now considered as a lifelong central nervous system disorder]<ref>{{Cite news|url=https://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx|title=Fibromyalgia now considered as a lifelong central nervous system disorder|date=2015-05-18|work=News-Medical.net|access-date=2018-08-09|language=en}}</ref>

*2015, [http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates]<ref>{{Cite news|url=http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html|title=Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates|date=2015-10-24|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2015, ''Question:'' [http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html 'Is Fibromyalgia a Psychosomatic Illness?'] via CelesteCooper.com ''Answer:'' "Fibromyalgia is NOT a psychosomatic illness."<ref>[http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html Is Fibromyalgia a Psychosomatic Illness? Med Student Asks Celeste Cooper by Celeste Cooper - CelesteCooper.com Sep 4, 2015]</ref>

*2016, [http://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination Diagnosing Fibromyalgia May Be Possible Using Noninvasive Eye Examination]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination|title=Diagnosing Fibromyalgia May Be Possible with Noninvasive Eye Exam|date=2016-09-09|work=Fibromyalgia News Today|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780 Microglia in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780|title=Microglia in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*2016, [http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/ Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders?]<ref>{{Cite news|url=http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/|title=Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders? - Simmaron Research|date=2016-03-21|work=Simmaron Research|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://consultqd.clevelandclinic.org/2016/03/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic Why Fibromyalgia Is Neuropathic]<ref>{{Cite news|url=https://consultqd.clevelandclinic.org/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic|title=Why Fibromyalgia Is Neuropathic|date=2016-03-08|work=Consult QD|access-date=2018-08-09|language=en-US}}</ref>

*2017, [http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain]<ref>{{Cite news|url=http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html|title=Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain|last=Liptan|first=Ginevra|date=2017-04-11|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
*2017, [https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947 AI can spot the pain from a disease some doctors still think is fake]<ref>{{Cite news|url=https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947|title=AI can spot the pain from a disease some doctors still think is fake|last=Goldhill|first=Olivia|date=Aug 9, 2018|work=Quartz|access-date=2018-08-15|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== Blood tests ===

*2013, [http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html New Fibromyalgia Blood Test is 99% Accurate]<ref>{{Cite news|url=http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html|title=New Fibromyalgia Blood Test is 99% Accurate|date=2013-07-31|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2014, [http://www.prohealth.com/library/showarticle.cfm?libid=18837 Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”]<ref>{{Cite news|url=https://www.prohealth.com/library/pridgen-reports-fibromyalgia-antiviral-trial-results-very-positive-predicts-new-approach-will-be-game-changer-32620|title=Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”|last=|first=|date=2014-03-25|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2016, [https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html Blood Test for Fibromyalgia: FM/a Test Ⓡ is now available, Q&A]<ref>{{Cite web|url=https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html|title=Blood Test for Fibromyalgia: FM/a Test ® Is Real, Q&A|last=Cooper|first=Celeste|date=May 3, 2016|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2016, [http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/ Fibromyalgia blood testing covered by rising number of insurance companies]<ref>{{Cite news|url=http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/|title=Fibromyalgia blood testing covered more of insurance companies|last=Campbell|first=Julie|date=2016-04-08|work=Live Insurance News|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2017, [http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches]<ref>{{Cite news|url=https://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=Business Wire|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Brain scans ===

*2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds]<ref>{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|publisher=ANAPSID|via=Chronic Neuroimmune Diseases|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2012, [https://www.sciencedaily.com/releases/2012/11/121111153426.htm Fibromyalgia and the brain: New clues reveal how pain and therapies are processed]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2012/11/121111153426.htm|title=Fibromyalgia and the brain: New clues reveal how pain and therapies are processed|last=|first=|date=Nov 11, 2012|work=ScienceDaily|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*2015, [https://www.verywell.com/unique-brain-connectivity-in-fibromyalgia-715630 Unique Brain Connectivity in Fibromyalgia - Increased Importance Assigned to Pain]<ref>{{Cite news|url=https://www.verywellhealth.com/how-lyrica-changes-the-fibromyalgia-brain-715767|title=How Lyrica Changes the Fibromyalgia Brain|last=Dellwo|first=Adrienne|date=Apr 30, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==See also==
* [[Fibromyalgia drugs]]

* [[Fibromyalgia notable studies]]
* [[Influenza vaccine]]

*[[Lady Gaga]]

==References==
<references />

[[Category:Diagnoses]]
[[Category:Comorbidities]]

Fibromyalgia

2018-08-25T14:31:59Z

77.111.246.7:/* Comorbidities, overlapping conditions, and common symptoms */ spacing

[[Fibromyalgia]] (FM/FMS) is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Pain is widespread, on both sides of the body, and above and below the waist.

Sufferers are fatigued and tired even when sleeping for long periods of time, and sleep is often disrupted by pain. Many FM sufferers have sleep disorders like [https://en.wikipedia.org/wiki/Sleep_apnea sleep apnea] and [[restless leg syndrome]]. [[Cognitive impairment]], when one cannot focus or pay attention and the patient has difficulty concentrating on mental tasks, is known by FM sufferers as "[[fibro fog]]".<ref name=":17">{{Cite news|url=https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014|title=What Is Fibro Fog and ME/CFS Brain Fog?|last=Dellwo|first=Adrienne|date=|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Some experience [[depression]], [[headache]]s, and lower [[abdominal pain]] or cramping. Other symptoms include tingling or [[numbness]] in hands and feet, pain in jaw and disorders of the jaw such as [[temporomandibular joint disorder|temporomandibular joint disorder]] (TMJ), [[Menstrual cycle#Health effects in other conditions|menstrual cycle]] cramps, and digestive problems like i[[Irritable bowel syndrome|rritable bowel syndrome]] (IBS).<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms#1|title=Fibromyalgia Symptoms|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780|title=Fibromyalgia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref>

[[File:Fibro_Tender_Points.png|400px|thumb|right|1990 ACR Diagnostic Criteria: 18 Tender Points]]
[[File:Fibro_Widespread_Pain.png|400px|thumb|right|2010 ACR Preliminatry Diagnostic Criteria: Wisedpread Pain Index (WPI), 19 Tender Point Areas]]

==Prevalence==
FM is the second most common [https://en.wikipedia.org/wiki/Rheumatism rheumatic disorder] behind [[wikipedia:Osteoarthritis|osteoarthritis]] and is "now considered to be a lifelong [[Central nervous system]] disorder."<ref>{{Cite news|url=https://naidw.org/blog/members-myblogs/fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder|title=Fibromyalgia now considered as a lifelong central nervous system disorder|work=NAIDW.org®|access-date=2018-08-09|language=en-gb}}</ref> An estimated 10 million people in the US and 3-6% of the world population have fibromyalgia. It is seen in women, men, children, and all ethnic groups. It is often seen in families and diagnosed between the ages of 20 to 50 years; incidence increases with age.<ref>{{Cite news|url=http://www.fmaware.org/about-fibromyalgia/prevalence/|title=Prevalence - National Fibromyalgia Association (NFA)|work=National Fibromyalgia Association (NFA)|access-date=2018-08-09|language=en-US}}</ref>

FM has a female:male 7:1 ratio under the ''American College of Rheumatology (ACR) 1990 Diagnostic Criteria'' and 2:1 when the ''ACR 2010 Preliminary Diagnostic Criteria'' is used.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=|publisher=|editor-last=Diamond|editor-first=Herbert|at=Sex-related differences in incidence}}</ref> ''See'': [[Fibromyalgia#American College of Rheumatology (ACR) Criteria|Fibromyalgia (''American College of Rheumatology (ACR) Criteria'' section)]].

==Fibromyalgia in ME/CFS==
Dr. [[Jarred Younger]] has said that many patients that meet the criteria for FM also meet criteria for [[chronic fatigue syndrome]] (CFS) but the reverse is not necessarily true as a lot of people with [[CFS]] do not have [[chronic pain]].<ref>{{Cite web|url=https://www.youtube.com/watch?v=wJB95m4FLa0#t=57m27s|title=Webinar with Jarred Younger, Ph.D.|last=Younger|first=Jared|date=May 20, 2016|website=YouTube|at=57:27|via=|archive-url=|archive-date=|dead-url=|access-date=|publisher=SolveCFS|type=Video}}</ref> However, the [[Canadian Consensus Criteria]] (CCC) requires the symptom of pain to diagnose [[ME/CFS]]. It is the pattern and significant degree of [[chronic pain]] in FM that sets it apart from other diseases that have pain.

"The most common overlapping condition with ME/CFS is fibromyalgia."<ref name=":30">{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions - American Myalgic Encephalomyelitis and
Chronic Fatigue Syndrome Society|last=|first=|date=|website=ammes.org|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref><ref name=":31">{{Cite journal|last=Jason|first=Leonard|last2=Taylor|first2=R.R.|last3=Kennedy|first3=C.L.|last4=Song|first4=S|last5=Johnson|first5=D|last6=Torres|first6=S.R.|date=2001-01-01|title=Chronic fatigue syndrome: Comorbidity with fibromyalgia and psychiatric illness|url=https://www.researchgate.net/publication/285787383_Chronic_fatigue_syndrome_Comorbidity_with_fibromyalgia_and_psychiatric_illness|journal=Medicine and Psychiatry|volume=4|pages=29–34}}</ref>

==Health complications==
FM is not a [https://en.wikipedia.org/wiki/Progressive_disease progressive disease] but according to Dr. Dan Clauw the "slow gradual worsening of chronic pain patients over time is due to downstream consequences of poorly controlled pain and other symptoms, wherein individuals then progressively get less active, sleep worse, are under more stress and unknowingly develop bad habits which worsen pain and other symptoms."<ref>{{Cite news|url=http://nationalpainreport.com/ask-the-dctors-is-fibromyalgia-progressive-8831105.html|title=Ask the Doctors: Is Fibromyalgia Progressive?|date=2016-08-09|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*[https://www.sharecare.com/health/fibromyalgia-effects Fibromyalgia Complications]<ref name=":19" />

:<blockquote>People who have fibromyalgia frequently complain of a variety of symptoms that affect other parts of the body. Many people complain of [[gastrointestinal]] issues and restless legs syndrome (RLS). Additionally, the [[chronic pain]] and discomfort of fibromyalgia may lead to [[depression]].<ref name=":19">{{Cite news|url=https://www.sharecare.com/health/fibromyalgia-effects|title=Fibromyalgia Complications - Fibromyalgia - Joint Health|work=Sharecare|access-date=2018-08-09|language=en}}</ref></blockquote>

*[https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions Can fibromyalgia cause other medical conditions?]<ref name=":20" />

:<blockquote>Fibromyalgia is not known to cause other medical conditions. However, people who have fibromyalgia seem to be at high risk for developing other painful conditions, including [https://en.wikipedia.org/wiki/Osteoarthritis osteoarthritis] (the common type of arthritis caused by wear and tear on the joints) as well as other related conditions, such as [[rheumatoid arthritis]], [[lupus]], and [https://en.wikipedia.org/wiki/Ankylosing_spondylitis ankylosing spondylitis]. Also, people with fibromyalgia are frequently diagnosed with chronic fatigue syndrome, irritable bowel syndrome (IBS), and temporomandibular joint (TMJ) disorder.<ref name=":20">{{Cite web|url=https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions|title=Can fibromyalgia cause other medical conditions? {{!}} Fibromyalgia Complications|last=Honor Society of Nursing|first=|date=|website=Sharecare|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref></blockquote>

==Risk factors==
[[Lupus]] and [[Rheumatoid arthritis]] (RA) are risk factors in developing FM. Car accidents, [[Post-traumatic stress disorder]] (PTSD), [https://en.wikipedia.org/wiki/Repetitive_strain_injury repetitive injuries], illness such as a [https://en.wikipedia.org/wiki/Viral_disease viral infection], [https://en.wikipedia.org/wiki/Family_history_(medicine) family history], and [https://en.wikipedia.org/wiki/Obesity obesity] have all been linked to FM.<ref>{{Cite web|url=https://www.cdc.gov/arthritis/basics/fibromyalgia.htm|title=Fibromyalgia {{!}} Arthritis {{!}} CDC|date=2018-04-03|website=www.cdc.gov|language=en-us|access-date=2018-08-09}}</ref><ref>{{Cite news|url=https://www.niams.nih.gov/health_info/Fibromyalgia/|title=Fibromyalgia What Causes it?|last=Director|first=Nancy Garrick, Deputy|date=2017-04-05|work=National Institute of Arthritis and Musculoskeletal and Skin Diseases|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

==Diagnosis==
[https://www.verywellhealth.com/what-are-fibromyalgia-tender-points-189768 Tender points], not [https://en.wikipedia.org/wiki/Myofascial_trigger_point trigger points], are used to diagnose Fibromyalgia.<ref>{{Cite web|url=http://www.healthcentral.com/chronic-pain/c/662034/176031/fibromyalgia-trigger/|title=The Difference Between Fibromyalgia Tender Points and Myofascial Trigger Points - Chronic Pain {{!}} HealthCentral|last=Cooper|first=Celeste|date=May 8, 2015|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> Tender points will be above and below the waist and on both sides of the body. (See: Illustrations of the 1990 and 2010 American College of Rheumatology (ACR) Criteria depicting tender points near the top of this page.) It is important to check for other conditions that could be causing pain such as hypothyroidism, Rheumatoid arthritis or lupus, osteoarthritis, Ankylosing spondylitis, and [[wikipedia:Polymyalgia_rheumatica|Polymyalgia rheumatica]].<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>

===United States===
==== American College of Rheumatology (ACR) Criteria ====

*1990, [http://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf The American College Of Rheumatology 1990 Criteria For The Classification Of Fibromyalgia]<ref>{{Cite web|url=https://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf|title=The American College of Rheumatology Criteria for the Classification of Fibromyalgia|last=Wolfe|first=Frederick|last2=Smythe|first2=Hugh|date=1990|website=rheumatology.org|publisher=|others=Abeles, Micha; Clark, Patricia; Fam, Adel; Farber, Stephen; Fiechtner, Justus; Franklin, Michael; Gatter, Robert; Hamaty, Daniel; Lessard, James; Lightbroun, Alan; Masi, Alfonse; McCain, Glenn; Reynolds, W. John; Romano, Thomas; Russell, Jon; Sheon, Robert|archive-url=|archive-date=|dead-url=|access-date=|last3=Yunus|first3=Muhammad|last4=Bennett|first4=Robert|last5=Bombardier|first5=Claire|last6=Goldenberg|first6=Don|last7=Tugwell|first7=Peter|last8=Campbell|first8=Stephen}}</ref> "American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure."<ref>{{Cite news|url=http://www.health.com/health/gallery/0,,20345635,00.html|title=18 Points Used to Diagnose Fibromyalgia|last=|first=|date=Feb 4, 2011|work=Health.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> <ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2010, The [https://www.fibroknowledge.com/site/acr-2010 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview]<ref>{{Cite web|url=https://www.fibroknowledge.com/sites/default/files/downloads/file/2010_ACR_CRITERIA.pdf|title=American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia|last=|first=|date=2010|website=fibroknowledge.com|type=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref> was proposed and modified in 2011<ref>{{Cite news|url=http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria|title=New and Modified Fibromyalgia Diagnostic Criteria|last=Garg|first=Neha|date=Feb 9, 2012|work=Rheumatology Network|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=|last2=Deodhar|first2=Atul}}</ref> with the modification being validated in 2013 and published in 2014.<ref>{{Cite journal|last=Bennett|first=Robert M.|last2=Friend|first2=Ronald|last3=Marcus|first3=Dawn|last4=Bernstein|first4=Cheryl|last5=Han|first5=Bobby Kwanghoon|last6=Yachoui|first6=Ralph|last7=Deodhar|first7=Atul|last8=Kaell|first8=Alan|last9=Bonafede|first9=Peter|date=2014|title=Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/24497443|journal=Arthritis Care & Research|volume=66|issue=9|pages=1364–1373|doi=10.1002/acr.22301|issn=2151-4658|pmid=24497443|via=}}</ref> September of 2016, another revision has been made.<ref>{{Cite news|url=http://acrabstracts.org/abstract/2016-revisions-to-the-20102011-fibromyalgia-diagnostic-criteria/|title=2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria - ACR Meeting Abstracts|last=|first=|date=Sep 28, 2016|work=ACR Meeting Abstracts|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

:Men do not seem to form the tender points needed for diagnosis under the 1990 criteria,<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/features/how-fibromyalgia-affects-men#2|title=How Fibromyalgia Affects Men: Symptoms and Diagnosis|work=WebMD|access-date=2018-08-09|language=en-US}}</ref> the 2010 proposed criteria diagnoses more men with a F/M ratio of 2:1.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=}}</ref>
:Tender points were used to diagnose with the 1990 criteria, however "considerable skill is needed to correctly check for a patient’s tender points (i.e., digital palpation that is done with certain amount of applied pressure), yet this technique is not typically taught at most medical schools."<ref name=":0">{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 5, 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>
:The new standards were designed to:
:*eliminate the use of a tender point examination
:*include a severity scale by which to identify and measure characteristic FM symptoms
:*utilize an index by which to rate pain<ref name=":0" />
:*There are 19 tender point areas in the widespread pain index (WPI), whereas the 1990 criteria had 18 tender points.<ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose fibromyalgia.<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=Jul 25, 2012|website=www.ssa.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

==== Sleep study ====
[[Sleep dysfunction]] is often involved in fibromyalgia. Treating a sleep disorder can help with fibromyalgia symptoms. A diagnosed sleep disorder is also helpful if one needs to file for disability.

*[https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054 Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054|title=Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*[http://www.sciencedaily.com/releases/2008/09/080903134311.htm What A Sleep Study Can Reveal About Fibromyalgia]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2008/09/080903134311.htm|title=What A Sleep Study Can Reveal About Fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*[http://linkis.com/nationalpainreport.com/lzYea Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says]<ref>{{Cite news|url=http://linkis.com/nationalpainreport.com/lzYea|title=Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says|last=|first=|date=Mar 25, 2016|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== ICD Diagnostic code===
====World Health Organization====
'''ICD-10'''

The [[World Health Organization]] (WHO) International Classification of Diseases (ICD) lists fibromyalgia as a "disease of the [[musculoskeletal system]] and connective tissue", under the code M79.7 (WHO ICD-10 Version: 016).<ref>World Health Organization, [http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7 International Classification of Diseases - Fibromyalgia M79.7], ICD-10, 2016</ref>

*'''M79.7 Fibromyalgia'''
::Fibromyositis
::Fibrositis
::Myofibrositis<ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7|title=ICD-10 Version:2016|website=apps.who.int|language=en|access-date=2018-08-09}}</ref>

In 2015, the [[United States]] finally adopted ICD-10 and Fibromyalgia as a diagnosis.<ref>{{Cite web|url=http://www.icd10data.com/ICD10CM/Codes/M00-M99/M70-M79/M79-/M79.7|title=2018 ICD-10-CM Diagnosis Code M79.7: Fibromyalgia|website=www.icd10data.com|language=en|access-date=2018-08-09}}</ref> <ref>{{Cite news|url=http://nationalpainreport.com/the-health-care-industry-finally-recognizes-fibromyalgia-8827637.html|title=The Health Care Industry Finally Recognizes Fibromyalgia|last=Liptan|first=Ginevra|date=2015-09-30|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

'''ICD-11 (2019)'''

[https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504 ICD-11] (2019) has diagnostic code ''MG30.1 Chronic widespread pain''.<ref name=":18">{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504|title=ICD-11 - Mortality and Morbidity Statistics|website=icd.who.int|language=en|access-date=2018-08-09}}</ref>

*'''MG30.01 Chronic widespread pain'''

'''Parent'''
::MG30.0 Chronic primary pain

'''Description'''
<blockquote>Chronic widespread pain (CWP) is diffuse pain in at least 4 of 5 body regions and is associated with significant emotional distress (anxiety, anger/frustration or depressed mood) or functional disability (interference in daily life activities and reduced participation in social roles) [1]. CWP is multifactorial: biological, psychological and social factors contribute to the pain syndrome. The diagnosis is appropriate when the pain is not directly attributable to a nociceptive process in these regions and there are features consistent with nociplastic pain [2] and identified psychological and social contributors.<ref name=":18" /></blockquote>

'''Inclusions'''
:*Fibromyalgia
'''Exclusions'''
:*Acute pain (MG31)<ref name=":18" />

==Pathophysiology==
"Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology. There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or [[Lyme disease]], as well as emotional or physical trauma."<ref>{{Cite web|url=https://www.uptodate.com/contents/pathogenesis-of-fibromyalgia#!|title=UpToDate|last=Goldenberg|first=Don L|date=|website=www.uptodate.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> The widespread pain is severe, debilitating, and abnormal in processing its pain. There is also sleep disturbance and fatigue. Cause or causes are unproven.<ref>{{Cite news|url=https://www.omf.ngo/what-is-mecfs-old/fibromyalgia/|title=What is Fibromyalgia? {{!}} Open Medicine Foundation|work=Open Medicine Foundation|access-date=2018-08-09|language=en-US}}</ref>

*May 2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/ Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management]<ref name=":21">{{Cite journal|last=Jahan|first=Firdous|last2=Nanji|first2=Kashmira|last3=Qidwai|first3=Waris|last4=Qasim|first4=Rizwan|date=2012|title=Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/|journal=Oman Medical Journal|volume=27|issue=3|pages=192–195|doi=10.5001/omj.2012.44|issn=1999-768X|pmc=|pmid=22811766|via=}}</ref> ''See'' Table 1: "Conditions associated with fibromyalgia." Musculoskeletal, genitourianry, gastro intestinal, and miscellaneous conditions often exist among fibromyalgia patients.

<blockquote>Pathophysiology: Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as [[serotonin]], substance P, growth hormone and [[cortisol]] suggest that regulation of the autonomic and neuro-endocrine system appears to be the basis of the syndrome. Fibromyalgia is not a life-threatening, deforming, or [https://en.wikipedia.org/wiki/Progressive_disease progressive disease]. [[Anxiety]] and [[depression]] are the most common association. Aberrant pain processing, which can result in [[chronic pain]], may be the result of several interplaying mechanisms. [[Central sensitization]], blunting of inhibitory pain pathways and alterations in [[neurotransmitters]] lead to aberrant neuro-chemical processing of sensory signals in the CNS, thus lowering the threshold of pain and amplification of normal sensory signals causing constant pain.<ref name=":21" /></blockquote>

<blockquote>The frequent co-morbidity of fibromyalgia with mood disorders suggests a major role for the stress response and for neuroendocrine abnormalities. The [[hypothalamic pituitary axis]] (HPA) is a critical component of the stress-adaptation response. In FMS, stress adaptation response is disturbed leading to stress induce symptoms. Psychiatric co-morbidity has been associated with FMS and needs to be identified during the consultation process, as this requires special consideration during treatment.<ref name=":21" /></blockquote>

*May 2018, [https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management]<ref>{{Cite journal|last=Bourgaize|first=Sheryl|last2=Newton|first2=Genevieve|last3=Kumbhare|first3=Dinesh|last4=Srbely|first4=John|date=2018|title=A comparison of the clinical manifestation and
pathophysiology of myofascial pain syndrome
and fibromyalgia: implications for differential
diagnosis and management|url=https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf|format=PDF|journal=Journal of the Canadian Chiropractic Assoc.|volume=|pages=26-41|at=See Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)|via=}}</ref> (PDF) ''See'' Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)

*Jul 2018, [https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/ Primary and Secondary Fibromyalgia Share Same Symptom Burden, Study Suggests]<ref name=":22">{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/|title=Primary, Secondary Fibromyalgia Share Same Symptom Burden, Study Says|last=Carvalho|first=John|date=2018-07-31|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

<blockquote>Fibromyalgia can be considered either primary, or dominant, also known as idiopathic fibromyalgia, or secondary. In the primary form, the causes of the disorder are unknown, but in secondary fibromyalgia, the disorder usually occurs alongside other debilitating medical conditions, such as rheumatoid arthritis (RA), lupus, and multiple sclerosis.<ref name=":22" /></blockquote>

===Immune system research===

Dr. [[Jarred Younger]] believes an overactive [[immune system]] is the cause and will be conducting a study to test this hypothesis.<ref>{{Cite news|url=http://nationalpainreport.com/new-uab-study-could-radically-change-fibromyalgia-treatment-as-we-know-it-8833437.html|title=New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It|last=Gregory Burch|first=Donna|date=2017-04-24|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=https://www.youtube.com/watch?v=8e5xKX036bE|title=Testing the fibromyalgia immune system with lipopolysaccharide (LPS)|last=Younger|first=Jarred|date=May 24, 2017|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=|via=Younger Lab}}</ref> An overactive immune system is responsible for [[inflammation]] which causes [[chronic pain]].

Dr. William Pridgen's research of [[HSV-1]] (cold sore virus) as being involved in FM has conducted a successful Phase III clinical trial, which had been fast-tracked by the [[Food and Drug Administration]] (FDA), of a combination drug that suppresses this virus and also helps with pain. ''See'': [[Fibromyalgia#IMC-1|Fibromyalgia (''Drugs: Trials: IMC-1'' section)]].

[[ProHealth]] reports that an old [https://en.wikipedia.org/wiki/Tuberculosis Tuberculosis] vaccine, [https://en.wikipedia.org/wiki/BCG_vaccine Bacille Calmette-Guerin] (BCG), may be researched for treatment of Fibromyalgia spearheaded by [http://www.buzzfile.com/business/Epicgenetics,-Inc.-310-586-2929 EpicGenetics] and [http://www.massgeneral.org/ Massachusetts General Hospital].<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

EpicGenetics has a blood test that is identifying the presence of specific white blood cell abnormalities of patients diagnosed with FM and has partnered with two universities to offer [https://en.wikipedia.org/wiki/Disease_gene_identification#Whole_exome_sequencing whole exome sequencing] free of charge to those who test positive with their [http://fmtest.com/ FM/a® test].<ref>{{Cite news|url=http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> Concerns have been raised in regards to the FM/a® EpicGenetics Blood Test.<ref>{{Cite web|url=http://www.fmperplex.com/2013/02/25/junk-science-junk-ethics/|title=Junk Science – Junk Ethics – The Fibromyalgia Perplex|last=Wolfe|first=Fred|date=Feb 25, 2013|website=www.fmperplex.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> EpicGenetics is awaiting FDA approval to test the Bacille Calmette-Guerin (BCG) vaccine (an old Tuberculosis vaccine) on patients that tested positive with its FM/a® test.<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689#comment-2286|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=See Comments Section: CDW12 says: June 26, 2018 at 2:05 pm|language=en-US}}</ref><ref>{{Cite web|url=https://www.celestecooper.com/2018/07/the-fma-blood-test-and-participation-in.html#.Wz4nxdJKjIU|title=The FM/a® Blood Test and Participation in Fibromyalgia Vaccine Study|last=Cooper|first=Celeste|date=Jul 5, 2018|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

A June 2018 study found inflammatory genes CCL11, CCL4, and MEFV in a fibromyalgia family study.<ref>{{Cite journal|last=Zhang|first=Zhifang|last2=Feng|first2=Jinong|last3=Mao|first3=Allen|last4=Le|first4=Keith|last5=Placa|first5=Deirdre La|last6=Wu|first6=Xiwei|last7=Longmate|first7=Jeffrey|last8=Marek|first8=Claudia|last9=Amand|first9=R. Paul St|date=2018-06-21|title=SNPs in inflammatory genes CCL11, CCL4 and MEFV in a fibromyalgia family study|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198625|journal=PLOS ONE|language=en|volume=13|issue=6|pages=e0198625|doi=10.1371/journal.pone.0198625|issn=1932-6203|pmid=29927949|via=}}</ref>
<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/03/immune-system-may-play-role-fibromyalgia-study/|title=Fibromyalgia May Be Linked to Immune System, Study Suggests|last=Inacio|first=Patricia|date=2018-07-03|work=Fibromyalgia News Today|access-date=2018-08-22|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Comorbidities, overlapping conditions, and common symptoms ==
[[File:Fibromyalgia and comorbid conditions.JPG|700px|thumb|center|Comorbid conditions of Fibromyalgia (FMS) are ME/CFS which is the most common; autoimmune diseases; migraines; Multiple Chemical Sensitivities (MCS); and orthostatic intolerance (OI) / Postural Orthostatic Tachycardia Syndrome (POTS).<ref name=":30" /><ref name=":31" /><ref name=":33">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref> Depression and anxiety; digestive conditions and menstrual problems; GWI; nervous system disorders; low blood pressure (Low BP); other pain conditions and migraines; and sleep dysfunction/disturbance all overlap with FMS.<ref name=":30" /> <ref name=":33" />]]

*[[Allodynia]]
** [http://chronicfatigue.about.com/od/glossary/g/allodynia.htm Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS]<ref name=":1">{{Cite news|url=https://www.verywellhealth.com/allodynia-definition-and-types-fibromyalgia-715929|title=Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Feb 23, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Types of Allodynia: Tactile; Mechanical; and Thermal. "Type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain" <ref name=":1" />
*[[Autoimmune disease]]<nowiki/>s "Research suggests that RA and other inflammatory diseases may somehow increase the risk for fibromyalgia."<ref>{{Cite news|url=https://www.health.com/health/gallery/0,,20520705,00.html#restless-legs-0|title=7 Conditions Linked to Fibromyalgia|work=Health.com|access-date=2018-08-19|language=en}}</ref>

*[[Body temperature]]
**[https://www.verywell.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025 Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":2">{{Cite news|url=https://www.verywellhealth.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025|title=Temperature Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Mar 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

<blockquote>When you're exposed to heat, does it feel like you're burning up? Does it seem impossible for you to cool off? Or maybe it's cold that bothers you, chilling you to the bone, leaving you unable to warm up? Or are you one of those people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) who is cold all the time, or hot all the time, or alternately hot or cold while out of sync with the environment?<ref name=":2" /></blockquote>

[[File:Costal cartilages.JPG|200px|thumb|left|Costochonritus is inflammation of the costal cartliges (shown in red) causing chest and ribcage pain]]

:* [https://www.verywell.com/costochondritis-in-fibromyalgia-716178 Costochondritis in Fibromyalgia]<ref name=":10">{{Cite news|url=https://www.verywellhealth.com/costochondritis-in-fibromyalgia-716178|title=Costochondritis Chest Pain in Fibromyalgia|last=Dellow|first=Adrienne|date=Feb 14, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|date=2018-05-25|title=Costochondritis|url=https://en.wikipedia.org/w/index.php?title=Costochondritis&oldid=842926736|journal=Wikipedia|language=en}}</ref>

<blockquote>Costochondritis is inflammation of the cartilage that connects your ribs to your breastbone. Depending on how much inflammation there is, it can range from mildly annoying to intensely painful. People sometimes describe the pain as stabbing, aching, or burning.<ref name=":10" /></blockquote>

<blockquote>Costochondritis can make you think you're having heart problems, which is a scary thing. Even though costochondritis is common, you should get medical attention if you have unexplained chest pain. You don't want to assume that it's FMS-related and end up with permanent heart damage or worse.<ref name=":10" /></blockquote>

<blockquote>The pain can radiate to your shoulder and arms as well (another way the condition mimics a heart attack). Sometimes the pain is accompanied by redness and/or swelling in the most painful areas. When that's the case, it's called Tietze's Syndrome.<ref name=":10" /></blockquote>

* [[Depression]] and [[Anxiety]] Fibromyalgia sufferers are "up to three times more likely to have depression at the time of their diagnosis than someone without fibromyalgia."<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/fibromyalgia-and-depression#1|title=Fibromyalgia and Depression|work=WebMD|access-date=2018-08-19|language=en-US}}</ref> Up to 20 percent of Fibromyalgia patients will have either depression or anxiety.<ref>{{Cite web|url=https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/fibromyalgia|title=Fibromyalgia {{!}} Anxiety and Depression Association of America, ADAA|website=adaa.org|language=en|access-date=2018-08-19}}</ref>

*[[Fibro fog]]

:*[http://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction]<ref name=":3">{{Cite news|url=https://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx|title=What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction|last=Mandal|first=Ananya|date=2013-06-03|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> 'Mental confusion along with difficulty in concentration and loss of memory is often termed “[[fibro fog]]"'.<ref name=":3" />

:* [https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014 What Is Fibro Fog and ME/CFS Brain Fog?]<ref name=":17" />

*[[Gastrointestinal system]]
**[[Irritable bowel syndrome]]: [http://chronicfatigue.about.com/od/whyfmscfsarelinked/a/IBS.htm Irritable Bowel Syndrome in Fibromyalgia & Chronic Fatigue Syndrome - Why Do They Go Together?]<ref name=":4">{{Cite news|url=https://www.verywellhealth.com/irritable-bowel-syndrome-in-fibromyalgia-cfs-716167|title=Irritable Bowel Syndrome in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jan 28, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>Fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome (IBS) frequently go together. No one really knows why, but we do know that all three conditions can include imbalances of serotonin -- although in fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS or ME/CFS) it's an imbalance in the brain, while with IBS it's in the gut.<ref name=":4" /></blockquote>
* [[Gulf War Illness]]
**[https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp Fibromyalgia in Gulf War Veterans]<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp|title=Fibromyalgia in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-19}}</ref> GWI increases risk of developing Fibromyalgia.

*[https://en.wikipedia.org/wiki/Interstitial_cystitis Interstitial Cystitis]<ref>{{Cite journal|date=2018-07-11|title=Interstitial cystitis|url=https://en.wikipedia.org/w/index.php?title=Interstitial_cystitis&oldid=849828657|journal=Wikipedia|language=en}}</ref> (Painful bladder)
**[https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168 Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis]<ref name=":5">{{Cite news|url=https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168|title=Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "Fibromyalgia, chronic fatigue syndrome and interstitial cystitis (IC) -- a painful bladder condition -- frequently occur together. Women may be up to 10 times more likely than men to develop it."<ref name=":5" />

*Language Impairment
**[[Word-finding problems]] is a symptom of ME/CFS.
:*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome Impaired Language in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":6" /> "Searching their brains for simple words that they just can't remember. On other occasions, individuals with these diagnoses may find it hard to write or even understand language."<ref name=":6">{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:*"The diagnosis of [[Aphasia]] is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written"<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref> but with [[dysphasia]] you will have those symptoms and trouble listening and doing numeral calculations.<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-09}}</ref> ''See also'': [[Dyscalculia]].
* [[ME/CFS]]
:*[https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184 Comorbid Conditions in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>
* [[Migraine]]
:*[https://migrainecenters.com/blog/migraines-and-fibromyalgia/ Migraines and Fibromyalgia]<ref name=":32" />
<blockquote>Both fibromyalgia and migraine may reflect problems in the brain’s pain processing center. It is believed that both conditions are caused by excitation of the nervous system or an over-response to stimuli. Stress is usually cited as a trigger for both migraine and fibromyalgia attacks.<ref name=":32">{{Cite news|url=https://migrainecenters.com/blog/migraines-and-fibromyalgia/|title=Migraines and Fibromyalgia - Migraine Centers|date=2016-05-06|work=Migraine Centers|access-date=2018-08-19|language=en-US}}</ref></blockquote>
* [[Multiple chemical sensitivity|Multiple Chemical Sensitivity]] (MCS) It is thought that both Fibromyalgia and MCS are central sensitivity syndromes.<ref>{{Cite news|url=https://www.verywellhealth.com/chemical-sensitivity-in-fibromyalgia-716170|title=Multiple Chemical Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>

*OBGYN
**[https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596 Menstrual Periods with Fibromyalgia: Personal Stories]<ref>{{Cite news|url=https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596|title=Menstrual Periods with Fibromyalgia: Personal Stories|last=Dellwo|first=Adrienne|date=May 18, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>
**[https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626 Fibromyalgia Tied to Hysterectomy, Gynecologic Disease].<ref name=":7" />
:<blockquote>You may have heard about a possible link between gynecologic surgery (such as a hysterectomy) and the development of fibromyalgia, and doctors have long suspected that fibromyalgia has strong hormonal ties and triggers. This does not seem surprising as we've long suspected a link between endocrine disorders, gynecological conditions, and autoimmune conditions.<ref name=":7">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626|title=Fibromyalgia Tied to Hysterectomy, Gynecologic Disease|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref></blockquote>

*[[Orthostatic intolerance]] (OI) and [[Postural orthostatic tachycardia syndrome]] (POTS)<ref>{{Cite journal|last=Yun|first=Dong Joo|last2=Choi|first2=Han Na|last3=Oh|first3=Gun-Sei|date=2013|title=A Case of Postural Orthostatic Tachycardia Syndrome Associated with Migraine and Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710947/|journal=The Korean Journal of Pain|volume=26|issue=3|pages=303–306|doi=10.3344/kjp.2013.26.3.303|issn=2005-9159|pmid=23862007|via=}}</ref>

:*[http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM]<ref>{{Cite web|url=http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf|title=Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM|last=Lapp|first=Charles W.|last2=Black|first2=Laura|date=|website=drlapp.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Smith|first3=Rebekah S.}}</ref> (PDF) Symptoms can include low blood pressure and/or sudden high blood pressure, dizziness, fainting.

:*[https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/ An Overlooked Issue in Fibromyalgia? Study Highlights Problems Standing (Orthostatic Intolerance)]<ref>{{Cite news|url=https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/|title=An Overlooked Issue in Fibromyalgia? Study Highlights Orthostatic Intolerance - Problems Standing - Health Rising|last=Johnson|first=Cort|date=2017-09-21|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[[Sleep dysfunction]]
**[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia]<ref name=":23">{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}</ref>

:<blockquote>The present results of this study suggest that long-term, comorbid pain and sleep disturbance may be associated with increased activation in core default mode brain areas that is above and beyond long-term pain disturbance alone.<ref name=":23" /></blockquote>

:*[http://www.prohealth.com/library/showarticle.cfm?libid=22344 Fibromyalgia and Sleep]<ref name=":8">{{Cite news|url=https://www.prohealth.com/library/fibromyalgia-and-sleep-38954|title=Fibromyalgia and Sleep - Prohealth|date=2016-01-11|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref> "Most people with fibromyalgia have an associated sleep disorder that makes it difficult for them to get the deep, restorative sleep they need."<ref name=":8" />

[[File:TMJ_1.jpg|200px|thumb|right|TMJ/TMD is a condition that occurs in some fibromyalgia and ME/CFS patients]]
* [[Temporomandibular joint disorder]] (TMJ/TMD)

:* [https://www.sciencedirect.com/science/article/pii/S2255502114001758 Temporomandibular disorders in fibromyalgia syndrome: a short-communication]<ref>{{Cite journal|last=Soares Gui|first=Maisa|last2=Pimentel|first2=Marcele Jardim|last3=Rizzatti-Barbosa|first3=C'elia Marisa|date=2015-03-01|title=Temporomandibular disorders in fibromyalgia syndrome: a short-communication|url=https://www.sciencedirect.com/science/article/pii/S2255502114001758|journal=Revista Brasileira de Reumatologia (English Edition)|language=en|volume=55|issue=2|pages=189–194|doi=10.1016/j.rbre.2014.07.004|issn=2255-5021|via=ScienceDirect}}</ref><ref>{{Cite news|url=https://www.whitesmilesforlife.com/blog/study-probes-pain-link-between-tmj-fibromyalgia/|title=Study Probes Pain Link Between TMJ, Fibromyalgia|date=2016-05-03|work=Kent E. White, DDS|access-date=2018-08-19|language=en-US}}</ref>

::Other than headaches, the symptoms are quite distinct from symptoms of FMS and ME/CFS.

::They include:
::*Jaw pain
::*Discomfort or difficulty chewing
::*Painful clicking in the jaw
::*Difficulty opening or closing the mouth
::*Headaches
::*Locking jaw
::*Teeth that don't come together properly<ref>{{Cite news|url=https://www.verywellhealth.com/tmj-in-fibromyalgia-chronic-fatigue-syndrome-716175|title=TMJ in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Mar 31, 2018|work=Verywell Health|access-date=2018-08-22|archive-url=|archive-date=|dead-url=}}</ref>

*[[Thyroid disease]]
**[https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677 Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease]<ref name=":9">{{Cite news|url=https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677|title=A Comparison of Chronic Fatigue, Fibromyalgia, and Thyroid Disease|last=Shomon|first=Mary|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>People with Hashimoto's autoimmune thyroid disease often experience significant fatigue and body aches. While these symptoms are common in Hashimoto's, they can also be markers of other diseases, like chronic fatigue syndrome or fibromyalgia.<ref name=":9" /></blockquote>

*Other symptoms
**[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/fibrosymptoms.htm Symptoms of Fibromyalgia]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-symptoms-716139|title=Symptoms of Fibromyalgia|last=Dellwo|first=Adrienne|date=May 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> (A comprehensive all in one place list for the many symptoms of fibromyalgia.)

==Treatment==

===United States===
'''Rheumatology and primary care providers: Diagnosing and treatment'''

*2012, [https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract A Framework for Fibromyalgia Management for Primary Care Providers]<ref>{{Cite journal|last=Arnold|first=Lesley M.|last2=Clauw|first2=Daniel J.|last3=Dunegan|first3=L. Jean|last4=Turk|first4=Dennis C.|date=2012|title=A Framework for Fibromyalgia Management for Primary Care Providers|url=https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract|journal=Mayo Clinic Proceedings|language=English|volume=87|issue=5|pages=488–496|doi=10.1016/j.mayocp.2012.02.010|issn=0025-6196|via=}}</ref> Rheumatologists stopped treating fibromyalgia patients and primary care providers began treatment managment although rheumatologists are most often the specialist to diagnose. (Please see [http://me-pedia.org/wiki/Fibromyalgia#Disability disability] heading about ''primary provider'' and ''specialists'' for disability cases.)

=== Drugs ===

{{Main article |page_name = Fibromyalgia drugs}}

=== Therapies ===

==== Exercise ====
''Please Note'': These recommendations are for fibromyalgia patients and '''not''' [[ME/CFS]] sufferers.
[[File:Warm water exercise.JPG|200px|thumb|left|Warm water exercise is best for fibromyalgia. Start slow and don't push through the pain<ref name=":11" />]]

*[https://www.verywellhealth.com/warm-water-exercise-for-fibromyalgia-716059 Warm Water Exercise for Fibromyalgia]<ref name=":11">{{Cite news|url=http://chronicfatigue.about.com/od/treatingfmscfs/a/warmwaterFMS.htm|title=Warm Water Exercise for Fibromyalgia|last=Dellwo|first=Adrienne|date=Nov 19, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|last=Munguía-Izquierdo|first=D.|last2=Legaz-Arrese|first2=A.|date=2007|title=Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/18173915|journal=Clinical and Experimental Rheumatology|volume=25|issue=6|pages=823–830|issn=0392-856X|pmid=18173915|via=}}</ref>

<blockquote>A warm-water pool is good for therapy because cold water can make muscles tense up. It's especially important in FMS because many people with the condition are intolerant of cold. A warm-water pool is one that's kept around 89.6 degrees Fahrenheit (32 Celsius), which is several degrees warmer than most heated pools.<ref name=":11" /></blockquote>

*Moderate aerobic exercise and weights with six to eight reps and then a day or two of rest in between. Do not start a program if you are in a flare.<ref>{{Cite web|url=http://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/fibromyalgia-questions/fibromyalgia-exercise.php|title=Fibromyalgia Exercise {{!}} Exercising with Fibromyalgia|last=Ronenn|first=Roubenoff|date=|website=www.arthritis.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[https://www.youtube.com/watch?v=BauJYuJwFsI Easy fibromyalgia exercises and motivation to keep you healthy!]<ref>{{Cite web|url=https://www.youtube.com/watch?v=BauJYuJwFsI|title=Easy Fibromyalgia exercises and motivation to keep you healthy!|last=Suarez|first=Eric|date=Jun 21, 2011|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=Aug 9, 2018}}</ref> Video

*[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/Fibromyalgia-Myth-Vs-Fact.htm Fibromyalgia Myth vs. Fact]<ref name=":15">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-myth-vs-fact-716131|title=Fibromyalgia: What's Myth, What's Fact?|last=Dellwo|first=Adrienne|date=Jun 8, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=Myth #3 People With Fibromyalgia Need More Exercise}}</ref> Heading: ''Myth #3: People With Fibromyalgia Need More Exercise''. Appropriate exercise, which each patient needs to gauge for themselves.<ref name=":15" />

==== Massage ====

*2014, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/ Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]<ref>{{Cite journal|last=Li|first=Yan-hui|last2=Wang|first2=Feng-yun|last3=Feng|first3=Chun-qing|last4=Yang|first4=Xia-feng|last5=Sun|first5=Yi-hua|date=2014-02-20|title=Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/|journal=PLoS ONE|volume=9|issue=2|doi=10.1371/journal.pone.0089304|issn=1932-6203|pmc=|pmid=24586677|pages=|via=}}</ref>

*2016, [http://chronicfatigue.about.com/od/alternativetreatments/a/bodywork.htm Massage, Rolfing & Other Bodywork - Are They Effective Fibromyalgia & Chronic Fatigue Syndrome Treatments?]<ref>{{Cite news|url=https://www.verywellhealth.com/massage-rolfing-other-bodywork-715645|title=Massage, Rolfing, Reiki: Do They Work for Fibromyalgia & ME/CFS?|last=Dellwo|first=Adrienne|date=Aug 10, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==== Acupuncture ====

*2004, [[U.S. Department of Health and Human Services]] (HHS) and [https://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services Centers for Medicare and Medicaid Services] (CMS) ruled April 16, 2004, a noncoverage determination for acupuncture.<ref>{{Cite web|url=https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R11NCD.pdf|title=CMS Manual System Pub. 100-03 Medicare
National Coverage Determinations|last=|first=|date=Apr 16, 2004|website=CMS.gov|format=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2005, [http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html Acupuncture Good for Fibromyalgia?] <ref name=":16">{{Cite web|url=http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html|title=Acupuncture Good for Fibromyalgia?|last=|first=|date=Oct 2, 2012|website=Acupuncture School Online|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> "Acupuncture gave no significant pain relief to fibromyalgia patients."<ref name=":16" />

*2016, [http://www.sciencedirect.com/science/article/pii/S2095496416602352 Short-term complementary and alternative medicine on quality of life in women with fibromyalgia] <ref name=":25">{{Cite journal|date=2016-01-01|title=Short-term complementary and alternative medicine on quality of life in women with fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S2095496416602352|journal=Journal of Integrative Medicine|language=en|volume=14|issue=1|pages=29–35|doi=10.1016/S2095-4964(16)60235-2|issn=2095-4964}}</ref> "There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session."<ref name=":25" />

*2016, [https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/ Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/|title=Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients - Fibromyalgia News Today|last=Semedo|first=Daniela|date=2016-02-01|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Disability ==
===United States===
''Please Note'': The following is NOT legal advice and it should not be relied upon in taking steps for a disability case. Only ''[https://www.ssa.gov/ Social Security]'' and a disability lawyer can provide the most up to date and the correct legal avenue for bringing a disability case.

In the[[ United States]], [https://www.ssa.gov/ssi/ Social Security Insurance] and [https://www.ssa.gov/disability/ Social Security Disability] (SSI) and (SSD) benefits are available for Fibromyalgia. Generally for SSI/SSD, notes and tests from a ''Primary Provider'' '''may''' be allowed for submission but ''Specialists'' such as a rheumatologist, neurologist, psychiatrist, etc. are required for diagnosis, ongoing treatment and completing SSI/SSD paperwork.

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose Fibromyalgia. (See: "Policy Interpretation" for the POLICY INTERPRETATION RULING.)<ref>[https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia]</ref>

*[http://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social Applying for Disability With Fibromyalgia]<ref>{{Cite news|url=https://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social|title=Fibromyalgia Disability: Applying for Disability Benefits With Fibromyalgia|date=2016-10-03|work=NewLifeOutlook {{!}} Fibromyalgia|access-date=2018-08-09|language=en-US}}</ref> One patient's success of applying, denial, successful appeal, and a breakdown of what SSI/SSD requires for the medical determination of a favorable decision of disability.

*[https://www.socialsecurity.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html Fibromyalgia: Policy Interpretation Ruling - Social Security]<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=|website=www.ssa.gov|at=Titles II and XVI: Evaluation of Fibromyalgia|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[http://www.disabilitysecrets.com/social_security_disability_fibromyalgia.html Social Security Disability (SSDI & SSI) for Fibromyalgia - Disability Secrets By NOLO]<ref>{{Cite news|url=https://www.disabilitysecrets.com/resources/social-security-disability-ssdi-ssi-fibromyalgia.htm|title=Social Security Disability (SSDI & SSI) for Fibromyalgia|last=Laurence|first=Bethany|date=|work=www.disabilitysecrets.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*[http://www.mdjunction.com/fibromyalgia/fibromyalgia-disability Fibromyalgia Disability Patient Support Forums]<ref>{{Cite web|url=https://www.mdjunction.com/fibromyalgia/fibromyalgia-disability|title=Fibromyalgia Disability|website=MDJunction|language=en|access-date=2018-08-09}}</ref> at [[MDJunction]]

==== Examinations and Tests ====
For documentation of symptoms and co-morbidities of a FM diagnosis, you and your doctor should consider the following examinations and tests:

:'''Fibromyaglia Diagnostic Examination'''
:*[http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist Rheumatologist] examination and diagnosis of FM. (Consider having a rheumatologist order tests and coordinate referrals for other specialists for examinations and testing. Only specialists can complete the paperwork for Social Security. A primary doctor cannot complete disability paperwork but ''may'' be able to forward test results they have ordered.)
[[File:Whole body bone scan.jpg|200px|thumb|right|A whole body bone scan (Bone scintigraphy) is a nuclear medicine test. '''Arthritis''', avascular necrosis, bone cancers, cancers that have spread to the bone, fibrous dysplasia, fractures, infection involving the bone, and Pagets disease can be diagnosed using this scan.<ref>{{Cite news|url=https://www.healthline.com/health/bone-scan#purpose|title=Bone Scan: Purpose, Procedure, and Risks|last=Krans|first=Brian|date=Dec 13, 2017|work=Healthline|access-date=2018-08-21|archive-url=|archive-date=|dead-url=|language=en}}</ref>]]
:'''Arthritis'''
:*[https://en.wikipedia.org/wiki/Bone_scintigraphy Whole body bone scan (Bone scintigraphy)]<ref>{{Cite journal|date=2018-05-22|title=Bone scintigraphy|url=https://en.wikipedia.org/wiki/Bone_scintigraphy|journal=Wikipedia|language=en}}</ref> to rule out treatable arthritis.
:'''Blood Tests'''
:*Routine blood tests for [[diabetes]] (fasting sugar, A1C) and a full [[Thyroid disease]] panel ([https://en.wikipedia.org/wiki/Thyroid_function_tests#Thyroid-stimulating_hormone TSH, T3, Free T3, T4 and Free T4]).
:*Rule out [[Rheumatoid arthritis]], lupus, [[Lyme disease]] and other diseases that can share some of the same symptoms of fibromyalgia and may be treatable.<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1-3|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>
:*Vitamin and mineral deficiencies such as [[B12]] and [[Vitamin D]] are treatable with over the counter supplements and prescription medications which can improve [[fatigue]] and [[pain]].
:'''Gastrointestinal'''
:*[[Irritable bowel syndrome]] diagnosis which may require blood, [http://www.mayoclinic.org/tests-procedures/endoscopy/basics/definition/PRC-20020363 upper endoscopy] to rule out [https://en.wikipedia.org/wiki/Coeliac_disease celiac disease] and [https://en.wikipedia.org/wiki/Stool_test fecal tests] to check for bacteria ([[SIBO]]) and [http://www.umm.edu/health/medical/altmed/condition/intestinal-parasites intestinal parasites].
:'''Mental Health and Cognition'''
:* Psychiatric evaluation as any [[depression]] and [[anxiety]] should be treated.
:* [[Cognitive dysfunction]] tests.
:'''Sleep dysfunction'''
:*Sleep study for [[Restless legs syndrome]], [[Sleep disturbance]] or [[Narcolepsy]].
:'''Orthostatic Intolerance'''
:*[[Tilt table test]] to diagnose [[Orthostatic intolerance]] or [[Postural orthostatic tachycardia syndrome|POTS]].
:'''TMJ, tinnitus, vertigo, and dizziness'''
:*An ear, nose, and throat specialist (ENT) ([http://www.mayoclinic.org/departments-centers/otorhinolaryngology-ent/overview Otorhinolaryngology]) examination and imaging may be ordered for [[Temporomandibular joint disorder]] (TMJ).
:*(Ear, sinus, throat/lymph infections, and [[tinnitus]] can also be documented.)
:*[https://en.wikipedia.org/wiki/Videonystagmography Videonystagmography] (VNG) testing if you experience [[vertigo]] and/or [[dizziness]].<ref>{{Cite news|url=https://www.everydayhearing.com/balance/articles/what-to-expect-at-your-vng-test/|title=What to Expect at Your VNG/ENG Test - Everyday Hearing|last=Banks|first=Lindsey|date=2014-05-07|work=Everyday Hearing|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

Of course, one can have arthritis, sleep apnea, [[Chronic lyme disease|chronic Lyme disease]] or other diseases and still have FM, but there may be a treatable condition where a patient's overall health, including their FM, improves.<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/guide/common-misdiagnoses-of-fibromyalgia#1|title=Common Misdiagnoses of Fibromyalgia|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite web|url=http://www.cfidsselfhelp.org/library/overlapping-and-related-conditions|title=Overlapping and Related Conditions {{!}} CFIDS & Fibromyalgia Self-Help|website=www.cfidsselfhelp.org|access-date=2018-08-09}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

There have been cases of [[Vitamin D]] deficiency being misdiagnosed as fibromyalgia as a D deficiency can cause pain. Supplementation or prescribed D treatments may alleviate this pain. However, it is possible to have both a D deficiency and fibromyalgia and correcting the deficiency will only resolve the pain stemming from it.<ref>{{Cite news|url=http://www.webmd.com/pain-management/features/vitamin-d-deficiency-and-chronic-pain-link#1|title=Does Vitamin D Deficiency Cause Chronic Pain?|last=Shaw|first=Gina|date=|work=WebMD|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

==== Blogs about navigating SSD process ====

*Resources for getting approved for disability include this [http://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/ Guide to Social Security Disability for People with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome],<ref>{{Cite web|url=https://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/|title=The Sleepy Girl Guide to Social Security Disability (U.S.) {{!}} #MEAction|last=Silver|first=Lily|date=Apr 17, 2017|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> available on the #[[MEAction]] website.

*[https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/ How Patty’s Lawyer Never Told Her What She Needed to Know]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/|title=How Patty’s Lawyer Never Told Her What She Needed to Know|last=Skelton Preston|first=Patty|date=2017-03-20|work=How to Get On|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/ Sample Doctor Letters for Disability]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/|title=21 Sample Doctor Letters for Disability|date=2017-05-01|work=How to Get On|access-date=2018-08-09|language=en-US}}</ref>

== Notable studies ==
{{Main article |page_name = Fibromyalgia notable studies}}

== Controversies ==
=== Dr. Frederick Wolfe ===
Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.<ref>{{Cite news|url=http://www.nytimes.com/2008/01/14/health/14pain.html?_r=0|title=Drug Approved. Is Disease Real?|last=Berenson|first=Alex|date=Jan 14, 2008|work=The Wall Street Journal|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>[http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf Fibromyalgia: A Short Commentary - iMedPub Journals - DOI: 10.4172/2472-1913.100027 - Frederick Wolfe and Brian Walitt - Sep. 23, 2016]</ref><ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|journal=Journal of Headache & Pain Management|volume=1|issue=3:27|pages=|via=iMedPub Journals}}</ref><ref>{{Cite news|url=https://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx|title=Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine|last=Cashin-Garbutt|first=April|date=2013-03-22|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Fibromyalgia vs Chiari malformation ===
Some individuals diagnosed with FMS were undergoing surgery for [[Chiari malformation]] (CM). These are two separate conditions; FMS cannot be resolved by undergoing a risky CM surgery.

*2011, [https://www.ncbi.nlm.nih.gov/pubmed/21135714 Is Chiari I malformation associated with fibromyalgia?]<ref>{{Cite journal|last=Watson|first=Nathaniel F.|last2=Buchwald|first2=Dedra|last3=Goldberg|first3=Jack|last4=Maravilla|first4=Kenneth R.|last5=Noonan|first5=Carolyn|last6=Guan|first6=Qingyan|last7=Ellenbogen|first7=Richard G.|date=2011|title=Is Chiari I malformation associated with fibromyalgia?|url=https://www.ncbi.nlm.nih.gov/pubmed/21135714|journal=Neurosurgery|volume=68|issue=2|pages=443–448; discussion 448–449|doi=10.1227/NEU.0b013e3182039a31|issn=1524-4040|pmid=21135714|via=}}</ref>
::Conclusion: Most patients with FM do not have [[CIM]] pathology. Future studies should focus on dynamic neuroimaging of craniocervical neuroanatomy in patients with FM.
*2015, [https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery CFS/FM and Chiari Malformation Surgery]<ref>{{Cite web|url=https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery|title=CFS/FM and Chiari Malformation Surgery|last=Casanova|first=Ken|date=Nov 15, 2015|website=www.massmecfs.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

== Learn more ==
*[https://www.s4me.info/forums/fibromyalgia-and-connective-tissue-disorders.35/ Forum: Fibromyalgia and Connective Tissue Disorders] at [[Science for ME]]
*[[Verywell FMS/CFS]]

=== Ongoing process of diagnosing and categorizing ===

*2014, [http://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114 Lyme Disease, Fibromyalgia Link Evaporates]<ref>{{Cite news|url=https://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114|title=Lyme Disease, Fibromylagia Link Evaporates|last=Kuznar|first=Wayne|date=2014-12-14|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> (See also: [[Chronic lyme disease]])

*2015, [http://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx Fibromyalgia now considered as a lifelong central nervous system disorder]<ref>{{Cite news|url=https://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx|title=Fibromyalgia now considered as a lifelong central nervous system disorder|date=2015-05-18|work=News-Medical.net|access-date=2018-08-09|language=en}}</ref>

*2015, [http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates]<ref>{{Cite news|url=http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html|title=Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates|date=2015-10-24|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2015, ''Question:'' [http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html 'Is Fibromyalgia a Psychosomatic Illness?'] via CelesteCooper.com ''Answer:'' "Fibromyalgia is NOT a psychosomatic illness."<ref>[http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html Is Fibromyalgia a Psychosomatic Illness? Med Student Asks Celeste Cooper by Celeste Cooper - CelesteCooper.com Sep 4, 2015]</ref>

*2016, [http://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination Diagnosing Fibromyalgia May Be Possible Using Noninvasive Eye Examination]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination|title=Diagnosing Fibromyalgia May Be Possible with Noninvasive Eye Exam|date=2016-09-09|work=Fibromyalgia News Today|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780 Microglia in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780|title=Microglia in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*2016, [http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/ Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders?]<ref>{{Cite news|url=http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/|title=Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders? - Simmaron Research|date=2016-03-21|work=Simmaron Research|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://consultqd.clevelandclinic.org/2016/03/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic Why Fibromyalgia Is Neuropathic]<ref>{{Cite news|url=https://consultqd.clevelandclinic.org/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic|title=Why Fibromyalgia Is Neuropathic|date=2016-03-08|work=Consult QD|access-date=2018-08-09|language=en-US}}</ref>

*2017, [http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain]<ref>{{Cite news|url=http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html|title=Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain|last=Liptan|first=Ginevra|date=2017-04-11|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
*2017, [https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947 AI can spot the pain from a disease some doctors still think is fake]<ref>{{Cite news|url=https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947|title=AI can spot the pain from a disease some doctors still think is fake|last=Goldhill|first=Olivia|date=Aug 9, 2018|work=Quartz|access-date=2018-08-15|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== Blood tests ===

*2013, [http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html New Fibromyalgia Blood Test is 99% Accurate]<ref>{{Cite news|url=http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html|title=New Fibromyalgia Blood Test is 99% Accurate|date=2013-07-31|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2014, [http://www.prohealth.com/library/showarticle.cfm?libid=18837 Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”]<ref>{{Cite news|url=https://www.prohealth.com/library/pridgen-reports-fibromyalgia-antiviral-trial-results-very-positive-predicts-new-approach-will-be-game-changer-32620|title=Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”|last=|first=|date=2014-03-25|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2016, [https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html Blood Test for Fibromyalgia: FM/a Test Ⓡ is now available, Q&A]<ref>{{Cite web|url=https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html|title=Blood Test for Fibromyalgia: FM/a Test ® Is Real, Q&A|last=Cooper|first=Celeste|date=May 3, 2016|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2016, [http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/ Fibromyalgia blood testing covered by rising number of insurance companies]<ref>{{Cite news|url=http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/|title=Fibromyalgia blood testing covered more of insurance companies|last=Campbell|first=Julie|date=2016-04-08|work=Live Insurance News|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2017, [http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches]<ref>{{Cite news|url=https://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=Business Wire|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Brain scans ===

*2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds]<ref>{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|publisher=ANAPSID|via=Chronic Neuroimmune Diseases|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2012, [https://www.sciencedaily.com/releases/2012/11/121111153426.htm Fibromyalgia and the brain: New clues reveal how pain and therapies are processed]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2012/11/121111153426.htm|title=Fibromyalgia and the brain: New clues reveal how pain and therapies are processed|last=|first=|date=Nov 11, 2012|work=ScienceDaily|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*2015, [https://www.verywell.com/unique-brain-connectivity-in-fibromyalgia-715630 Unique Brain Connectivity in Fibromyalgia - Increased Importance Assigned to Pain]<ref>{{Cite news|url=https://www.verywellhealth.com/how-lyrica-changes-the-fibromyalgia-brain-715767|title=How Lyrica Changes the Fibromyalgia Brain|last=Dellwo|first=Adrienne|date=Apr 30, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==See also==
* [[Central sensitization]]

* [[Fibromyalgia drugs]]

* [[Fibromyalgia notable studies]]
* [[Influenza vaccine]]

*[[Lady Gaga]]

==References==
<references />

[[Category:Diagnoses]]
[[Category:Comorbidities]]

Fibromyalgia

2018-08-25T14:24:43Z

77.111.246.7:/* Prevalence */ internal link

[[Fibromyalgia]] (FM/FMS) is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Pain is widespread, on both sides of the body, and above and below the waist.

Sufferers are fatigued and tired even when sleeping for long periods of time, and sleep is often disrupted by pain. Many FM sufferers have sleep disorders like [https://en.wikipedia.org/wiki/Sleep_apnea sleep apnea] and [[restless leg syndrome]]. [[Cognitive impairment]], when one cannot focus or pay attention and the patient has difficulty concentrating on mental tasks, is known by FM sufferers as "[[fibro fog]]".<ref name=":17">{{Cite news|url=https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014|title=What Is Fibro Fog and ME/CFS Brain Fog?|last=Dellwo|first=Adrienne|date=|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Some experience [[depression]], [[headache]]s, and lower [[abdominal pain]] or cramping. Other symptoms include tingling or [[numbness]] in hands and feet, pain in jaw and disorders of the jaw such as [[temporomandibular joint disorder|temporomandibular joint disorder]] (TMJ), [[Menstrual cycle#Health effects in other conditions|menstrual cycle]] cramps, and digestive problems like i[[Irritable bowel syndrome|rritable bowel syndrome]] (IBS).<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms#1|title=Fibromyalgia Symptoms|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780|title=Fibromyalgia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref>

[[File:Fibro_Tender_Points.png|400px|thumb|right|1990 ACR Diagnostic Criteria: 18 Tender Points]]
[[File:Fibro_Widespread_Pain.png|400px|thumb|right|2010 ACR Preliminatry Diagnostic Criteria: Wisedpread Pain Index (WPI), 19 Tender Point Areas]]

==Prevalence==
FM is the second most common [https://en.wikipedia.org/wiki/Rheumatism rheumatic disorder] behind [[wikipedia:Osteoarthritis|osteoarthritis]] and is "now considered to be a lifelong [[Central nervous system]] disorder."<ref>{{Cite news|url=https://naidw.org/blog/members-myblogs/fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder|title=Fibromyalgia now considered as a lifelong central nervous system disorder|work=NAIDW.org®|access-date=2018-08-09|language=en-gb}}</ref> An estimated 10 million people in the US and 3-6% of the world population have fibromyalgia. It is seen in women, men, children, and all ethnic groups. It is often seen in families and diagnosed between the ages of 20 to 50 years; incidence increases with age.<ref>{{Cite news|url=http://www.fmaware.org/about-fibromyalgia/prevalence/|title=Prevalence - National Fibromyalgia Association (NFA)|work=National Fibromyalgia Association (NFA)|access-date=2018-08-09|language=en-US}}</ref>

FM has a female:male 7:1 ratio under the ''American College of Rheumatology (ACR) 1990 Diagnostic Criteria'' and 2:1 when the ''ACR 2010 Preliminary Diagnostic Criteria'' is used.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=|publisher=|editor-last=Diamond|editor-first=Herbert|at=Sex-related differences in incidence}}</ref> ''See'': [[Fibromyalgia#American College of Rheumatology (ACR) Criteria|Fibromyalgia (''American College of Rheumatology (ACR) Criteria'' section)]].

==Fibromyalgia in ME/CFS==
Dr. [[Jarred Younger]] has said that many patients that meet the criteria for FM also meet criteria for [[chronic fatigue syndrome]] (CFS) but the reverse is not necessarily true as a lot of people with [[CFS]] do not have [[chronic pain]].<ref>{{Cite web|url=https://www.youtube.com/watch?v=wJB95m4FLa0#t=57m27s|title=Webinar with Jarred Younger, Ph.D.|last=Younger|first=Jared|date=May 20, 2016|website=YouTube|at=57:27|via=|archive-url=|archive-date=|dead-url=|access-date=|publisher=SolveCFS|type=Video}}</ref> However, the [[Canadian Consensus Criteria]] (CCC) requires the symptom of pain to diagnose [[ME/CFS]]. It is the pattern and significant degree of [[chronic pain]] in FM that sets it apart from other diseases that have pain.

"The most common overlapping condition with ME/CFS is fibromyalgia."<ref name=":30">{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions - American Myalgic Encephalomyelitis and
Chronic Fatigue Syndrome Society|last=|first=|date=|website=ammes.org|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref><ref name=":31">{{Cite journal|last=Jason|first=Leonard|last2=Taylor|first2=R.R.|last3=Kennedy|first3=C.L.|last4=Song|first4=S|last5=Johnson|first5=D|last6=Torres|first6=S.R.|date=2001-01-01|title=Chronic fatigue syndrome: Comorbidity with fibromyalgia and psychiatric illness|url=https://www.researchgate.net/publication/285787383_Chronic_fatigue_syndrome_Comorbidity_with_fibromyalgia_and_psychiatric_illness|journal=Medicine and Psychiatry|volume=4|pages=29–34}}</ref>

==Health complications==
FM is not a [https://en.wikipedia.org/wiki/Progressive_disease progressive disease] but according to Dr. Dan Clauw the "slow gradual worsening of chronic pain patients over time is due to downstream consequences of poorly controlled pain and other symptoms, wherein individuals then progressively get less active, sleep worse, are under more stress and unknowingly develop bad habits which worsen pain and other symptoms."<ref>{{Cite news|url=http://nationalpainreport.com/ask-the-dctors-is-fibromyalgia-progressive-8831105.html|title=Ask the Doctors: Is Fibromyalgia Progressive?|date=2016-08-09|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*[https://www.sharecare.com/health/fibromyalgia-effects Fibromyalgia Complications]<ref name=":19" />

:<blockquote>People who have fibromyalgia frequently complain of a variety of symptoms that affect other parts of the body. Many people complain of [[gastrointestinal]] issues and restless legs syndrome (RLS). Additionally, the [[chronic pain]] and discomfort of fibromyalgia may lead to [[depression]].<ref name=":19">{{Cite news|url=https://www.sharecare.com/health/fibromyalgia-effects|title=Fibromyalgia Complications - Fibromyalgia - Joint Health|work=Sharecare|access-date=2018-08-09|language=en}}</ref></blockquote>

*[https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions Can fibromyalgia cause other medical conditions?]<ref name=":20" />

:<blockquote>Fibromyalgia is not known to cause other medical conditions. However, people who have fibromyalgia seem to be at high risk for developing other painful conditions, including [https://en.wikipedia.org/wiki/Osteoarthritis osteoarthritis] (the common type of arthritis caused by wear and tear on the joints) as well as other related conditions, such as [[rheumatoid arthritis]], [[lupus]], and [https://en.wikipedia.org/wiki/Ankylosing_spondylitis ankylosing spondylitis]. Also, people with fibromyalgia are frequently diagnosed with chronic fatigue syndrome, irritable bowel syndrome (IBS), and temporomandibular joint (TMJ) disorder.<ref name=":20">{{Cite web|url=https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions|title=Can fibromyalgia cause other medical conditions? {{!}} Fibromyalgia Complications|last=Honor Society of Nursing|first=|date=|website=Sharecare|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref></blockquote>

==Risk factors==
[[Lupus]] and [[Rheumatoid arthritis]] (RA) are risk factors in developing FM. Car accidents, [[Post-traumatic stress disorder]] (PTSD), [https://en.wikipedia.org/wiki/Repetitive_strain_injury repetitive injuries], illness such as a [https://en.wikipedia.org/wiki/Viral_disease viral infection], [https://en.wikipedia.org/wiki/Family_history_(medicine) family history], and [https://en.wikipedia.org/wiki/Obesity obesity] have all been linked to FM.<ref>{{Cite web|url=https://www.cdc.gov/arthritis/basics/fibromyalgia.htm|title=Fibromyalgia {{!}} Arthritis {{!}} CDC|date=2018-04-03|website=www.cdc.gov|language=en-us|access-date=2018-08-09}}</ref><ref>{{Cite news|url=https://www.niams.nih.gov/health_info/Fibromyalgia/|title=Fibromyalgia What Causes it?|last=Director|first=Nancy Garrick, Deputy|date=2017-04-05|work=National Institute of Arthritis and Musculoskeletal and Skin Diseases|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

==Diagnosis==
[https://www.verywellhealth.com/what-are-fibromyalgia-tender-points-189768 Tender points], not [https://en.wikipedia.org/wiki/Myofascial_trigger_point trigger points], are used to diagnose Fibromyalgia.<ref>{{Cite web|url=http://www.healthcentral.com/chronic-pain/c/662034/176031/fibromyalgia-trigger/|title=The Difference Between Fibromyalgia Tender Points and Myofascial Trigger Points - Chronic Pain {{!}} HealthCentral|last=Cooper|first=Celeste|date=May 8, 2015|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> Tender points will be above and below the waist and on both sides of the body. (See: Illustrations of the 1990 and 2010 American College of Rheumatology (ACR) Criteria depicting tender points near the top of this page.) It is important to check for other conditions that could be causing pain such as hypothyroidism, Rheumatoid arthritis or lupus, osteoarthritis, Ankylosing spondylitis, and [[wikipedia:Polymyalgia_rheumatica|Polymyalgia rheumatica]].<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>

===United States===
==== American College of Rheumatology (ACR) Criteria ====

*1990, [http://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf The American College Of Rheumatology 1990 Criteria For The Classification Of Fibromyalgia]<ref>{{Cite web|url=https://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf|title=The American College of Rheumatology Criteria for the Classification of Fibromyalgia|last=Wolfe|first=Frederick|last2=Smythe|first2=Hugh|date=1990|website=rheumatology.org|publisher=|others=Abeles, Micha; Clark, Patricia; Fam, Adel; Farber, Stephen; Fiechtner, Justus; Franklin, Michael; Gatter, Robert; Hamaty, Daniel; Lessard, James; Lightbroun, Alan; Masi, Alfonse; McCain, Glenn; Reynolds, W. John; Romano, Thomas; Russell, Jon; Sheon, Robert|archive-url=|archive-date=|dead-url=|access-date=|last3=Yunus|first3=Muhammad|last4=Bennett|first4=Robert|last5=Bombardier|first5=Claire|last6=Goldenberg|first6=Don|last7=Tugwell|first7=Peter|last8=Campbell|first8=Stephen}}</ref> "American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure."<ref>{{Cite news|url=http://www.health.com/health/gallery/0,,20345635,00.html|title=18 Points Used to Diagnose Fibromyalgia|last=|first=|date=Feb 4, 2011|work=Health.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> <ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2010, The [https://www.fibroknowledge.com/site/acr-2010 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview]<ref>{{Cite web|url=https://www.fibroknowledge.com/sites/default/files/downloads/file/2010_ACR_CRITERIA.pdf|title=American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia|last=|first=|date=2010|website=fibroknowledge.com|type=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref> was proposed and modified in 2011<ref>{{Cite news|url=http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria|title=New and Modified Fibromyalgia Diagnostic Criteria|last=Garg|first=Neha|date=Feb 9, 2012|work=Rheumatology Network|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=|last2=Deodhar|first2=Atul}}</ref> with the modification being validated in 2013 and published in 2014.<ref>{{Cite journal|last=Bennett|first=Robert M.|last2=Friend|first2=Ronald|last3=Marcus|first3=Dawn|last4=Bernstein|first4=Cheryl|last5=Han|first5=Bobby Kwanghoon|last6=Yachoui|first6=Ralph|last7=Deodhar|first7=Atul|last8=Kaell|first8=Alan|last9=Bonafede|first9=Peter|date=2014|title=Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/24497443|journal=Arthritis Care & Research|volume=66|issue=9|pages=1364–1373|doi=10.1002/acr.22301|issn=2151-4658|pmid=24497443|via=}}</ref> September of 2016, another revision has been made.<ref>{{Cite news|url=http://acrabstracts.org/abstract/2016-revisions-to-the-20102011-fibromyalgia-diagnostic-criteria/|title=2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria - ACR Meeting Abstracts|last=|first=|date=Sep 28, 2016|work=ACR Meeting Abstracts|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

:Men do not seem to form the tender points needed for diagnosis under the 1990 criteria,<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/features/how-fibromyalgia-affects-men#2|title=How Fibromyalgia Affects Men: Symptoms and Diagnosis|work=WebMD|access-date=2018-08-09|language=en-US}}</ref> the 2010 proposed criteria diagnoses more men with a F/M ratio of 2:1.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=}}</ref>
:Tender points were used to diagnose with the 1990 criteria, however "considerable skill is needed to correctly check for a patient’s tender points (i.e., digital palpation that is done with certain amount of applied pressure), yet this technique is not typically taught at most medical schools."<ref name=":0">{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 5, 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>
:The new standards were designed to:
:*eliminate the use of a tender point examination
:*include a severity scale by which to identify and measure characteristic FM symptoms
:*utilize an index by which to rate pain<ref name=":0" />
:*There are 19 tender point areas in the widespread pain index (WPI), whereas the 1990 criteria had 18 tender points.<ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose fibromyalgia.<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=Jul 25, 2012|website=www.ssa.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

==== Sleep study ====
[[Sleep dysfunction]] is often involved in fibromyalgia. Treating a sleep disorder can help with fibromyalgia symptoms. A diagnosed sleep disorder is also helpful if one needs to file for disability.

*[https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054 Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054|title=Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*[http://www.sciencedaily.com/releases/2008/09/080903134311.htm What A Sleep Study Can Reveal About Fibromyalgia]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2008/09/080903134311.htm|title=What A Sleep Study Can Reveal About Fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*[http://linkis.com/nationalpainreport.com/lzYea Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says]<ref>{{Cite news|url=http://linkis.com/nationalpainreport.com/lzYea|title=Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says|last=|first=|date=Mar 25, 2016|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== ICD Diagnostic code===
====World Health Organization====
'''ICD-10'''

The [[World Health Organization]] (WHO) International Classification of Diseases (ICD) lists fibromyalgia as a "disease of the [[musculoskeletal system]] and connective tissue", under the code M79.7 (WHO ICD-10 Version: 016).<ref>World Health Organization, [http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7 International Classification of Diseases - Fibromyalgia M79.7], ICD-10, 2016</ref>

*'''M79.7 Fibromyalgia'''
::Fibromyositis
::Fibrositis
::Myofibrositis<ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7|title=ICD-10 Version:2016|website=apps.who.int|language=en|access-date=2018-08-09}}</ref>

In 2015, the [[United States]] finally adopted ICD-10 and Fibromyalgia as a diagnosis.<ref>{{Cite web|url=http://www.icd10data.com/ICD10CM/Codes/M00-M99/M70-M79/M79-/M79.7|title=2018 ICD-10-CM Diagnosis Code M79.7: Fibromyalgia|website=www.icd10data.com|language=en|access-date=2018-08-09}}</ref> <ref>{{Cite news|url=http://nationalpainreport.com/the-health-care-industry-finally-recognizes-fibromyalgia-8827637.html|title=The Health Care Industry Finally Recognizes Fibromyalgia|last=Liptan|first=Ginevra|date=2015-09-30|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

'''ICD-11 (2019)'''

[https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504 ICD-11] (2019) has diagnostic code ''MG30.1 Chronic widespread pain''.<ref name=":18">{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504|title=ICD-11 - Mortality and Morbidity Statistics|website=icd.who.int|language=en|access-date=2018-08-09}}</ref>

*'''MG30.01 Chronic widespread pain'''

'''Parent'''
::MG30.0 Chronic primary pain

'''Description'''
<blockquote>Chronic widespread pain (CWP) is diffuse pain in at least 4 of 5 body regions and is associated with significant emotional distress (anxiety, anger/frustration or depressed mood) or functional disability (interference in daily life activities and reduced participation in social roles) [1]. CWP is multifactorial: biological, psychological and social factors contribute to the pain syndrome. The diagnosis is appropriate when the pain is not directly attributable to a nociceptive process in these regions and there are features consistent with nociplastic pain [2] and identified psychological and social contributors.<ref name=":18" /></blockquote>

'''Inclusions'''
:*Fibromyalgia
'''Exclusions'''
:*Acute pain (MG31)<ref name=":18" />

==Pathophysiology==
"Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology. There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or [[Lyme disease]], as well as emotional or physical trauma."<ref>{{Cite web|url=https://www.uptodate.com/contents/pathogenesis-of-fibromyalgia#!|title=UpToDate|last=Goldenberg|first=Don L|date=|website=www.uptodate.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> The widespread pain is severe, debilitating, and abnormal in processing its pain. There is also sleep disturbance and fatigue. Cause or causes are unproven.<ref>{{Cite news|url=https://www.omf.ngo/what-is-mecfs-old/fibromyalgia/|title=What is Fibromyalgia? {{!}} Open Medicine Foundation|work=Open Medicine Foundation|access-date=2018-08-09|language=en-US}}</ref>

*May 2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/ Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management]<ref name=":21">{{Cite journal|last=Jahan|first=Firdous|last2=Nanji|first2=Kashmira|last3=Qidwai|first3=Waris|last4=Qasim|first4=Rizwan|date=2012|title=Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/|journal=Oman Medical Journal|volume=27|issue=3|pages=192–195|doi=10.5001/omj.2012.44|issn=1999-768X|pmc=|pmid=22811766|via=}}</ref> ''See'' Table 1: "Conditions associated with fibromyalgia." Musculoskeletal, genitourianry, gastro intestinal, and miscellaneous conditions often exist among fibromyalgia patients.

<blockquote>Pathophysiology: Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as [[serotonin]], substance P, growth hormone and [[cortisol]] suggest that regulation of the autonomic and neuro-endocrine system appears to be the basis of the syndrome. Fibromyalgia is not a life-threatening, deforming, or [https://en.wikipedia.org/wiki/Progressive_disease progressive disease]. [[Anxiety]] and [[depression]] are the most common association. Aberrant pain processing, which can result in [[chronic pain]], may be the result of several interplaying mechanisms. [[Central sensitization]], blunting of inhibitory pain pathways and alterations in [[neurotransmitters]] lead to aberrant neuro-chemical processing of sensory signals in the CNS, thus lowering the threshold of pain and amplification of normal sensory signals causing constant pain.<ref name=":21" /></blockquote>

<blockquote>The frequent co-morbidity of fibromyalgia with mood disorders suggests a major role for the stress response and for neuroendocrine abnormalities. The [[hypothalamic pituitary axis]] (HPA) is a critical component of the stress-adaptation response. In FMS, stress adaptation response is disturbed leading to stress induce symptoms. Psychiatric co-morbidity has been associated with FMS and needs to be identified during the consultation process, as this requires special consideration during treatment.<ref name=":21" /></blockquote>

*May 2018, [https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management]<ref>{{Cite journal|last=Bourgaize|first=Sheryl|last2=Newton|first2=Genevieve|last3=Kumbhare|first3=Dinesh|last4=Srbely|first4=John|date=2018|title=A comparison of the clinical manifestation and
pathophysiology of myofascial pain syndrome
and fibromyalgia: implications for differential
diagnosis and management|url=https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf|format=PDF|journal=Journal of the Canadian Chiropractic Assoc.|volume=|pages=26-41|at=See Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)|via=}}</ref> (PDF) ''See'' Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)

*Jul 2018, [https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/ Primary and Secondary Fibromyalgia Share Same Symptom Burden, Study Suggests]<ref name=":22">{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/|title=Primary, Secondary Fibromyalgia Share Same Symptom Burden, Study Says|last=Carvalho|first=John|date=2018-07-31|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

<blockquote>Fibromyalgia can be considered either primary, or dominant, also known as idiopathic fibromyalgia, or secondary. In the primary form, the causes of the disorder are unknown, but in secondary fibromyalgia, the disorder usually occurs alongside other debilitating medical conditions, such as rheumatoid arthritis (RA), lupus, and multiple sclerosis.<ref name=":22" /></blockquote>

===Immune system research===

Dr. [[Jarred Younger]] believes an overactive [[immune system]] is the cause and will be conducting a study to test this hypothesis.<ref>{{Cite news|url=http://nationalpainreport.com/new-uab-study-could-radically-change-fibromyalgia-treatment-as-we-know-it-8833437.html|title=New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It|last=Gregory Burch|first=Donna|date=2017-04-24|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=https://www.youtube.com/watch?v=8e5xKX036bE|title=Testing the fibromyalgia immune system with lipopolysaccharide (LPS)|last=Younger|first=Jarred|date=May 24, 2017|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=|via=Younger Lab}}</ref> An overactive immune system is responsible for [[inflammation]] which causes [[chronic pain]].

Dr. William Pridgen's research of [[HSV-1]] (cold sore virus) as being involved in FM has conducted a successful Phase III clinical trial, which had been fast-tracked by the [[Food and Drug Administration]] (FDA), of a combination drug that suppresses this virus and also helps with pain. ''See'': [[Fibromyalgia#IMC-1|Fibromyalgia (''Drugs: Trials: IMC-1'' section)]].

[[ProHealth]] reports that an old [https://en.wikipedia.org/wiki/Tuberculosis Tuberculosis] vaccine, [https://en.wikipedia.org/wiki/BCG_vaccine Bacille Calmette-Guerin] (BCG), may be researched for treatment of Fibromyalgia spearheaded by [http://www.buzzfile.com/business/Epicgenetics,-Inc.-310-586-2929 EpicGenetics] and [http://www.massgeneral.org/ Massachusetts General Hospital].<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

EpicGenetics has a blood test that is identifying the presence of specific white blood cell abnormalities of patients diagnosed with FM and has partnered with two universities to offer [https://en.wikipedia.org/wiki/Disease_gene_identification#Whole_exome_sequencing whole exome sequencing] free of charge to those who test positive with their [http://fmtest.com/ FM/a® test].<ref>{{Cite news|url=http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> Concerns have been raised in regards to the FM/a® EpicGenetics Blood Test.<ref>{{Cite web|url=http://www.fmperplex.com/2013/02/25/junk-science-junk-ethics/|title=Junk Science – Junk Ethics – The Fibromyalgia Perplex|last=Wolfe|first=Fred|date=Feb 25, 2013|website=www.fmperplex.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> EpicGenetics is awaiting FDA approval to test the Bacille Calmette-Guerin (BCG) vaccine (an old Tuberculosis vaccine) on patients that tested positive with its FM/a® test.<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689#comment-2286|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=See Comments Section: CDW12 says: June 26, 2018 at 2:05 pm|language=en-US}}</ref><ref>{{Cite web|url=https://www.celestecooper.com/2018/07/the-fma-blood-test-and-participation-in.html#.Wz4nxdJKjIU|title=The FM/a® Blood Test and Participation in Fibromyalgia Vaccine Study|last=Cooper|first=Celeste|date=Jul 5, 2018|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

A June 2018 study found inflammatory genes CCL11, CCL4, and MEFV in a fibromyalgia family study.<ref>{{Cite journal|last=Zhang|first=Zhifang|last2=Feng|first2=Jinong|last3=Mao|first3=Allen|last4=Le|first4=Keith|last5=Placa|first5=Deirdre La|last6=Wu|first6=Xiwei|last7=Longmate|first7=Jeffrey|last8=Marek|first8=Claudia|last9=Amand|first9=R. Paul St|date=2018-06-21|title=SNPs in inflammatory genes CCL11, CCL4 and MEFV in a fibromyalgia family study|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198625|journal=PLOS ONE|language=en|volume=13|issue=6|pages=e0198625|doi=10.1371/journal.pone.0198625|issn=1932-6203|pmid=29927949|via=}}</ref>
<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/03/immune-system-may-play-role-fibromyalgia-study/|title=Fibromyalgia May Be Linked to Immune System, Study Suggests|last=Inacio|first=Patricia|date=2018-07-03|work=Fibromyalgia News Today|access-date=2018-08-22|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Comorbidities, overlapping conditions, and common symptoms ==
[[File:Fibromyalgia and comorbid conditions.JPG|700px|thumb|center|Comorbid conditions of Fibromyalgia (FMS) are ME/CFS which is the most common; autoimmune diseases; migraines; Multiple Chemical Sensitivities (MCS); and orthostatic intolerance (OI) / Postural Orthostatic Tachycardia Syndrome (POTS).<ref name=":30" /><ref name=":31" /><ref name=":33">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref> Depression and anxiety; digestive conditions and menstrual problems; GWI; nervous system disorders; low blood pressure (Low BP); other pain conditions and migraines; and sleep dysfunction/disturbance all overlap with FMS.<ref name=":30" /> <ref name=":33" />]]

*[[Allodynia]]
** [http://chronicfatigue.about.com/od/glossary/g/allodynia.htm Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS]<ref name=":1">{{Cite news|url=https://www.verywellhealth.com/allodynia-definition-and-types-fibromyalgia-715929|title=Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Feb 23, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Types of Allodynia: Tactile; Mechanical; and Thermal. "Type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain" <ref name=":1" />
*[[Autoimmune disease]]<nowiki/>s "Research suggests that RA and other inflammatory diseases may somehow increase the risk for fibromyalgia."<ref>{{Cite news|url=https://www.health.com/health/gallery/0,,20520705,00.html#restless-legs-0|title=7 Conditions Linked to Fibromyalgia|work=Health.com|access-date=2018-08-19|language=en}}</ref>

*[[Body temperature]]
**[https://www.verywell.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025 Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":2">{{Cite news|url=https://www.verywellhealth.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025|title=Temperature Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Mar 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

<blockquote>When you're exposed to heat, does it feel like you're burning up? Does it seem impossible for you to cool off? Or maybe it's cold that bothers you, chilling you to the bone, leaving you unable to warm up? Or are you one of those people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) who is cold all the time, or hot all the time, or alternately hot or cold while out of sync with the environment?<ref name=":2" /></blockquote>

[[File:Costal cartilages.JPG|200px|thumb|left|Costochonritus is inflammation of the costal cartliges (shown in red) causing chest and ribcage pain]]

:* [https://www.verywell.com/costochondritis-in-fibromyalgia-716178 Costochondritis in Fibromyalgia]<ref name=":10">{{Cite news|url=https://www.verywellhealth.com/costochondritis-in-fibromyalgia-716178|title=Costochondritis Chest Pain in Fibromyalgia|last=Dellow|first=Adrienne|date=Feb 14, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|date=2018-05-25|title=Costochondritis|url=https://en.wikipedia.org/w/index.php?title=Costochondritis&oldid=842926736|journal=Wikipedia|language=en}}</ref>

<blockquote>Costochondritis is inflammation of the cartilage that connects your ribs to your breastbone. Depending on how much inflammation there is, it can range from mildly annoying to intensely painful. People sometimes describe the pain as stabbing, aching, or burning.<ref name=":10" /></blockquote>

<blockquote>Costochondritis can make you think you're having heart problems, which is a scary thing. Even though costochondritis is common, you should get medical attention if you have unexplained chest pain. You don't want to assume that it's FMS-related and end up with permanent heart damage or worse.<ref name=":10" /></blockquote>

<blockquote>The pain can radiate to your shoulder and arms as well (another way the condition mimics a heart attack). Sometimes the pain is accompanied by redness and/or swelling in the most painful areas. When that's the case, it's called Tietze's Syndrome.<ref name=":10" /></blockquote>

* [[Depression]] and [[Anxiety]] Fibromyalgia sufferers are "up to three times more likely to have depression at the time of their diagnosis than someone without fibromyalgia."<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/fibromyalgia-and-depression#1|title=Fibromyalgia and Depression|work=WebMD|access-date=2018-08-19|language=en-US}}</ref> Up to 20 percent of Fibromyalgia patients will have either depression or anxiety.<ref>{{Cite web|url=https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/fibromyalgia|title=Fibromyalgia {{!}} Anxiety and Depression Association of America, ADAA|website=adaa.org|language=en|access-date=2018-08-19}}</ref>

*[[Fibro fog]]

:*[http://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction]<ref name=":3">{{Cite news|url=https://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx|title=What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction|last=Mandal|first=Ananya|date=2013-06-03|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> 'Mental confusion along with difficulty in concentration and loss of memory is often termed “[[fibro fog]]"'.<ref name=":3" />

:* [https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014 What Is Fibro Fog and ME/CFS Brain Fog?]<ref name=":17" />

*[[Gastrointestinal system]]
**[[Irritable bowel syndrome]]: [http://chronicfatigue.about.com/od/whyfmscfsarelinked/a/IBS.htm Irritable Bowel Syndrome in Fibromyalgia & Chronic Fatigue Syndrome - Why Do They Go Together?]<ref name=":4">{{Cite news|url=https://www.verywellhealth.com/irritable-bowel-syndrome-in-fibromyalgia-cfs-716167|title=Irritable Bowel Syndrome in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jan 28, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>Fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome (IBS) frequently go together. No one really knows why, but we do know that all three conditions can include imbalances of serotonin -- although in fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS or ME/CFS) it's an imbalance in the brain, while with IBS it's in the gut.<ref name=":4" /></blockquote>
* [[Gulf War Illness]]
**[https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp Fibromyalgia in Gulf War Veterans]<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp|title=Fibromyalgia in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-19}}</ref> GWI increases risk of developing Fibromyalgia.

*[https://en.wikipedia.org/wiki/Interstitial_cystitis Interstitial Cystitis]<ref>{{Cite journal|date=2018-07-11|title=Interstitial cystitis|url=https://en.wikipedia.org/w/index.php?title=Interstitial_cystitis&oldid=849828657|journal=Wikipedia|language=en}}</ref> (Painful bladder)
**[https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168 Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis]<ref name=":5">{{Cite news|url=https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168|title=Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "Fibromyalgia, chronic fatigue syndrome and interstitial cystitis (IC) -- a painful bladder condition -- frequently occur together. Women may be up to 10 times more likely than men to develop it."<ref name=":5" />

*Language Impairment
**[[Word-finding problems]] is a symptom of ME/CFS.
:*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome Impaired Language in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":6" /> "Searching their brains for simple words that they just can't remember. On other occasions, individuals with these diagnoses may find it hard to write or even understand language."<ref name=":6">{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:*"The diagnosis of [[Aphasia]] is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written"<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref> but with [[dysphasia]] you will have those symptoms and trouble listening and doing numeral calculations.<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-09}}</ref> ''See also'': [[Dyscalculia]].
* [[ME/CFS]] [https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184 Comorbid Conditions in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia & Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>
* [[Migraine]] [https://migrainecenters.com/blog/migraines-and-fibromyalgia/ Migraines and Fibromyalgia]<ref name=":32" />
<blockquote>Both fibromyalgia and migraine may reflect problems in the brain’s pain processing center. It is believed that both conditions are caused by excitation of the nervous system or an over-response to stimuli. Stress is usually cited as a trigger for both migraine and fibromyalgia attacks.<ref name=":32">{{Cite news|url=https://migrainecenters.com/blog/migraines-and-fibromyalgia/|title=Migraines and Fibromyalgia - Migraine Centers|date=2016-05-06|work=Migraine Centers|access-date=2018-08-19|language=en-US}}</ref></blockquote>
* [[Multiple chemical sensitivity|Multiple Chemical Sensitivity]] (MCS) It is thought that both Fibromyalgia and MCS are central sensitivity syndromes.<ref>{{Cite news|url=https://www.verywellhealth.com/chemical-sensitivity-in-fibromyalgia-716170|title=Multiple Chemical Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}</ref>

*OBGYN
**[https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596 Menstrual Periods with Fibromyalgia: Personal Stories]<ref>{{Cite news|url=https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596|title=Menstrual Periods with Fibromyalgia: Personal Stories|last=Dellwo|first=Adrienne|date=May 18, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>
**[https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626 Fibromyalgia Tied to Hysterectomy, Gynecologic Disease].<ref name=":7" />
:<blockquote>You may have heard about a possible link between gynecologic surgery (such as a hysterectomy) and the development of fibromyalgia, and doctors have long suspected that fibromyalgia has strong hormonal ties and triggers. This does not seem surprising as we've long suspected a link between endocrine disorders, gynecological conditions, and autoimmune conditions.<ref name=":7">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626|title=Fibromyalgia Tied to Hysterectomy, Gynecologic Disease|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref></blockquote>

*[[Orthostatic intolerance]] (OI) and [[Postural orthostatic tachycardia syndrome]] (POTS)<ref>{{Cite journal|last=Yun|first=Dong Joo|last2=Choi|first2=Han Na|last3=Oh|first3=Gun-Sei|date=2013|title=A Case of Postural Orthostatic Tachycardia Syndrome Associated with Migraine and Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710947/|journal=The Korean Journal of Pain|volume=26|issue=3|pages=303–306|doi=10.3344/kjp.2013.26.3.303|issn=2005-9159|pmid=23862007|via=}}</ref>

:*[http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM]<ref>{{Cite web|url=http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf|title=Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM|last=Lapp|first=Charles W.|last2=Black|first2=Laura|date=|website=drlapp.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Smith|first3=Rebekah S.}}</ref> (PDF) Symptoms can include low blood pressure and/or sudden high blood pressure, dizziness, fainting.

:*[https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/ An Overlooked Issue in Fibromyalgia? Study Highlights Problems Standing (Orthostatic Intolerance)]<ref>{{Cite news|url=https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/|title=An Overlooked Issue in Fibromyalgia? Study Highlights Orthostatic Intolerance - Problems Standing - Health Rising|last=Johnson|first=Cort|date=2017-09-21|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[[Sleep dysfunction]]
**[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia]<ref name=":23">{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}</ref>

:<blockquote>The present results of this study suggest that long-term, comorbid pain and sleep disturbance may be associated with increased activation in core default mode brain areas that is above and beyond long-term pain disturbance alone.<ref name=":23" /></blockquote>

:*[http://www.prohealth.com/library/showarticle.cfm?libid=22344 Fibromyalgia and Sleep]<ref name=":8">{{Cite news|url=https://www.prohealth.com/library/fibromyalgia-and-sleep-38954|title=Fibromyalgia and Sleep - Prohealth|date=2016-01-11|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref> "Most people with fibromyalgia have an associated sleep disorder that makes it difficult for them to get the deep, restorative sleep they need."<ref name=":8" />

[[File:TMJ_1.jpg|200px|thumb|right|TMJ/TMD is a condition that occurs in some fibromyalgia and ME/CFS patients]]
* [[Temporomandibular joint disorder]] (TMJ/TMD)

:* [https://www.sciencedirect.com/science/article/pii/S2255502114001758 Temporomandibular disorders in fibromyalgia syndrome: a short-communication]<ref>{{Cite journal|last=Soares Gui|first=Maisa|last2=Pimentel|first2=Marcele Jardim|last3=Rizzatti-Barbosa|first3=C'elia Marisa|date=2015-03-01|title=Temporomandibular disorders in fibromyalgia syndrome: a short-communication|url=https://www.sciencedirect.com/science/article/pii/S2255502114001758|journal=Revista Brasileira de Reumatologia (English Edition)|language=en|volume=55|issue=2|pages=189–194|doi=10.1016/j.rbre.2014.07.004|issn=2255-5021|via=ScienceDirect}}</ref><ref>{{Cite news|url=https://www.whitesmilesforlife.com/blog/study-probes-pain-link-between-tmj-fibromyalgia/|title=Study Probes Pain Link Between TMJ, Fibromyalgia|date=2016-05-03|work=Kent E. White, DDS|access-date=2018-08-19|language=en-US}}</ref>

::Other than headaches, the symptoms are quite distinct from symptoms of FMS and ME/CFS.

::They include:
::*Jaw pain
::*Discomfort or difficulty chewing
::*Painful clicking in the jaw
::*Difficulty opening or closing the mouth
::*Headaches
::*Locking jaw
::*Teeth that don't come together properly<ref>{{Cite news|url=https://www.verywellhealth.com/tmj-in-fibromyalgia-chronic-fatigue-syndrome-716175|title=TMJ in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Mar 31, 2018|work=Verywell Health|access-date=2018-08-22|archive-url=|archive-date=|dead-url=}}</ref>

*[[Thyroid disease]]
**[https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677 Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease]<ref name=":9">{{Cite news|url=https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677|title=A Comparison of Chronic Fatigue, Fibromyalgia, and Thyroid Disease|last=Shomon|first=Mary|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:<blockquote>People with Hashimoto's autoimmune thyroid disease often experience significant fatigue and body aches. While these symptoms are common in Hashimoto's, they can also be markers of other diseases, like chronic fatigue syndrome or fibromyalgia.<ref name=":9" /></blockquote>

*Other symptoms
**[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/fibrosymptoms.htm Symptoms of Fibromyalgia]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-symptoms-716139|title=Symptoms of Fibromyalgia|last=Dellwo|first=Adrienne|date=May 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> (A comprehensive all in one place list for the many symptoms of fibromyalgia.)

==Treatment==

===United States===
'''Rheumatology and primary care providers: Diagnosing and treatment'''

*2012, [https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract A Framework for Fibromyalgia Management for Primary Care Providers]<ref>{{Cite journal|last=Arnold|first=Lesley M.|last2=Clauw|first2=Daniel J.|last3=Dunegan|first3=L. Jean|last4=Turk|first4=Dennis C.|date=2012|title=A Framework for Fibromyalgia Management for Primary Care Providers|url=https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract|journal=Mayo Clinic Proceedings|language=English|volume=87|issue=5|pages=488–496|doi=10.1016/j.mayocp.2012.02.010|issn=0025-6196|via=}}</ref> Rheumatologists stopped treating fibromyalgia patients and primary care providers began treatment managment although rheumatologists are most often the specialist to diagnose. (Please see [http://me-pedia.org/wiki/Fibromyalgia#Disability disability] heading about ''primary provider'' and ''specialists'' for disability cases.)

=== Drugs ===

{{Main article |page_name = Fibromyalgia drugs}}

=== Therapies ===

==== Exercise ====
''Please Note'': These recommendations are for fibromyalgia patients and '''not''' [[ME/CFS]] sufferers.
[[File:Warm water exercise.JPG|200px|thumb|left|Warm water exercise is best for fibromyalgia. Start slow and don't push through the pain<ref name=":11" />]]

*[https://www.verywellhealth.com/warm-water-exercise-for-fibromyalgia-716059 Warm Water Exercise for Fibromyalgia]<ref name=":11">{{Cite news|url=http://chronicfatigue.about.com/od/treatingfmscfs/a/warmwaterFMS.htm|title=Warm Water Exercise for Fibromyalgia|last=Dellwo|first=Adrienne|date=Nov 19, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|last=Munguía-Izquierdo|first=D.|last2=Legaz-Arrese|first2=A.|date=2007|title=Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/18173915|journal=Clinical and Experimental Rheumatology|volume=25|issue=6|pages=823–830|issn=0392-856X|pmid=18173915|via=}}</ref>

<blockquote>A warm-water pool is good for therapy because cold water can make muscles tense up. It's especially important in FMS because many people with the condition are intolerant of cold. A warm-water pool is one that's kept around 89.6 degrees Fahrenheit (32 Celsius), which is several degrees warmer than most heated pools.<ref name=":11" /></blockquote>

*Moderate aerobic exercise and weights with six to eight reps and then a day or two of rest in between. Do not start a program if you are in a flare.<ref>{{Cite web|url=http://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/fibromyalgia-questions/fibromyalgia-exercise.php|title=Fibromyalgia Exercise {{!}} Exercising with Fibromyalgia|last=Ronenn|first=Roubenoff|date=|website=www.arthritis.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[https://www.youtube.com/watch?v=BauJYuJwFsI Easy fibromyalgia exercises and motivation to keep you healthy!]<ref>{{Cite web|url=https://www.youtube.com/watch?v=BauJYuJwFsI|title=Easy Fibromyalgia exercises and motivation to keep you healthy!|last=Suarez|first=Eric|date=Jun 21, 2011|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=Aug 9, 2018}}</ref> Video

*[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/Fibromyalgia-Myth-Vs-Fact.htm Fibromyalgia Myth vs. Fact]<ref name=":15">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-myth-vs-fact-716131|title=Fibromyalgia: What's Myth, What's Fact?|last=Dellwo|first=Adrienne|date=Jun 8, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=Myth #3 People With Fibromyalgia Need More Exercise}}</ref> Heading: ''Myth #3: People With Fibromyalgia Need More Exercise''. Appropriate exercise, which each patient needs to gauge for themselves.<ref name=":15" />

==== Massage ====

*2014, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/ Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]<ref>{{Cite journal|last=Li|first=Yan-hui|last2=Wang|first2=Feng-yun|last3=Feng|first3=Chun-qing|last4=Yang|first4=Xia-feng|last5=Sun|first5=Yi-hua|date=2014-02-20|title=Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/|journal=PLoS ONE|volume=9|issue=2|doi=10.1371/journal.pone.0089304|issn=1932-6203|pmc=|pmid=24586677|pages=|via=}}</ref>

*2016, [http://chronicfatigue.about.com/od/alternativetreatments/a/bodywork.htm Massage, Rolfing & Other Bodywork - Are They Effective Fibromyalgia & Chronic Fatigue Syndrome Treatments?]<ref>{{Cite news|url=https://www.verywellhealth.com/massage-rolfing-other-bodywork-715645|title=Massage, Rolfing, Reiki: Do They Work for Fibromyalgia & ME/CFS?|last=Dellwo|first=Adrienne|date=Aug 10, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==== Acupuncture ====

*2004, [[U.S. Department of Health and Human Services]] (HHS) and [https://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services Centers for Medicare and Medicaid Services] (CMS) ruled April 16, 2004, a noncoverage determination for acupuncture.<ref>{{Cite web|url=https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R11NCD.pdf|title=CMS Manual System Pub. 100-03 Medicare
National Coverage Determinations|last=|first=|date=Apr 16, 2004|website=CMS.gov|format=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2005, [http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html Acupuncture Good for Fibromyalgia?] <ref name=":16">{{Cite web|url=http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html|title=Acupuncture Good for Fibromyalgia?|last=|first=|date=Oct 2, 2012|website=Acupuncture School Online|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> "Acupuncture gave no significant pain relief to fibromyalgia patients."<ref name=":16" />

*2016, [http://www.sciencedirect.com/science/article/pii/S2095496416602352 Short-term complementary and alternative medicine on quality of life in women with fibromyalgia] <ref name=":25">{{Cite journal|date=2016-01-01|title=Short-term complementary and alternative medicine on quality of life in women with fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S2095496416602352|journal=Journal of Integrative Medicine|language=en|volume=14|issue=1|pages=29–35|doi=10.1016/S2095-4964(16)60235-2|issn=2095-4964}}</ref> "There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session."<ref name=":25" />

*2016, [https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/ Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/|title=Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients - Fibromyalgia News Today|last=Semedo|first=Daniela|date=2016-02-01|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Disability ==
===United States===
''Please Note'': The following is NOT legal advice and it should not be relied upon in taking steps for a disability case. Only ''[https://www.ssa.gov/ Social Security]'' and a disability lawyer can provide the most up to date and the correct legal avenue for bringing a disability case.

In the[[ United States]], [https://www.ssa.gov/ssi/ Social Security Insurance] and [https://www.ssa.gov/disability/ Social Security Disability] (SSI) and (SSD) benefits are available for Fibromyalgia. Generally for SSI/SSD, notes and tests from a ''Primary Provider'' '''may''' be allowed for submission but ''Specialists'' such as a rheumatologist, neurologist, psychiatrist, etc. are required for diagnosis, ongoing treatment and completing SSI/SSD paperwork.

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose Fibromyalgia. (See: "Policy Interpretation" for the POLICY INTERPRETATION RULING.)<ref>[https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia]</ref>

*[http://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social Applying for Disability With Fibromyalgia]<ref>{{Cite news|url=https://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social|title=Fibromyalgia Disability: Applying for Disability Benefits With Fibromyalgia|date=2016-10-03|work=NewLifeOutlook {{!}} Fibromyalgia|access-date=2018-08-09|language=en-US}}</ref> One patient's success of applying, denial, successful appeal, and a breakdown of what SSI/SSD requires for the medical determination of a favorable decision of disability.

*[https://www.socialsecurity.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html Fibromyalgia: Policy Interpretation Ruling - Social Security]<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=|website=www.ssa.gov|at=Titles II and XVI: Evaluation of Fibromyalgia|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[http://www.disabilitysecrets.com/social_security_disability_fibromyalgia.html Social Security Disability (SSDI & SSI) for Fibromyalgia - Disability Secrets By NOLO]<ref>{{Cite news|url=https://www.disabilitysecrets.com/resources/social-security-disability-ssdi-ssi-fibromyalgia.htm|title=Social Security Disability (SSDI & SSI) for Fibromyalgia|last=Laurence|first=Bethany|date=|work=www.disabilitysecrets.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*[http://www.mdjunction.com/fibromyalgia/fibromyalgia-disability Fibromyalgia Disability Patient Support Forums]<ref>{{Cite web|url=https://www.mdjunction.com/fibromyalgia/fibromyalgia-disability|title=Fibromyalgia Disability|website=MDJunction|language=en|access-date=2018-08-09}}</ref> at [[MDJunction]]

==== Examinations and Tests ====
For documentation of symptoms and co-morbidities of a FM diagnosis, you and your doctor should consider the following examinations and tests:

:'''Fibromyaglia Diagnostic Examination'''
:*[http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist Rheumatologist] examination and diagnosis of FM. (Consider having a rheumatologist order tests and coordinate referrals for other specialists for examinations and testing. Only specialists can complete the paperwork for Social Security. A primary doctor cannot complete disability paperwork but ''may'' be able to forward test results they have ordered.)
[[File:Whole body bone scan.jpg|200px|thumb|right|A whole body bone scan (Bone scintigraphy) is a nuclear medicine test. '''Arthritis''', avascular necrosis, bone cancers, cancers that have spread to the bone, fibrous dysplasia, fractures, infection involving the bone, and Pagets disease can be diagnosed using this scan.<ref>{{Cite news|url=https://www.healthline.com/health/bone-scan#purpose|title=Bone Scan: Purpose, Procedure, and Risks|last=Krans|first=Brian|date=Dec 13, 2017|work=Healthline|access-date=2018-08-21|archive-url=|archive-date=|dead-url=|language=en}}</ref>]]
:'''Arthritis'''
:*[https://en.wikipedia.org/wiki/Bone_scintigraphy Whole body bone scan (Bone scintigraphy)]<ref>{{Cite journal|date=2018-05-22|title=Bone scintigraphy|url=https://en.wikipedia.org/wiki/Bone_scintigraphy|journal=Wikipedia|language=en}}</ref> to rule out treatable arthritis.
:'''Blood Tests'''
:*Routine blood tests for [[diabetes]] (fasting sugar, A1C) and a full [[Thyroid disease]] panel ([https://en.wikipedia.org/wiki/Thyroid_function_tests#Thyroid-stimulating_hormone TSH, T3, Free T3, T4 and Free T4]).
:*Rule out [[Rheumatoid arthritis]], lupus, [[Lyme disease]] and other diseases that can share some of the same symptoms of fibromyalgia and may be treatable.<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1-3|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>
:*Vitamin and mineral deficiencies such as [[B12]] and [[Vitamin D]] are treatable with over the counter supplements and prescription medications which can improve [[fatigue]] and [[pain]].
:'''Gastrointestinal'''
:*[[Irritable bowel syndrome]] diagnosis which may require blood, [http://www.mayoclinic.org/tests-procedures/endoscopy/basics/definition/PRC-20020363 upper endoscopy] to rule out [https://en.wikipedia.org/wiki/Coeliac_disease celiac disease] and [https://en.wikipedia.org/wiki/Stool_test fecal tests] to check for bacteria ([[SIBO]]) and [http://www.umm.edu/health/medical/altmed/condition/intestinal-parasites intestinal parasites].
:'''Mental Health and Cognition'''
:* Psychiatric evaluation as any [[depression]] and [[anxiety]] should be treated.
:* [[Cognitive dysfunction]] tests.
:'''Sleep dysfunction'''
:*Sleep study for [[Restless legs syndrome]], [[Sleep disturbance]] or [[Narcolepsy]].
:'''Orthostatic Intolerance'''
:*[[Tilt table test]] to diagnose [[Orthostatic intolerance]] or [[Postural orthostatic tachycardia syndrome|POTS]].
:'''TMJ, tinnitus, vertigo, and dizziness'''
:*An ear, nose, and throat specialist (ENT) ([http://www.mayoclinic.org/departments-centers/otorhinolaryngology-ent/overview Otorhinolaryngology]) examination and imaging may be ordered for [[Temporomandibular joint disorder]] (TMJ).
:*(Ear, sinus, throat/lymph infections, and [[tinnitus]] can also be documented.)
:*[https://en.wikipedia.org/wiki/Videonystagmography Videonystagmography] (VNG) testing if you experience [[vertigo]] and/or [[dizziness]].<ref>{{Cite news|url=https://www.everydayhearing.com/balance/articles/what-to-expect-at-your-vng-test/|title=What to Expect at Your VNG/ENG Test - Everyday Hearing|last=Banks|first=Lindsey|date=2014-05-07|work=Everyday Hearing|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

Of course, one can have arthritis, sleep apnea, [[Chronic lyme disease|chronic Lyme disease]] or other diseases and still have FM, but there may be a treatable condition where a patient's overall health, including their FM, improves.<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/guide/common-misdiagnoses-of-fibromyalgia#1|title=Common Misdiagnoses of Fibromyalgia|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite web|url=http://www.cfidsselfhelp.org/library/overlapping-and-related-conditions|title=Overlapping and Related Conditions {{!}} CFIDS & Fibromyalgia Self-Help|website=www.cfidsselfhelp.org|access-date=2018-08-09}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

There have been cases of [[Vitamin D]] deficiency being misdiagnosed as fibromyalgia as a D deficiency can cause pain. Supplementation or prescribed D treatments may alleviate this pain. However, it is possible to have both a D deficiency and fibromyalgia and correcting the deficiency will only resolve the pain stemming from it.<ref>{{Cite news|url=http://www.webmd.com/pain-management/features/vitamin-d-deficiency-and-chronic-pain-link#1|title=Does Vitamin D Deficiency Cause Chronic Pain?|last=Shaw|first=Gina|date=|work=WebMD|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

==== Blogs about navigating SSD process ====

*Resources for getting approved for disability include this [http://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/ Guide to Social Security Disability for People with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome],<ref>{{Cite web|url=https://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/|title=The Sleepy Girl Guide to Social Security Disability (U.S.) {{!}} #MEAction|last=Silver|first=Lily|date=Apr 17, 2017|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> available on the #[[MEAction]] website.

*[https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/ How Patty’s Lawyer Never Told Her What She Needed to Know]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/|title=How Patty’s Lawyer Never Told Her What She Needed to Know|last=Skelton Preston|first=Patty|date=2017-03-20|work=How to Get On|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/ Sample Doctor Letters for Disability]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/|title=21 Sample Doctor Letters for Disability|date=2017-05-01|work=How to Get On|access-date=2018-08-09|language=en-US}}</ref>

== Notable studies ==
{{Main article |page_name = Fibromyalgia notable studies}}

== Controversies ==
=== Dr. Frederick Wolfe ===
Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.<ref>{{Cite news|url=http://www.nytimes.com/2008/01/14/health/14pain.html?_r=0|title=Drug Approved. Is Disease Real?|last=Berenson|first=Alex|date=Jan 14, 2008|work=The Wall Street Journal|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>[http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf Fibromyalgia: A Short Commentary - iMedPub Journals - DOI: 10.4172/2472-1913.100027 - Frederick Wolfe and Brian Walitt - Sep. 23, 2016]</ref><ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|journal=Journal of Headache & Pain Management|volume=1|issue=3:27|pages=|via=iMedPub Journals}}</ref><ref>{{Cite news|url=https://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx|title=Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine|last=Cashin-Garbutt|first=April|date=2013-03-22|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Fibromyalgia vs Chiari malformation ===
Some individuals diagnosed with FMS were undergoing surgery for [[Chiari malformation]] (CM). These are two separate conditions; FMS cannot be resolved by undergoing a risky CM surgery.

*2011, [https://www.ncbi.nlm.nih.gov/pubmed/21135714 Is Chiari I malformation associated with fibromyalgia?]<ref>{{Cite journal|last=Watson|first=Nathaniel F.|last2=Buchwald|first2=Dedra|last3=Goldberg|first3=Jack|last4=Maravilla|first4=Kenneth R.|last5=Noonan|first5=Carolyn|last6=Guan|first6=Qingyan|last7=Ellenbogen|first7=Richard G.|date=2011|title=Is Chiari I malformation associated with fibromyalgia?|url=https://www.ncbi.nlm.nih.gov/pubmed/21135714|journal=Neurosurgery|volume=68|issue=2|pages=443–448; discussion 448–449|doi=10.1227/NEU.0b013e3182039a31|issn=1524-4040|pmid=21135714|via=}}</ref>
::Conclusion: Most patients with FM do not have [[CIM]] pathology. Future studies should focus on dynamic neuroimaging of craniocervical neuroanatomy in patients with FM.
*2015, [https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery CFS/FM and Chiari Malformation Surgery]<ref>{{Cite web|url=https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery|title=CFS/FM and Chiari Malformation Surgery|last=Casanova|first=Ken|date=Nov 15, 2015|website=www.massmecfs.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

== Learn more ==
*[https://www.s4me.info/forums/fibromyalgia-and-connective-tissue-disorders.35/ Forum: Fibromyalgia and Connective Tissue Disorders] at [[Science for ME]]
*[[Verywell FMS/CFS]]

=== Ongoing process of diagnosing and categorizing ===

*2014, [http://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114 Lyme Disease, Fibromyalgia Link Evaporates]<ref>{{Cite news|url=https://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114|title=Lyme Disease, Fibromylagia Link Evaporates|last=Kuznar|first=Wayne|date=2014-12-14|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> (See also: [[Chronic lyme disease]])

*2015, [http://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx Fibromyalgia now considered as a lifelong central nervous system disorder]<ref>{{Cite news|url=https://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx|title=Fibromyalgia now considered as a lifelong central nervous system disorder|date=2015-05-18|work=News-Medical.net|access-date=2018-08-09|language=en}}</ref>

*2015, [http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates]<ref>{{Cite news|url=http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html|title=Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates|date=2015-10-24|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2015, ''Question:'' [http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html 'Is Fibromyalgia a Psychosomatic Illness?'] via CelesteCooper.com ''Answer:'' "Fibromyalgia is NOT a psychosomatic illness."<ref>[http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html Is Fibromyalgia a Psychosomatic Illness? Med Student Asks Celeste Cooper by Celeste Cooper - CelesteCooper.com Sep 4, 2015]</ref>

*2016, [http://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination Diagnosing Fibromyalgia May Be Possible Using Noninvasive Eye Examination]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination|title=Diagnosing Fibromyalgia May Be Possible with Noninvasive Eye Exam|date=2016-09-09|work=Fibromyalgia News Today|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780 Microglia in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780|title=Microglia in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*2016, [http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/ Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders?]<ref>{{Cite news|url=http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/|title=Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders? - Simmaron Research|date=2016-03-21|work=Simmaron Research|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://consultqd.clevelandclinic.org/2016/03/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic Why Fibromyalgia Is Neuropathic]<ref>{{Cite news|url=https://consultqd.clevelandclinic.org/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic|title=Why Fibromyalgia Is Neuropathic|date=2016-03-08|work=Consult QD|access-date=2018-08-09|language=en-US}}</ref>

*2017, [http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain]<ref>{{Cite news|url=http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html|title=Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain|last=Liptan|first=Ginevra|date=2017-04-11|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
*2017, [https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947 AI can spot the pain from a disease some doctors still think is fake]<ref>{{Cite news|url=https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&mc_eid=c75cd86947|title=AI can spot the pain from a disease some doctors still think is fake|last=Goldhill|first=Olivia|date=Aug 9, 2018|work=Quartz|access-date=2018-08-15|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== Blood tests ===

*2013, [http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html New Fibromyalgia Blood Test is 99% Accurate]<ref>{{Cite news|url=http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html|title=New Fibromyalgia Blood Test is 99% Accurate|date=2013-07-31|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2014, [http://www.prohealth.com/library/showarticle.cfm?libid=18837 Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”]<ref>{{Cite news|url=https://www.prohealth.com/library/pridgen-reports-fibromyalgia-antiviral-trial-results-very-positive-predicts-new-approach-will-be-game-changer-32620|title=Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”|last=|first=|date=2014-03-25|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2016, [https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html Blood Test for Fibromyalgia: FM/a Test Ⓡ is now available, Q&A]<ref>{{Cite web|url=https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html|title=Blood Test for Fibromyalgia: FM/a Test ® Is Real, Q&A|last=Cooper|first=Celeste|date=May 3, 2016|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2016, [http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/ Fibromyalgia blood testing covered by rising number of insurance companies]<ref>{{Cite news|url=http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/|title=Fibromyalgia blood testing covered more of insurance companies|last=Campbell|first=Julie|date=2016-04-08|work=Live Insurance News|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2017, [http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches]<ref>{{Cite news|url=https://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=Business Wire|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Brain scans ===

*2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds]<ref>{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|publisher=ANAPSID|via=Chronic Neuroimmune Diseases|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2012, [https://www.sciencedaily.com/releases/2012/11/121111153426.htm Fibromyalgia and the brain: New clues reveal how pain and therapies are processed]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2012/11/121111153426.htm|title=Fibromyalgia and the brain: New clues reveal how pain and therapies are processed|last=|first=|date=Nov 11, 2012|work=ScienceDaily|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*2015, [https://www.verywell.com/unique-brain-connectivity-in-fibromyalgia-715630 Unique Brain Connectivity in Fibromyalgia - Increased Importance Assigned to Pain]<ref>{{Cite news|url=https://www.verywellhealth.com/how-lyrica-changes-the-fibromyalgia-brain-715767|title=How Lyrica Changes the Fibromyalgia Brain|last=Dellwo|first=Adrienne|date=Apr 30, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==See also==
* [[Central sensitization]]

* [[Fibromyalgia drugs]]

* [[Fibromyalgia notable studies]]
* [[Influenza vaccine]]

*[[Lady Gaga]]

==References==
<references />

[[Category:Diagnoses]]
[[Category:Comorbidities]]

Names of myalgic encephalomyelitis and chronic fatigue syndrome

2018-08-13T06:59:09Z

77.111.246.7:trying to fix date

The name [[myalgic encephalomyelitis]] was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]<ref>{{Cite journal|last=|first=|date=1957-10-19|title=An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/|journal=British Medical Journal|volume=2|issue=5050|pages=895–904|issn=0007-1447|pmc=|pmid=13472002|via=}}</ref> and is a portmanteau of several of the key signs and symptoms of the disease: myalgic ([[muscle pain]]), encephalo ([[brain]]), myel ([[spinal cord]]), itis ([[inflammation]]).<ref>{{Cite web|url=http://www.investinme.org/Article%20010-Encephalopathy%20Hooper.shtml|title=Invest in ME Research - The Terminology of ME & CFS|last=Hooper|first=Malcolm|date=Feb 2005|website=www.investinme.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}</ref>

Several other names have been used or proposed throughout the history of the disease, including [[atypical polio]], [[Icelandic disease]], benign myalgic encephalomyelitis, [[epidemic neuromyasthenia]], [[chronic fatigue syndrome]], and [[systemic exertion intolerance disease]]. This has lead to much confusion as a variety of names have been used at different times to describe discrete [[outbreaks]], a wider and potentially more heterogenous population of sporadic cases, and with a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|case definitions]].

A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name myalgic encephalomyelitis to other names including [[Chronic Fatigue Syndrome|chronic fatigue syndrome]].<ref>{{Cite web|url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/|title=#MEAction RFI Poll Report (Part 1 of 3) {{!}} #MEAction|last=|first=|date=Aug 7, 2016|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}</ref> Most government agencies and researchers around the world use the term [[ME/CFS]].{{Citation needed}}

== References ==
<references />

Names of myalgic encephalomyelitis and chronic fatigue syndrome

2018-08-13T06:52:08Z

77.111.246.7:citations converted, internal links

The name [[myalgic encephalomyelitis]] was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]<ref>{{Cite journal|last=|first=|date=1957-10-19|title=An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/|journal=British Medical Journal|volume=2|issue=5050|pages=895–904|issn=0007-1447|pmc=|pmid=13472002|via=}}</ref> and is a portmanteau of several of the key signs and symptoms of the disease: myalgic ([[muscle pain]]), encephalo ([[brain]]), myel ([[spinal cord]]), itis ([[inflammation]]).<ref>{{Cite web|url=http://www.investinme.org/Article%20010-Encephalopathy%20Hooper.shtml|title=Invest in ME Research - The Terminology of ME & CFS|last=Hooper|first=Malcolm|date=Feb, 2005|website=www.investinme.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}</ref>

Several other names have been used or proposed throughout the history of the disease, including [[atypical polio]], [[Icelandic disease]], benign myalgic encephalomyelitis, [[epidemic neuromyasthenia]], [[chronic fatigue syndrome]], and [[systemic exertion intolerance disease]]. This has lead to much confusion as a variety of names have been used at different times to describe discrete [[outbreaks]], a wider and potentially more heterogenous population of sporadic cases, and with a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|case definitions]].

A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name myalgic encephalomyelitis to other names including [[Chronic Fatigue Syndrome|chronic fatigue syndrome]].<ref>{{Cite web|url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/|title=#MEAction RFI Poll Report (Part 1 of 3) {{!}} #MEAction|last=|first=|date=Aug 7, 2016|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}</ref> Most government agencies and researchers around the world use the term [[ME/CFS]].{{Citation needed}}

== References ==
<references />

Outbreaks

2018-08-13T06:51:24Z

77.111.246.7:change

#redirect [[List of myalgic encephalomyelitis and chronic fatigue syndrome outbreaks]]

Myalgic encephalomyelitis

2018-08-13T06:35:51Z

77.111.246.7:/* Signs and Symptoms */ internal links

'''Myalgic Encephalomyelitis''' (ME) is a chronic, [[inflammatory]], physically and [[neurological|neurologically]] disabling disease that presents with symptoms involving multiple bodily systems. Frequently triggered by a [[viral infection]], it affects the [[central nervous system]] (CNS), [[autonomic nervous system]] (ANS), [[immune system]], [[cardiovascular system]], [[endocrine system]], [[digestive system]], and [[musculoskeletal system]].<ref>[https://rarediseases.org/rare-diseases/myalgic-encephalomyelitis/ Myalgic Encephalomyelitis - NORD]</ref><ref>[http://paradigmchange.me/wp-content/uploads/2016/04/ME-CFS-Medical-Abormalities-040416.pdf Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS) Medical Abnormalities Research Citations Compiled by Lisa Petrison, Ph.D.Updated April 4, 2016 - PDF]</ref> It has been classified by the [[World Health Organization]] (WHO) as a neurological disease since 1969<ref>[https://en.wikipedia.org/wiki/History_of_chronic_fatigue_syndrome#International_classifications History of chronic fatigue syndrome - International Classifications]</ref><ref>[http://www.name-us.org/DefintionsPages/DefinitionsArticles/Hoopersdescription.pdf The Terminology of ME & CFS By Professor Malcolm Hooper - PDF]</ref> and has occurred in both [[Epidemic myalgic encephalomyelitis|epidemic]] and sporadic forms since at least the 1930s.

A hallmark symptom of ME is [[Post-exertional malaise|post-exertional malaise]] (PEM), which is an intolerance to previously achievable cognitive or physical effort.<ref name=":0">[https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/me-cfs ME/CFS - Pathways to Prevention - NIH]</ref><ref name=":1">[http://www.meactionuk.org.uk/definition.html Research Descriptions of M.E. - ME Action UK]</ref><ref name=":2">[http://www.cfids-me.org/ramsay86.html The Clinical Features of Myalgic Encephalomyelitis Melvin Ramsay, M.D., 1986]</ref><ref name=":3">[https://www.verywell.com/what-is-post-exertional-malaise-716023 What Is Post-exertional Malaise - Very Well - Adrienne Dellwo]</ref><ref name=":4">[https://www.verywell.com/post-exertional-malaise-715670 Post Exertional Malaise - Very Well - Adrienne Dellwo]</ref><ref name=":5">[http://www.webmd.com/chronic-fatigue-syndrome/chronic-fatigue-syndrome-symptoms Chronic Fatigue Syndrome - Web MD]</ref><ref name=":6">[http://solvecfs.org/wp-content/uploads/2013/10/pem-series.pdf PEM Series - Solve ME/CFS - Jenny Spotila]</ref> Other key symptoms include [[muscle]] [[Muscle weakness|weakness]] and easy [[Muscle fatigability|fatiguability]], [[sleep disturbance]], and [[cognitive dysfunction]]. [[Autonomic nervous system]] dysfunction is frequent, although specific symptoms vary from patient to patient and may include [[Postural orthostatic tachycardia syndrome|postural orthostatic tachycardia]], [[Orthostatic intolerance|orthostatic hypotension]], [[cold intolerance]] and [[heat intolerance]]. Other common symptoms include [[myalgia]] (muscle pain), [[neuralgia]] (neuropathic pain), neck and spine stiffness, and sensory symptoms including [[sensitivity to light]], sound, [[touch]], [[Paresthesia|paraesthesia]] (skin tingling or numbness) and hyperaesthesia (skin sensitivity and pain).

Among adults, ME is more common in women than men. New onset has been observed in children and in adults as old as 80 years old. Its course is usually relapsing-remitting with new symptoms occurring either in discrete relapses (or 'crashes') or accruing over time.<ref>[http://www.medscape.com/viewarticle/871482 Postexertion 'Crash,' not Fatigue per se, Marks Syndrome - MedScape]</ref> There is a progressive form of ME but it is rarer than the relapsing-remitting type.<ref>[http://www.meassociation.org.uk/wp-content/uploads/fulltext_pmr-v2-id10521.pdf Progressive Myalgic Encephalomyelitis (ME) or A New Disease? A Case Report]</ref>

There are no approved pharmacological treatments for ME anywhere in the world, except in [[Argentina]], which has approved the immunomodulator [[Ampligen]] for [[ME/CFS]] as off August 23, 2016.<ref>{{Cite news|title=Hemispherx Biopharma Announces Major Breakthrough: Approval for Commercial Sale of Rintatolimod (U.S. Tradename: Ampligen®) to Treat Severe Cases of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in the Argentine Republic|url=http://www.globenewswire.com/news-release/2016/08/23/866212/0/en/Hemispherx-Biopharma-Announces-Major-Breakthrough-Approval-for-Commercial-Sale-of-Rintatolimod-U-S-Tradename-Ampligen-to-Treat-Severe-Cases-of-Myalgic-Encephalomyelitis-Chronic-Fat.html|work=GlobeNewswire News Room|access-date=2018-08-12|language=en-US|first=Hemispherx Biopharma,|last=Inc.|date=Aug 23, 2016|archive-url=|archive-date=|dead-url=}}</ref>
== History ==

{{Main article | History of myalgic encephalomyelitis and chronic fatigue syndrome}}

ME has occurred in both [[Epidemic myalgic encephalomyelitis|epidemic]] and sporadic form since at least the 1930s, although is probably much older. The first recorded outbreak of epidemic myalgic encephalomyelitis was in [[1934 Los Angeles atypical polio outbreak|1934 in Los Angeles]] and was thought to be an outbreak of atypical [[polio]]. After the outbreak in [[Akureyri]], Iceland in 1946, the disease came to be called 'Akureyri Disease' or [[Icelandic disease]] through much of the 1940s and 1950s. It was named [[Myalgic Encephalomyelitis|myalgic encephalomyelitis]] after London's [[Royal Free Hospital outbreak]] in 1955. Other names included benign myalgic encephalomyelitis and epidemic neuromyasthenia.

After the [[1984 Incline Village chronic fatigue syndrome outbreak|Incline Village]] outbreak in Nevada in 1984, the disease came to be called and redefined as [[Chronic Fatigue Syndrome]]. The most recent was putative outbreak was in Arizona in 1996.

==Disease Name==

{{Main article | Names of myalgic encephalomyelitis and chronic fatigue syndrome}}
* ''Myalgic adj. - of or relating to [[myalgia]].'' Is [[muscle pain]].<ref>{{Cite news|url=https://www.thefreedictionary.com/myalgic|title=myalgic|work=TheFreeDictionary.com|access-date=2018-08-12}}</ref>

* ''Encephalo'': Refers to the [[brain]].<ref>{{Cite news|url=https://medical-dictionary.thefreedictionary.com/encephalo-|title=encephalo-|work=TheFreeDictionary.com|access-date=2018-08-12}}</ref>

* ''Myel'': Relating to the [[spinal cord]].<ref>{{Cite news|url=https://www.thefreedictionary.com/myel-|title=myel-|work=TheFreeDictionary.com|access-date=2018-08-12}}</ref>

* ''Itis'': [[Inflammation]].<ref>{{Cite news|url=https://www.thefreedictionary.com/-itis|title=Itis|work=TheFreeDictionary.com|access-date=2018-08-12|last=|first=|date=|archive-url=|archive-date=|dead-url=}}</ref>
The name myalgic encephalomyelitis<ref>{{Cite news|url=https://www.verywell.com/myalgic-encephalomyelitis-me-715663|title=Myalgic Encephalomyelitis: Chronic Fatigue Syndrome's Other Name|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-12|archive-url=|archive-date=|dead-url=}}</ref> was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]<ref>[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/ An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955 - The Medical Staff Of The Royal Free Hospital]</ref> and is a portmanteau of several of the key signs and symptoms of the disease: myalgic (muscle pain), encephalo (brain), myel (spinal cord), itis (inflammation).<ref>[http://www.name-us.org/DefintionsPages/DefinitionsArticles/Hoopersdescription.pdf The Terminology of ME & CFS By Professor Malcolm Hooper]</ref>

Several other names have been used or proposed throughout the history of the disease, including [[atypical polio]], [[Icelandic disease]], benign myalgic encephalomyelitis, [[epidemic neuromyasthenia]], [[chronic fatigue syndrome]], and [[systemic exertion intolerance disease]]. This has lead to much confusion as a variety of names have been used at different times to describe discrete outbreaks as well as a larger and potentially more heterogenous population of sporadic cases, defined by a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|case definitions]].

A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name myalgic encephalomyelitis to other names including [[Chronic Fatigue Syndrome|chronic fatigue syndrome]].<ref>[http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/ MEAction RFI Poll Report (Part 1 of 3)]</ref> Most government agencies and researchers around the world use the term [[ME/CFS]].{{Citation needed}}

== Onset ==
Following after an incubation period of 4 to 7 days, the prodromal phase generally involve a flu-like illness with low-grade fever. In the majority but not all cases, an infection or infectious process is evident.<ref>[http://www.nightingale.ca/documents/Nightingale_ME_Definition_en.pdf ME Definition - Nightingale - PDF pg. 6]</ref> Two to seven days later, a chronic phase commences, characterized by a measurable diffuse change in the function of the [[central nervous system]]. It is this second phase, persistent phase that is most ME.<ref>[http://www.nightingale.ca/documents/Nightingale_ME_Definition_en.pdf ME Definition - Nightingale - PDF pg. 6]</ref>

In some patients, the initial presentation involved a severe, incapacitating prolonged illness. In others, an apparent remission was followed by relapses brought on by exertion, [[menstrual period]], or cold.
==Signs and Symptoms==

Symptoms can range from mild to very severe and can include:

<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">

*[[low-grade fever]], [[Temperature dysregulation|temperature instability]]
*[[post-exertional malaise]]
*[[Cognitive dysfunction]]
*[[muscle]] [[Muscle weakness|weakness]] and [[Muscle fatigability|fatiguability]]
*[[Headache]]
*[[myalgia|myalgia (muscle pain)]]
*[[neuralgia|neuralgia (nerve pain)]]
*[[ataxia|ataxia (coordination difficulties)]]
*[[gastrointestinal]] symptoms
*[[sleep dysfunction]]
*neck and back or spinal cord stiffness
*sensitivity to [[Light sensitivity|light]], [[Hyperacusis|sound]] and/or [[Allodynia|touch]]
*sensitivity to [[Temperature sensitivity|heat or cold]]

</div>

Symptoms presentation and severity can vary considerably day to day and even hour to hour.<ref>[https://rarediseases.org/rare-diseases/myalgic-encephalomyelitis/ Myalgic Encephalomyelitis - NORD]</ref> Overexertion can make all symptoms worse, the effects are often delayed and may not be seen within 24 hours.<ref>[http://www.investinme.org/landerP5.shtml What is ME - Invest in ME Research]</ref> <ref>[https://rarediseases.org/rare-diseases/myalgic-encephalomyelitis/ Myalgic Encephalomyelitis - NORD]</ref> The US [[National Institutes of Health]] notes that sensitivity to noise, light and chemicals may force patients to withdraw from society.<ref>[https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/me-cfs ME/CFS - Pathways to Prevention - Advancing the Research on Myalgic encephalomyelitis/Chronic Fatigue Syndrome]</ref>

The severity of a patient's symptoms often depends on the time period since the disease was contacted and rate of progression of each patient. The rate of progression can be accelerated by physical or cognitive activity beyond a patient's limits, which typically entails anaerobic activity <ref>{{Cite web|url=https://www.me-pedia.org/wiki/Unrest|title=Unrest - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-08-12}}</ref>

=== Post-exertional malaise ===
{{Main article | Post-exertional malaise}}
A core symptom, [[Post-exertional malaise]], is intolerance to previously trivial effort such as walking to the mailbox, running an errand or grocery shopping, taking a shower or brushing teeth, and deterioration of health from persistent or repeated exertion.<ref name=":0" /><ref name=":1" /><ref name=":2" /><ref name=":3" /><ref name=":4" /><ref name=":5" /><ref name=":6" />

== Clinical Findings ==
Although there is no definitive [[biomarker]], several signs and findings have been frequently observed in clinical settings:<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">

*reaction to physical and mental activity and sensory input
*[[Postural orthostatic tachycardia syndrome|postural orthostatic tachychardia]]
*[[Hormones|hormone]] imbalance
*[[Immune system|immunological abnormalities]]
*[[Natural Killer Cell (NKC) function|low natural killer cell function]]
*high titers to specific infection
*low red blood cell [[magnesium]]

</div>
==Diagnosis==

{{Main article | Definitions of myalgic encephalomyelitis and chronic fatigue syndrome}}

There are several proposed criteria for diagnosing ME including the [[International Consensus Criteria]] (ICC) and the [[Canadian Consensus Criteria]] (CCC). The original criteria developed by [[Melvin Ramsay]], the [[Ramsay definition]], is not used for diagnosing ME today.

=== Other diagnostic criteria ===
Several, overly broad criteria have been proposed and are in use. These criteria likely capture some patients with the disease characterized in the medical literature on [[Epidemic myalgic encephalomyelitis|epidemic ME]], exclude others, and also include patients with a wide range of other undiagnosed conditions including cancer, depression, and a range of autoimmune diseases. The United Kingdom's [[Oxford criteria]] is the broadest and likely most heterogenous definition. (The US [[Institute of Medicine report]] called for its complete retirement<ref>[http://theargusreport.com/us-nih-report-calls-uk-definition-mecfs-scrapped/ US NIH Report Calls for UK Definition of ME/CFS to be Scrapped]</ref>). The US [[Centers for Disease Control and Prevention|Centers for Disease Control]]'s [[Fukuda criteria]], in use since 1994, is also overly broad.

===Differential diagnosis===
The signs and symptoms of ME can be similar to other medical problems, "such as cancer, [[multiple sclerosis]], lupus, [[brucellosis]], or another condition."<ref>[https://www.dartmouth-hitchcock.org/medical-information/health_encyclopedia/nord792 Dartmouth Hitchock - Myalgic Encephalomyelitis National Organization for Rare Disorders, Inc.]</ref> Additional testing may be needed to help distinguish ME from these other problems.

==Course and Prognosis ==
ME relapses are often a result of over-activity, but can occur without warning with no obvious inciting factors. Exposure to increased sensory information in light, sound, and movement can provoke a sensory storm.

Infections, such as the common cold, influenza and gastroenteritis, also increase the risk for a relapse. Heat and cold can transiently increase symptoms.

Pregnancy can directly affect the susceptibility for relapse. Later pregnancy appears to offer a natural protection against relapses, and there are anecdotal reports of postpartum remission. However, pregnancy does not seem to influence long-term disability.

"The later course of ME is difficult to predict, and may either become consistently severe, improve to a plateau, or be markedly relapse-remitting. In some, even prolonged severe incapacitation can be relieved by unpredictable remission, although relapse is always possible. The degree of impairment and complexity depends on the degree of diffuse brain injury and end organ involvement."<ref>[https://arainbowatnight.com/whatisme/#Signs_and_symptoms What Is ME? - Disease course and clinical subtypes - A rainbow at night]</ref>

==Clinical Subtypes==
There are no standard subtypes. Some researchers and clinicians have proposed distinguishing between a relapsing-remitting and progressive course.{{Citation needed}} However, it is difficult to distinguish between natural variation in the population of ME patients who might share a common disease process but owing to individual, genetic, or environmental differences, have different symptom clusters or disease course versus heterogeneity created by imprecise criteria and misdiagnosis.<ref>[https://arainbowatnight.com/whatisme/#Signs_and_symptoms What Is ME? - Disease course and clinical subtypes - A rainbow at night]</ref>

Kerr et al proposed 7 different subsets for 'CFS' as it is defined today:<ref>[http://me-ireland.com/genes2.pdf Seven genomic subtypes of chronic fatigue syndrome/myalgic encephalomyelitis: a detailed analysis of gene networks and clinical phenotypes - JCP Online]</ref>

* Subtype 1 This is one of the more severe subtypes. Effects are cognitive, musculoskeletal, sleep-related and anxiety/depression.

* Subtype 2 This is one of the more severe subtypes. Effects are musculoskeletal, pain and anxiety/depression.

* Subtype 3 This subtype has the mildest symptoms.

* Subtype 4 This subtype is dominated by cognitive issues.

* Subtype 5 Effects are musculoskeletal and gastrointestinal.

* Subtype 6 This subtype is dominated by post-exertional malaise (extreme crash after exercise or exertion.)

* Subtype 7 This is one of the more severe subtypes. Effects are pain, infections, musculoskeletal, sleep-related, neurological, gastrointestinal, neurocognitive and anxiety/depression.

==Pathophysiology==
{{Main article | List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis}}

ME is a multi-system disease. Numerous biological abnormalities have been found in multiple bodily system, however no common, central cause or mechanism has yet been elucidated.

=== Central nervous system ===
{{Main article |Central nervous system}}Radiological research on ME has shown hypoperfusion of the brain stem and an abnormal response to exertion, but research on CFS is often inconsistent and must be interpreted with caution. For example, some research stated that a reduced volume of grey matter may be a result of a lack of activity and is reversible with cognitive behavior therapy.

=== Autonomic nervous system ===
{{Main article |Autonomic nervous system}}

=== Peripheral nervous system ===
{{Main article |Peripheral nervous system}}

=== Musculoskeletal system ===
{{Main article |Muscle}}

=== Immune system ===
{{Main article |Immune system}}

According to a strictly immunological explanation of CFS, the inflammatory processes triggered by [[T cell]]s create leaks in the [[blood-brain barrier]] (a capillary system that should prevent entrance of T-cells in the nervous system). These leaks, in turn, cause a number of other damaging effects such as swelling, activation of macrophages, and more activation of [[cytokine]]s and other destructive proteins such as [[RNase L|Rnase-L]]. [[Channelopathy]], a reduced ability to move metabolites in and out of cells has been implicated in this process. This may also be applicable to ME.

=== Chronic infection ===
Some evidence shows viral infection of muscle and brain in at least a proportion of sufferers. This triggers inflammatory processes, stimulating other immune cells and soluble factors like cytokines and antibodies. A model for late ME has been proposed analogously to post-polio syndrome in which repaired nerve tissue forms inappropriately [The Late Effects of ME: Can they be distinguished from the post-polio syndrome?].

=== Cardiovascular ===
Hemodynamic abnormalities are widely found, including serum and RBC hypovolemia, NMH, and cerebral hypoperfusion. Vascular and endothelial abnormalities have been published by MERUK. However, none of these studies used research criteria for ME so the results may not be applicable to ME.

Some cardiologic features such as cardiac insufficiency, inverted T-waves and myofiber disarray have been reported in CFS and recently added to by findings of reduced Q-value. This has led clinician and researcher Dr Paul Cheney to posit that CFS is form of partially compensated cardiomyopathy in which [[orthostatic intolerance]] and rapid fatiguability are secondary protective mechanisms. Due to the heterogeneity of the population, a single cause is unlikely, but one-third of people with ME have abnormalities when tested with Holter monitors.

=== Gastrointestinal system ===
{{Main article |Gastrointestinal system}}

== Sex Differences ==
{{Main article | Sex differences in myalgic encephalomyelitis and chronic fatigue syndrome}}
A Norwegian [[CFS/ME]] study shows that the disease affects all ages, with two peak ages of 10-19 years and 30-39 years; it is more common in women than in men.<ref>[http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0167-5 Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012 - BMC Medicine]</ref> Research by the [[Open Medicine Foundation]] cited in its paper, [[Metabolic features of chronic fatigue syndrome]] which studied severe [[CFS]], found that the disease is different in men and women but this is not related to testosterone or estrogen. [[Michael VanElzakker]] notes there are [http://me-pedia.org/wiki/Michael_VanElzakker#Male_and_female_differences_in_neuropathic_pain male and female differences in neuropathic pain]. A study of UK and Dutch cohorts found "younger children had a more equal gender balance compared to adolescents and adults."<ref>[https://www.ncbi.nlm.nih.gov/pubmed/26510728 Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is different in children compared to in adults: a study of UK and Dutch clinical cohorts. BMJ Open - PubMed]</ref>

==Risk Factors and Potential Causes==

{{Main article | Risk factors and potential causes of myalgic encephalomyelitis and chronic fatigue syndrome}}

===Risk factors===

===Potential causes===

Although risk factors for myalgic encephalomyelitis have been identified, no single definitive virus has been found in all cases, which has led to the claim that ME is a common end path of a variety of infectious insults.<ref>[http://via.library.depaul.edu/csh_etd/117/ Onset Patterns of Chronic Fatigue Syndrome and Myalgic Encephalomyelitis: A Mixed Method Approach - Meredyth Evans - DePaul University]</ref><ref>[http://me-pedia.org/wiki/Vagus_nerve_infection_hypothesis Vagus nerve infection hypothesis - MEpedia]</ref><ref>[http://www.clevelandclinicmeded.com/online/casebased/decisionmaking/chronic-fatigue/case3.htm Chronic Fatigue Syndrome - Cleveland Clinic]</ref><ref>[https://www.ncbi.nlm.nih.gov/pubmed/26475444/ Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine. - PubMed]</ref> It is still possible ME involves some combination of both environmental and genetic factors. Various theories try to combine the known data into plausible explanations.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/26604026 Myalgic encephalomyelitis, chronic fatigue syndrome: An infectious disease. Myalgic encephalomyelitis, chronic fatigue syndrome: An infectious disease. RA Underhill - PubMed]</ref><ref>[http://www.nature.com/tp/journal/v6/n2/full/tp2015208a.html Genome-wide association analysis identifies genetic variations in subjects with myalgic encephalomyelitis/chronic fatigue syndrome]</ref> Several theories suggest that ME is an inappropriate immune response to an infection, a theory bolstered by the observation that there is sometimes a family history of [[autoimmune disease]].<ref>[https://www.facebook.com/permalink.php?story_fbid=564532390371988&id=564526123705948 Klimas ME/CFS Genes Study - Face Book - Video]</ref> There is also a shift from the [[Th1]] type of helper [[T cell]]s, which fight infection, to the [[Th2]] type, which are more active in allergy and more likely to attack the body.<ref>[http://www.sciencedirect.com/science/article/pii/S1043466614006024 Cytokine expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis - ScienceDirect]</ref><ref>[http://www.m-hikari.com/bmgt/bmgt2014/bmgt1-4-2014/hardcastleBMGT1-4-2014.pdf Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and the Potential Role of T Cells - Biological Markers and Guided Therapy, Vol. 1, 2014, no. 1, 25 -38 - PDF]</ref>

===Viruses===

{{Main article | Viruses}}

Other theories describe ME as an immune response to a chronic infection. The association between ME and the [[Coxsackie B]], [[HHV-6]], and [[HHV-7]] viruses<ref>[https://www.ncbi.nlm.nih.gov/pubmed/2841461 Coxsackie B viruses and myalgic encephalomyelitis.]</ref><ref>[http://solvecfs.org/ramsay-research-team-5-the-potential-role-of-hhv-6-in-mecfs/ Ramsay Research Team 5 – The Potential Role of HHV-6 in ME/CFS]</ref> <ref>[https://www.ncbi.nlm.nih.gov/pubmed/22927850 Association of active human herpesvirus-6, -7 and parvovirus b19 infection with clinical outcomes in patients with myalgic encephalomyelitis/chronic fatigue syndrome.]</ref> suggests a potential viral contribution in at least some individuals. Evidence from [[epidemic myalgic encephalomyelitis]] strongly point to an enterovirus, however, in most outbreaks, no virus was successfully isolated.

=== Bacteria ===

{{Main article | Bacteria}}

Others believe ME may sometimes result from a chronic infection with spirochetal bacteria, such as [[Lyme disease]]. Another bacterium that has been implicated in ME is [[Chlamydia pneumoniae]].<ref>[http://med.stanford.edu/chronicfatiguesyndrome/infections/chlamydia/chlamydia-experts.html Chlamydia Pneumoniae - Stanford Myalgic Encephalomyelitis/Chronic Fatigue syndrome Initiative]</ref> Protein findings relating to several infections have seen found in the oligoclonal bands ME of patients.<ref>[http://www.nytimes.com/health/guides/test/csf-oligoclonal-banding/overview.html CSF Oligoclonal Banding - NY Times]</ref>

The [[Vagus nerve infection hypothesis]] accounts for why so many different infectious onsets could be responsible. The vagus nerve runs from the brain stem and throughout the body and has an impact on many body systems.

Given the uncertainty regarding the cause, ME and CFS patients are barred from donating blood or organs in the [[United Kingdom]], [[United States]] and [[New Zealand]] while symptoms persist.<ref>[http://www.meassociation.org.uk/2010/08/people-with-mecfs-to-be-permanently-excluded-from-giving-blood-in-the-uk-from-1-november-this-year-department-of-health-announcement/ People with ME/CFS to be permanently excluded from giving blood in the UK from 1 November this year – Department of Health announcement - ME Association]</ref><ref>[http://www.redcrossblood.org/news/northcentral/american-red-cross-statement-xmrv-and-chronic-fatigue-syndrome American Red Cross Statement on XMRV and Chronic Fatigue Syndrome - American Red Cross]</ref><ref>[http://www.washingtonpost.com/wp-dyn/content/article/2010/12/03/AR2010120305888.html Chronic fatigue patients barred from blood donation - Washington Post - By: Rob Stein - Dec 3, 2010]</ref><ref>[http://www.nzblood.co.nz/Give-blood/Donating/Detailed-eligibility-criteria#C - NZBlood]</ref>

==Treatments==

{{Main article | Potential treatments for myalgic encephalomyelitis and chronic fatigue syndrome}}

There is no cure for ME and no country as approved any pharmacological treatment for the disease except, [[Argentina]] which has approved [[Ampligen]] for the treatment of [[chronic fatigue syndrome]]. However the effectiveness of Ampligen is under dispute<ref>{{Cite web|url=https://www.bizjournals.com/philadelphia/stories/2009/11/30/daily23.html|title=https://www.bizjournals.com/philadelphia/stories/2009/11/30/daily23.html|website=www.bizjournals.com|access-date=2018-08-12}}</ref>. Other off label medications have been used with varying effectiveness in some patients.<ref>{{Cite web|url=https://www.me-pedia.org/wiki/Valganciclovir|title=Valganciclovir - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-08-12}}</ref><ref>{{Cite web|url=https://www.me-pedia.org/wiki/Oxymatrine|title=Oxymatrine - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-08-12}}</ref>

Treatments for sleep problems, headaches and pain are utilized by some doctors for some patients although these are treating symptoms and not ME itself.

Success of treating symptoms of ME is not well researched or documented.

Treatments being trialled include an antiviral drug called [[Ampligen]] (now approved for use on [[ME/CFS]] patients in [[Argentina]]) and an immune system modulator drug called [[Rituximab]].<ref>[http://www.prohealth.com/me-cfs/me-chronic-fatigue-syndrome-experimental-treatments.cfm Chronic Fatigue Syndrome & Myalgic Encephalomyelitis Experimental Treatments - ProHealth (Ampligen and Rituximab Tabs]</ref>

==Epidemiology==

{{Main article | Epidemiology of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome}}

ME has been found world-wide, in at least 75 [[Outbreaks|epidemics]] documented in published papers from the 1930s to the 1980s.<ref>[http://www.hfme.org/methemedicalfacts.htm Myalgic Encephalomyelitis: The medical facts - What causes Myalgic Encephalomyelitis? Are there outbreaks of M.E.?]</ref> Epidemics often occur in enclosed communities such as schools and hospitals.

As observed in many autoimmune disorders, ME is more common in females than males; the mean sex ratio is approxmately 2-3 females for every male.<ref>[http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0167-5 Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012 - BMC Medicine]</ref> In children the sex ratio is approximately equal.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/26510728 Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is different in children compared to in adults: a study of UK and Dutch clinical cohorts. BMJ Open - PubMed]</ref>

== Co-morbidities ==
Clinicians have observed several predisposing conditions, co-morbidities, overlapping conditions,<ref>{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions – American ME and CFS Society|website=ammes.org|language=en-US|access-date=2018-08-12}}</ref> and increased risks for secondary diseases in patients with ME. However, as no large-scale epidemiological studies, genetic studies, or family studies have been done, there is little that can be said definitively about the rate or underlying biological reasons for these potentially related conditions. Overlapping diagnostic criteria and the lack of a biomarker in many of these conditions add to the confusion and diagnostic uncertainty. Moreover, certain conditions such as [[postural orthostatic tachycardia syndrome]] (POTS) and [[idiopathic intracranial hypertension|intracranial hypertension]] (IIH) are symptoms that can occur in or be co-morbid with numerous conditions, including ME.

The following are some syndromes and diseases that have been associated with or misdiagnosed as ME:

<div style="column-count:2;-moz-column-count:2;-webkit-column-count:2">
*[[fibromyalgia]]
*[[Chronic lyme disease|chronic Lyme disease]]
*[[Postural orthostatic tachycardia syndrome|postural orthostatic tachychardia syndrome]]
*[[mast cell activation disorder]]
*[[small intestinal bacterial overgrowth]] (SIBO)
*[[thyroid disease]]
*[[Ehlers-Danlos syndrome]]
*[[endometriosis]]
*[[Sjögren's syndrome]]
*[[mold illness]]
*[[multiple chemical sensitivity]]
*[[environmentally acquired illness]]
*[[chronic inflammatory response syndrome]]
*[[cancer]]
*[[idiopathic intracranial hypertension]]
*[[Chiari malformation]]
*[[craniocervical instability]]
*See more [[:Category:Diagnoses|diagnoses]].

</div>

== See also ==

*[[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome]]
*[[List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis]]

== References ==

[[Category:Diagnoses]]
[[Category:Disease names]]
<references />

Dorsal root ganglion

2018-08-13T04:47:49Z

77.111.246.7:.

[[File:Dorsal Root Ganglion.JPG|400px|thumb|right|Dorsal Root Ganglion]]
[[File:Spinal Cord Sectional Anatomy.png|300px|thumb|right|Spinal Cord Sectional Anatomy (Note: Dorsal root and Dorsal root ganglion)]]

[[Dorsal root ganglia]] (DRG) is "a nodule in a dorsal root that contains cell bodies of neurons in afferent spinal nerves."<ref name=":0">{{Cite web|url=https://www.thefullwiki.org/Dorsal_root_ganglia|title=Dorsal root ganglia : Wikis (The Full Wiki)|website=www.thefullwiki.org|language=en|access-date=2018-08-13}}</ref> They lie along the vertebral column by the spine. The dorsal root ganglia "contain the cell bodies of afferent nerve fibres (those carrying impulses toward the [[central nervous system]]); efferent neurons (carrying motor impulses away from the central nervous system) are present in the ventral root ganglia."<ref>{{Cite news|url=https://www.britannica.com/science/ganglion#ref114478|title=Ganglion {{!}} physiology|work=Encyclopedia Britannica|access-date=2018-08-13|language=en}}</ref>

The neuron is parted of two parts:

#[https://en.wikipedia.org/wiki/Dendrite Dendrite]<ref>{{Cite journal|date=2018-06-06|title=Dendrite|url=https://en.wikipedia.org/w/index.php?title=Dendrite&oldid=844690110|journal=Wikipedia|language=en}}</ref> receives the information and sends it to the Perykaron (cytoplasm which is around the nucleus).
#[https://en.wikipedia.org/wiki/Axon Axon]<ref>{{Cite journal|date=2018-07-23|title=Axon|url=https://en.wikipedia.org/w/index.php?title=Axon&oldid=851666075|journal=Wikipedia|language=en}}</ref> takes this information and sends forward.

[[File:Dorsal Root Ganglion Chicken.JPG|200px|thumb|right|"This is a dorsal root ganglion (DRG) from a chicken embryo (around stage of day 7) after incubation overnight in NGF growth medium stained with anti-neurofilament antibody. Axons growing out of the ganglion are visible."<ref name=":0" />]]

== Dorsal root ganglia in ME/CFS ==
[[Inflammation]] of the DRG has been found in the autopsies of several very severely ill [[Myalgic encephalomyelitis]] patients including [[Lynn Gilderdale|Lynn Gilderdale]], [[Sophia Mirza]] and [[Merryn Crofts]].

== Learn more ==
*[https://www.thefullwiki.org/Dorsal_root_ganglion Dorsal root ganglion: Wikis]<ref name=":0" /> Images and diagrams.
*[http://eugraph.com/histology/nervous/drgang.html Histology Photomicrographs]<ref>{{Cite web|url=http://eugraph.com/histology/nervous/drgang.html|title=Histology Photomicrographs - Dorsal root ganglion|last=Hart|first=Karen|date=|website=eugraph.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}</ref>
*[https://www.youtube.com/watch?v=oTPqAYqMsFk Shotgun Histology Dorsal Root Ganglion]<ref>{{Cite web|url=https://www.youtube.com/watch?v=oTPqAYqMsFk|title=Shotgun Histology Dorsal Root Ganglion|last=|first=|date=Aug 23, 2007|website=YouTube|publisher=WashingtonDeceit|archive-url=|archive-date=|dead-url=|access-date=}}</ref> Video

== See also ==
*[[Glial cell]]
*[[Microglia]]
*[[Nervous system]]

== References ==

[[Category:Body systems]]
[[Category:Central Nervous System]]
[[Category:Neurology]]
<references />

Dorsal root ganglion

2018-08-13T04:44:34Z

77.111.246.7:merged citation

[[File:Dorsal Root Ganglion.JPG|400px|thumb|right|Dorsal Root Ganglion]]
[[File:Spinal Cord Sectional Anatomy.png|300px|thumb|right|Spinal Cord Sectional Anatomy (Note: Dorsal root and Dorsal root ganglion)]]

[[Dorsal root ganglia]] (DRG) is "a nodule in a dorsal root that contains cell bodies of neurons in afferent spinal nerves."<ref name=":0">{{Cite web|url=https://www.thefullwiki.org/Dorsal_root_ganglia|title=Dorsal root ganglia : Wikis (The Full Wiki)|website=www.thefullwiki.org|language=en|access-date=2018-08-13}}</ref> They lie along the vertebral column by the spine. The dorsal root ganglia "contain the cell bodies of afferent nerve fibres (those carrying impulses toward the [[central nervous system]]); efferent neurons (carrying motor impulses away from the central nervous system) are present in the ventral root ganglia."<ref>{{Cite news|url=https://www.britannica.com/science/ganglion#ref114478|title=Ganglion {{!}} physiology|work=Encyclopedia Britannica|access-date=2018-08-13|language=en}}</ref>

The neuron is parted of two parts:

#[https://en.wikipedia.org/wiki/Dendrite Dendrite]<ref>{{Cite journal|date=2018-06-06|title=Dendrite|url=https://en.wikipedia.org/w/index.php?title=Dendrite&oldid=844690110|journal=Wikipedia|language=en}}</ref> receives the information and sends it to the Perykaron (cytoplasm which is around the nucleus)
#[https://en.wikipedia.org/wiki/Axon Axon]<ref>{{Cite journal|date=2018-07-23|title=Axon|url=https://en.wikipedia.org/w/index.php?title=Axon&oldid=851666075|journal=Wikipedia|language=en}}</ref> takes this information and sends forward

[[File:Dorsal Root Ganglion Chicken.JPG|200px|thumb|right|"This is a dorsal root ganglion (DRG) from a chicken embryo (around stage of day 7) after incubation overnight in NGF growth medium stained with anti-neurofilament antibody. Axons growing out of the ganglion are visible."<ref name=":0" />]]

== Dorsal root ganglia in ME/CFS ==
[[Inflammation]] of the DRG has been found in the autopsies of several very severely ill [[Myalgic encephalomyelitis]] patients including [[Lynn Gilderdale|Lynn Gilderdale]], [[Sophia Mirza]] and [[Merryn Crofts]].

== Learn more ==
*[https://www.thefullwiki.org/Dorsal_root_ganglion Dorsal root ganglion: Wikis]<ref name=":0" /> Images and diagrams.
*[http://eugraph.com/histology/nervous/drgang.html Histology Photomicrographs]<ref>{{Cite web|url=http://eugraph.com/histology/nervous/drgang.html|title=Histology Photomicrographs - Dorsal root ganglion|last=Hart|first=Karen|date=|website=eugraph.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}</ref>
*[https://www.youtube.com/watch?v=oTPqAYqMsFk Shotgun Histology Dorsal Root Ganglion]<ref>{{Cite web|url=https://www.youtube.com/watch?v=oTPqAYqMsFk|title=Shotgun Histology Dorsal Root Ganglion|last=|first=|date=Aug 23, 2007|website=YouTube|publisher=WashingtonDeceit|archive-url=|archive-date=|dead-url=|access-date=}}</ref> Video

== See also ==
*[[Glial cell]]
*[[Microglia]]
*[[Nervous system]]

== References ==

[[Category:Body systems]]
[[Category:Central Nervous System]]
[[Category:Neurology]]
<references />

Dorsal root ganglion

2018-08-13T04:43:15Z

77.111.246.7:merged citation

[[File:Dorsal Root Ganglion.JPG|400px|thumb|right|Dorsal Root Ganglion]]
[[File:Spinal Cord Sectional Anatomy.png|300px|thumb|right|Spinal Cord Sectional Anatomy (Note: Dorsal root and Dorsal root ganglion)]]

[[Dorsal root ganglia]] (DRG) is "a nodule in a dorsal root that contains cell bodies of neurons in afferent spinal nerves."<ref name=":0">{{Cite web|url=https://www.thefullwiki.org/Dorsal_root_ganglia|title=Dorsal root ganglia : Wikis (The Full Wiki)|website=www.thefullwiki.org|language=en|access-date=2018-08-13}}</ref> They lie along the vertebral column by the spine. The dorsal root ganglia "contain the cell bodies of afferent nerve fibres (those carrying impulses toward the [[central nervous system]]); efferent neurons (carrying motor impulses away from the central nervous system) are present in the ventral root ganglia."<ref>{{Cite news|url=https://www.britannica.com/science/ganglion#ref114478|title=Ganglion {{!}} physiology|work=Encyclopedia Britannica|access-date=2018-08-13|language=en}}</ref>

The neuron is parted of two parts:

#[https://en.wikipedia.org/wiki/Dendrite Dendrite]<ref>{{Cite journal|date=2018-06-06|title=Dendrite|url=https://en.wikipedia.org/w/index.php?title=Dendrite&oldid=844690110|journal=Wikipedia|language=en}}</ref> receives the information and sends it to the Perykaron (cytoplasm which is around the nucleus)
#[https://en.wikipedia.org/wiki/Axon Axon]<ref>{{Cite journal|date=2018-07-23|title=Axon|url=https://en.wikipedia.org/w/index.php?title=Axon&oldid=851666075|journal=Wikipedia|language=en}}</ref> takes this information and sends forward

[[File:Dorsal Root Ganglion Chicken.JPG|200px|thumb|right|"This is a dorsal root ganglion (DRG) from a chicken embryo (around stage of day 7) after incubation overnight in NGF growth medium stained with anti-neurofilament antibody. Axons growing out of the ganglion are visible."<ref name=":0" />]]

== Dorsal root ganglia in ME/CFS ==
[[Inflammation]] of the DRG has been found in the autopsies of several very severely ill [[Myalgic encephalomyelitis]] patients including [[Lynn Gilderdale|Lynn Gilderdale]], [[Sophia Mirza]] and [[Merryn Crofts]].

== Learn more ==
*[https://www.thefullwiki.org/Dorsal_root_ganglion Dorsal root ganglion: Wikis]<ref>{{Cite web|url=https://www.thefullwiki.org/Dorsal_root_ganglion|title=Dorsal root ganglion : Wikis (The Full Wiki)|website=www.thefullwiki.org|language=en|access-date=2018-08-13}}</ref> Images and diagrams.
*[http://eugraph.com/histology/nervous/drgang.html Histology Photomicrographs]<ref>{{Cite web|url=http://eugraph.com/histology/nervous/drgang.html|title=Histology Photomicrographs - Dorsal root ganglion|last=Hart|first=Karen|date=|website=eugraph.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}</ref>
*[https://www.youtube.com/watch?v=oTPqAYqMsFk Shotgun Histology Dorsal Root Ganglion]<ref>{{Cite web|url=https://www.youtube.com/watch?v=oTPqAYqMsFk|title=Shotgun Histology Dorsal Root Ganglion|last=|first=|date=Aug 23, 2007|website=YouTube|publisher=WashingtonDeceit|archive-url=|archive-date=|dead-url=|access-date=}}</ref> Video

== See also ==
*[[Glial cell]]
*[[Microglia]]
*[[Nervous system]]

== References ==

[[Category:Body systems]]
[[Category:Central Nervous System]]
[[Category:Neurology]]
<references />

Dorsal root ganglion

2018-08-13T04:39:36Z

77.111.246.7:x

[[File:Dorsal Root Ganglion.JPG|400px|thumb|right|Dorsal Root Ganglion]]
[[File:Spinal Cord Sectional Anatomy.png|300px|thumb|right|Spinal Cord Sectional Anatomy (Note: Dorsal root and Dorsal root ganglion)]]

[[Dorsal root ganglia]] (DRG) is "a nodule in a dorsal root that contains cell bodies of neurons in afferent spinal nerves."<ref>{{Cite web|url=https://www.thefullwiki.org/Dorsal_root_ganglia|title=Dorsal root ganglia : Wikis (The Full Wiki)|website=www.thefullwiki.org|language=en|access-date=2018-08-13}}</ref> They lie along the vertebral column by the spine. The dorsal root ganglia "contain the cell bodies of afferent nerve fibres (those carrying impulses toward the [[central nervous system]]); efferent neurons (carrying motor impulses away from the central nervous system) are present in the ventral root ganglia."<ref>{{Cite news|url=https://www.britannica.com/science/ganglion#ref114478|title=Ganglion {{!}} physiology|work=Encyclopedia Britannica|access-date=2018-08-13|language=en}}</ref>

The neuron is parted of two parts:

#[https://en.wikipedia.org/wiki/Dendrite Dendrite]<ref>{{Cite journal|date=2018-06-06|title=Dendrite|url=https://en.wikipedia.org/w/index.php?title=Dendrite&oldid=844690110|journal=Wikipedia|language=en}}</ref> receives the information and sends it to the Perykaron (cytoplasm which is around the nucleus)
#[https://en.wikipedia.org/wiki/Axon Axon]<ref>{{Cite journal|date=2018-07-23|title=Axon|url=https://en.wikipedia.org/w/index.php?title=Axon&oldid=851666075|journal=Wikipedia|language=en}}</ref> takes this information and sends forward

[[File:Dorsal Root Ganglion Chicken.JPG|200px|thumb|right|"This is a dorsal root ganglion (DRG) from a chicken embryo (around stage of day 7) after incubation overnight in NGF growth medium stained with anti-neurofilament antibody. Axons growing out of the ganglion are visible."<ref>[https://www.thefullwiki.org/Dorsal_root_ganglia Dorsal Root Ganglion - The Full Wiki]</ref>]]

== Dorsal root ganglia in ME/CFS ==
[[Inflammation]] of the DRG has been found in the autopsies of several very severely ill [[Myalgic encephalomyelitis]] patients including [[Lynn Gilderdale|Lynn Gilderdale]], [[Sophia Mirza]] and [[Merryn Crofts]].

== Learn more ==
*[https://www.thefullwiki.org/Dorsal_root_ganglion Dorsal root ganglion: Wikis]<ref>{{Cite web|url=https://www.thefullwiki.org/Dorsal_root_ganglion|title=Dorsal root ganglion : Wikis (The Full Wiki)|website=www.thefullwiki.org|language=en|access-date=2018-08-13}}</ref> Images and diagrams.
*[http://eugraph.com/histology/nervous/drgang.html Histology Photomicrographs]<ref>{{Cite web|url=http://eugraph.com/histology/nervous/drgang.html|title=Histology Photomicrographs - Dorsal root ganglion|last=Hart|first=Karen|date=|website=eugraph.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}</ref>
*[https://www.youtube.com/watch?v=oTPqAYqMsFk Shotgun Histology Dorsal Root Ganglion]<ref>{{Cite web|url=https://www.youtube.com/watch?v=oTPqAYqMsFk|title=Shotgun Histology Dorsal Root Ganglion|last=|first=|date=Aug 23, 2007|website=YouTube|publisher=WashingtonDeceit|archive-url=|archive-date=|dead-url=|access-date=}}</ref> Video

== See also ==
*[[Glial cell]]
*[[Microglia]]
*[[Nervous system]]

== References ==

[[Category:Body systems]]
[[Category:Central Nervous System]]
[[Category:Neurology]]
<references />

Dorsal root ganglion

2018-08-13T04:38:55Z

77.111.246.7:convert citations

[[File:Dorsal Root Ganglion.JPG|400px|thumb|right|Dorsal Root Ganglion]]
[[File:Spinal Cord Sectional Anatomy.png|300px|thumb|right|Spinal Cord Sectional Anatomy (Note: Dorsal root and Dorsal root ganglion)]]

[[Dorsal root ganglia]] (DRG) is "a nodule in a dorsal root that contains cell bodies of neurons in afferent spinal nerves."<ref>{{Cite web|url=https://www.thefullwiki.org/Dorsal_root_ganglia|title=Dorsal root ganglia : Wikis (The Full Wiki)|website=www.thefullwiki.org|language=en|access-date=2018-08-13}}</ref> They lie along the vertebral column by the spine. The dorsal root ganglia "contain the cell bodies of afferent nerve fibres (those carrying impulses toward the [[central nervous system]]); efferent neurons (carrying motor impulses away from the central nervous system) are present in the ventral root ganglia."<ref>{{Cite news|url=https://www.britannica.com/science/ganglion#ref114478|title=Ganglion {{!}} physiology|work=Encyclopedia Britannica|access-date=2018-08-13|language=en}}</ref>

The neuron is parted of two parts:

#[https://en.wikipedia.org/wiki/Dendrite Dendrite]<ref>{{Cite journal|date=2018-06-06|title=Dendrite|url=https://en.wikipedia.org/w/index.php?title=Dendrite&oldid=844690110|journal=Wikipedia|language=en}}</ref> that receives the information and sends it to the Perykaron (cytoplasm which is around the nucleus)
#[https://en.wikipedia.org/wiki/Axon Axon]<ref>{{Cite journal|date=2018-07-23|title=Axon|url=https://en.wikipedia.org/w/index.php?title=Axon&oldid=851666075|journal=Wikipedia|language=en}}</ref> takes this information and sends forward

[[File:Dorsal Root Ganglion Chicken.JPG|200px|thumb|right|"This is a dorsal root ganglion (DRG) from a chicken embryo (around stage of day 7) after incubation overnight in NGF growth medium stained with anti-neurofilament antibody. Axons growing out of the ganglion are visible."<ref>[https://www.thefullwiki.org/Dorsal_root_ganglia Dorsal Root Ganglion - The Full Wiki]</ref>]]

== Dorsal root ganglia in ME/CFS ==
[[Inflammation]] of the DRG has been found in the autopsies of several very severely ill [[Myalgic encephalomyelitis]] patients including [[Lynn Gilderdale|Lynn Gilderdale]], [[Sophia Mirza]] and [[Merryn Crofts]].

== Learn more ==
*[https://www.thefullwiki.org/Dorsal_root_ganglion Dorsal root ganglion: Wikis]<ref>{{Cite web|url=https://www.thefullwiki.org/Dorsal_root_ganglion|title=Dorsal root ganglion : Wikis (The Full Wiki)|website=www.thefullwiki.org|language=en|access-date=2018-08-13}}</ref> Images and diagrams.
*[http://eugraph.com/histology/nervous/drgang.html Histology Photomicrographs]<ref>{{Cite web|url=http://eugraph.com/histology/nervous/drgang.html|title=Histology Photomicrographs - Dorsal root ganglion|last=Hart|first=Karen|date=|website=eugraph.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}</ref>
*[https://www.youtube.com/watch?v=oTPqAYqMsFk Shotgun Histology Dorsal Root Ganglion]<ref>{{Cite web|url=https://www.youtube.com/watch?v=oTPqAYqMsFk|title=Shotgun Histology Dorsal Root Ganglion|last=|first=|date=Aug 23, 2007|website=YouTube|publisher=WashingtonDeceit|archive-url=|archive-date=|dead-url=|access-date=}}</ref> Video

== See also ==
*[[Glial cell]]
*[[Microglia]]
*[[Nervous system]]

== References ==

[[Category:Body systems]]
[[Category:Central Nervous System]]
[[Category:Neurology]]
<references />

Lyme disease

2018-08-13T03:48:37Z

77.111.246.7:bullets

[[File:Borrelia burgdorferi-cropped.jpg|225px|thumb|right|Spirochete, or “corkscrew-shaped” bacteria known as Borrelia burgdorferi.]]
[[File:Lyme Rash.jpg|200px|thumb|right|Classic bulls-eye rash from the bite of a deer tick.]]

'''Lyme Disease''' is caused by ''[[borrelia burgdorferi]]'', a pathogen transmitted by the black legged tick.<ref>{{Cite news|url=http://www.webmd.com/rheumatoid-arthritis/arthritis-lyme-disease|title=Lyme Disease: Symptoms, Causes, Diagnosis, Treatment, Prevention|work=WebMD|access-date=2018-08-13|language=en-US}}</ref> It is treatable but can become [[Chronic lyme disease]]. A bulls-eye rash can appear at the site of a deer tick bite but can be in different forms<ref>{{Cite news|url=http://www.bayarealyme.org/blog/lyme-disease-bullseye-rash/|title=Does Everyone Get the Telltale Bullseye Rash? {{!}} Bay Area Lyme Foundation|date=2014-09-12|work=Bay Area Lyme Foundation|access-date=2018-08-13|language=en-US}}</ref> while some people never recall having a rash.

== Treatment ==
*[[Centers for Disease Control & Prevention]] (CDC) on Treatment

::Patients treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Antibiotics commonly used for oral treatment include doxycycline, amoxicillin, or cefuroxime axetil. Patients with certain neurological or cardiac forms of illness may require intravenous treatment with drugs such as ceftriaxone or penicillin.<ref>{{Cite web|url=http://www.cdc.gov/lyme/treatment/index.html|title=Treatment {{!}} Lyme Disease {{!}} CDC|date=2017-12-13|website=www.cdc.gov|language=en-us|access-date=2018-08-13}}</ref>

*Diseases & Conditions: Lyme Disease

*2006, [http://cid.oxfordjournals.org/content/43/9/1089.full The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America]<ref>{{Cite journal|last=Wormser|first=Gary P.|last2=Dattwyler|first2=Raymond J.|last3=Shapiro|first3=Eugene D.|last4=Halperin|first4=John J.|last5=Steere|first5=Allen C.|last6=Klempner|first6=Mark S.|last7=Krause|first7=Peter J.|last8=Bakken|first8=Johan S.|last9=Strle|first9=Franc|date=2006-11-01|title=The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America|url=https://academic.oup.com/cid/article/43/9/1089/422463|journal=Clinical Infectious Diseases|language=en|volume=43|issue=9|pages=1089–1134|doi=10.1086/508667|issn=1537-6591}}</ref>

== Multiple pathogens ==
*2016, [http://www.sciencedaily.com/releases/2016/02/160208135440.htm Researchers identify new Borrelia species that causes Lyme disease]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2016/02/160208135440.htm|title=Researchers identify new Borrelia species that causes Lyme disease: Until now, Borrelia burgdorferi was only species believed to cause Lyme disease in North America|last=|first=|date=Feb 8, 2016|work=ScienceDaily|access-date=2018-08-13|archive-url=|archive-date=|dead-url=|publisher=|language=en}}</ref>

=== Pathobiome Paradigm ===
Some future research will focus on a spectrum of pathogens instead of a "one pathogen-one disease" vision.<ref name="VayssierT2015" />

==Articles==
*Apr 23, 2014, [http://www.perthnow.com.au/news/western-australia/lyme-disease-a-ticking-timebomb-that-health-authorities-say-does-not-exist/story-fnhocxo3-1226886911487 Lyme disease — a ticking timebomb that health authorities say does not exist]<ref>{{Cite news|url=https://www.perthnow.com.au/news/wa/lyme-disease-a-ticking-timebomb-that-health-authorities-say-does-not-exist-ng-f3b5ed3f7106ca370ac9cfc467028a31|title=Lyme disease — a ticking timebomb|last=Ambrose|first=Melenie|date=2014-04-22|work=PerthNow|access-date=2018-08-13|archive-url=|archive-date=|dead-url=|language=en-GB}}</ref>
*Jul 31, 2016, [http://www.bbc.co.uk/news/magazine-36923336 How I was floored by a tick]<ref>{{Cite news|url=https://www.bbc.com/news/magazine-36923336|title=How I was floored by a tick|date=2016-07-31|work=BBC News|access-date=2018-08-13|language=en-GB}}</ref>

==Learn more==
*[http://www.columbia-lyme.org/ Lyme and Tick-Borne Diseases Research Center]<ref>{{Cite web|url=https://www.columbia-lyme.org|title=Lyme Disease|last=|first=|date=|website=Columbia-lyme.org|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}</ref>

==See also==
*[[Borrelia burgdorferi]]
*[[Vagus nerve infection hypothesis]]

== References ==
<references>
<ref name="VayssierT2015">{{citation
| last1 = Vayssier-Taussat | first1 = M | authorlink1 =
| last2 = Kazimirova | first2 = M | authorlink2 =
| last3 = Hubalek | first3 = Z | authorlink3 =
| last4 = Hornok | first4 = S | authorlink4 =
| last5 = Farkas | first5 = R | authorlink5 =
| last6 = Cosson | first6 = JF | authorlink6 =
| last7 = Bonnet | first7 = S | authorlink7 =
| last8 = Vourch | first8 = G | authorlink8 =
| last9 = Gasqui | first9 = P | authorlink9 =
| last10 = Mihalca | first10= AD | authorlink10=
| last11 = Plantard | first11= O | authorlink11=
| last12 = Silaghi | first12= C | authorlink12=
| last13 = Cutler | first13= S | authorlink13=
| last14 = Rizzlo | first14= A | authorlink14=
| title = Emerging horizons for tick-borne pathogens: from the 'one pathogen-one disease' vision to the pathobiome paradigm
| journal = Future Microbiol | volume = 10 | issue = 12 | page = 2033-43
| date = 19 Nov 2015
| pmid = 26610021 | doi = 10.2217/fmb.15.114
| url = http://www.futuremedicine.com/doi/abs/10.2217/fmb.15.114
}}</ref>
</references>

[[Category:Diagnoses]]
[[Category:Comorbidities]]

Lyme disease

2018-08-13T03:46:43Z

77.111.246.7:convert citations

[[File:Borrelia burgdorferi-cropped.jpg|225px|thumb|right|Spirochete, or “corkscrew-shaped” bacteria known as Borrelia burgdorferi.]]
[[File:Lyme Rash.jpg|200px|thumb|right|Classic bulls-eye rash from the bite of a deer tick.]]

'''Lyme Disease''' is caused by ''[[borrelia burgdorferi]]'', a pathogen transmitted by the black legged tick.<ref>{{Cite news|url=http://www.webmd.com/rheumatoid-arthritis/arthritis-lyme-disease|title=Lyme Disease: Symptoms, Causes, Diagnosis, Treatment, Prevention|work=WebMD|access-date=2018-08-13|language=en-US}}</ref> It is treatable but can become [[Chronic lyme disease]]. A bulls-eye rash can appear at the site of a deer tick bite but can be in different forms<ref>{{Cite news|url=http://www.bayarealyme.org/blog/lyme-disease-bullseye-rash/|title=Does Everyone Get the Telltale Bullseye Rash? {{!}} Bay Area Lyme Foundation|date=2014-09-12|work=Bay Area Lyme Foundation|access-date=2018-08-13|language=en-US}}</ref> while some people never recall having a rash.

== Treatment ==
*[[Centers for Disease Control & Prevention]] (CDC) on Treatment

::Patients treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Antibiotics commonly used for oral treatment include doxycycline, amoxicillin, or cefuroxime axetil. Patients with certain neurological or cardiac forms of illness may require intravenous treatment with drugs such as ceftriaxone or penicillin.<ref>{{Cite web|url=http://www.cdc.gov/lyme/treatment/index.html|title=Treatment {{!}} Lyme Disease {{!}} CDC|date=2017-12-13|website=www.cdc.gov|language=en-us|access-date=2018-08-13}}</ref>
::
::
::2006, [http://cid.oxfordjournals.org/content/43/9/1089.full The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America]<ref>{{Cite journal|last=Wormser|first=Gary P.|last2=Dattwyler|first2=Raymond J.|last3=Shapiro|first3=Eugene D.|last4=Halperin|first4=John J.|last5=Steere|first5=Allen C.|last6=Klempner|first6=Mark S.|last7=Krause|first7=Peter J.|last8=Bakken|first8=Johan S.|last9=Strle|first9=Franc|date=2006-11-01|title=The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America|url=https://academic.oup.com/cid/article/43/9/1089/422463|journal=Clinical Infectious Diseases|language=en|volume=43|issue=9|pages=1089–1134|doi=10.1086/508667|issn=1537-6591}}</ref>

== Multiple pathogens ==
*2016, [http://www.sciencedaily.com/releases/2016/02/160208135440.htm Researchers identify new Borrelia species that causes Lyme disease]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2016/02/160208135440.htm|title=Researchers identify new Borrelia species that causes Lyme disease: Until now, Borrelia burgdorferi was only species believed to cause Lyme disease in North America|last=|first=|date=Feb 8, 2016|work=ScienceDaily|access-date=2018-08-13|archive-url=|archive-date=|dead-url=|publisher=|language=en}}</ref>

=== Pathobiome Paradigm ===
Some future research will focus on a spectrum of pathogens instead of a "one pathogen-one disease" vision.<ref name="VayssierT2015" />

==Articles==
*Apr 23, 2014, [http://www.perthnow.com.au/news/western-australia/lyme-disease-a-ticking-timebomb-that-health-authorities-say-does-not-exist/story-fnhocxo3-1226886911487 Lyme disease — a ticking timebomb that health authorities say does not exist]<ref>{{Cite news|url=https://www.perthnow.com.au/news/wa/lyme-disease-a-ticking-timebomb-that-health-authorities-say-does-not-exist-ng-f3b5ed3f7106ca370ac9cfc467028a31|title=Lyme disease — a ticking timebomb|last=Ambrose|first=Melenie|date=2014-04-22|work=PerthNow|access-date=2018-08-13|archive-url=|archive-date=|dead-url=|language=en-GB}}</ref>
*Jul 31, 2016, [http://www.bbc.co.uk/news/magazine-36923336 How I was floored by a tick]<ref>{{Cite news|url=https://www.bbc.com/news/magazine-36923336|title=How I was floored by a tick|date=2016-07-31|work=BBC News|access-date=2018-08-13|language=en-GB}}</ref>

==Learn more==
*[http://www.columbia-lyme.org/ Lyme and Tick-Borne Diseases Research Center]<ref>{{Cite web|url=https://www.columbia-lyme.org|title=Lyme Disease|last=|first=|date=|website=Columbia-lyme.org|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}</ref>

==See also==
*[[Borrelia burgdorferi]]
*[[Vagus nerve infection hypothesis]]

== References ==
<references>
<ref name="VayssierT2015">{{citation
| last1 = Vayssier-Taussat | first1 = M | authorlink1 =
| last2 = Kazimirova | first2 = M | authorlink2 =
| last3 = Hubalek | first3 = Z | authorlink3 =
| last4 = Hornok | first4 = S | authorlink4 =
| last5 = Farkas | first5 = R | authorlink5 =
| last6 = Cosson | first6 = JF | authorlink6 =
| last7 = Bonnet | first7 = S | authorlink7 =
| last8 = Vourch | first8 = G | authorlink8 =
| last9 = Gasqui | first9 = P | authorlink9 =
| last10 = Mihalca | first10= AD | authorlink10=
| last11 = Plantard | first11= O | authorlink11=
| last12 = Silaghi | first12= C | authorlink12=
| last13 = Cutler | first13= S | authorlink13=
| last14 = Rizzlo | first14= A | authorlink14=
| title = Emerging horizons for tick-borne pathogens: from the 'one pathogen-one disease' vision to the pathobiome paradigm
| journal = Future Microbiol | volume = 10 | issue = 12 | page = 2033-43
| date = 19 Nov 2015
| pmid = 26610021 | doi = 10.2217/fmb.15.114
| url = http://www.futuremedicine.com/doi/abs/10.2217/fmb.15.114
}}</ref>
</references>

[[Category:Diagnoses]]
[[Category:Comorbidities]]

Fibromyalgia

2018-08-13T03:31:33Z

77.111.246.7:x

[[Fibromyalgia]] (FM/FMS) is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Pain is widespread, on both sides of the body, and above and below the waist.

Sufferers are fatigued and tired even when sleeping for long periods of time, and sleep is often disrupted by pain. Many FM sufferers have sleep disorders like [https://en.wikipedia.org/wiki/Sleep_apnea sleep apnea] and [[restless leg syndrome]]. [[Cognitive impairment]], when one cannot focus or pay attention and the patient has difficulty concentrating on mental tasks, is known by FM sufferers as "[[fibro fog]]".<ref name=":17">{{Cite news|url=https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014|title=What Is Fibro Fog and ME/CFS Brain Fog?|last=Dellwo|first=Adrienne|date=|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Some experience [[depression]], [[headache]]s, and lower [[abdominal pain]] or cramping. Other symptoms include tingling or [[numbness]] in hands and feet, pain in jaw and disorders of the jaw such as [[temporomandibular joint disorder|temporomandibular joint disorder]] (TMJ), [[Menstrual cycle#Health effects in other conditions|menstrual cycle]] cramps, and digestive problems like i[[Irritable bowel syndrome|rritable bowel syndrome]] (IBS).<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms#1|title=Fibromyalgia Symptoms|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780|title=Fibromyalgia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref>

[[File:Fibro_Tender_Points.png|400px|thumb|right|1990 ACR Diagnostic Criteria: 18 Tender Points]]
[[File:Fibro_Widespread_Pain.png|400px|thumb|right|2010 ACR Preliminatry Diagnostic Criteria: Wisedpread Pain Index (WPI), 19 Tender Point Areas]]

==Prevalence==
FM is the second most common [https://en.wikipedia.org/wiki/Rheumatism rheumatic disorder] behind [[wikipedia:Osteoarthritis|osteoarthritis]] and is "now considered to be a lifelong [[Central nervous system]] disorder."<ref>{{Cite news|url=https://naidw.org/blog/members-myblogs/fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder|title=Fibromyalgia now considered as a lifelong central nervous system disorder|work=NAIDW.org®|access-date=2018-08-09|language=en-gb}}</ref> An estimated 10 million people in the US and 3-6% of the world population have fibromyalgia. It is seen in women, men, children, and all ethnic groups. It is often seen in families and diagnosed between the ages of 20 to 50 years; incidence increases with age.<ref>{{Cite news|url=http://www.fmaware.org/about-fibromyalgia/prevalence/|title=Prevalence - National Fibromyalgia Association (NFA)|work=National Fibromyalgia Association (NFA)|access-date=2018-08-09|language=en-US}}</ref>

FM has a female:male 7:1 ratio under the ''American College of Rheumatology (ACR) 1990 Diagnostic Criteria'' and 2:1 when the ''ACR 2010 Preliminary Diagnostic Criteria'' is used.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=|publisher=|editor-last=Diamond|editor-first=Herbert|at=Sex-related differences in incidence}}</ref> ''See'': [[Fibromyalgia#American College of Rheumatology (ACR) Criteria|Fibromyalgia (''American College of Rheumatology (ACR) Criteria'' section)]].

==Fibromyalgia in ME/CFS==
Dr. [[Jarred Younger]] has said that many patients that meet the criteria for FM also meet criteria for [[chronic fatigue syndrome]] (CFS) but the reverse is not necessarily true as a lot of people with [[CFS]] do not have [[chronic pain]].<ref>{{Cite web|url=https://www.youtube.com/watch?v=wJB95m4FLa0#t=57m27s|title=Webinar with Jarred Younger, Ph.D.|last=Younger|first=Jared|date=May 20, 2016|website=YouTube|at=57:27|via=|archive-url=|archive-date=|dead-url=|access-date=|publisher=SolveCFS|type=Video}}</ref> However, the [[Canadian Consensus Criteria]] (CCC) requires the symptom of pain to diagnose [[ME/CFS]]. It is the pattern and significant degree of [[chronic pain]] in FM that sets it apart from other diseases that have pain.

"The most common overlapping condition with ME/CFS is fibromyalgia."<ref>{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions - American Myalgic Encephalomyelitis and
Chronic Fatigue Syndrome Society|last=|first=|date=|website=ammes.org|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref><ref>{{Cite journal|last=Jason|first=Leonard|last2=Taylor|first2=R.R.|last3=Kennedy|first3=C.L.|last4=Song|first4=S|last5=Johnson|first5=D|last6=Torres|first6=S.R.|date=2001-01-01|title=Chronic fatigue syndrome: Comorbidity with fibromyalgia and psychiatric illness|url=https://www.researchgate.net/publication/285787383_Chronic_fatigue_syndrome_Comorbidity_with_fibromyalgia_and_psychiatric_illness|journal=Medicine and Psychiatry|volume=4|pages=29–34}}</ref>

==Health complications==
FM is not a [https://en.wikipedia.org/wiki/Progressive_disease progressive disease] but according to Dr. Dan Clauw the "slow gradual worsening of chronic pain patients over time is due to downstream consequences of poorly controlled pain and other symptoms, wherein individuals then progressively get less active, sleep worse, are under more stress and unknowingly develop bad habits which worsen pain and other symptoms."<ref>{{Cite news|url=http://nationalpainreport.com/ask-the-dctors-is-fibromyalgia-progressive-8831105.html|title=Ask the Doctors: Is Fibromyalgia Progressive?|date=2016-08-09|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*[https://www.sharecare.com/health/fibromyalgia-effects Fibromyalgia Complications]<ref name=":19" />

:People who have fibromyalgia frequently complain of a variety of symptoms that affect other parts of the body. Many people complain of [[gastrointestinal]] issues and restless legs syndrome (RLS). Additionally, the [[chronic pain]] and discomfort of fibromyalgia may lead to [[depression]].<ref name=":19">{{Cite news|url=https://www.sharecare.com/health/fibromyalgia-effects|title=Fibromyalgia Complications - Fibromyalgia - Joint Health|work=Sharecare|access-date=2018-08-09|language=en}}</ref>

*[https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions Can fibromyalgia cause other medical conditions?]<ref name=":20" />

:Fibromyalgia is not known to cause other medical conditions. However, people who have fibromyalgia seem to be at high risk for developing other painful conditions, including [https://en.wikipedia.org/wiki/Osteoarthritis osteoarthritis] (the common type of arthritis caused by wear and tear on the joints) as well as other related conditions, such as [[rheumatoid arthritis]], [[lupus]], and [https://en.wikipedia.org/wiki/Ankylosing_spondylitis ankylosing spondylitis]. Also, people with fibromyalgia are frequently diagnosed with chronic fatigue syndrome, irritable bowel syndrome (IBS), and temporomandibular joint (TMJ) disorder.<ref name=":20">{{Cite web|url=https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions|title=Can fibromyalgia cause other medical conditions? {{!}} Fibromyalgia Complications|last=Honor Society of Nursing|first=|date=|website=Sharecare|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

==Risk factors==
[[Lupus]] and [[Rheumatoid arthritis]] (RA) are risk factors in developing FM. Car accidents, [[Post-traumatic stress disorder]] (PTSD), [https://en.wikipedia.org/wiki/Repetitive_strain_injury repetitive injuries], illness such as a [https://en.wikipedia.org/wiki/Viral_disease viral infection], [https://en.wikipedia.org/wiki/Family_history_(medicine) family history], and [https://en.wikipedia.org/wiki/Obesity obesity] have all been linked to FM.<ref>{{Cite web|url=https://www.cdc.gov/arthritis/basics/fibromyalgia.htm|title=Fibromyalgia {{!}} Arthritis {{!}} CDC|date=2018-04-03|website=www.cdc.gov|language=en-us|access-date=2018-08-09}}</ref><ref>{{Cite news|url=https://www.niams.nih.gov/health_info/Fibromyalgia/|title=Fibromyalgia What Causes it?|last=Director|first=Nancy Garrick, Deputy|date=2017-04-05|work=National Institute of Arthritis and Musculoskeletal and Skin Diseases|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

==Diagnosis==
[https://www.verywellhealth.com/what-are-fibromyalgia-tender-points-189768 Tender points], not [https://en.wikipedia.org/wiki/Myofascial_trigger_point trigger points], are used to diagnose Fibromyalgia.<ref>{{Cite web|url=http://www.healthcentral.com/chronic-pain/c/662034/176031/fibromyalgia-trigger/|title=The Difference Between Fibromyalgia Tender Points and Myofascial Trigger Points - Chronic Pain {{!}} HealthCentral|last=Cooper|first=Celeste|date=May 8, 2015|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> Tender points will be above and below the waist and on both sides of the body. (See: Illustrations of the 1990 and 2010 American College of Rheumatology (ACR) Criteria depicting tender points near the top of this page.) It is important to check for other conditions that could be causing pain such as hypothyroidism, Rheumatoid arthritis or lupus, osteoarthritis, Ankylosing spondylitis, and [[wikipedia:Polymyalgia_rheumatica|Polymyalgia rheumatica]].<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>

===United States===
==== American College of Rheumatology (ACR) Criteria ====

*1990, [http://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf The American College Of Rheumatology 1990 Criteria For The Classification Of Fibromyalgia] "American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure."<ref>{{Cite news|url=http://www.health.com/health/gallery/0,,20345635,00.html|title=18 Points Used to Diagnose Fibromyalgia|last=|first=|date=Feb 4, 2011|work=Health.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> <ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2010, The [https://www.fibroknowledge.com/site/acr-2010 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview] was proposed and modified in 2011<ref>{{Cite news|url=http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria|title=New and Modified Fibromyalgia Diagnostic Criteria|last=Garg|first=Neha|date=Feb 9, 2012|work=Rheumatology Network|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=|last2=Deodhar|first2=Atul}}</ref> with the modification being validated in 2013 and published in 2014.<ref>{{Cite journal|last=Bennett|first=Robert M.|last2=Friend|first2=Ronald|last3=Marcus|first3=Dawn|last4=Bernstein|first4=Cheryl|last5=Han|first5=Bobby Kwanghoon|last6=Yachoui|first6=Ralph|last7=Deodhar|first7=Atul|last8=Kaell|first8=Alan|last9=Bonafede|first9=Peter|date=2014|title=Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/24497443|journal=Arthritis Care & Research|volume=66|issue=9|pages=1364–1373|doi=10.1002/acr.22301|issn=2151-4658|pmid=24497443|via=}}</ref> September of 2016, another revision has been made.<ref>{{Cite news|url=http://acrabstracts.org/abstract/2016-revisions-to-the-20102011-fibromyalgia-diagnostic-criteria/|title=2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria - ACR Meeting Abstracts|last=|first=|date=Sep 28, 2016|work=ACR Meeting Abstracts|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

:Men do not seem to form the tender points needed for diagnosis under the 1990 criteria,<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/features/how-fibromyalgia-affects-men#2|title=How Fibromyalgia Affects Men: Symptoms and Diagnosis|work=WebMD|access-date=2018-08-09|language=en-US}}</ref> the 2010 proposed criteria diagnoses more men with a F/M ratio of 2:1.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=}}</ref>
:Tender points were used to diagnose with the 1990 criteria, however "considerable skill is needed to correctly check for a patient’s tender points (i.e., digital palpation that is done with certain amount of applied pressure), yet this technique is not typically taught at most medical schools."<ref name=":0">{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 5, 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>
:The new standards were designed to:
:*eliminate the use of a tender point examination
:*include a severity scale by which to identify and measure characteristic FM symptoms
:*utilize an index by which to rate pain<ref name=":0" />
:*There are 19 tender point areas in the widespread pain index (WPI), whereas the 1990 criteria had 18 tender points.<ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose fibromyalgia.<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=Jul 25, 2012|website=www.ssa.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

==== Sleep study ====
Sleep dysfunction is often involved in fibromyalgia. Treating a sleep disorder can help with fibromyalgia symptoms. A diagnosed sleep disorder is also helpful if one needs to file for disability.

*[https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054 Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054|title=Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*[http://www.sciencedaily.com/releases/2008/09/080903134311.htm What A Sleep Study Can Reveal About Fibromyalgia]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2008/09/080903134311.htm|title=What A Sleep Study Can Reveal About Fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*[http://linkis.com/nationalpainreport.com/lzYea Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says]<ref>{{Cite news|url=http://linkis.com/nationalpainreport.com/lzYea|title=Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says|last=|first=|date=Mar 25, 2016|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== ICD Diagnostic code===
====World Health Organization====
'''ICD-10'''

The [[World Health Organization]] (WHO) International Classification of Diseases (ICD) lists fibromyalgia as a "disease of the [[musculoskeletal system]] and connective tissue", under the code M79.7 (WHO ICD-10 Version: 016).<ref>World Health Organization, [http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7 International Classification of Diseases - Fibromyalgia M79.7], ICD-10, 2016</ref>

*'''M79.7 Fibromyalgia'''
::Fibromyositis
::Fibrositis
::Myofibrositis<ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7|title=ICD-10 Version:2016|website=apps.who.int|language=en|access-date=2018-08-09}}</ref>

In 2015, the [[United States]] finally adopted ICD-10 and Fibromyalgia as a diagnosis.<ref>{{Cite web|url=http://www.icd10data.com/ICD10CM/Codes/M00-M99/M70-M79/M79-/M79.7|title=2018 ICD-10-CM Diagnosis Code M79.7: Fibromyalgia|website=www.icd10data.com|language=en|access-date=2018-08-09}}</ref> <ref>{{Cite news|url=http://nationalpainreport.com/the-health-care-industry-finally-recognizes-fibromyalgia-8827637.html|title=The Health Care Industry Finally Recognizes Fibromyalgia|last=Liptan|first=Ginevra|date=2015-09-30|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

'''ICD-11 (2019)'''

[https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504 ICD-11] (2019) has diagnostic code ''MG30.1 Chronic widespread pain''.<ref name=":18">{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504|title=ICD-11 - Mortality and Morbidity Statistics|website=icd.who.int|language=en|access-date=2018-08-09}}</ref>

*'''MG30.01 Chronic widespread pain'''

'''Parent'''
::MG30.0 Chronic primary pain

'''Description'''
<blockquote>Chronic widespread pain (CWP) is diffuse pain in at least 4 of 5 body regions and is associated with significant emotional distress (anxiety, anger/frustration or depressed mood) or functional disability (interference in daily life activities and reduced participation in social roles) [1]. CWP is multifactorial: biological, psychological and social factors contribute to the pain syndrome. The diagnosis is appropriate when the pain is not directly attributable to a nociceptive process in these regions and there are features consistent with nociplastic pain [2] and identified psychological and social contributors.</blockquote>

'''Inclusions'''
:*Fibromyalgia
'''Exclusions'''
:*Acute pain (MG31)<ref name=":18" />

==Pathophysiology==
"Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology. There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or [[Lyme disease]], as well as emotional or physical trauma."<ref>{{Cite web|url=https://www.uptodate.com/contents/pathogenesis-of-fibromyalgia#!|title=UpToDate|last=Goldenberg|first=Don L|date=|website=www.uptodate.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> The widespread pain is severe, debilitating, and abnormal in processing its pain. There is also sleep disturbance and fatigue. Cause or causes are unproven.<ref>{{Cite news|url=https://www.omf.ngo/what-is-mecfs-old/fibromyalgia/|title=What is Fibromyalgia? {{!}} Open Medicine Foundation|work=Open Medicine Foundation|access-date=2018-08-09|language=en-US}}</ref>

*May 2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/ Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management]<ref>{{Cite journal|last=Jahan|first=Firdous|last2=Nanji|first2=Kashmira|last3=Qidwai|first3=Waris|last4=Qasim|first4=Rizwan|date=2012|title=Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/|journal=Oman Medical Journal|volume=27|issue=3|pages=192–195|doi=10.5001/omj.2012.44|issn=1999-768X|pmc=|pmid=22811766|via=}}</ref> ''See'' Table 1: "Conditions associated with fibromyalgia." Musculoskeletal, genitourianry, gastro intestinal, and miscellaneous conditions often exist among fibromyalgia patients.

<blockquote>Pathophysiology: Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as [[serotonin]], substance P, growth hormone and [[cortisol]] suggest that regulation of the autonomic and neuro-endocrine system appears to be the basis of the syndrome. Fibromyalgia is not a life-threatening, deforming, or [https://en.wikipedia.org/wiki/Progressive_disease progressive disease]. [[Anxiety]] and [[depression]] are the most common association. Aberrant pain processing, which can result in [[chronic pain]], may be the result of several interplaying mechanisms. [[Central sensitization]], blunting of inhibitory pain pathways and alterations in [[neurotransmitters]] lead to aberrant neuro-chemical processing of sensory signals in the CNS, thus lowering the threshold of pain and amplification of normal sensory signals causing constant pain.</blockquote>

<blockquote>The frequent co-morbidity of fibromyalgia with mood disorders suggests a major role for the stress response and for neuroendocrine abnormalities. The [[hypothalamic pituitary axis]] (HPA) is a critical component of the stress-adaptation response. In FMS, stress adaptation response is disturbed leading to stress induce symptoms. Psychiatric co-morbidity has been associated with FMS and needs to be identified during the consultation process, as this requires special consideration during treatment.</blockquote>

*May 2018, [https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management]<ref>{{Cite journal|last=Bourgaize|first=Sheryl|last2=Newton|first2=Genevieve|last3=Kumbhare|first3=Dinesh|last4=Srbely|first4=John|date=2018|title=A comparison of the clinical manifestation and
pathophysiology of myofascial pain syndrome
and fibromyalgia: implications for differential
diagnosis and management|url=https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf|format=PDF|journal=Journal of the Canadian Chiropractic Assoc.|volume=|pages=26-41|at=See Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)|via=}}</ref> (PDF) ''See'' Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)

*Jul 2018, [https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/ Primary and Secondary Fibromyalgia Share Same Symptom Burden, Study Suggests]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/|title=Primary, Secondary Fibromyalgia Share Same Symptom Burden, Study Says|last=Carvalho|first=John|date=2018-07-31|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

<blockquote>Fibromyalgia can be considered either primary, or dominant, also known as idiopathic fibromyalgia, or secondary. In the primary form, the causes of the disorder are unknown, but in secondary fibromyalgia, the disorder usually occurs alongside other debilitating medical conditions, such as rheumatoid arthritis (RA), lupus, and multiple sclerosis.</blockquote>

===Immune system research===

Dr. [[Jarred Younger]] believes an overactive [[immune system]] is the cause and will be conducting a study to test this hypothesis.<ref>{{Cite news|url=http://nationalpainreport.com/new-uab-study-could-radically-change-fibromyalgia-treatment-as-we-know-it-8833437.html|title=New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It|last=Gregory Burch|first=Donna|date=2017-04-24|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=https://www.youtube.com/watch?v=8e5xKX036bE|title=Testing the fibromyalgia immune system with lipopolysaccharide (LPS)|last=Younger|first=Jarred|date=May 24, 2017|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=|via=Younger Lab}}</ref> An overactive immune system is responsible for [[inflammation]] which causes [[chronic pain]].

Dr. William Pridgen's research of [[HSV-1]] (cold sore virus) as being involved in FM has conducted a successful Phase III clinical trial, which had been fast-tracked by the [[Food and Drug Administration]] (FDA), of a combination drug that suppresses this virus and also helps with pain. ''See'': [[Fibromyalgia#IMC-1|Fibromyalgia (''Drugs: Trials: IMC-1'' section)]].

[[ProHealth]] reports that an old [https://en.wikipedia.org/wiki/Tuberculosis Tuberculosis] vaccine, [https://en.wikipedia.org/wiki/BCG_vaccine Bacille Calmette-Guerin] (BCG), may be researched for treatment of Fibromyalgia spearheaded by [http://www.buzzfile.com/business/Epicgenetics,-Inc.-310-586-2929 EpicGenetics] and [http://www.massgeneral.org/ Massachusetts General Hospital].<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

EpicGenetics has a blood test that is identifying the presence of specific white blood cell abnormalities of patients diagnosed with FM and has partnered with two universities to offer [https://en.wikipedia.org/wiki/Disease_gene_identification#Whole_exome_sequencing whole exome sequencing] free of charge to those who test positive with their [http://fmtest.com/ FM/a® test].<ref>{{Cite news|url=http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> Concerns have been raised in regards to the FM/a® EpicGenetics Blood Test.<ref>{{Cite web|url=http://www.fmperplex.com/2013/02/25/junk-science-junk-ethics/|title=Junk Science – Junk Ethics – The Fibromyalgia Perplex|last=Wolfe|first=Fred|date=Feb 25, 2013|website=www.fmperplex.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> EpicGenetics is awaiting FDA approval to test the Bacille Calmette-Guerin (BCG) vaccine (an old Tuberculosis vaccine) on patients that tested positive with its FM/a® test.<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689#comment-2286|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=See Comments Section: CDW12 says: June 26, 2018 at 2:05 pm|language=en-US}}</ref><ref>{{Cite web|url=https://www.celestecooper.com/2018/07/the-fma-blood-test-and-participation-in.html#.Wz4nxdJKjIU|title=The FM/a® Blood Test and Participation in Fibromyalgia Vaccine Study|last=Cooper|first=Celeste|date=Jul 5, 2018|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

== Comorbidities ==

*[[Allodynia]]
** [http://chronicfatigue.about.com/od/glossary/g/allodynia.htm Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS]<ref name=":1">{{Cite news|url=https://www.verywellhealth.com/allodynia-definition-and-types-fibromyalgia-715929|title=Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Feb 23, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Types of Allodynia: Tactile; Mechanical; and Thermal. "Type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain" <ref name=":1" />

*[[Body temperature]]
**[https://www.verywell.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025 Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":2">{{Cite news|url=https://www.verywellhealth.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025|title=Temperature Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Mar 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "When you're exposed to heat, does it feel like you're burning up? Does it seem impossible for you to cool off? Or maybe it's cold that bothers you, chilling you to the bone, leaving you unable to warm up.

::Or are you one of those people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) who is cold all the time, or hot all the time, or alternately hot or cold while out of sync with the environment?"<ref name=":2" />

*[[Fibro fog]]

:*[http://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction]<ref name=":3">{{Cite news|url=https://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx|title=What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction|last=Mandal|first=Ananya|date=2013-06-03|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> 'Mental confusion along with difficulty in concentration and loss of memory is often termed “[[fibro fog]]"'.<ref name=":3" />

:*[https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014 What Is Fibro Fog and ME/CFS Brain Fog?]<ref name=":17" />

*[https://en.wikipedia.org/wiki/Costochondritis Costochondritis]<ref>{{Cite journal|date=2018-05-25|title=Costochondritis|url=https://en.wikipedia.org/w/index.php?title=Costochondritis&oldid=842926736|journal=Wikipedia|language=en}}</ref> (Chest and rib cage pain.)
**[https://www.verywell.com/costochondritis-in-fibromyalgia-716178 Costochondritis in Fibromyalgia]<ref>{{Cite news|url=https://www.verywellhealth.com/costochondritis-in-fibromyalgia-716178|title=Costochondritis Chest Pain in Fibromyalgia|last=Dellow|first=Adrienne|date=Feb 14, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*[[Gastrointestinal system]]
**[[Irritable bowel syndrome]]: [http://chronicfatigue.about.com/od/whyfmscfsarelinked/a/IBS.htm Irritable Bowel Syndrome in Fibromyalgia & Chronic Fatigue Syndrome - Why Do They Go Together?]<ref name=":4">{{Cite news|url=https://www.verywellhealth.com/irritable-bowel-syndrome-in-fibromyalgia-cfs-716167|title=Irritable Bowel Syndrome in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jan 28, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "Fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome (IBS) frequently go together. No one really knows why, but we do know that all three conditions can include imbalances of serotonin -- although in fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS or ME/CFS) it's an imbalance in the brain, while with IBS it's in the gut."<ref name=":4" />

*[https://en.wikipedia.org/wiki/Interstitial_cystitis Interstitial Cystitis]<ref>{{Cite journal|date=2018-07-11|title=Interstitial cystitis|url=https://en.wikipedia.org/w/index.php?title=Interstitial_cystitis&oldid=849828657|journal=Wikipedia|language=en}}</ref> (Painful bladder)
**[https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168 Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis]<ref name=":5">{{Cite news|url=https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168|title=Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "Fibromyalgia, chronic fatigue syndrome and interstitial cystitis (IC) -- a painful bladder condition -- frequently occur together. Women may be up to 10 times more likely than men to develop it."<ref name=":5" />

*Language Impairment
**[[Word-finding problems]] is a symptom of ME/CFS.
:*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome Impaired Language in Fibromyalgia & Chronic Fatigue Syndrome]<ref name=":6" /> "Searching their brains for simple words that they just can't remember. On other occasions, individuals with these diagnoses may find it hard to write or even understand language."<ref name=":6">{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:*"The diagnosis of [[Aphasia]] is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written"<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref> but with [[dysphasia]] you will have those symptoms and trouble listening and doing numeral calculations.<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-09}}</ref> ''See also'': [[Dyscalculia]].

*OBGYN
**[https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596 Menstrual Periods with Fibromyalgia: Personal Stories]<ref>{{Cite news|url=https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596|title=Menstrual Periods with Fibromyalgia: Personal Stories|last=Dellwo|first=Adrienne|date=May 18, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>
**[https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626 Fibromyalgia Tied to Hysterectomy, Gynecologic Disease].<ref name=":7">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626|title=Fibromyalgia Tied to Hysterectomy, Gynecologic Disease|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "You may have heard about a possible link between gynecologic surgery (such as a hysterectomy) and the development of fibromyalgia, and doctors have long suspected that fibromyalgia has strong hormonal ties and triggers. This does not seem surprising as we've long suspected a link between endocrine disorders, gynecological conditions, and autoimmune conditions."<ref name=":7" />

*[[Orthostatic intolerance]]
**[https://www.verywell.com/orthostatic-intolerance-715915 Orthostatic Intolerance]<ref>{{Cite news|url=https://www.verywellhealth.com/orthostatic-intolerance-715915|title=Orthostatic Intolerance Can Happen When You Stand Up Too Quickly|last=Dellwo|first=Adrienne|date=Mar 7, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:*[http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM]<ref>{{Cite web|url=http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf|title=Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM|last=Lapp|first=Charles W.|last2=Black|first2=Laura|date=|website=drlapp.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Smith|first3=Rebekah S.}}</ref> (PDF) Symptoms can include low blood pressure and/or sudden high blood pressure, dizziness, fainting.

:*[https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/ An Overlooked Issue in Fibromyalgia? Study Highlights Problems Standing (Orthostatic Intolerance)]<ref>{{Cite news|url=https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/|title=An Overlooked Issue in Fibromyalgia? Study Highlights Orthostatic Intolerance - Problems Standing - Health Rising|last=Johnson|first=Cort|date=2017-09-21|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[[Sleep dysfunction]]
**[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia]<ref>{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}</ref>

<blockquote>The present results of this study suggest that long-term, comorbid pain and sleep disturbance may be associated with increased activation in core default mode brain areas that is above and beyond long-term pain disturbance alone.</blockquote>

:*[http://www.prohealth.com/library/showarticle.cfm?libid=22344 Fibromyalgia and Sleep]<ref name=":8">{{Cite news|url=https://www.prohealth.com/library/fibromyalgia-and-sleep-38954|title=Fibromyalgia and Sleep - Prohealth|date=2016-01-11|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref> "Most people with fibromyalgia have an associated sleep disorder that makes it difficult for them to get the deep, restorative sleep they need."<ref name=":8" />

*[[Thyroid disease]]
**[https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677 Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease]<ref name=":9">{{Cite news|url=https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677|title=A Comparison of Chronic Fatigue, Fibromyalgia, and Thyroid Disease|last=Shomon|first=Mary|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "People with Hashimoto's autoimmune thyroid disease often experience significant fatigue and body aches. While these symptoms are common in Hashimoto's, they can also be markers of other diseases, like chronic fatigue syndrome or fibromyalgia."<ref name=":9" />

*Other symptoms
**[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/fibrosymptoms.htm Symptoms of Fibromyalgia]<ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-symptoms-716139|title=Symptoms of Fibromyalgia|last=Dellwo|first=Adrienne|date=May 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> (A comprehensive all in one place list for the many symptoms of Fibromyalgia.)

==Treatment==

===United States===
'''Rheumatology and primary care providers: Diagnosing and treatment'''

*2012, [https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract A Framework for Fibromyalgia Management for Primary Care Providers]<ref>{{Cite journal|last=Arnold|first=Lesley M.|last2=Clauw|first2=Daniel J.|last3=Dunegan|first3=L. Jean|last4=Turk|first4=Dennis C.|date=2012|title=A Framework for Fibromyalgia Management for Primary Care Providers|url=https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract|journal=Mayo Clinic Proceedings|language=English|volume=87|issue=5|pages=488–496|doi=10.1016/j.mayocp.2012.02.010|issn=0025-6196|via=}}</ref> Rheumatologists stopped treating fibromyalgia patients and primary care providers began treatment managment although rheumatologists are most often the specialist to diagnose. (Please see [http://me-pedia.org/wiki/Fibromyalgia#Disability disability] heading about ''primary provider'' and ''specialists'' for disability cases.)

----

=== Drugs ===
There are approved and off-label drugs for treating FM. ''Please Note: The information under "Drugs" is not meant to promote any Rx drug for Fibromyalgia or its comorbidities but to inform you of these drugs both approved and off-label. Always consult your doctor for guidance on Rx drug use for any illness or disease. Always check with your doctor and pharmacist for drug interactions.''

Always review a drug company's prescription drug's side effects and possible drug interactions with your doctor and pharmacist.

Pregnant women must always consult with their doctor and pharmacist when taking any prescription drug, over-the-counter drug, supplement, or herbal remedy for side effects, drug interactions, and possible miscarriage, injury, birth defect, addiction, or death to the embryo, fetus, or baby. Breastfeeding women should always talk to their doctor and pharmacist for information about breast milk being laced with the drug she has taken causing side effects, injury, addiction, or death, and drug interactions to the baby consuming her breast milk.

Check with your doctor and pharmacist before using any prescription or over-the-counter drug, supplement, or herbal remedy being administered to a child. Check with your doctor for children's side effects or drug interactions that may not be listed.

==== FDA approved====

*[http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107802.htm Living with Fibromyalgia, Drugs Approved to Manage Pain]<ref>{{Cite web|url=https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107802.htm|title=Consumer Updates - Living with Fibromyalgia, Drugs Approved to Manage Pain|last=Commissioner|first=Office of the|website=www.fda.gov|language=en|access-date=2018-08-09}}</ref> ([https://en.wikipedia.org/wiki/FDA_Consumer FDA For Consumers])

*[https://en.wikipedia.org/w/index.php?title=Cymbalta&redirect=no Cymbalta] ([https://www.drugs.com/availability/generic-cymbalta.html Duloxetine is Generic])<ref>{{Cite journal|date=2018-08-05|title=Duloxetine|url=https://en.wikipedia.org/w/index.php?title=Duloxetine&oldid=853590069|journal=Wikipedia|language=en}}</ref>

*[[Lyrica]] (generic will be [[Pregabalin]])

*[https://en.wikipedia.org/w/index.php?title=Savella&redirect=no Savella] ([https://www.drugs.com/mtm/milnacipran.html Milnacipran is Generic])<ref>{{Cite news|url=https://www.drugs.com/mtm/milnacipran.html|title=Milnacipran Uses, Side Effects & Warnings - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref>

==== FDA approved Side effects ====
''Not all side effects or possible drug interactions of brand name or generic name drugs are listed or linked, review EACH brand name and EACH generic name medication's side effects and possible drug interactions with your doctor and pharmacist.''

*Cymbalta is facing lawsuits due to severe withdrawal symptoms.<ref>(Duloxetine is Generic):[http://www.drugwatch.com/cymbalta/lawsuits/ Cymbalta Lawsuits - Drug Watch]</ref> There is a Facebook group dedicated to questions about the drug and tapering off of it; [https://www.facebook.com/groups/Cymbaltahurtsworse/?multi_permalinks=572848582870894&notif_t=group_highlights Cymbalta Hurts Worse]. Eli Lilly has settled hundreds of personal injury lawsuits with patients experiencing severe withdrawal symptoms.<ref>{{Cite news|url=http://nationalpainreport.com/eli-lilly-settles-cymbalta-withdrawal-lawsuits-8831647.html|title=Eli Lilly Settles Cymbalta Withdrawal Lawsuits|last=Gregory Burch|first=Donna|date=2016-10-06|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref> [https://www.drugs.com/sfx/cymbalta-side-effects.html Cymbalta side effects] and ([https://www.drugs.com/sfx/milnacipran-side-effects.html Duloxetine side effects]).

*Lyrica is causing weight gain. [https://www.drugs.com/sfx/lyrica-side-effects.html Lyrica side effects] and ([https://www.drugs.com/availability/generic-lyrica.html no generic available])<ref>{{Cite web|url=https://www.healthcentral.com/article/court-blocks-sale-of-generic-lyrica-upholds-pfizer-patents|title=Court Blocks Sale of Generic Lyrica, Upholds Pfizer Patents - Non-opioid Pain Medication - Chronic Pain {{!}} HealthCentral|last=Kathy Lee|first=Richards|date=Jul 25, 2012|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> until after 2018 when [[Pregabalin]] will be marketed.

*Savella has a list of side effects. (Milnacipran is Generic): [http://www.drugs.com/sfx/savella-side-effects.html Savella side effects]<ref>{{Cite news|url=https://www.drugs.com/sfx/savella-side-effects.html|title=Savella Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref> and ([https://www.drugs.com/sfx/milnacipran-side-effects.html Milnacipran side effects]).<ref>{{Cite news|url=https://www.drugs.com/sfx/milnacipran-side-effects.html|title=Milnacipran Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref>

----

====Off-label====
*[https://www.drugs.com/dosage/florinef.html Florinef]: ([[Fludrocortisone]] is generic) Off-label use for [[Orthostatic intolerance]] (OI) and [[Postural orthostatic tachycardia syndrome]] (POTS)

*[[Low dose naltrexone]]: Taken at bedtime for sleep. Helps pain due to better sleep.

*[https://www.drugs.com/neurontin.html Neurontin] ([[Gabapentin]] is generic): [http://www.mayoclinic.org/diseases-conditions/fibromyalgia/expert-answers/fibromyalgia-treatment/FAQ-20058273 Is gabapentin (Neurontin, others) an effective fibromyalgia treatment?]<ref>{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/expert-answers/fibromyalgia-treatment/FAQ-20058273|title=Fibromyalgia treatment: Is Neurontin effective?|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref> Used for pain, sleep.

*Low dose [https://www.drugs.com/seroquel.html Seroquel] ([[wikipedia:Quetiapine|Quetiapine is Generic]]):<ref>{{Cite journal|date=2018-08-02|title=Quetiapine|url=https://en.wikipedia.org/w/index.php?title=Quetiapine&oldid=853058838|journal=Wikipedia|language=en}}</ref> [http://www.cortjohnson.org/blog/2014/02/27/tackling-pain-depression-fibromyalgia-quetiapine-scores-benefits-clinical-trial/ Tackling Pain and Depression in Fibromyalgia: Quetiapine Scores Some Benefits in Clinical Trial] <ref>{{Cite news|url=https://www.healthrising.org/blog/2014/02/27/tackling-pain-depression-fibromyalgia-quetiapine-scores-benefits-clinical-trial/|title=Tackling Pain and Depression in Fibromyalgia: Quetiapine Scores Some Benefits in Clinical Trial - Health Rising|last=Johnson|first=Cort|date=2014-02-27|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref> Taken at bedtime for sleep.

*[https://www.drugs.com/ultram.html Ultram] and ([[Tramadol]] is Generic): For chronic ongoing pain.

*[https://www.drugs.com/zanaflex.html Zanaflex] ([[wikipedia:Tizanidine|Tizanidine is Generic]]):<ref>{{Cite journal|date=2018-07-03|title=Tizanidine|url=https://en.wikipedia.org/w/index.php?title=Tizanidine&oldid=848610982|journal=Wikipedia|language=en}}</ref> Muscle relaxer for pain, sleep.

==== Off-label Side effects ====
''Not all side effects or possible drug interactions of brand name or generic name drugs are listed or linked, review EACH brand name and EACH generic name medication's side effects and possible drug interactions with your doctor and pharmacist.''

*[https://www.drugs.com/dosage/florinef.html Florinef]: ([[Fludrocortisone]] is generic.) Weight gain, interacts with many other medications. [https://www.drugs.com/sfx/fludrocortisone-side-effects.html Fludrocortisione side effects]<ref>{{Cite news|url=https://www.drugs.com/sfx/fludrocortisone-side-effects.html|title=Fludrocortisone Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref> [https://www.drugs.com/sfx/florinef-side-effects.html Florinef side effects].<ref>{{Cite news|url=https://www.drugs.com/sfx/florinef-side-effects.html|title=Florinef Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US|last=|first=|date=|archive-url=|archive-date=|dead-url=}}</ref>
*Low dose naltrexone: Insomnia, the drug must be [https://me-pedia.org/wiki/Low_dose_naltrexone#Start_Low.2C_Go_Slow stepped up slowly].<ref>{{Cite news|url=http://www.drwhitaker.com/what-is-low-dose-naltrexone/|title=What is Low-Dose Naltrexone?|last=Whitaker|first=Julian|date=|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> Opioids will be rendered ineffective.<ref>{{Cite news|url=https://yourverity.wordpress.com/2009/07/07/drugs-to-avoid-when-taking-low-dose-naltrexone/|title=Drugs To Avoid When Taking Low Dose Naltrexone|date=2009-07-07|work=Yourverity's Blog|access-date=2018-08-09|language=en-US}}</ref>
*Neurontin (Gabapentin is generic): [https://www.drugs.com/sfx/neurontin-side-effects.html Neurontin side effects].
*Low dose Seroquel (Quetiapine is generic): (Used for Chronic Insomnia.) Weight gain, [https://en.wikipedia.org/wiki/Suicidal_ideation suicidal ideation]. Although prescribed for sleep it is not recommended.<ref>{{Cite journal|last=Coe|first=Holly V|last2=Hong|first2=Irene S|date=2012-04-17|title=Safety of Low Doses of Quetiapine When Used for Insomnia|url=http://journals.sagepub.com/doi/10.1345/aph.1Q697|journal=Annals of Pharmacotherapy|language=en|volume=46|issue=5|pages=718–722|doi=10.1345/aph.1q697|issn=1060-0280}}</ref><ref>{{Cite book|url=http://www.ncbi.nlm.nih.gov/books/NBK66081/|title=Off-Label Use of Atypical Antipsychotics: An Update|last=Maglione|first=Margaret|last2=Maher|first2=Alicia Ruelaz|last3=Hu|first3=Jianhui|last4=Wang|first4=Zhen|last5=Shanman|first5=Roberta|last6=Shekelle|first6=Paul G.|last7=Roth|first7=Beth|last8=Hilton|first8=Lara|last9=Suttorp|first9=Marika J.|date=2011|publisher=Agency for Healthcare Research and Quality (US)|series=AHRQ Comparative Effectiveness Reviews|location=Rockville (MD)|pmid=22132426}}</ref> [https://www.drugs.com/sfx/seroquel-side-effects.html Side effects of Seroquel].<ref>{{Cite news|url=https://www.drugs.com/sfx/seroquel-side-effects.html|title=Seroquel Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref>
*Ultram: ([[Tramadol]] is generic) [https://www.drugs.com/sfx/ultram-side-effects.html Ultram side effects].<ref>{{Cite news|url=https://www.drugs.com/sfx/ultram-side-effects.html|title=Ultram Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref>
:*Tramadol (Generic of Ultram): [http://fibromapp.com/fibromyalgia-cfsme-seizuresblackouts-the-tramadol-connection/ Having Seizures or Blackouts? The Tramadol Connection]<ref>{{Cite news|url=https://fibromapp.com/having-seizures-or-blackouts-the-tramadol-connection/|title=Tramadol: The Seizure and Blackout Connection|last=Reid|first=Alyssa|date=2016-05-23|work=FibroMapp Pain Manager+|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-GB}}</ref> [https://www.drugs.com/sfx/tramadol-side-effects.html Tramadol side effects].
*Zanaflex (Tizanadine is generic): [https://www.drugs.com/sfx/zanaflex-side-effects.html Zanaflex Side Effects].<ref name=":10">{{Cite news|url=https://fibromapp.com/having-seizures-or-blackouts-the-tramadol-connection/|title=Having Seizures or Blackouts? The Tramadol Connection|last=Reid|first=Alyssa|date=2016-05-23|work=FibroMapp Pain Manager+|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-GB}}</ref>

----

====Sleep medications====
''Not all side effects or possible drug interactions of brand name or generic name drugs are listed or linked, review EACH brand name and EACH generic name medication's side effects and possible drug interactions with your doctor and pharmacist.''

Disordered sleep is a prominent symptom in FM. There are four
types of sleep medications used in FM; antihistamines, benzodiazepines, nonbenzodiazepines, sedating antidepressants.<ref>{{Cite news|url=http://www.fibrodaze.com/sleep-medications/|title=Sleep Medications For Fibromyalgia •|last=Sue|first=|date=2014-12-17|work=Fibrodaze|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|publisher=|language=en-US|type=Blog}}</ref>

===Articles and blogs on drugs===

*[http://fibromapp.com/fibromyalgia-cfsme-seizuresblackouts-the-tramadol-connection/ Having Seizures or Blackouts? The Tramadol Connection]<ref name=":10" />

*[http://fedupwithfatigue.com/why-your-fibro-meds-arent-working/ Why Your Fibro Meds Aren't Working]<ref>{{Cite news|url=https://fedupwithfatigue.com/why-your-fibro-meds-arent-working/|title=Why your fibro meds aren't working {{!}} Fed Up with Fatigue|date=2015-05-28|work=Fed Up with Fatigue|access-date=2018-08-09|language=en-US}}</ref>

=== Drug trials ===

*ASP8062
:*2017, [https://clinicaltrials.gov/ct2/show/NCT03092726?term=ASP8062&cond=Fibromyalgia&rank=1 ClinicalTrials.gov A Phase 2a, Randomized, Double-Blind Placebo-controlled, Parallel-group Study to Assess the Analgesic Efficacy and Safety of ASP8062 in Subjects With Fibromyalgia]<ref>{{Cite news|url=https://clinicaltrials.gov/ct2/show/NCT03092726?term=ASP8062&cond=Fibromyalgia&rank=1|title=A Study to Assess the Analgesic Efficacy and Safety of ASP8062 in Subjects With Fibromyalgia - Full Text View - ClinicalTrials.gov|access-date=2018-08-09|language=en}}</ref>
*Cannabinoid-based therapy
:*2017, [https://fibromyalgianewstoday.com/2017/03/27/fibromyalgia-targeted-ap-cbd-thc-therapy-undergoing-phase-1-clinical-trial/ Intec Pharma Launches Phase 1 Trial of Cannabinoid-based Therapy for Fibromyalgia, Lower Back Pain.]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2017/03/27/fibromyalgia-targeted-ap-cbd-thc-therapy-undergoing-phase-1-clinical-trial/|title=Intec Pharma Launches Phase 1 Trial of Cannabinoid-based Therapy for Fibromyalgia, Lower Back Pain|last=Henriques|first=Carolina|date=Mar 27, 2017|work=Fibromyalgia News Today|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=}}</ref>

*IMC-1

:*2016, [http://simmaronresearch.com/2016/10/pridgen-antiviral-treatment-fibromyaligia/ The Pridgen Revolution? Dr. Pridgen on Bringing His Antiviral Approach to Fibromyalgia To Market] <ref name=":11" /> "Almost three years ago, Dr. Pridgen threatened to turn the world of fibromyalgia treatment on its head. Few had connected fibromyalgia with viruses or even immune problems when Pridgen announced that a) FM is caused herpes simplex virus reactivation and b) that it could be treated with antivirals."<ref name=":11">{{Cite news|url=http://simmaronresearch.com/2016/10/pridgen-antiviral-treatment-fibromyaligia/|title=The Pridgen Revolution? Dr. Pridgen on Bringing His Antiviral Approach to Fibromyalgia To Market - Simmaron Research|last=Johnson|first=Cort|date=2016-10-17|work=Simmaron Research|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
:*2016, [https://fibromyalgianewstoday.com/2016/02/02/combo-tx-fast-tracked-for-fibromyalgia/ Novel Fibromyalgia Treatment Granted FDA Fast Track Designation] <ref name=":12" /> "In the successful Phase II trial in fibromyalgia, IMC-1 was studied to confirm the hypothesis that chronic tissue-resident herpes simplex virus type 1 ([[HSV-1]]) may be one of the underlying causes of fibromyalgia and causally related to fibromyalgia symptoms or recurrence. IMC-1 is a novel fixed-dose oral combination antiviral medication designed to suppress this suspected virus and thus alleviate fibromyalgia symptoms."<ref name=":12">{{Cite news|url=http://fibromyalgianewstoday.com/2016/02/02/combo-tx-fast-tracked-for-fibromyalgia/|title=Novel Fibromyalgia Treatment Granted FDA Fast Track Designation - Fibromyalgia News Today|last=Moore|first=Charles|date=2016-02-02|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
:*2017, [http://simmaronresearch.com/2017/03/valley-death-fibromyalgia-pridgen/ Through the “Valley of Death”: Dr. Pridgen, Fibromyalgia and the Looming Trials]<ref name=":13" /> "First there were the anecdotal reports – FM patients were not just getting better but some, and not just a few, were getting well using something entirely new – an antiviral protocol, of all things, created not by a pain specialist or rheumatologist but by a surgeon."<ref name=":13">{{Cite news|url=http://simmaronresearch.com/2017/03/valley-death-fibromyalgia-pridgen/|title=Through the "Valley of Death": Dr. Pridgen, Fibromyalgia and the Looming Trials - Simmaron Research|last=Johnson|first=Cort|date=2017-03-26|work=Simmaron Research|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
:*2017, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328426/? A famciclovir + celecoxib combination treatment is safe and efficacious in the treatment of fibromyalgia]<ref>{{Cite journal|last=Pridgen|first=William L|last2=Duffy|first2=Carol|last3=Gendreau|first3=Judy F|last4=Gendreau|first4=R Michael|date=2017-02-22|title=A famciclovir + celecoxib combination treatment is safe and efficacious in the treatment of fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328426/|journal=Journal of Pain Research|volume=10|pages=451–460|doi=10.2147/JPR.S127288|issn=1178-7090|pmc=|pmid=28260944|via=}}</ref>

<blockquote>IMC-1 was efficacious and safe in treating symptoms of fibromyalgia, supporting the hypothesis that herpes virus infections may contribute to this syndrome. Improved retention rates, decreased adverse event rates, and evidence of efficacy on a broad spectrum of outcome measures are suggestive that IMC-1 may represent an effective, novel treatment for fibromyalgia.</blockquote>

*Bacille Calmette-Guerin (BCG) vaccine
:*2017, [http://www.prohealth.com/library/showArticle.cfm?libid=30644 Century-old vaccine gives new hope to fibromyalgia community]<ref>{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

===Drug trials failed===

*TNX-102

:*2016, The drug failed in its primary goal in providing pain relief and ''Tonix Pharmaceuticals'' will not be moving forward in developing a Ffbromyalgia drug.<ref>{{Cite news|url=http://nationalpainreport.com/potential-fibromyalgia-treatment-is-put-on-hold-8831410.html|title=Potential Fibromyalgia Treatment is Put on Hold|last=Gregory Burch|first=Donna|date=2016-09-10|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*Phase III clinical trial of DS-5565 found ineffective

:*2017, [https://www.healthrising.org/blog/2017/07/08/mirogabalin-fibromyalgia-drug-fails/ The Big Hurt: Second Major Fibromyalgia Drug in a Year Fails] <ref name=":14" /> "In the three 13-week, double-blind, global, phase 3 ALDAY clinical trials evaluating Mirogabalin for the treatment of pain associated with fibromyalgia, Mirogabalin did not meet the primary efficacy endpoint to demonstrate a statistically significant reduction in the weekly average of worst daily pain score from baseline to Week 13."<ref name=":14">{{Cite news|url=https://www.healthrising.org/blog/2017/07/08/mirogabalin-fibromyalgia-drug-fails/|title=The Big Hurt: Second Major Fibromyalgia Drug in a Year Fails - Health Rising|last=Johnson|first=Cort|date=2017-07-08|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== Therapies ===

==== Exercise ====
''Please Note'': These recommendations are for fibromyalgia patients and '''not''' [[ME/CFS]] sufferers.

*Warm water exercise is best.<ref>{{Cite news|url=http://chronicfatigue.about.com/od/treatingfmscfs/a/warmwaterFMS.htm|title=Warm Water Exercise for Fibromyalgia|last=Dellwo|first=Adrienne|date=Nov 19, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|last=Munguía-Izquierdo|first=D.|last2=Legaz-Arrese|first2=A.|date=2007|title=Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/18173915|journal=Clinical and Experimental Rheumatology|volume=25|issue=6|pages=823–830|issn=0392-856X|pmid=18173915|via=}}</ref>

*Moderate aerobic exercise and weights with as fewer reps possible with a day or two of rest in between. Do not start a program if you are in a flare.<ref>{{Cite web|url=http://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/fibromyalgia-questions/fibromyalgia-exercise.php|title=Fibromyalgia Exercise {{!}} Exercising with Fibromyalgia|last=Ronenn|first=Roubenoff|date=|website=www.arthritis.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[https://www.youtube.com/watch?v=BauJYuJwFsI Easy fibromyalgia exercises and motivation to keep you healthy!]<ref>{{Cite web|url=https://www.youtube.com/watch?v=BauJYuJwFsI|title=Easy Fibromyalgia exercises and motivation to keep you healthy!|last=Suarez|first=Eric|date=Jun 21, 2011|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=Aug 9, 2018}}</ref> Video

*[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/Fibromyalgia-Myth-Vs-Fact.htm Fibromyalgia Myth vs. Fact]<ref name=":15">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-myth-vs-fact-716131|title=Fibromyalgia: What's Myth, What's Fact?|last=Dellwo|first=Adrienne|date=Jun 8, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=Myth #3 People With Fibromyalgia Need More Exercise}}</ref> Heading: ''Myth #3: People With Fibromyalgia Need More Exercise''. Appropriate exercise, which each patient needs to gauge for themselves.<ref name=":15" />

==== Massage ====

*2014, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/ Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]<ref>{{Cite journal|last=Li|first=Yan-hui|last2=Wang|first2=Feng-yun|last3=Feng|first3=Chun-qing|last4=Yang|first4=Xia-feng|last5=Sun|first5=Yi-hua|date=2014-02-20|title=Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/|journal=PLoS ONE|volume=9|issue=2|doi=10.1371/journal.pone.0089304|issn=1932-6203|pmc=|pmid=24586677|pages=|via=}}</ref>

*2016, [http://chronicfatigue.about.com/od/alternativetreatments/a/bodywork.htm Massage, Rolfing & Other Bodywork - Are They Effective Fibromyalgia & Chronic Fatigue Syndrome Treatments?]<ref>{{Cite news|url=https://www.verywellhealth.com/massage-rolfing-other-bodywork-715645|title=Massage, Rolfing, Reiki: Do They Work for Fibromyalgia & ME/CFS?|last=Dellwo|first=Adrienne|date=Aug 10, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==== Acupuncture ====

*2004, [[U.S. Department of Health and Human Services]] (HHS) and [https://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services Centers for Medicare and Medicaid Services] (CMS) ruled April 16, 2004, a noncoverage determination for acupuncture.<ref>{{Cite web|url=https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R11NCD.pdf|title=CMS Manual System Pub. 100-03 Medicare
National Coverage Determinations|last=|first=|date=Apr 16, 2004|website=CMS.gov|format=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2005, [http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html Acupuncture Good for Fibromyalgia?] <ref name=":16">{{Cite web|url=http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html|title=Acupuncture Good for Fibromyalgia?|last=|first=|date=Oct 2, 2012|website=Acupuncture School Online|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> "Acupuncture gave no significant pain relief to fibromyalgia patients."<ref name=":16" />

*2016, [http://www.sciencedirect.com/science/article/pii/S2095496416602352 Short-term complementary and alternative medicine on quality of life in women with fibromyalgia] <ref>{{Cite journal|date=2016-01-01|title=Short-term complementary and alternative medicine on quality of life in women with fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S2095496416602352|journal=Journal of Integrative Medicine|language=en|volume=14|issue=1|pages=29–35|doi=10.1016/S2095-4964(16)60235-2|issn=2095-4964}}</ref>

<blockquote>There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session.</blockquote>

*2016, [https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/ Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/|title=Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients - Fibromyalgia News Today|last=Semedo|first=Daniela|date=2016-02-01|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Disability ==
===United States===
''Please Note'': The following is NOT legal advice and it should not be relied upon in taking steps for a disability case. Only ''[https://www.ssa.gov/ Social Security]'' and a disability lawyer can provide the most up to date and the correct legal avenue for bringing a disability case.

In the[[ United States]], [https://www.ssa.gov/ssi/ Social Security Insurance] and [https://www.ssa.gov/disability/ Social Security Disability] (SSI) and (SSD) benefits are available for Fibromyalgia. Generally for SSI/SSD, notes and tests from a ''Primary Provider'' '''may''' be allowed for submission but ''Specialists'' such as a rheumatologist, neurologist, psychiatrist, etc. are required for diagnosis, ongoing treatment and completing SSI/SSD paperwork.

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose Fibromyalgia. (See: "Policy Interpretation" for the POLICY INTERPRETATION RULING.)<ref>[https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia]</ref>

*[http://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social Applying for Disability With Fibromyalgia]<ref>{{Cite news|url=https://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social|title=Fibromyalgia Disability: Applying for Disability Benefits With Fibromyalgia|date=2016-10-03|work=NewLifeOutlook {{!}} Fibromyalgia|access-date=2018-08-09|language=en-US}}</ref> One patient's success of applying, denial, successful appeal, and a breakdown of what SSI/SSD requires for the medical determination of a favorable decision of disability.

*[https://www.socialsecurity.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html Fibromyalgia: Policy Interpretation Ruling - Social Security]<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=|website=www.ssa.gov|at=Titles II and XVI: Evaluation of Fibromyalgia|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[http://www.disabilitysecrets.com/social_security_disability_fibromyalgia.html Social Security Disability (SSDI & SSI) for Fibromyalgia - Disability Secrets By NOLO]<ref>{{Cite news|url=https://www.disabilitysecrets.com/resources/social-security-disability-ssdi-ssi-fibromyalgia.htm|title=Social Security Disability (SSDI & SSI) for Fibromyalgia|last=Laurence|first=Bethany|date=|work=www.disabilitysecrets.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*[http://www.mdjunction.com/fibromyalgia/fibromyalgia-disability Fibromyalgia Disability Patient Support Forums]<ref>{{Cite web|url=https://www.mdjunction.com/fibromyalgia/fibromyalgia-disability|title=Fibromyalgia Disability|website=MDJunction|language=en|access-date=2018-08-09}}</ref> at [[MDJunction]]

==== Examinations and Tests ====
For documentation of symptoms and co-morbidities of a FM diagnosis, you and your doctor should consider the following examinations and tests:

:'''Fibromyaglia Diagnostic Examination'''
:*[http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist Rheumatologist] examination and diagnosis of FM. (Consider having a rheumatologist order tests and coordinate referrals for other specialists for examinations and testing. Only specialists can complete the paperwork for Social Security. A primary doctor cannot complete disability paperwork but ''may'' be able to forward test results they have ordered.)
:'''Arthritis'''
:*[https://en.wikipedia.org/wiki/Nuclear_medicine#Diagnostic Whole body bone scan]<ref>{{Cite journal|date=2018-05-22|title=Nuclear medicine|url=https://en.wikipedia.org/w/index.php?title=Nuclear_medicine&oldid=842409692|journal=Wikipedia|language=en}}</ref> to rule out treatable arthritis.
:'''Blood Tests'''
:*Routine blood tests for [[diabetes]] (fasting sugar, A1C) and a full [[Thyroid disease]] panel ([https://en.wikipedia.org/wiki/Thyroid_function_tests#Thyroid-stimulating_hormone TSH, T3, Free T3, T4 and Free T4]).
:*Rule out [[Rheumatoid arthritis]], lupus, [[Lyme disease]] and other diseases that can share some of the same symptoms of fibromyalgia and may be treatable.<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1-3|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}</ref>
:*Vitamin and mineral deficiencies such as [[B12]] and [[Vitamin D]] are treatable with over the counter supplements and prescription medications which can improve [[fatigue]] and [[pain]].
:'''Gastrointestinal'''
:*[[Irritable bowel syndrome]] diagnosis which may require blood, [http://www.mayoclinic.org/tests-procedures/endoscopy/basics/definition/PRC-20020363 upper endoscopy] to rule out [https://en.wikipedia.org/wiki/Coeliac_disease celiac disease] and [https://en.wikipedia.org/wiki/Stool_test fecal tests] to check for bacteria ([[SIBO]]) and [http://www.umm.edu/health/medical/altmed/condition/intestinal-parasites intestinal parasites].
:'''Mental Health and Cognition'''
:* Psychiatric evaluation as any [[depression]] and [[anxiety]] should be treated.
:* [[Cognitive dysfunction]] tests.
:'''Sleep dysfunction'''
:*Sleep study for [[Restless legs syndrome]], [[Sleep disturbance]] and rule out [[Narcolepsy]].
:'''Orthostatic Intolerance'''
:*[[Tilt table test]] for [[Orthostatic intolerance]].
:'''TMJ, tinnitus, vertigo, and dizziness'''
:*An ear, nose, and throat specialist (ENT) ([http://www.mayoclinic.org/departments-centers/otorhinolaryngology-ent/overview Otorhinolaryngology]) examination and imaging may be ordered for [[Temporomandibular joint disorder]] (TMJ).
:*(Ear, sinus, throat/lymph infections, and [[tinnitus]] can also be documented.)
:*[https://en.wikipedia.org/wiki/Videonystagmography Videonystagmography] (VNG) testing if you experience [[vertigo]] and/or [[dizziness]].<ref>{{Cite news|url=https://www.everydayhearing.com/balance/articles/what-to-expect-at-your-vng-test/|title=What to Expect at Your VNG/ENG Test - Everyday Hearing|last=Banks|first=Lindsey|date=2014-05-07|work=Everyday Hearing|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

Of course, one can have arthritis, sleep apnea, [[Chronic lyme disease|chronic Lyme disease]] or other diseases and still have FM, but there may be a treatable condition where a patient's overall health, including their FM, improves.<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/guide/common-misdiagnoses-of-fibromyalgia#1|title=Common Misdiagnoses of Fibromyalgia|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite web|url=http://www.cfidsselfhelp.org/library/overlapping-and-related-conditions|title=Overlapping and Related Conditions {{!}} CFIDS & Fibromyalgia Self-Help|website=www.cfidsselfhelp.org|access-date=2018-08-09}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

There have been cases of [[Vitamin D]] deficiency being misdiagnosed as fibromyalgia as a D deficiency can cause pain. Supplementation or prescribed D treatments may alleviate this pain. However, it is possible to have both a D deficiency and fibromyalgia and correcting the deficiency will only resolve the pain stemming from it.<ref>{{Cite news|url=http://www.webmd.com/pain-management/features/vitamin-d-deficiency-and-chronic-pain-link#1|title=Does Vitamin D Deficiency Cause Chronic Pain?|last=Shaw|first=Gina|date=|work=WebMD|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

==== Blogs about navigating SSD process ====

*Resources for getting approved for disability include this [http://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/ Guide to Social Security Disability for People with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome],<ref>{{Cite web|url=https://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/|title=The Sleepy Girl Guide to Social Security Disability (U.S.) {{!}} #MEAction|last=Silver|first=Lily|date=Apr 17, 2017|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> available on the #[[MEAction]] website.

*[https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/ How Patty’s Lawyer Never Told Her What She Needed to Know]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/|title=How Patty’s Lawyer Never Told Her What She Needed to Know|last=Skelton Preston|first=Patty|date=2017-03-20|work=How to Get On|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/ Sample Doctor Letters for Disability]<ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/|title=21 Sample Doctor Letters for Disability|date=2017-05-01|work=How to Get On|access-date=2018-08-09|language=en-US}}</ref>

== Notable studies ==

*2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds]<ref>{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=CND: Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2004, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1754959/ A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing]<ref>{{Cite journal|last=Pimentel|first=M|last2=Wallace|first2=D|last3=Hallegua|first3=D|last4=Chow|first4=E|last5=Kong|first5=Y|last6=Park|first6=S|last7=Lin|first7=H|date=2004|title=A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1754959/|journal=Annals of the Rheumatic Diseases|volume=63|issue=4|pages=450–452|doi=10.1136/ard.2003.011502|issn=0003-4967|pmid=15020342|via=}}</ref>

*2012, [https://www.researchgate.net/publication/230626400_Dysfunctional_endogenous_analgesia_during_exercise_in_patients_with_chronic_pain_To_exercise_or_not_to_exercise Dysfunctional endogenous analgesia during exercise in patients with chronic pain: To exercise or not to exercise?]<ref>{{Cite book|url=https://www.researchgate.net/publication/230626400_Dysfunctional_endogenous_analgesia_during_exercise_in_patients_with_chronic_pain_To_exercise_or_not_to_exercise|title=Dysfunctional endogenous analgesia during exercise in patients with chronic pain: To exercise or not to exercise?|last=Nijs|first=Jo|last2=Kosek|first2=Eva|last3=Van Oosterwijck|first3=Jessica|last4=Meeus|first4=Mira|date=2012-07-01|volume=15}}</ref>

*2015, [http://onlinelibrary.wiley.com/doi/10.1111/1756-185X.12550/abstract Some oxidative and antioxidative parameters and their relationship with clinical symptoms in women with fibromyalgia syndrome]<ref>{{Cite journal|last=Fatima|first=Ghizal|last2=Das|first2=Siddharth Kumar|last3=Mahdi|first3=Abbas Ali|date=2015-07-14|title=Some oxidative and antioxidative parameters and their relationship with clinical symptoms in women with fibromyalgia syndrome|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/1756-185X.12550|journal=International Journal of Rheumatic Diseases|language=en|volume=20|issue=1|pages=39–45|doi=10.1111/1756-185x.12550|issn=1756-1841}}</ref>

*2015, [http://onlinelibrary.wiley.com/doi/10.1002/acr.22626/full Understanding the Association of Fatigue With Other Symptoms of Fibromyalgia: Development of a Cluster Model] <ref>{{Cite journal|last=Lukkahatai|first=Nada|last2=Walitt|first2=Brian|last3=Espina|first3=Alexandra|last4=Gelio|first4=Alves|last5=Saligan|first5=Leorey N.|date=2015-12-21|title=Understanding the Association of Fatigue With Other Symptoms of Fibromyalgia: Development of a Cluster Model|url=https://onlinelibrary.wiley.com/doi/full/10.1002/acr.22626|journal=Arthritis Care & Research|language=en|volume=68|issue=1|pages=99–107|doi=10.1002/acr.22626|issn=2151-464X|pmc=|pmid=26017904|via=}}</ref>

*2015, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia]<ref>{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}</ref>

*2015, [https://biblio.ugent.be/publication/6993821 Cognitive performance is related to central sensitization in patients with chronic whiplash-associated disorders and fibromyalgia: a case-control study]<ref>{{Cite journal|last=Iris|first=Coppieters,|last2=Kelly|first2=Ickmans,|last3=Barbara|first3=Cagnie,|last4=Jo|first4=Nijs,|last5=Robby|first5=De Pauw,|last6=Mira|first6=Meeus,|date=2015|title=Cognitive performance is related to central sensitization in patients with chronic whiplash-associated disorders and fibromyalgia: a case-control study|url=https://biblio.ugent.be/publication/6993821}}</ref>

*2015, [http://eujournal.org/index.php/esj/article/viewFile/6167/5952 Fibromyalgia: A search for markers and their evaluation throughout a treatment]<ref>{{Cite journal|last=Wyatt|first=H. J.|last2=Day|first2=N. W.|date=1976-01-16|title=Specific effects of neurotransmitter antagonists on ganglion cells in rabbit retina|url=https://www.ncbi.nlm.nih.gov/pubmed/1857|format=PDF|journal=Science (New York, N.Y.)|volume=191|issue=4223|pages=204–205|issn=0036-8075|pmid=1857|via=European Scientific Journal}}</ref>

*2015, [http://www.sciencedirect.com/science/article/pii/S2213158215001394 Normalization of aberrant resting state functional connectivity in fibromyalgia patients following a three-month physical exercise therapy]<ref>{{Cite journal|date=2015-01-01|title=Normalization of aberrant resting state functional connectivity in fibromyalgia patients following a three month physical exercise therapy|url=https://www.sciencedirect.com/science/article/pii/S2213158215001394|journal=NeuroImage: Clinical|language=en|volume=9|pages=134–139|doi=10.1016/j.nicl.2015.08.004|issn=2213-1582}}</ref>

*2015, [https://www.sciencedaily.com/releases/2015/08/150819172431.htm Researchers identify potential sleep-related treatment targets for fibromyalgia]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2015/08/150819172431.htm|title=Researchers identify potential sleep-related treatment targets for fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*2015, [https://www.sciencedaily.com/releases/2015/05/150517071813.htm Fibromyalgia has central nervous system origins]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2015/05/150517071813.htm|title=Fibromyalgia has central nervous system origins|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*2015, [http://synapse.koreamed.org/search.php?where=aview&id=10.3344/kjp.2015.28.3.169&code=0047KJP&vmode=FULL The Iceberg Nature of Fibromyalgia Burden: The Clinical and Economic Aspects]<ref>{{Cite journal|last=Banafsheh|first=Ghavidel-Parsa,|last2=Ali|first2=Bidari,|last3=Alireza|first3=Amir Maafi,|last4=Babak|first4=Ghalebaghi,|date=2015-07-01|title=The Iceberg Nature of Fibromyalgia Burden: The Clinical and Economic Aspects|url=https://synapse.koreamed.org/search.php?where=aview&id=10.3344/kjp.2015.28.3.169&code=0047KJP&vmode=FULL|journal=The Korean Journal of Pain|language=English|volume=28|issue=3|doi=10.3344/kjp.2015.28.3.169&code=0047kjp&vmode=full|issn=2005-9159}}</ref>

*2015, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499983/ The effects of aquatic, isometric strength-stretching and aerobic exercise on physical and psychological parameters of female patients with fibromyalgia syndrome]<ref>{{Cite journal|last=Sevimli|first=Dilek|last2=Kozanoglu|first2=Erkan|last3=Guzel|first3=Rengin|last4=Doganay|first4=Ahmet|date=2015|title=The effects of aquatic, isometric strength-stretching and aerobic exercise on
physical and psychological parameters of female patients with fibromyalgia
syndrome|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499983/|journal=Journal of Physical Therapy Science|volume=27|issue=6|pages=1781–1786|doi=10.1589/jpts.27.1781|issn=0915-5287|pmid=26180320|via=}}</ref>

*2016, [https://www.ncbi.nlm.nih.gov/pubmed/27713820 Fibromyalgia syndrome: metabolic and autophagic processes in intermittent cold stress mice.]<ref>{{Cite journal|last=Oezel|first=Lisa|last2=Then|first2=Hanna|last3=Jung|first3=Anna L.|last4=Jabari|first4=Samir|last5=Bonaterra|first5=Gabriel A.|last6=Wissniowski|first6=Thaddeus T.|last7=Önel|first7=Susanne F.|last8=Ocker|first8=Matthias|last9=Thieme|first9=Kati|date=2016|title=Fibromyalgia syndrome: metabolic and autophagic processes in intermittent cold stress mice|url=https://www.ncbi.nlm.nih.gov/pubmed/27713820|journal=Pharmacology Research & Perspectives|volume=4|issue=5|pages=e00248|doi=10.1002/prp2.248|issn=2052-1707|pmc=|pmid=27713820|via=}}</ref>

*2016, [http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161574 Fibromyalgia Is Correlated with Retinal Nerve Fiber Layer Thinning]<ref>{{Cite journal|last=Garcia-Martin|first=Elena|last2=Garcia-Campayo|first2=Javier|last3=Puebla-Guedea|first3=Marta|last4=Ascaso|first4=Francisco J.|last5=Roca|first5=Miguel|last6=Gutierrez-Ruiz|first6=Fernando|last7=Vilades|first7=Elisa|last8=Polo|first8=Vicente|last9=Larrosa|first9=Jose M.|date=2016-09-01|title=Fibromyalgia Is Correlated with Retinal Nerve Fiber Layer Thinning|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161574|journal=PLOS ONE|language=en|volume=11|issue=9|pages=e0161574|doi=10.1371/journal.pone.0161574|issn=1932-6203|pmc=|pmid=27584145|via=}}</ref>

*2016, [https://www.ncbi.nlm.nih.gov/pubmed/26272057 The prevalence of severe fatigue in rheumatic diseases: an international study.]<ref>{{Cite journal|last=Overman|first=Cécile L.|last2=Kool|first2=Marianne B.|last3=Da Silva|first3=José A. P.|last4=Geenen|first4=Rinie|date=2016|title=The prevalence of severe fatigue in rheumatic diseases: an international study|url=https://www.ncbi.nlm.nih.gov/pubmed/26272057|journal=Clinical Rheumatology|volume=35|issue=2|pages=409–415|doi=10.1007/s10067-015-3035-6|issn=1434-9949|pmid=26272057|via=}}</ref>

*2016, [http://journals.lww.com/clinicalpain/Abstract/2016/04000/Characteristics_of_Disturbed_Sleep_in_Patients.4.aspx Characteristics of Disturbed Sleep in Patients With Fibromyalgia Compared With Insomnia or With Pain-Free Volunteers]<ref>{{Cite journal|last=Roth|first=Thomas|last2=Bhadra-Brown|first2=Pritha|last3=Pitman|first3=Verne W.|last4=Roehrs|first4=Timothy A.|last5=Resnick|first5=E. Malca|date=2016|title=Characteristics of Disturbed Sleep in Patients With Fibromyalgia Compared With Insomnia or With Pain-Free Volunteers|url=https://journals.lww.com/clinicalpain/Abstract/2016/04000/Characteristics_of_Disturbed_Sleep_in_Patients.4.aspx|journal=The Clinical Journal of Pain|language=en-US|volume=32|issue=4|pages=302–307|doi=10.1097/AJP.0000000000000261|issn=0749-8047|via=}}</ref>

*2016, [https://www.ncbi.nlm.nih.gov/pubmed/26218005 Is Efficacy of Milnacipran in Fibromyalgia Predictable? A Data Mining Analysis of Baseline and Outcome Variables.]<ref>{{Cite journal|last=Abtroun|first=Lilia|last2=Bunouf|first2=Pierre|last3=Gendreau|first3=Roger M.|last4=Vitton|first4=Olivier|date=2016|title=Is the Efficacy of Milnacipran in Fibromyalgia Predictable? A Data-Mining Analysis of Baseline and Outcome Variables|url=https://www.ncbi.nlm.nih.gov/pubmed/26218005|journal=The Clinical Journal of Pain|volume=32|issue=5|pages=435–440|doi=10.1097/AJP.0000000000000284|issn=1536-5409|pmid=26218005|via=}}</ref>

*2017, [https://www.ncbi.nlm.nih.gov/pubmed/28614420# The degree of cardiac baroreflex involvement during active standing is associated with the quality of life in fibromyalgia patients.]<ref>{{Cite journal|last=Zamunér|first=Antonio Roberto|last2=Porta|first2=Alberto|last3=Andrade|first3=Carolina Pieroni|last4=Forti|first4=Meire|last5=Marchi|first5=Andrea|last6=Furlan|first6=Raffaello|last7=Barbic|first7=Franca|last8=Catai|first8=Aparecida Maria|last9=Silva|first9=Ester|date=2017|title=The degree of cardiac baroreflex involvement during active standing is associated with the quality of life in fibromyalgia patients|url=https://www.ncbi.nlm.nih.gov/pubmed/28614420#|journal=PloS One|volume=12|issue=6|pages=e0179500|doi=10.1371/journal.pone.0179500|issn=1932-6203|pmid=28614420|via=}}</ref> (Orthostatic Intollerance)

*2017, [https://www.dovepress.com/evidence-of-both-systemic-inflammation-and-neuroinflammation-in-fibrom-peer-reviewed-fulltext-article-JPR Evidence of both systemic inflammation and neuroinflammation in fibromyalgia patients, as assessed by a multiplex protein panel applied to the cerebrospinal fluid and to plasma]<ref>{{Cite journal|last=Bäckryd|first=Emmanuel|last2=Tanum|first2=Lars|last3=Lind|first3=Anne-Li|last4=Larsson|first4=Anders|last5=Gordh|first5=Torsten|date=2017|title=Evidence of both systemic inflammation and neuroinflammation in fibromyalgia patients, as assessed by a multiplex protein panel applied to the cerebrospinal fluid and to plasma|url=https://www.dovepress.com/evidence-of-both-systemic-inflammation-and-neuroinflammation-in-fibrom-peer-reviewed-fulltext-article-JPR|journal=Journal of Pain Research|language=English|volume=Volume 10|pages=515–525|doi=10.2147/JPR.S128508|issn=1178-7090|via=}}</ref>

*2017, [https://www.ncbi.nlm.nih.gov/pubmed/27583567 Towards a neurophysiological signature for fibromyalgia.]<ref>{{Cite journal|last=López-Solà|first=Marina|last2=Woo|first2=Choong-Wan|last3=Pujol|first3=Jesus|last4=Deus|first4=Joan|last5=Harrison|first5=Ben J.|last6=Monfort|first6=Jordi|last7=Wager|first7=Tor D.|date=2017|title=Towards a neurophysiological signature for fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/27583567|journal=Pain|volume=158|issue=1|pages=34–47|doi=10.1097/j.pain.0000000000000707|issn=1872-6623|pmid=27583567|via=}}</ref>

*2018, [https://www.ncbi.nlm.nih.gov/pubmed/29149437 A Blinded, Randomized, Placebo-Controlled Study to Investigate the Efficacy and Safety of Ferric Carboxymaltose in Iron-Deficient Patients with Fibromyalgia.]<ref>{{Cite journal|last=Boomershine|first=Chad S.|last2=Koch|first2=Todd A.|last3=Morris|first3=David|date=2018|title=A Blinded, Randomized, Placebo-Controlled Study to Investigate the Efficacy and Safety of Ferric Carboxymaltose in Iron-Deficient Patients with Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/29149437|journal=Rheumatology and Therapy|volume=5|issue=1|pages=271–281|doi=10.1007/s40744-017-0088-9|issn=2198-6576|pmid=29149437|via=}}</ref>

===Grant awards and current research===
*Oct 2016, [http://www.uofmhealth.org/news/archive/201610/chronic-pain-researchers-expand-work-75m-award-nih Chronic pain researchers to expand work with $7.5M award from NIH]<ref>{{Cite web|url=https://www.uofmhealth.org/news/archive/201610/chronic-pain-researchers-expand-work-75m-award-nih|title=Chronic pain researchers to expand work with $7.5M award from NIH {{!}} Michigan Medicine|last=|first=|date=Oct 17, 2016|website=www.uofmhealth.org|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>
*Jun 2018, The [[Bateman Horne Center]] will be an ''[https://allofus.nih.gov All of Us]'' recruitment center for people living with ME/CFS and fibromyalgia. ''All of Us'' is a ten year [https://en.wikipedia.org/wiki/Precision_medicine#Precision_Medicine_Initiative Precision Medicine Initiative] project that has been funded $1.5 Billion to recruit one million patients for its bio-bank. The idea is to research all diseases, from the most common to the most rare while taking into account lifestyle, environment, and biology.<ref>{{Cite news|url=http://batemanhornecenter.org/nih-announces-precision-medicine-initiative/|title=NIH Announces Precision Medicine Initiative - Bateman Horne Center|last=Black|first=Rachel|date=2018-06-20|work=Bateman Horne Center|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=https://allofus.nih.gov|title=National Institutes of Health (NIH) — All of Us|website=allofus.nih.gov|language=en|access-date=2018-08-09}}</ref>

=== Psychiatric paradigm ===

*2015, [https://www.ncbi.nlm.nih.gov/pubmed/26190965 Brain "fog," inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin.]<ref>{{Cite journal|last=Theoharides|first=Theoharis C.|last2=Stewart|first2=Julia M.|last3=Hatziagelaki|first3=Erifili|last4=Kolaitis|first4=Gerasimos|date=2015|title=Brain "fog," inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin|url=https://www.ncbi.nlm.nih.gov/pubmed/26190965|journal=Frontiers in Neuroscience|volume=9|pages=225|doi=10.3389/fnins.2015.00225|issn=1662-4548|pmid=26190965|via=}}</ref>

*2016, [http://bjp.sagepub.com/content/10/3/156.full.pdf+html Explaining unexplained pain to fibromyalgia patients: finding a narrative that is acceptable to patients and provides a rationale for evidence-based interventions]<ref>{{Cite journal|last=Hyland|first=Michael E|last2=Hinton|first2=Claire|last3=Hill|first3=Charlotte|last4=Whalley|first4=Ben|last5=Jones|first5=Rupert CM|last6=Davies|first6=Anthony F|date=2016-07-08|title=Explaining unexplained pain to fibromyalgia patients: finding a narrative that is acceptable to patients and provides a rationale for evidence based interventions|url=http://journals.sagepub.com/doi/pdf/10.1177/2049463716642601|journal=British Journal of Pain|language=en|volume=10|issue=3|pages=156–161|doi=10.1177/2049463716642601|issn=2049-4637|pmid=27583142|via=}}</ref>

*2016, [http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf Fibromyalgia: A Short Commentary iMedPub Journals - Journal of Headache & Pain Management - Frederick Wolfe and Brian Walitt]<ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=Oct 15, 2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|format=PDF|journal=Journal of Headache & Pain Management|volume=|pages=|doi=10.4172/2472-1913.100027|issn=2472-1913|via=iMedPub Journals}}</ref>

===Hyperbaric oxygen therapy===

*2015, [http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0127012 Hyperbaric Oxygen Therapy Can Diminish Fibromyalgia Syndrome]<ref>{{Cite journal|last=Efrati|first=Shai|last2=Golan|first2=Haim|last3=Bechor|first3=Yair|last4=Faran|first4=Yifat|last5=Daphna-Tekoah|first5=Shir|last6=Sekler|first6=Gal|last7=Fishlev|first7=Gregori|last8=Ablin|first8=Jacob N.|last9=Bergan|first9=Jacob|date=2015-05-26|title=Hyperbaric Oxygen Therapy Can Diminish Fibromyalgia Syndrome – Prospective Clinical Trial|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0127012|journal=PLOS ONE|language=en|volume=10|issue=5|pages=e0127012|doi=10.1371/journal.pone.0127012|issn=1932-6203|pmid=26010952|via=}}</ref>

:[http://www.news-medical.net/news/20150603/Women-who-suffer-from-fibromyalgia-benefit-from-hyperbaric-oxygen-therapy.aspx Noted in this News Medical article about the research all the women had concussions.]<ref>{{Cite news|url=https://www.news-medical.net/news/20150603/Women-who-suffer-from-fibromyalgia-benefit-from-hyperbaric-oxygen-therapy.aspx|title=Women who suffer from fibromyalgia benefit from hyperbaric oxygen therapy|date=2015-06-03|work=News-Medical.net|access-date=2018-08-09|language=en}}</ref>

*2016, [https://t.co/BqnFto5mTe Hyperbaric Oxygen Therapy for treating Fibromyalgia: An update]<ref>{{Cite news|url=https://februarystars.co.uk/2016/06/hyperbaric-oxygen-therapy-for-treating-fibromyalgia-an-update/?utm_source=ReviveOldPost&utm_medium=social&utm_campaign=ReviveOldPost|title=Hyperbaric Oxygen Therapy for treating Fibromyalgia: An update|date=2016-06-20|work=February Stars|access-date=2018-08-09|language=en-GB}}</ref>

== Controversies ==
=== Dr. Frederick Wolfe ===
Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.<ref>{{Cite news|url=http://www.nytimes.com/2008/01/14/health/14pain.html?_r=0|title=Drug Approved. Is Disease Real?|last=Berenson|first=Alex|date=Jan 14, 2008|work=The Wall Street Journal|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>[http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf Fibromyalgia: A Short Commentary - iMedPub Journals - DOI: 10.4172/2472-1913.100027 - Frederick Wolfe and Brian Walitt - Sep. 23, 2016]</ref><ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|journal=Journal of Headache & Pain Management|volume=1|issue=3:27|pages=|via=iMedPub Journals}}</ref><ref>{{Cite news|url=https://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx|title=Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine|last=Cashin-Garbutt|first=April|date=2013-03-22|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Fibromyalgia vs Chiari malformation ===
Some individuals diagnosed with FMS were undergoing surgery for [[Chiari malformation]] (CM). These are two separate conditions; FMS cannot be resolved by undergoing a risky CM surgery.

*2011, [https://www.ncbi.nlm.nih.gov/pubmed/21135714 Is Chiari I malformation associated with fibromyalgia?]<ref>{{Cite journal|last=Watson|first=Nathaniel F.|last2=Buchwald|first2=Dedra|last3=Goldberg|first3=Jack|last4=Maravilla|first4=Kenneth R.|last5=Noonan|first5=Carolyn|last6=Guan|first6=Qingyan|last7=Ellenbogen|first7=Richard G.|date=2011|title=Is Chiari I malformation associated with fibromyalgia?|url=https://www.ncbi.nlm.nih.gov/pubmed/21135714|journal=Neurosurgery|volume=68|issue=2|pages=443–448; discussion 448–449|doi=10.1227/NEU.0b013e3182039a31|issn=1524-4040|pmid=21135714|via=}}</ref>
::Conclusion: Most patients with FM do not have [[CIM]] pathology. Future studies should focus on dynamic neuroimaging of craniocervical neuroanatomy in patients with FM.
*2015, [https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery CFS/FM and Chiari Malformation Surgery]<ref>{{Cite web|url=https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery|title=CFS/FM and Chiari Malformation Surgery|last=Casanova|first=Ken|date=Nov 15, 2015|website=www.massmecfs.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

== Learn more ==
*[https://www.s4me.info/forums/fibromyalgia-and-connective-tissue-disorders.35/ Forum: Fibromyalgia and Connective Tissue Disorders] at [[Science for ME]]
*[[Verywell FMS/CFS]]

=== Ongoing process of diagnosing and categorizing ===

*2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3447191/ Personality and Fibromyalgia Syndrome]<ref>{{Cite journal|last=Malin|first=Katrina|last2=Littlejohn|first2=Geoffrey O|date=2012-09-07|title=Personality and Fibromyalgia Syndrome|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3447191/|journal=The Open Rheumatology Journal|volume=6|pages=273–285|doi=10.2174/1874312901206010273|issn=1874-3129|pmid=23002409|via=}}</ref>

<blockquote>Conclusion: No specific fibromyalgia personality is defined but it is proposed that personality is an important filter that modulates a person’s response to psychological stressors. Certain personalities may facilitate translation of these stressors to physiological responses driving the fibromyalgia mechanism.</blockquote>

*2014, [http://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114 Lyme Disease, Fibromyalgia Link Evaporates]<ref>{{Cite news|url=https://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114|title=Lyme Disease, Fibromylagia Link Evaporates|last=Kuznar|first=Wayne|date=2014-12-14|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> (See also: [[Chronic lyme disease]])

*2015, [http://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx Fibromyalgia now considered as a lifelong central nervous system disorder]<ref>{{Cite news|url=https://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx|title=Fibromyalgia now considered as a lifelong central nervous system disorder|date=2015-05-18|work=News-Medical.net|access-date=2018-08-09|language=en}}</ref>

*2015, [http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates]<ref>{{Cite news|url=http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html|title=Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates|date=2015-10-24|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2015, [http://www.jneuro.com/neurology-neuroscience/evaluation-of-antiviral-antibodies-against-epsteinbarr-virus-and-neurotransmitters-in-patients-with-fibromyalgia.pdf Evaluation of Antiviral Antibodies against Epstein-Barr Virus and Neurotransmitters in Patients with Fibromyalgia]<ref>{{Cite journal|last=Reshkova|first=V|last2=D|first2=Kalinova|last3=Milanov|first3=Ivan|date=2015-01-01|title=Evaluation of Antiviral Antibodies against Epstein-Barr Virus and Neurotransmitters in Patients with Fibromyalgia|url=https://www.researchgate.net/publication/289245186_Evaluation_of_Antiviral_Antibodies_against_Epstein-Barr_Virus_and_Neurotransmitters_in_Patients_with_Fibromyalgia|journal=Journal of Neurology and Neuroscience|volume=6|pages=35|doi=10.21767/2171-6625.100035}}</ref>

*2015, ''Question:'' [http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html 'Is Fibromyalgia a Psychosomatic Illness?'] via CelesteCooper.com ''Answer:'' "Fibromyalgia is NOT a psychosomatic illness."<ref>[http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html Is Fibromyalgia a Psychosomatic Illness? Med Student Asks Celeste Cooper by Celeste Cooper - CelesteCooper.com Sep 4, 2015]</ref>

*2015, [https://onlinelibrary.wiley.com/doi/full/10.1002/acr.22626 Understanding the Association of Fatigue With Other Symptoms of Fibromyalgia: Development of a Cluster Model]<ref>{{Cite journal|last=Lukkahatai|first=Nada|last2=Walitt|first2=Brian|last3=Espina|first3=Alexandra|last4=Gelio|first4=Alves|last5=Saligan|first5=Leorey N.|date=2015-12-21|title=Understanding the Association of Fatigue With Other Symptoms of Fibromyalgia: Development of a Cluster Model|url=https://onlinelibrary.wiley.com/doi/full/10.1002/acr.22626|journal=Arthritis Care & Research|language=en|volume=68|issue=1|pages=99–107|doi=10.1002/acr.22626|issn=2151-464X|pmid=26017904|via=}}</ref>

*2016, [http://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination Diagnosing Fibromyalgia May Be Possible Using Noninvasive Eye Examination]<ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination|title=Diagnosing Fibromyalgia May Be Possible with Noninvasive Eye Exam|date=2016-09-09|work=Fibromyalgia News Today|access-date=2018-08-09|language=en-US}}</ref>

*2016, [http://bjpo.rcpsych.org/content/2/4/275 The association between borderline personality disorder, fibromyalgia and chronic fatigue syndrome: systematic review]<ref>{{Cite journal|last=Penfold|first=Sarah|last2=Denis|first2=Emily St|last3=Mazhar|first3=Mir Nadeem|date=Jul 2016|title=The association between borderline personality disorder, fibromyalgia and chronic fatigue syndrome: systematic review|url=https://www.cambridge.org/core/journals/bjpsych-open/article/association-between-borderline-personality-disorder-fibromyalgia-and-chronic-fatigue-syndrome-systematic-review/119F3075289EBCC85D454D8D182DB1A6|journal=BJPsych Open|language=en|volume=2|issue=4|pages=275–279|doi=10.1192/bjpo.bp.115.002808|issn=2056-4724}}</ref>

<blockquote>There does not appear to be firm and consistent evidence to support the hypothesis that the prevalence of BPD ([[Borderline Personality Disorder]]) would be higher in individuals with fibromyalgia compared with the general population.</blockquote>

*2016, [https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780 Microglia in Fibromyalgia & Chronic Fatigue Syndrome]<ref>{{Cite news|url=https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780|title=Microglia in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*2016, [http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/ Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders?]<ref>{{Cite news|url=http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/|title=Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders? - Simmaron Research|date=2016-03-21|work=Simmaron Research|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://consultqd.clevelandclinic.org/2016/03/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic Why Fibromyalgia Is Neuropathic]<ref>{{Cite news|url=https://consultqd.clevelandclinic.org/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic|title=Why Fibromyalgia Is Neuropathic|date=2016-03-08|work=Consult QD|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://www.ncbi.nlm.nih.gov/pubmed/27583567 Towards a neurophysiological signature for fibromyalgia]<ref>{{Cite journal|last=López-Solà|first=Marina|last2=Woo|first2=Choong-Wan|last3=Pujol|first3=Jesus|last4=Deus|first4=Joan|last5=Harrison|first5=Ben J.|last6=Monfort|first6=Jordi|last7=Wager|first7=Tor D.|date=2017|title=Towards a neurophysiological signature for fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/27583567|journal=Pain|volume=158|issue=1|pages=34–47|doi=10.1097/j.pain.0000000000000707|issn=1872-6623|pmid=27583567|via=}}</ref> (With MRI images.)

<blockquote>Discovered a brain signature that identifies fibromyalgia sufferers with 93 percent accuracy.</blockquote>

*2017, [http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain]<ref>{{Cite news|url=http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html|title=Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain|last=Liptan|first=Ginevra|date=2017-04-11|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2018, [http://www.jrheum.org/content/early/2018/07/09/jrheum.180083 Primary and Secondary Fibromyalgia Are The Same: The Universality of Polysymptomatic Distress]<ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|last3=Rasker|first3=Johannes J.|last4=Häuser|first4=Winfried|date=2018-07-15|title=Primary and Secondary Fibromyalgia Are The Same: The Universality of Polysymptomatic Distress|url=http://www.jrheum.org/content/early/2018/07/09/jrheum.180083|journal=The Journal of Rheumatology|language=en|pages=jrheum.180083|doi=10.3899/jrheum.180083|issn=0315-162X|pmid=30008459}}</ref>

<blockquote>PFM and SFM are equivalent regarding symptom burden.</blockquote>

=== Blood tests ===

*2013, [http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html New Fibromyalgia Blood Test is 99% Accurate]<ref>{{Cite news|url=http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html|title=New Fibromyalgia Blood Test is 99% Accurate|date=2013-07-31|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2014, [http://www.prohealth.com/library/showarticle.cfm?libid=18837 Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”]<ref>{{Cite news|url=https://www.prohealth.com/library/pridgen-reports-fibromyalgia-antiviral-trial-results-very-positive-predicts-new-approach-will-be-game-changer-32620|title=Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”|last=|first=|date=2014-03-25|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2015, [http://www.ncbi.nlm.nih.gov/pubmed/25377646 Cytokine and chemokine profiles in fibromyalgia, rheumatoid arthritis, and systemic lupus erythematosus: a potentially useful tool in differential diagnosis.]<ref>{{Cite journal|last=Wallace|first=Daniel J.|last2=Gavin|first2=Igor M.|last3=Karpenko|first3=Oleksly|last4=Barkhordar|first4=Farnaz|last5=Gillis|first5=Bruce S.|date=2015|title=Cytokine and chemokine profiles in fibromyalgia, rheumatoid arthritis and systemic lupus erythematosus: a potentially useful tool in differential diagnosis|url=https://www.ncbi.nlm.nih.gov/pubmed/25377646|journal=Rheumatology International|volume=35|issue=6|pages=991–996|doi=10.1007/s00296-014-3172-2|issn=1437-160X|pmc=|pmid=25377646|via=}}</ref>

*2016, [https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html Blood Test for Fibromyalgia: FM/a Test Ⓡ is now available, Q&A]<ref>{{Cite web|url=https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html|title=Blood Test for Fibromyalgia: FM/a Test ® Is Real, Q&A|last=Cooper|first=Celeste|date=May 3, 2016|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2016, [http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/ Fibromyalgia blood testing covered by rising number of insurance companies]<ref>{{Cite news|url=http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/|title=Fibromyalgia blood testing covered more of insurance companies|last=Campbell|first=Julie|date=2016-04-08|work=Live Insurance News|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2017, [http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches]<ref>{{Cite news|url=https://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=Business Wire|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Brain scans ===

*2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds]<ref>{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|publisher=ANAPSID|via=Chronic Neuroimmune Diseases|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2012, [https://www.sciencedaily.com/releases/2012/11/121111153426.htm Fibromyalgia and the brain: New clues reveal how pain and therapies are processed]<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2012/11/121111153426.htm|title=Fibromyalgia and the brain: New clues reveal how pain and therapies are processed|last=|first=|date=Nov 11, 2012|work=ScienceDaily|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*2015, [https://www.verywell.com/unique-brain-connectivity-in-fibromyalgia-715630 Unique Brain Connectivity in Fibromyalgia - Increased Importance Assigned to Pain]<ref>{{Cite news|url=https://www.verywellhealth.com/how-lyrica-changes-the-fibromyalgia-brain-715767|title=How Lyrica Changes the Fibromyalgia Brain|last=Dellwo|first=Adrienne|date=Apr 30, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*2015, [http://onlinelibrary.wiley.com/doi/10.1002/art.39043/abstract The Somatosensory Link in Fibromyalgia: Functional Connectivity of the Primary Somatosensory Cortex Is Altered by Sustained Pain and Is Associated With Clinical/Autonomic Dysfunction]<ref>{{Cite journal|last=Kim|first=Jieun|last2=Loggia|first2=Marco L.|last3=Cahalan|first3=Christine M.|last4=Harris|first4=Richard E.|last5=Beissner|first5=Florian|last6=Garcia|first6=Ronald G.|last7=Kim|first7=Hyungjun|last8=Barbieri|first8=Riccardo|last9=Wasan|first9=Ajay D.|date=2015-04-27|title=The Somatosensory Link in Fibromyalgia: Functional Connectivity of the Primary Somatosensory Cortex Is Altered by Sustained Pain and Is Associated With Clinical/Autonomic Dysfunction|url=https://onlinelibrary.wiley.com/doi/abs/10.1002/art.39043|journal=Arthritis & Rheumatology|language=en|volume=67|issue=5|pages=1395–1405|doi=10.1002/art.39043|issn=2326-5191|pmc=|pmid=25622796|via=}}</ref>

==See also==
*[[Lady Gaga]]

==References==
<references />

[[Category:Diagnoses]]
[[Category:Comorbidities]]

Fibromyalgia

2018-08-12T16:34:07Z

77.111.246.7:/* Fibromyalgia in ME/CFS */ added info

[[Fibromyalgia]] (FM/FMS) is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Pain is widespread, on both sides of the body, and above and below the waist.

Sufferers are fatigued and tired even when sleeping for long periods of time, and sleep is often disrupted by pain. Many FM sufferers have sleep disorders like [https://en.wikipedia.org/wiki/Sleep_apnea sleep apnea] and [[restless leg syndrome]]. [[Cognitive impairment]], when one cannot focus or pay attention and the patient has difficulty concentrating on mental tasks, is known by FM sufferers as "[[fibro fog]]".<ref name=":17">{{Cite news|url=https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014|title=What Is Fibro Fog and ME/CFS Brain Fog?|last=Dellwo|first=Adrienne|date=|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Some experience [[depression]], [[headache]]s, and lower [[abdominal pain]] or cramping. Other symptoms include tingling or [[numbness]] in hands and feet, pain in jaw and disorders of the jaw such as t[[temporomandibular joint disorder|emporomandibular joint disorder]] (TMJ), [[Menstrual cycle#Health effects in other conditions|menstrual cycle]] cramps, and digestive problems like i[[Irritable bowel syndrome|rritable bowel syndrome]] (IBS).<ref>{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms#1|title=Fibromyalgia Symptoms|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780|title=Fibromyalgia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref>

[[File:Fibro_Tender_Points.png|400px|thumb|right|1990 ACR Diagnostic Criteria: 18 Tender Points]]
[[File:Fibro_Widespread_Pain.png|400px|thumb|right|2010 ACR Preliminatry Diagnostic Criteria: Wisedpread Pain Index (WPI), 19 Tender Point Areas]]

==Prevalence==
FM is the second most common [https://en.wikipedia.org/wiki/Rheumatism rheumatic disorder] behind [https://en.wikipedia.org/wiki/Osteoarthritis osteoarthritis] and is "now considered to be a lifelong [[Central nervous system]] disorder."<ref>{{Cite news|url=https://naidw.org/blog/members-myblogs/fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder|title=Fibromyalgia now considered as a lifelong central nervous system disorder|work=NAIDW.org®|access-date=2018-08-09|language=en-gb}}</ref> An estimated 10 million people in the US and 3-6% of the world population have fibromyalgia. It is seen in women, men, children, and all ethnic groups. It is often seen in families and diagnosed between the ages of 20 to 50 years; incidence increases with age.<ref>{{Cite news|url=http://www.fmaware.org/about-fibromyalgia/prevalence/|title=Prevalence - National Fibromyalgia Association (NFA)|work=National Fibromyalgia Association (NFA)|access-date=2018-08-09|language=en-US}}</ref>

FM has a female:male 7:1 ratio under the ''American College of Rheumatology (ACR) 1990 Diagnostic Criteria'' and 2:1 when the ''ACR 2010 Preliminary Diagnostic Criteria'' is used.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=|publisher=|editor-last=Diamond|editor-first=Herbert|at=Sex-related differences in incidence}}</ref> ''See'': [[Fibromyalgia#American College of Rheumatology (ACR) Criteria|Fibromyalgia (''American College of Rheumatology (ACR) Criteria'' section)]].

==Fibromyalgia in ME/CFS==
Dr. [[Jarred Younger]] has said that many patients that meet the criteria for FM also meet criteria for [[chronic fatigue syndrome]] (CFS) but the reverse is not necessarily true as a lot of people with [[CFS]] do not have [[chronic pain]].<ref>{{Cite web|url=https://www.youtube.com/watch?v=wJB95m4FLa0#t=57m27s|title=Webinar with Jarred Younger, Ph.D.|last=Younger|first=Jared|date=May 20, 2016|website=YouTube|at=57:27|via=|archive-url=|archive-date=|dead-url=|access-date=|publisher=SolveCFS|type=Video}}</ref> However, the [[Canadian Consensus Criteria]] (CCC) requires the symptom of pain to diagnose [[ME/CFS]]. It is the pattern and significant degree of [[chronic pain]] in FM that sets it apart from other diseases that have pain.

"The most common overlapping condition with ME/CFS is fibromyalgia."<ref>[https://ammes.org/overlapping-conditions/]</ref>

==Health complications==
FM is not a [https://en.wikipedia.org/wiki/Progressive_disease progressive disease] but according to Dr. Dan Clauw the "slow gradual worsening of chronic pain patients over time is due to downstream consequences of poorly controlled pain and other symptoms, wherein individuals then progressively get less active, sleep worse, are under more stress and unknowingly develop bad habits which worsen pain and other symptoms."<ref>{{Cite news|url=http://nationalpainreport.com/ask-the-dctors-is-fibromyalgia-progressive-8831105.html|title=Ask the Doctors: Is Fibromyalgia Progressive?|date=2016-08-09|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*[https://www.sharecare.com/health/fibromyalgia-effects Fibromyalgia Complications]<ref name=":19" />

:People who have fibromyalgia frequently complain of a variety of symptoms that affect other parts of the body. Many people complain of [[gastrointestinal]] issues and restless legs syndrome (RLS). Additionally, the [[chronic pain]] and discomfort of fibromyalgia may lead to [[depression]].<ref name=":19">{{Cite news|url=https://www.sharecare.com/health/fibromyalgia-effects|title=Fibromyalgia Complications - Fibromyalgia - Joint Health|work=Sharecare|access-date=2018-08-09|language=en}}</ref>

*[https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions Can fibromyalgia cause other medical conditions?]<ref name=":20" />

:Fibromyalgia is not known to cause other medical conditions. However, people who have fibromyalgia seem to be at high risk for developing other painful conditions, including [https://en.wikipedia.org/wiki/Osteoarthritis osteoarthritis] (the common type of arthritis caused by wear and tear on the joints) as well as other related conditions, such as [[rheumatoid arthritis]], [https://en.wikipedia.org/wiki/Systemic_lupus_erythematosus lupus], and [https://en.wikipedia.org/wiki/Ankylosing_spondylitis ankylosing spondylitis]. Also, people with fibromyalgia are frequently diagnosed with chronic fatigue syndrome, irritable bowel syndrome (IBS), and temporomandibular joint (TMJ) disorder.<ref name=":20">{{Cite web|url=https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions|title=Can fibromyalgia cause other medical conditions? {{!}} Fibromyalgia Complications|last=Honor Society of Nursing|first=|date=|website=Sharecare|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

==Risk factors==
[[Lupus]] and [[Rheumatoid arthritis]] (RA) are risk factors in developing FM. Car accidents, [[Post-traumatic stress disorder]] (PTSD), [https://en.wikipedia.org/wiki/Repetitive_strain_injury repetitive injuries], illness such as a [https://en.wikipedia.org/wiki/Viral_disease viral infection], [https://en.wikipedia.org/wiki/Family_history_(medicine) family history], and [https://en.wikipedia.org/wiki/Obesity obesity] have all been linked to FM.<ref>{{Cite web|url=https://www.cdc.gov/arthritis/basics/fibromyalgia.htm|title=Fibromyalgia {{!}} Arthritis {{!}} CDC|date=2018-04-03|website=www.cdc.gov|language=en-us|access-date=2018-08-09}}</ref><ref>{{Cite news|url=https://www.niams.nih.gov/health_info/Fibromyalgia/|title=Fibromyalgia What Causes it?|last=Director|first=Nancy Garrick, Deputy|date=2017-04-05|work=National Institute of Arthritis and Musculoskeletal and Skin Diseases|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

==Diagnosis==
[https://www.verywellhealth.com/what-are-fibromyalgia-tender-points-189768 Tender points], not [https://en.wikipedia.org/wiki/Myofascial_trigger_point trigger points], are used to diagnose Fibromyalgia.<ref>{{Cite web|url=http://www.healthcentral.com/chronic-pain/c/662034/176031/fibromyalgia-trigger/|title=The Difference Between Fibromyalgia Tender Points and Myofascial Trigger Points - Chronic Pain {{!}} HealthCentral|last=Cooper|first=Celeste|date=May 8, 2015|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> Tender points will be above and below the waist and on both sides of the body. (See: Illustrations of the 1990 and 2010 American College of Rheumatology (ACR) Criteria depicting tender points near the top of this page.)

===United States===
==== American College of Rheumatology (ACR) Criteria ====

*1990, [http://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf The American College Of Rheumatology 1990 Criteria For The Classification Of Fibromyalgia] "American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure."<ref>{{Cite news|url=http://www.health.com/health/gallery/0,,20345635,00.html|title=18 Points Used to Diagnose Fibromyalgia|last=|first=|date=Feb 4, 2011|work=Health.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> <ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2010, The [https://www.fibroknowledge.com/site/acr-2010 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview] was proposed and modified in 2011<ref>{{Cite news|url=http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria|title=New and Modified Fibromyalgia Diagnostic Criteria|last=Garg|first=Neha|date=Feb 9, 2012|work=Rheumatology Network|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=|last2=Deodhar|first2=Atul}}</ref> with the modification being validated in 2013 and published in 2014.<ref>{{Cite journal|last=Bennett|first=Robert M.|last2=Friend|first2=Ronald|last3=Marcus|first3=Dawn|last4=Bernstein|first4=Cheryl|last5=Han|first5=Bobby Kwanghoon|last6=Yachoui|first6=Ralph|last7=Deodhar|first7=Atul|last8=Kaell|first8=Alan|last9=Bonafede|first9=Peter|date=2014|title=Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/24497443|journal=Arthritis Care & Research|volume=66|issue=9|pages=1364–1373|doi=10.1002/acr.22301|issn=2151-4658|pmid=24497443|via=}}</ref> September of 2016, another revision has been made.<ref>{{Cite news|url=http://acrabstracts.org/abstract/2016-revisions-to-the-20102011-fibromyalgia-diagnostic-criteria/|title=2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria - ACR Meeting Abstracts|last=|first=|date=Sep 28, 2016|work=ACR Meeting Abstracts|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

:Men do not seem to form the tender points needed for diagnosis under the 1990 criteria,<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/features/how-fibromyalgia-affects-men#2|title=How Fibromyalgia Affects Men: Symptoms and Diagnosis|work=WebMD|access-date=2018-08-09|language=en-US}}</ref> the 2010 proposed criteria diagnoses more men with a F/M ratio of 2:1.<ref>{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=}}</ref>
:Tender points were used to diagnose with the 1990 criteria, however "considerable skill is needed to correctly check for a patient’s tender points (i.e., digital palpation that is done with certain amount of applied pressure), yet this technique is not typically taught at most medical schools."<ref name=":0">{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 5, 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>
:The new standards were designed to:
:*eliminate the use of a tender point examination
:*include a severity scale by which to identify and measure characteristic FM symptoms
:*utilize an index by which to rate pain<ref name=":0" />
:*There are 19 tender point areas in the widespread pain index (WPI), whereas the 1990 criteria had 18 tender points.<ref>{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose fibromyalgia.<ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=Jul 25, 2012|website=www.ssa.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

==== Sleep study ====
Sleep dysfunction is often involved in fibromyalgia. Treating a sleep disorder can help with fibromyalgia symptoms. A diagnosed sleep disorder is also helpful if one needs to file for disability.

*[https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054 Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome] <ref>{{Cite news|url=https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054|title=Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*[http://www.sciencedaily.com/releases/2008/09/080903134311.htm What A Sleep Study Can Reveal About Fibromyalgia] <ref>{{Cite news|url=https://www.sciencedaily.com/releases/2008/09/080903134311.htm|title=What A Sleep Study Can Reveal About Fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*[http://linkis.com/nationalpainreport.com/lzYea Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says] <ref>{{Cite news|url=http://linkis.com/nationalpainreport.com/lzYea|title=Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says|last=|first=|date=Mar 25, 2016|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== ICD Diagnostic code===
====World Health Organization====
'''ICD-10'''

The [[World Health Organization]] (WHO) International Classification of Diseases (ICD) lists fibromyalgia as a "disease of the [[musculoskeletal system]] and connective tissue", under the code M79.7 (WHO ICD-10 Version: 016).<ref>World Health Organization, [http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7 International Classification of Diseases - Fibromyalgia M79.7], ICD-10, 2016</ref>

*'''M79.7 Fibromyalgia'''
::Fibromyositis
::Fibrositis
::Myofibrositis<ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7|title=ICD-10 Version:2016|website=apps.who.int|language=en|access-date=2018-08-09}}</ref>

In 2015, the [[United States]] finally adopted ICD-10 and Fibromyalgia as a diagnosis.<ref>{{Cite web|url=http://www.icd10data.com/ICD10CM/Codes/M00-M99/M70-M79/M79-/M79.7|title=2018 ICD-10-CM Diagnosis Code M79.7: Fibromyalgia|website=www.icd10data.com|language=en|access-date=2018-08-09}}</ref> <ref>{{Cite news|url=http://nationalpainreport.com/the-health-care-industry-finally-recognizes-fibromyalgia-8827637.html|title=The Health Care Industry Finally Recognizes Fibromyalgia|last=Liptan|first=Ginevra|date=2015-09-30|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

'''ICD-11 (2019)'''

[https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504 ICD-11] (2019) has diagnostic code ''MG30.1 Chronic widespread pain''.<ref name=":18">{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504|title=ICD-11 - Mortality and Morbidity Statistics|website=icd.who.int|language=en|access-date=2018-08-09}}</ref>

*'''MG30.01 Chronic widespread pain'''

'''Parent'''
::MG30.0 Chronic primary pain

'''Description'''
<blockquote>Chronic widespread pain (CWP) is diffuse pain in at least 4 of 5 body regions and is associated with significant emotional distress (anxiety, anger/frustration or depressed mood) or functional disability (interference in daily life activities and reduced participation in social roles) [1]. CWP is multifactorial: biological, psychological and social factors contribute to the pain syndrome. The diagnosis is appropriate when the pain is not directly attributable to a nociceptive process in these regions and there are features consistent with nociplastic pain [2] and identified psychological and social contributors.</blockquote>

'''Inclusions'''
:*Fibromyalgia
'''Exclusions'''
:*Acute pain (MG31)<ref name=":18" />

==Pathophysiology==
"Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology. There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or [[Lyme disease]], as well as emotional or physical trauma."<ref>{{Cite web|url=https://www.uptodate.com/contents/pathogenesis-of-fibromyalgia#!|title=UpToDate|last=Goldenberg|first=Don L|date=|website=www.uptodate.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> The widespread pain is severe, debilitating, and abnormal in processing its pain. There is also sleep disturbance and fatigue. Cause or causes are unproven.<ref>{{Cite news|url=https://www.omf.ngo/what-is-mecfs-old/fibromyalgia/|title=What is Fibromyalgia? {{!}} Open Medicine Foundation|work=Open Medicine Foundation|access-date=2018-08-09|language=en-US}}</ref>

*May 2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/ Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management]<ref>{{Cite journal|last=Jahan|first=Firdous|last2=Nanji|first2=Kashmira|last3=Qidwai|first3=Waris|last4=Qasim|first4=Rizwan|date=2012|title=Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/|journal=Oman Medical Journal|volume=27|issue=3|pages=192–195|doi=10.5001/omj.2012.44|issn=1999-768X|pmc=|pmid=22811766|via=}}</ref> ''See'' Table 1: "Conditions associated with fibromyalgia." Musculoskeletal, genitourianry, gastro intestinal, and miscellaneous conditions often exist among fibromyalgia patients.

<blockquote>Pathophysiology: Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as [[serotonin]], substance P, growth hormone and [[cortisol]] suggest that regulation of the autonomic and neuro-endocrine system appears to be the basis of the syndrome. Fibromyalgia is not a life-threatening, deforming, or [https://en.wikipedia.org/wiki/Progressive_disease progressive disease]. [[Anxiety]] and [[depression]] are the most common association. Aberrant pain processing, which can result in [[chronic pain]], may be the result of several interplaying mechanisms. [[Central sensitization]], blunting of inhibitory pain pathways and alterations in [[neurotransmitters]] lead to aberrant neuro-chemical processing of sensory signals in the CNS, thus lowering the threshold of pain and amplification of normal sensory signals causing constant pain.

The frequent co-morbidity of fibromyalgia with mood disorders suggests a major role for the stress response and for neuroendocrine abnormalities. The [[hypothalamic pituitary axis]] (HPA) is a critical component of the stress-adaptation response. In FMS, stress adaptation response is disturbed leading to stress induce symptoms. Psychiatric co-morbidity has been associated with FMS and needs to be identified during the consultation process, as this requires special consideration during treatment.</blockquote>

*May 2018, [https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management] <ref>{{Cite journal|last=Bourgaize|first=Sheryl|last2=Newton|first2=Genevieve|last3=Kumbhare|first3=Dinesh|last4=Srbely|first4=John|date=2018|title=A comparison of the clinical manifestation and
pathophysiology of myofascial pain syndrome
and fibromyalgia: implications for differential
diagnosis and management|url=https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf|format=PDF|journal=JCCA|volume=|pages=26-41|at=See Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)|via=J Can Chiropractor Assoc}}</ref> (PDF) ''See'' Table 1 "Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome." pg. 29 (pg. 4 of PDF)

*Jul 2018, [https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/ Primary and Secondary Fibromyalgia Share Same Symptom Burden, Study Suggests] <ref>{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/|title=Primary, Secondary Fibromyalgia Share Same Symptom Burden, Study Says|last=Carvalho|first=John|date=2018-07-31|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

<blockquote>Fibromyalgia can be considered either primary, or dominant, also known as idiopathic fibromyalgia, or secondary. In the primary form, the causes of the disorder are unknown, but in secondary fibromyalgia, the disorder usually occurs alongside other debilitating medical conditions, such as rheumatoid arthritis (RA), lupus, and multiple sclerosis.</blockquote>

===Immune system research===

Dr. [[Jarred Younger]] believes an overactive [[immune system]] is the cause and will be conducting a study to test this hypothesis.<ref>{{Cite news|url=http://nationalpainreport.com/new-uab-study-could-radically-change-fibromyalgia-treatment-as-we-know-it-8833437.html|title=New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It|last=Gregory Burch|first=Donna|date=2017-04-24|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=https://www.youtube.com/watch?v=8e5xKX036bE|title=Testing the fibromyalgia immune system with lipopolysaccharide (LPS)|last=Younger|first=Jarred|date=May 24, 2017|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=|via=Younger Lab}}</ref> An overactive immune system is responsible for [[inflammation]] which causes [[chronic pain]].

Dr. William Pridgen's research of [[HSV-1]] (cold sore virus) as being involved in FM has conducted a successful Phase III clinical trial, which had been fast-tracked by the [[Food and Drug Administration]] (FDA), of a combination drug that suppresses this virus and also helps with pain. ''See'': [[Fibromyalgia#IMC-1|Fibromyalgia (''Drugs: Trials: IMC-1'' section)]].

[[ProHealth]] reports that an old [https://en.wikipedia.org/wiki/Tuberculosis Tuberculosis] vaccine, [https://en.wikipedia.org/wiki/BCG_vaccine Bacille Calmette-Guerin] (BCG), may be researched for treatment of Fibromyalgia spearheaded by [http://www.buzzfile.com/business/Epicgenetics,-Inc.-310-586-2929 EpicGenetics] and [http://www.massgeneral.org/ Massachusetts General Hospital].<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

EpicGenetics has a blood test that is identifying the presence of specific white blood cell abnormalities of patients diagnosed with FM and has partnered with two universities to offer [https://en.wikipedia.org/wiki/Disease_gene_identification#Whole_exome_sequencing whole exome sequencing] free of charge to those who test positive with their [http://fmtest.com/ FM/a® test].<ref>{{Cite news|url=http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> Concerns have been raised in regards to the FM/a® EpicGenetics Blood Test.<ref>{{Cite web|url=http://www.fmperplex.com/2013/02/25/junk-science-junk-ethics/|title=Junk Science – Junk Ethics – The Fibromyalgia Perplex|last=Wolfe|first=Fred|date=Feb 25, 2013|website=www.fmperplex.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> EpicGenetics is awaiting FDA approval to test the Bacille Calmette-Guerin (BCG) vaccine (an old Tuberculosis vaccine) on patients that tested positive with its FM/a® test.<ref>{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689#comment-2286|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=See Comments Section: CDW12 says: June 26, 2018 at 2:05 pm|language=en-US}}</ref><ref>{{Cite web|url=https://www.celestecooper.com/2018/07/the-fma-blood-test-and-participation-in.html#.Wz4nxdJKjIU|title=The FM/a® Blood Test and Participation in Fibromyalgia Vaccine Study|last=Cooper|first=Celeste|date=Jul 5, 2018|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

== Comorbidities ==

*[[Allodynia]]
** [http://chronicfatigue.about.com/od/glossary/g/allodynia.htm Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS] <ref name=":1">{{Cite news|url=https://www.verywellhealth.com/allodynia-definition-and-types-fibromyalgia-715929|title=Allodynia: A Rare & Distinct Type of Pain in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Feb 23, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> Types of Allodynia: Tactile; Mechanical; and Thermal. "Type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain" <ref name=":1" />

*[[Body temperature]]
**[https://www.verywell.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025 Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome] <ref name=":2">{{Cite news|url=https://www.verywellhealth.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025|title=Temperature Sensitivity in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Mar 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "When you're exposed to heat, does it feel like you're burning up? Does it seem impossible for you to cool off? Or maybe it's cold that bothers you, chilling you to the bone, leaving you unable to warm up.

::Or are you one of those people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) who is cold all the time, or hot all the time, or alternately hot or cold while out of sync with the environment?"<ref name=":2" />

*[[Fibro fog]]

:*[http://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction] <ref name=":3">{{Cite news|url=https://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx|title=What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction|last=Mandal|first=Ananya|date=2013-06-03|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> 'Mental confusion along with difficulty in concentration and loss of memory is often termed “[[fibro fog]]"'.<ref name=":3" />

:*[https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014 What Is Fibro Fog and ME/CFS Brain Fog?] <ref name=":17" />

*[https://en.wikipedia.org/wiki/Costochondritis Costochondritis] <ref>{{Cite journal|date=2018-05-25|title=Costochondritis|url=https://en.wikipedia.org/w/index.php?title=Costochondritis&oldid=842926736|journal=Wikipedia|language=en}}</ref>(Chest and rib cage pain.)
**[https://www.verywell.com/costochondritis-in-fibromyalgia-716178 Costochondritis in Fibromyalgia] <ref>{{Cite news|url=https://www.verywellhealth.com/costochondritis-in-fibromyalgia-716178|title=Costochondritis Chest Pain in Fibromyalgia|last=Dellow|first=Adrienne|date=Feb 14, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*[[Gastrointestinal system]]
**[[Irritable bowel syndrome]]: [http://chronicfatigue.about.com/od/whyfmscfsarelinked/a/IBS.htm Irritable Bowel Syndrome in Fibromyalgia & Chronic Fatigue Syndrome - Why Do They Go Together?] <ref name=":4">{{Cite news|url=https://www.verywellhealth.com/irritable-bowel-syndrome-in-fibromyalgia-cfs-716167|title=Irritable Bowel Syndrome in Fibromyalgia & ME/CFS|last=Dellwo|first=Adrienne|date=Jan 28, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "Fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome (IBS) frequently go together. No one really knows why, but we do know that all three conditions can include imbalances of serotonin -- although in fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS or ME/CFS) it's an imbalance in the brain, while with IBS it's in the gut."<ref name=":4" />

*[https://en.wikipedia.org/wiki/Interstitial_cystitis Interstitial Cystitis] <ref>{{Cite journal|date=2018-07-11|title=Interstitial cystitis|url=https://en.wikipedia.org/w/index.php?title=Interstitial_cystitis&oldid=849828657|journal=Wikipedia|language=en}}</ref>(Painful bladder)
**[https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168 Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis] <ref name=":5">{{Cite news|url=https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168|title=Fibromyalgia, Chronic Fatigue Syndrome & Interstitial Cystitis|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "Fibromyalgia, chronic fatigue syndrome and interstitial cystitis (IC) -- a painful bladder condition -- frequently occur together. Women may be up to 10 times more likely than men to develop it."<ref name=":5" />

*Language Impairment
**[[Word-finding problems]] is a symptom of ME/CFS.
:*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome Impaired Language in Fibromyalgia & Chronic Fatigue Syndrome] <ref name=":6" /> "Searching their brains for simple words that they just can't remember. On other occasions, individuals with these diagnoses may find it hard to write or even understand language."<ref name=":6">{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:*"The diagnosis of [[Aphasia]] is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written"<ref>{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref> but with [[dysphasia]] you will have those symptoms and trouble listening and doing numeral calculations.<ref>{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms & Treatment|website=www.ayushveda.com|access-date=2018-08-09}}</ref> ''See also'': [[Dyscalculia]].

*OBGYN
**[https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596 Menstrual Periods with Fibromyalgia: Personal Stories] <ref>{{Cite news|url=https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596|title=Menstrual Periods with Fibromyalgia: Personal Stories|last=Dellwo|first=Adrienne|date=May 18, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>
**[https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626 Fibromyalgia Tied to Hysterectomy, Gynecologic Disease]. <ref name=":7">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626|title=Fibromyalgia Tied to Hysterectomy, Gynecologic Disease|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "You may have heard about a possible link between gynecologic surgery (such as a hysterectomy) and the development of fibromyalgia, and doctors have long suspected that fibromyalgia has strong hormonal ties and triggers. This does not seem surprising as we've long suspected a link between endocrine disorders, gynecological conditions, and autoimmune conditions."<ref name=":7" />

*[[Orthostatic intolerance]]
**[https://www.verywell.com/orthostatic-intolerance-715915 Orthostatic Intolerance] <ref>{{Cite news|url=https://www.verywellhealth.com/orthostatic-intolerance-715915|title=Orthostatic Intolerance Can Happen When You Stand Up Too Quickly|last=Dellwo|first=Adrienne|date=Mar 7, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

:*[http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM] <ref>{{Cite web|url=http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf|title=Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM|last=Lapp|first=Charles W.|last2=Black|first2=Laura|date=|website=drlapp.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Smith|first3=Rebekah S.}}</ref> (PDF) Symptoms can include low blood pressure and/or sudden high blood pressure, dizziness, fainting.

:*[https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/ An Overlooked Issue in Fibromyalgia? Study Highlights Problems Standing (Orthostatic Intolerance)] <ref>{{Cite news|url=https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/|title=An Overlooked Issue in Fibromyalgia? Study Highlights Orthostatic Intolerance - Problems Standing - Health Rising|last=Johnson|first=Cort|date=2017-09-21|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[[Sleep dysfunction]]
**[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia] <ref>{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}</ref>

<blockquote>The present results of this study suggest that long-term, comorbid pain and sleep disturbance may be associated with increased activation in core default mode brain areas that is above and beyond long-term pain disturbance alone.</blockquote>

:*[http://www.prohealth.com/library/showarticle.cfm?libid=22344 Fibromyalgia and Sleep] <ref name=":8">{{Cite news|url=https://www.prohealth.com/library/fibromyalgia-and-sleep-38954|title=Fibromyalgia and Sleep - Prohealth|date=2016-01-11|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref> "Most people with fibromyalgia have an associated sleep disorder that makes it difficult for them to get the deep, restorative sleep they need."<ref name=":8" />

*[[Thyroid disease]]
**[https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677 Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease] <ref name=":9">{{Cite news|url=https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677|title=A Comparison of Chronic Fatigue, Fibromyalgia, and Thyroid Disease|last=Shomon|first=Mary|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> "People with Hashimoto's autoimmune thyroid disease often experience significant fatigue and body aches. While these symptoms are common in Hashimoto's, they can also be markers of other diseases, like chronic fatigue syndrome or fibromyalgia." <ref name=":9" />

*Other symptoms
**[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/fibrosymptoms.htm Symptoms of Fibromyalgia] <ref>{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-symptoms-716139|title=Symptoms of Fibromyalgia|last=Dellwo|first=Adrienne|date=May 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref> (A comprehensive all in one place list for the many symptoms of Fibromyalgia.)

==Treatment==

===United States===
'''Rheumatology and primary care providers: Diagnosing and treatment'''

*2012, [https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract A Framework for Fibromyalgia Management for Primary Care Providers] <ref>{{Cite journal|last=Arnold|first=Lesley M.|last2=Clauw|first2=Daniel J.|last3=Dunegan|first3=L. Jean|last4=Turk|first4=Dennis C.|date=2012|title=A Framework for Fibromyalgia Management for Primary Care Providers|url=https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract|journal=Mayo Clinic Proceedings|language=English|volume=87|issue=5|pages=488–496|doi=10.1016/j.mayocp.2012.02.010|issn=0025-6196|via=}}</ref> Rheumatologists stopped treating fibromyalgia patients and primary care providers began treatment managment although rheumatologists are most often the specialist to diagnose. (Please see [http://me-pedia.org/wiki/Fibromyalgia#Disability disability] heading about ''primary provider'' and ''specialists'' for disability cases.)

----

=== Drugs ===
There are approved and off-label drugs for treating FM. ''Please Note: The information under "Drugs" is not meant to promote any Rx drug for Fibromyalgia or its comorbidities but to inform you of these drugs both approved and off-label. Always consult your doctor for guidance on Rx drug use for any illness or disease. Always check with your doctor and pharmacist for drug interactions.''

Always review a drug company's prescription drug's side effects and possible drug interactions with your doctor and pharmacist.

Pregnant women must always consult with their doctor and pharmacist when taking any prescription drug, over-the-counter drug, supplement, or herbal remedy for side effects, drug interactions, and possible miscarriage, injury, birth defect, addiction, or death to the embryo, fetus, or baby. Breastfeeding women should always talk to their doctor and pharmacist for information about breast milk being laced with the drug she has taken causing side effects, injury, addiction, or death, and drug interactions to the baby consuming her breast milk.

Check with your doctor and pharmacist before using any prescription or over-the-counter drug, supplement, or herbal remedy being administered to a child. Check with your doctor for children's side effects or drug interactions that may not be listed.

==== FDA approved====

*[http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107802.htm Living with Fibromyalgia, Drugs Approved to Manage Pain] <ref>{{Cite web|url=https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107802.htm|title=Consumer Updates - Living with Fibromyalgia, Drugs Approved to Manage Pain|last=Commissioner|first=Office of the|website=www.fda.gov|language=en|access-date=2018-08-09}}</ref> ([https://en.wikipedia.org/wiki/FDA_Consumer FDA For Consumers])

*[https://en.wikipedia.org/w/index.php?title=Cymbalta&redirect=no Cymbalta] ([https://www.drugs.com/availability/generic-cymbalta.html Duloxetine is Generic])<ref>{{Cite journal|date=2018-08-05|title=Duloxetine|url=https://en.wikipedia.org/w/index.php?title=Duloxetine&oldid=853590069|journal=Wikipedia|language=en}}</ref>

*[[Lyrica]] (generic will be [[Pregabalin]])

*[https://en.wikipedia.org/w/index.php?title=Savella&redirect=no Savella] ([https://www.drugs.com/mtm/milnacipran.html Milnacipran is Generic])<ref>{{Cite news|url=https://www.drugs.com/mtm/milnacipran.html|title=Milnacipran Uses, Side Effects & Warnings - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref>

==== FDA approved Side effects ====
''Not all side effects or possible drug interactions of brand name or generic name drugs are listed or linked, review EACH brand name and EACH generic name medication's side effects and possible drug interactions with your doctor and pharmacist.''

*Cymbalta is facing lawsuits due to severe withdrawal symptoms.<ref>(Duloxetine is Generic):[http://www.drugwatch.com/cymbalta/lawsuits/ Cymbalta Lawsuits - Drug Watch]</ref> There is a Facebook group dedicated to questions about the drug and tapering off of it; [https://www.facebook.com/groups/Cymbaltahurtsworse/?multi_permalinks=572848582870894&notif_t=group_highlights Cymbalta Hurts Worse]. Eli Lilly has settled hundreds of personal injury lawsuits with patients experiencing severe withdrawal symptoms.<ref>{{Cite news|url=http://nationalpainreport.com/eli-lilly-settles-cymbalta-withdrawal-lawsuits-8831647.html|title=Eli Lilly Settles Cymbalta Withdrawal Lawsuits|last=Gregory Burch|first=Donna|date=2016-10-06|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref> [https://www.drugs.com/sfx/cymbalta-side-effects.html Cymbalta side effects] and ([https://www.drugs.com/sfx/milnacipran-side-effects.html Duloxetine side effects]).

*Lyrica is causing weight gain. [https://www.drugs.com/sfx/lyrica-side-effects.html Lyrica side effects] and ([https://www.drugs.com/availability/generic-lyrica.html no generic available])<ref>{{Cite web|url=https://www.healthcentral.com/article/court-blocks-sale-of-generic-lyrica-upholds-pfizer-patents|title=Court Blocks Sale of Generic Lyrica, Upholds Pfizer Patents - Non-opioid Pain Medication - Chronic Pain {{!}} HealthCentral|last=Kathy Lee|first=Richards|date=Jul 25, 2012|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> until after 2018 when [[Pregabalin]] will be marketed.

*Savella has a list of side effects. (Milnacipran is Generic): [http://www.drugs.com/sfx/savella-side-effects.html Savella side effects] <ref>{{Cite news|url=https://www.drugs.com/sfx/savella-side-effects.html|title=Savella Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref> and ([https://www.drugs.com/sfx/milnacipran-side-effects.html Milnacipran side effects]).<ref>{{Cite news|url=https://www.drugs.com/sfx/milnacipran-side-effects.html|title=Milnacipran Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref>

----

====Off-label====
*[https://www.drugs.com/dosage/florinef.html Florinef]: ([[Fludrocortisone]] is generic) Off-label use for [[Orthostatic intolerance]] (OI) and [[Postural orthostatic tachycardia syndrome]] (POTS)

*[[Low dose naltrexone]]: Taken at bedtime for sleep. Helps pain due to better sleep.

*[https://www.drugs.com/neurontin.html Neurontin] ([[Gabapentin]] is generic): [http://www.mayoclinic.org/diseases-conditions/fibromyalgia/expert-answers/fibromyalgia-treatment/FAQ-20058273 Is gabapentin (Neurontin, others) an effective fibromyalgia treatment?] <ref>{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/expert-answers/fibromyalgia-treatment/FAQ-20058273|title=Fibromyalgia treatment: Is Neurontin effective?|work=Mayo Clinic|access-date=2018-08-09|language=en}}</ref> Used for pain, sleep.

*Low dose [https://www.drugs.com/seroquel.html Seroquel] ([[wikipedia:Quetiapine|Quetiapine is Generic]]):<ref>{{Cite journal|date=2018-08-02|title=Quetiapine|url=https://en.wikipedia.org/w/index.php?title=Quetiapine&oldid=853058838|journal=Wikipedia|language=en}}</ref> [http://www.cortjohnson.org/blog/2014/02/27/tackling-pain-depression-fibromyalgia-quetiapine-scores-benefits-clinical-trial/ Tackling Pain and Depression in Fibromyalgia: Quetiapine Scores Some Benefits in Clinical Trial] <ref>{{Cite news|url=https://www.healthrising.org/blog/2014/02/27/tackling-pain-depression-fibromyalgia-quetiapine-scores-benefits-clinical-trial/|title=Tackling Pain and Depression in Fibromyalgia: Quetiapine Scores Some Benefits in Clinical Trial - Health Rising|last=Johnson|first=Cort|date=2014-02-27|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref> Taken at bedtime for sleep.

*[https://www.drugs.com/ultram.html Ultram] and ([[Tramadol]] is Generic): For chronic ongoing pain.

*[https://www.drugs.com/zanaflex.html Zanaflex] ([[wikipedia:Tizanidine|Tizanidine is Generic]]):<ref>{{Cite journal|date=2018-07-03|title=Tizanidine|url=https://en.wikipedia.org/w/index.php?title=Tizanidine&oldid=848610982|journal=Wikipedia|language=en}}</ref> Muscle relaxer for pain, sleep.

==== Off-label Side effects ====
''Not all side effects or possible drug interactions of brand name or generic name drugs are listed or linked, review EACH brand name and EACH generic name medication's side effects and possible drug interactions with your doctor and pharmacist.''

*[https://www.drugs.com/dosage/florinef.html Florinef]: ([[Fludrocortisone]] is generic.) Weight gain, interacts with many other medications. [https://www.drugs.com/sfx/fludrocortisone-side-effects.html Fludrocortisione side effects]<ref>{{Cite news|url=https://www.drugs.com/sfx/fludrocortisone-side-effects.html|title=Fludrocortisone Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref> [https://www.drugs.com/sfx/florinef-side-effects.html Florinef side effects].<ref>{{Cite news|url=https://www.drugs.com/sfx/florinef-side-effects.html|title=Florinef Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US|last=|first=|date=|archive-url=|archive-date=|dead-url=}}</ref>
*Low dose naltrexone: Insomnia, the drug must be [https://me-pedia.org/wiki/Low_dose_naltrexone#Start_Low.2C_Go_Slow stepped up slowly].<ref>{{Cite news|url=http://www.drwhitaker.com/what-is-low-dose-naltrexone/|title=What is Low-Dose Naltrexone?|last=Whitaker|first=Julian|date=|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> Opioids will be rendered ineffective.<ref>{{Cite news|url=https://yourverity.wordpress.com/2009/07/07/drugs-to-avoid-when-taking-low-dose-naltrexone/|title=Drugs To Avoid When Taking Low Dose Naltrexone|date=2009-07-07|work=Yourverity's Blog|access-date=2018-08-09|language=en-US}}</ref>
*Neurontin (Gabapentin is generic): [https://www.drugs.com/sfx/neurontin-side-effects.html Neurontin side effects].
*Low dose Seroquel (Quetiapine is generic): (Used for Chronic Insomnia.) Weight gain, [https://en.wikipedia.org/wiki/Suicidal_ideation suicidal ideation]. Although prescribed for sleep it is not recommended.<ref>{{Cite journal|last=Coe|first=Holly V|last2=Hong|first2=Irene S|date=2012-04-17|title=Safety of Low Doses of Quetiapine When Used for Insomnia|url=http://journals.sagepub.com/doi/10.1345/aph.1Q697|journal=Annals of Pharmacotherapy|language=en|volume=46|issue=5|pages=718–722|doi=10.1345/aph.1q697|issn=1060-0280}}</ref><ref>{{Cite book|url=http://www.ncbi.nlm.nih.gov/books/NBK66081/|title=Off-Label Use of Atypical Antipsychotics: An Update|last=Maglione|first=Margaret|last2=Maher|first2=Alicia Ruelaz|last3=Hu|first3=Jianhui|last4=Wang|first4=Zhen|last5=Shanman|first5=Roberta|last6=Shekelle|first6=Paul G.|last7=Roth|first7=Beth|last8=Hilton|first8=Lara|last9=Suttorp|first9=Marika J.|date=2011|publisher=Agency for Healthcare Research and Quality (US)|series=AHRQ Comparative Effectiveness Reviews|location=Rockville (MD)|pmid=22132426}}</ref> [https://www.drugs.com/sfx/seroquel-side-effects.html Side effects of Seroquel].<ref>{{Cite news|url=https://www.drugs.com/sfx/seroquel-side-effects.html|title=Seroquel Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref>
*Ultram: ([[Tramadol]] is generic) [https://www.drugs.com/sfx/ultram-side-effects.html Ultram side effects].<ref>{{Cite news|url=https://www.drugs.com/sfx/ultram-side-effects.html|title=Ultram Side Effects in Detail - Drugs.com|work=Drugs.com|access-date=2018-08-09|language=en-US}}</ref>
:*Tramadol (Generic of Ultram): [http://fibromapp.com/fibromyalgia-cfsme-seizuresblackouts-the-tramadol-connection/ Having Seizures or Blackouts? The Tramadol Connection] <ref>{{Cite news|url=https://fibromapp.com/having-seizures-or-blackouts-the-tramadol-connection/|title=Tramadol: The Seizure and Blackout Connection|last=Reid|first=Alyssa|date=2016-05-23|work=FibroMapp Pain Manager+|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-GB}}</ref> [https://www.drugs.com/sfx/tramadol-side-effects.html Tramadol side effects].
*Zanaflex (Tizanadine is generic): [https://www.drugs.com/sfx/zanaflex-side-effects.html Zanaflex Side Effects].<ref name=":10">{{Cite news|url=https://fibromapp.com/having-seizures-or-blackouts-the-tramadol-connection/|title=Having Seizures or Blackouts? The Tramadol Connection|last=Reid|first=Alyssa|date=2016-05-23|work=FibroMapp Pain Manager+|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-GB}}</ref>

----

====Sleep medications====
''Not all side effects or possible drug interactions of brand name or generic name drugs are listed or linked, review EACH brand name and EACH generic name medication's side effects and possible drug interactions with your doctor and pharmacist.''

Disordered sleep is a prominent symptom in FM. There are four
types of sleep medications used in FM; antihistamines, benzodiazepines, nonbenzodiazepines, sedating antidepressants.<ref>{{Cite news|url=http://www.fibrodaze.com/sleep-medications/|title=Sleep Medications For Fibromyalgia •|last=Sue|first=|date=2014-12-17|work=Fibrodaze|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|publisher=|language=en-US|type=Blog}}</ref>

===Articles and blogs on drugs===

*[http://fibromapp.com/fibromyalgia-cfsme-seizuresblackouts-the-tramadol-connection/ Having Seizures or Blackouts? The Tramadol Connection]<ref name=":10" />

*[http://fedupwithfatigue.com/why-your-fibro-meds-arent-working/ Why Your Fibro Meds Aren't Working] <ref>{{Cite news|url=https://fedupwithfatigue.com/why-your-fibro-meds-arent-working/|title=Why your fibro meds aren't working {{!}} Fed Up with Fatigue|date=2015-05-28|work=Fed Up with Fatigue|access-date=2018-08-09|language=en-US}}</ref>

=== Drug trials ===

*ASP8062
:*2017, [https://clinicaltrials.gov/ct2/show/NCT03092726?term=ASP8062&cond=Fibromyalgia&rank=1 ClinicalTrials.gov A Phase 2a, Randomized, Double-Blind Placebo-controlled, Parallel-group Study to Assess the Analgesic Efficacy and Safety of ASP8062 in Subjects With Fibromyalgia] <ref>{{Cite news|url=https://clinicaltrials.gov/ct2/show/NCT03092726?term=ASP8062&cond=Fibromyalgia&rank=1|title=A Study to Assess the Analgesic Efficacy and Safety of ASP8062 in Subjects With Fibromyalgia - Full Text View - ClinicalTrials.gov|access-date=2018-08-09|language=en}}</ref>
*Cannabinoid-based therapy
:*2017, [https://fibromyalgianewstoday.com/2017/03/27/fibromyalgia-targeted-ap-cbd-thc-therapy-undergoing-phase-1-clinical-trial/ Intec Pharma Launches Phase 1 Trial of Cannabinoid-based Therapy for Fibromyalgia, Lower Back Pain.] <ref>{{Cite news|url=https://fibromyalgianewstoday.com/2017/03/27/fibromyalgia-targeted-ap-cbd-thc-therapy-undergoing-phase-1-clinical-trial/|title=Intec Pharma Launches Phase 1 Trial of Cannabinoid-based Therapy for Fibromyalgia, Lower Back Pain|last=Henriques|first=Carolina|date=Mar 27, 2017|work=Fibromyalgia News Today|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=}}</ref>

*IMC-1

:*2016, [http://simmaronresearch.com/2016/10/pridgen-antiviral-treatment-fibromyaligia/ The Pridgen Revolution? Dr. Pridgen on Bringing His Antiviral Approach to Fibromyalgia To Market] <ref name=":11" /> "Almost three years ago, Dr. Pridgen threatened to turn the world of fibromyalgia treatment on its head. Few had connected fibromyalgia with viruses or even immune problems when Pridgen announced that a) FM is caused herpes simplex virus reactivation and b) that it could be treated with antivirals."<ref name=":11">{{Cite news|url=http://simmaronresearch.com/2016/10/pridgen-antiviral-treatment-fibromyaligia/|title=The Pridgen Revolution? Dr. Pridgen on Bringing His Antiviral Approach to Fibromyalgia To Market - Simmaron Research|last=Johnson|first=Cort|date=2016-10-17|work=Simmaron Research|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
:*2016, [https://fibromyalgianewstoday.com/2016/02/02/combo-tx-fast-tracked-for-fibromyalgia/ Novel Fibromyalgia Treatment Granted FDA Fast Track Designation] <ref name=":12" /> "In the successful Phase II trial in fibromyalgia, IMC-1 was studied to confirm the hypothesis that chronic tissue-resident herpes simplex virus type 1 ([[HSV-1]]) may be one of the underlying causes of fibromyalgia and causally related to fibromyalgia symptoms or recurrence. IMC-1 is a novel fixed-dose oral combination antiviral medication designed to suppress this suspected virus and thus alleviate fibromyalgia symptoms."<ref name=":12">{{Cite news|url=http://fibromyalgianewstoday.com/2016/02/02/combo-tx-fast-tracked-for-fibromyalgia/|title=Novel Fibromyalgia Treatment Granted FDA Fast Track Designation - Fibromyalgia News Today|last=Moore|first=Charles|date=2016-02-02|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
:*2017, [http://simmaronresearch.com/2017/03/valley-death-fibromyalgia-pridgen/ Through the “Valley of Death”: Dr. Pridgen, Fibromyalgia and the Looming Trials] <ref name=":13" /> "First there were the anecdotal reports – FM patients were not just getting better but some, and not just a few, were getting well using something entirely new – an antiviral protocol, of all things, created not by a pain specialist or rheumatologist but by a surgeon."<ref name=":13">{{Cite news|url=http://simmaronresearch.com/2017/03/valley-death-fibromyalgia-pridgen/|title=Through the "Valley of Death": Dr. Pridgen, Fibromyalgia and the Looming Trials - Simmaron Research|last=Johnson|first=Cort|date=2017-03-26|work=Simmaron Research|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
:*2017, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328426/? A famciclovir + celecoxib combination treatment is safe and efficacious in the treatment of fibromyalgia] <ref>{{Cite journal|last=Pridgen|first=William L|last2=Duffy|first2=Carol|last3=Gendreau|first3=Judy F|last4=Gendreau|first4=R Michael|date=2017-02-22|title=A famciclovir + celecoxib combination treatment is safe and efficacious in the treatment of fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328426/|journal=Journal of Pain Research|volume=10|pages=451–460|doi=10.2147/JPR.S127288|issn=1178-7090|pmc=|pmid=28260944|via=}}</ref>

<blockquote>IMC-1 was efficacious and safe in treating symptoms of fibromyalgia, supporting the hypothesis that herpes virus infections may contribute to this syndrome. Improved retention rates, decreased adverse event rates, and evidence of efficacy on a broad spectrum of outcome measures are suggestive that IMC-1 may represent an effective, novel treatment for fibromyalgia.</blockquote>

*Bacille Calmette-Guerin (BCG) vaccine
:*2017, [http://www.prohealth.com/library/showArticle.cfm?libid=30644 Century-old vaccine gives new hope to fibromyalgia community] <ref>{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

===Drug trials failed===

*TNX-102

:*2016, The drug failed in its primary goal in providing pain relief and ''Tonix Pharmaceuticals'' will not be moving forward in developing a Ffbromyalgia drug.<ref>{{Cite news|url=http://nationalpainreport.com/potential-fibromyalgia-treatment-is-put-on-hold-8831410.html|title=Potential Fibromyalgia Treatment is Put on Hold|last=Gregory Burch|first=Donna|date=2016-09-10|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
*DS-5565
:*2016, [http://nationalpainreport.com/three-new-fibromyalgia-drugs-could-be-on-the-way-8830514.html Three New Fibromyalgia Drugs Could Be On The Way] <ref>{{Cite news|url=http://nationalpainreport.com/three-new-fibromyalgia-drugs-could-be-on-the-way-8830514.html|title=Three New Fibromyalgia Drugs Could Be On The Way|last=Gregory Burch|first=Donna|date=2016-05-20|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref> (All failed.)

*Phase III clinical trial of DS-5565 found ineffective

:*2017, [https://www.healthrising.org/blog/2017/07/08/mirogabalin-fibromyalgia-drug-fails/ The Big Hurt: Second Major Fibromyalgia Drug in a Year Fails] <ref name=":14" /> "In the three 13-week, double-blind, global, phase 3 ALDAY clinical trials evaluating Mirogabalin for the treatment of pain associated with fibromyalgia, Mirogabalin did not meet the primary efficacy endpoint to demonstrate a statistically significant reduction in the weekly average of worst daily pain score from baseline to Week 13."<ref name=":14">{{Cite news|url=https://www.healthrising.org/blog/2017/07/08/mirogabalin-fibromyalgia-drug-fails/|title=The Big Hurt: Second Major Fibromyalgia Drug in a Year Fails - Health Rising|last=Johnson|first=Cort|date=2017-07-08|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

=== Therapies ===

==== Exercise ====
''Please Note'': These recommendations are for fibromyalgia patients and '''not''' [[ME/CFS]] sufferers.

*Warm water exercise is best.<ref>{{Cite news|url=http://chronicfatigue.about.com/od/treatingfmscfs/a/warmwaterFMS.htm|title=Warm Water Exercise for Fibromyalgia|last=Dellwo|first=Adrienne|date=Nov 19, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref><ref>{{Cite journal|last=Munguía-Izquierdo|first=D.|last2=Legaz-Arrese|first2=A.|date=2007|title=Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/18173915|journal=Clinical and Experimental Rheumatology|volume=25|issue=6|pages=823–830|issn=0392-856X|pmid=18173915|via=}}</ref>

*Moderate aerobic exercise and weights with as fewer reps possible with a day or two of rest in between. Do not start a program if you are in a flare.<ref>{{Cite web|url=http://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/fibromyalgia-questions/fibromyalgia-exercise.php|title=Fibromyalgia Exercise {{!}} Exercising with Fibromyalgia|last=Ronenn|first=Roubenoff|date=|website=www.arthritis.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[https://www.youtube.com/watch?v=BauJYuJwFsI Easy fibromyalgia exercises and motivation to keep you healthy!] <ref>{{Cite web|url=https://www.youtube.com/watch?v=BauJYuJwFsI|title=Easy Fibromyalgia exercises and motivation to keep you healthy!|last=Suarez|first=Eric|date=Jun 21, 2011|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=Aug 9, 2018}}</ref> Video

*[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/Fibromyalgia-Myth-Vs-Fact.htm Fibromyalgia Myth vs. Fact] <ref name=":15">{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-myth-vs-fact-716131|title=Fibromyalgia: What's Myth, What's Fact?|last=Dellwo|first=Adrienne|date=Jun 8, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=Myth #3 People With Fibromyalgia Need More Exercise}}</ref> Heading: ''Myth #3: People With Fibromyalgia Need More Exercise''. Appropriate exercise, which each patient needs to gauge for themselves.<ref name=":15" />

==== Massage ====

*2014, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/ Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials] <ref>{{Cite journal|last=Li|first=Yan-hui|last2=Wang|first2=Feng-yun|last3=Feng|first3=Chun-qing|last4=Yang|first4=Xia-feng|last5=Sun|first5=Yi-hua|date=2014-02-20|title=Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/|journal=PLoS ONE|volume=9|issue=2|doi=10.1371/journal.pone.0089304|issn=1932-6203|pmc=|pmid=24586677|pages=|via=}}</ref>

*2016, [http://chronicfatigue.about.com/od/alternativetreatments/a/bodywork.htm Massage, Rolfing & Other Bodywork - Are They Effective Fibromyalgia & Chronic Fatigue Syndrome Treatments?] <ref>{{Cite news|url=https://www.verywellhealth.com/massage-rolfing-other-bodywork-715645|title=Massage, Rolfing, Reiki: Do They Work for Fibromyalgia & ME/CFS?|last=Dellwo|first=Adrienne|date=Aug 10, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

==== Acupuncture ====

*2004, [[U.S. Department of Health and Human Services]] (HHS) and [https://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services Centers for Medicare and Medicaid Services] (CMS) ruled April 16, 2004, a noncoverage determination for acupuncture.<ref>{{Cite web|url=https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R11NCD.pdf|title=CMS Manual System Pub. 100-03 Medicare
National Coverage Determinations|last=|first=|date=Apr 16, 2004|website=CMS.gov|format=PDF|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2005, [http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html Acupuncture Good for Fibromyalgia?] <ref name=":16">{{Cite web|url=http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html|title=Acupuncture Good for Fibromyalgia?|last=|first=|date=Oct 2, 2012|website=Acupuncture School Online|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> "Acupuncture gave no significant pain relief to fibromyalgia patients."<ref name=":16" />

*2016, [http://www.sciencedirect.com/science/article/pii/S2095496416602352 Short-term complementary and alternative medicine on quality of life in women with fibromyalgia] <ref>{{Cite journal|date=2016-01-01|title=Short-term complementary and alternative medicine on quality of life in women with fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S2095496416602352|journal=Journal of Integrative Medicine|language=en|volume=14|issue=1|pages=29–35|doi=10.1016/S2095-4964(16)60235-2|issn=2095-4964}}</ref>

<blockquote>There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session.</blockquote>

*2016, [https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/ Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients] <ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/|title=Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients - Fibromyalgia News Today|last=Semedo|first=Daniela|date=2016-02-01|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

== Disability ==
===United States===
''Please Note'': The following is NOT legal advice and it should not be relied upon in taking steps for a disability case. Only ''[https://www.ssa.gov/ Social Security]'' and a disability lawyer can provide the most up to date and the correct legal avenue for bringing a disability case.

In the[[ United States]], [https://www.ssa.gov/ssi/ Social Security Insurance] and [https://www.ssa.gov/disability/ Social Security Disability] (SSI) and (SSD) benefits are available for Fibromyalgia. Generally for SSI/SSD, notes and tests from a ''Primary Provider'' '''may''' be allowed for submission but ''Specialists'' such as a rheumatologist, neurologist, psychiatrist, etc. are required for diagnosis, ongoing treatment and completing SSI/SSD paperwork.

The Social Security Administration for SSD/SSI filings relies on the 1990 or 2010 ACR criteria to diagnose Fibromyalgia. (See: "Policy Interpretation" for the POLICY INTERPRETATION RULING.)<ref>[https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia]</ref>

*[http://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social Applying for Disability With Fibromyalgia] <ref>{{Cite news|url=https://fibromyalgia.newlifeoutlook.com/fibromyalgia-disability-benefits/?utm_source=Twitter&utm_medium=Social|title=Fibromyalgia Disability: Applying for Disability Benefits With Fibromyalgia|date=2016-10-03|work=NewLifeOutlook {{!}} Fibromyalgia|access-date=2018-08-09|language=en-US}}</ref> One patient's success of applying, denial, successful appeal, and a breakdown of what SSI/SSD requires for the medical determination of a favorable decision of disability.

*[https://www.socialsecurity.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html Fibromyalgia: Policy Interpretation Ruling - Social Security] <ref>{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=|website=www.ssa.gov|at=Titles II and XVI: Evaluation of Fibromyalgia|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*[http://www.disabilitysecrets.com/social_security_disability_fibromyalgia.html Social Security Disability (SSDI & SSI) for Fibromyalgia - Disability Secrets By NOLO] <ref>{{Cite news|url=https://www.disabilitysecrets.com/resources/social-security-disability-ssdi-ssi-fibromyalgia.htm|title=Social Security Disability (SSDI & SSI) for Fibromyalgia|last=Laurence|first=Bethany|date=|work=www.disabilitysecrets.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*[http://www.mdjunction.com/fibromyalgia/fibromyalgia-disability Fibromyalgia Disability Patient Support Forums] <ref>{{Cite web|url=https://www.mdjunction.com/fibromyalgia/fibromyalgia-disability|title=Fibromyalgia Disability|website=MDJunction|language=en|access-date=2018-08-09}}</ref> at [[MDJunction]]

==== Examinations and Tests ====
For documentation of symptoms and co-morbidities of a FM diagnosis, you and your doctor should consider the following examinations and tests:

:'''Fibromyaglia Diagnostic Examination'''
:*[http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist Rheumatologist] examination and diagnosis of FM. (Consider having a rheumatologist order tests and coordinate referrals for other specialists for examinations and testing. Only specialists can complete the paperwork for Social Security. A primary doctor cannot complete disability paperwork but ''may'' be able to forward test results they have ordered.)
:'''Arthritis'''
:*[https://en.wikipedia.org/wiki/Nuclear_medicine#Diagnostic Whole body bone scan] <ref>{{Cite journal|date=2018-05-22|title=Nuclear medicine|url=https://en.wikipedia.org/w/index.php?title=Nuclear_medicine&oldid=842409692|journal=Wikipedia|language=en}}</ref> to rule out treatable arthritis.
:'''Blood Tests'''
:*Routine blood tests for [[diabetes]] (fasting sugar, A1C) and a full [[Thyroid disease]] panel ([https://en.wikipedia.org/wiki/Thyroid_function_tests#Thyroid-stimulating_hormone TSH, T3, Free T3, T4 and Free T4]).
:*Rule out [[Rheumatoid arthritis]], lupus, [[Lyme disease]] and other diseases that can share some of the same symptoms of fibromyalgia and may be treatable.
:*Vitamin and mineral deficiencies such as [[B12]] and [[Vitamin D]] are treatable with over the counter supplements and prescription medications which can improve [[fatigue]] and [[pain]].
:'''Gastrointestinal'''
:*[[Irritable bowel syndrome]] diagnosis which may require blood, [http://www.mayoclinic.org/tests-procedures/endoscopy/basics/definition/PRC-20020363 upper endoscopy] to rule out [https://en.wikipedia.org/wiki/Coeliac_disease celiac disease] and [https://en.wikipedia.org/wiki/Stool_test fecal tests] to check for bacteria ([[SIBO]]) and [http://www.umm.edu/health/medical/altmed/condition/intestinal-parasites intestinal parasites].
:'''Mental Health and Cognition'''
:* Psychiatric evaluation as any [[depression]] and [[anxiety]] should be treated.
:* [[Cognitive dysfunction]] tests.
:'''Sleep dysfunction'''
:*Sleep study for [[Restless legs syndrome]], [[Sleep disturbance]] and rule out [[Narcolepsy]].
:'''Orthostatic Intolerance'''
:*[[Tilt table test]] for [[Orthostatic intolerance]].
:'''TMJ, tinnitus, vertigo, and dizziness'''
:*An ear, nose, and throat specialist (ENT) ([http://www.mayoclinic.org/departments-centers/otorhinolaryngology-ent/overview Otorhinolaryngology]) examination and imaging may be ordered for [[Temporomandibular joint disorder]] (TMJ).
:*(Ear, sinus, throat/lymph infections, and [[tinnitus]] can also be documented.)
:*[https://en.wikipedia.org/wiki/Videonystagmography Videonystagmography] (VNG) testing if you experience [[vertigo]] and/or [[dizziness]].<ref>{{Cite news|url=https://www.everydayhearing.com/balance/articles/what-to-expect-at-your-vng-test/|title=What to Expect at Your VNG/ENG Test - Everyday Hearing|last=Banks|first=Lindsey|date=2014-05-07|work=Everyday Hearing|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

Of course, one can have arthritis, sleep apnea, [[Chronic lyme disease|chronic Lyme disease]] or other diseases and still have FM, but there may be a treatable condition where a patient's overall health, including their FM, improves.<ref>{{Cite news|url=http://www.webmd.com/fibromyalgia/guide/common-misdiagnoses-of-fibromyalgia#1|title=Common Misdiagnoses of Fibromyalgia|work=WebMD|access-date=2018-08-09|language=en-US}}</ref><ref>{{Cite web|url=http://www.cfidsselfhelp.org/library/overlapping-and-related-conditions|title=Overlapping and Related Conditions {{!}} CFIDS & Fibromyalgia Self-Help|website=www.cfidsselfhelp.org|access-date=2018-08-09}}</ref><ref>{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}</ref>

There have been cases of [[Vitamin D]] deficiency being misdiagnosed as fibromyalgia as a D deficiency can cause pain. Supplementation or prescribed D treatments may alleviate this pain. However, it is possible to have both a D deficiency and fibromyalgia and correcting the deficiency will only resolve the pain stemming from it.<ref>{{Cite news|url=http://www.webmd.com/pain-management/features/vitamin-d-deficiency-and-chronic-pain-link#1|title=Does Vitamin D Deficiency Cause Chronic Pain?|last=Shaw|first=Gina|date=|work=WebMD|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

==== Blogs about navigating SSD process ====

*Resources for getting approved for disability include this [http://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/ Guide to Social Security Disability for People with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome], <ref>{{Cite web|url=https://www.meaction.net/2017/04/17/the-sleepy-girl-guide-to-social-security-disability-u-s/|title=The Sleepy Girl Guide to Social Security Disability (U.S.) {{!}} #MEAction|last=Silver|first=Lily|date=Apr 17, 2017|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref> available on the #[[MEAction]] website.

*[https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/ How Patty’s Lawyer Never Told Her What She Needed to Know] <ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/03/20/how-pattys-lawyer-never-told-her-the-most-important-thing-she-needed-to-know/|title=How Patty’s Lawyer Never Told Her What She Needed to Know|last=Skelton Preston|first=Patty|date=2017-03-20|work=How to Get On|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*[https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/ Sample Doctor Letters for Disability] <ref>{{Cite news|url=https://howtogeton.wordpress.com/2017/05/01/sample-doctor-letters-for-disability/|title=21 Sample Doctor Letters for Disability|date=2017-05-01|work=How to Get On|access-date=2018-08-09|language=en-US}}</ref>

== Notable studies ==

*2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds] <ref>{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=CND: Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2004, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1754959/ A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing] <ref>{{Cite journal|last=Pimentel|first=M|last2=Wallace|first2=D|last3=Hallegua|first3=D|last4=Chow|first4=E|last5=Kong|first5=Y|last6=Park|first6=S|last7=Lin|first7=H|date=2004|title=A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1754959/|journal=Annals of the Rheumatic Diseases|volume=63|issue=4|pages=450–452|doi=10.1136/ard.2003.011502|issn=0003-4967|pmid=15020342|via=}}</ref>

*2012, [https://www.researchgate.net/publication/230626400_Dysfunctional_endogenous_analgesia_during_exercise_in_patients_with_chronic_pain_To_exercise_or_not_to_exercise Dysfunctional endogenous analgesia during exercise in patients with chronic pain: To exercise or not to exercise?] <ref>{{Cite book|url=https://www.researchgate.net/publication/230626400_Dysfunctional_endogenous_analgesia_during_exercise_in_patients_with_chronic_pain_To_exercise_or_not_to_exercise|title=Dysfunctional endogenous analgesia during exercise in patients with chronic pain: To exercise or not to exercise?|last=Nijs|first=Jo|last2=Kosek|first2=Eva|last3=Van Oosterwijck|first3=Jessica|last4=Meeus|first4=Mira|date=2012-07-01|volume=15}}</ref>

*2015, [http://onlinelibrary.wiley.com/doi/10.1111/1756-185X.12550/abstract Some oxidative and antioxidative parameters and their relationship with clinical symptoms in women with fibromyalgia syndrome] <ref>{{Cite journal|last=Fatima|first=Ghizal|last2=Das|first2=Siddharth Kumar|last3=Mahdi|first3=Abbas Ali|date=2015-07-14|title=Some oxidative and antioxidative parameters and their relationship with clinical symptoms in women with fibromyalgia syndrome|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/1756-185X.12550|journal=International Journal of Rheumatic Diseases|language=en|volume=20|issue=1|pages=39–45|doi=10.1111/1756-185x.12550|issn=1756-1841}}</ref>

*2015, [http://onlinelibrary.wiley.com/doi/10.1002/acr.22626/full Understanding the Association of Fatigue With Other Symptoms of Fibromyalgia: Development of a Cluster Model] <ref>{{Cite journal|last=Lukkahatai|first=Nada|last2=Walitt|first2=Brian|last3=Espina|first3=Alexandra|last4=Gelio|first4=Alves|last5=Saligan|first5=Leorey N.|date=2015-12-21|title=Understanding the Association of Fatigue With Other Symptoms of Fibromyalgia: Development of a Cluster Model|url=https://onlinelibrary.wiley.com/doi/full/10.1002/acr.22626|journal=Arthritis Care & Research|language=en|volume=68|issue=1|pages=99–107|doi=10.1002/acr.22626|issn=2151-464X|pmc=|pmid=26017904|via=}}</ref>

*2015, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia] <ref>{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}</ref>

*2015, [https://biblio.ugent.be/publication/6993821 Cognitive performance is related to central sensitization in patients with chronic whiplash-associated disorders and fibromyalgia: a case-control study] <ref>{{Cite journal|last=Iris|first=Coppieters,|last2=Kelly|first2=Ickmans,|last3=Barbara|first3=Cagnie,|last4=Jo|first4=Nijs,|last5=Robby|first5=De Pauw,|last6=Mira|first6=Meeus,|date=2015|title=Cognitive performance is related to central sensitization in patients with chronic whiplash-associated disorders and fibromyalgia: a case-control study|url=https://biblio.ugent.be/publication/6993821}}</ref>

*2015, [http://eujournal.org/index.php/esj/article/viewFile/6167/5952 Fibromyalgia: A search for markers and their evaluation throughout a treatment] <ref>{{Cite journal|last=Wyatt|first=H. J.|last2=Day|first2=N. W.|date=1976-01-16|title=Specific effects of neurotransmitter antagonists on ganglion cells in rabbit retina|url=https://www.ncbi.nlm.nih.gov/pubmed/1857|format=PDF|journal=Science (New York, N.Y.)|volume=191|issue=4223|pages=204–205|issn=0036-8075|pmid=1857|via=European Scientific Journal}}</ref>

*2015, [http://www.sciencedirect.com/science/article/pii/S2213158215001394 Normalization of aberrant resting state functional connectivity in fibromyalgia patients following a three-month physical exercise therapy] <ref>{{Cite journal|date=2015-01-01|title=Normalization of aberrant resting state functional connectivity in fibromyalgia patients following a three month physical exercise therapy|url=https://www.sciencedirect.com/science/article/pii/S2213158215001394|journal=NeuroImage: Clinical|language=en|volume=9|pages=134–139|doi=10.1016/j.nicl.2015.08.004|issn=2213-1582}}</ref>

*2015, [https://www.sciencedaily.com/releases/2015/08/150819172431.htm Researchers identify potential sleep-related treatment targets for fibromyalgia] <ref>{{Cite news|url=https://www.sciencedaily.com/releases/2015/08/150819172431.htm|title=Researchers identify potential sleep-related treatment targets for fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*2015, [https://www.sciencedaily.com/releases/2015/05/150517071813.htm Fibromyalgia has central nervous system origins] <ref>{{Cite news|url=https://www.sciencedaily.com/releases/2015/05/150517071813.htm|title=Fibromyalgia has central nervous system origins|work=ScienceDaily|access-date=2018-08-09|language=en}}</ref>

*2015, [http://synapse.koreamed.org/search.php?where=aview&id=10.3344/kjp.2015.28.3.169&code=0047KJP&vmode=FULL The Iceberg Nature of Fibromyalgia Burden: The Clinical and Economic Aspects] <ref>{{Cite journal|last=Banafsheh|first=Ghavidel-Parsa,|last2=Ali|first2=Bidari,|last3=Alireza|first3=Amir Maafi,|last4=Babak|first4=Ghalebaghi,|date=2015-07-01|title=The Iceberg Nature of Fibromyalgia Burden: The Clinical and Economic Aspects|url=https://synapse.koreamed.org/search.php?where=aview&id=10.3344/kjp.2015.28.3.169&code=0047KJP&vmode=FULL|journal=The Korean Journal of Pain|language=English|volume=28|issue=3|doi=10.3344/kjp.2015.28.3.169&code=0047kjp&vmode=full|issn=2005-9159}}</ref>

*2015, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499983/ The effects of aquatic, isometric strength-stretching and aerobic exercise on physical and psychological parameters of female patients with fibromyalgia syndrome] <ref>{{Cite journal|last=Sevimli|first=Dilek|last2=Kozanoglu|first2=Erkan|last3=Guzel|first3=Rengin|last4=Doganay|first4=Ahmet|date=2015|title=The effects of aquatic, isometric strength-stretching and aerobic exercise on
physical and psychological parameters of female patients with fibromyalgia
syndrome|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499983/|journal=Journal of Physical Therapy Science|volume=27|issue=6|pages=1781–1786|doi=10.1589/jpts.27.1781|issn=0915-5287|pmid=26180320|via=}}</ref>

*2016, [https://www.ncbi.nlm.nih.gov/pubmed/27713820 Fibromyalgia syndrome: metabolic and autophagic processes in intermittent cold stress mice.] <ref>{{Cite journal|last=Oezel|first=Lisa|last2=Then|first2=Hanna|last3=Jung|first3=Anna L.|last4=Jabari|first4=Samir|last5=Bonaterra|first5=Gabriel A.|last6=Wissniowski|first6=Thaddeus T.|last7=Önel|first7=Susanne F.|last8=Ocker|first8=Matthias|last9=Thieme|first9=Kati|date=2016|title=Fibromyalgia syndrome: metabolic and autophagic processes in intermittent cold stress mice|url=https://www.ncbi.nlm.nih.gov/pubmed/27713820|journal=Pharmacology Research & Perspectives|volume=4|issue=5|pages=e00248|doi=10.1002/prp2.248|issn=2052-1707|pmc=|pmid=27713820|via=}}</ref>

*2016, [http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161574 Fibromyalgia Is Correlated with Retinal Nerve Fiber Layer Thinning] <ref>{{Cite journal|last=Garcia-Martin|first=Elena|last2=Garcia-Campayo|first2=Javier|last3=Puebla-Guedea|first3=Marta|last4=Ascaso|first4=Francisco J.|last5=Roca|first5=Miguel|last6=Gutierrez-Ruiz|first6=Fernando|last7=Vilades|first7=Elisa|last8=Polo|first8=Vicente|last9=Larrosa|first9=Jose M.|date=2016-09-01|title=Fibromyalgia Is Correlated with Retinal Nerve Fiber Layer Thinning|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161574|journal=PLOS ONE|language=en|volume=11|issue=9|pages=e0161574|doi=10.1371/journal.pone.0161574|issn=1932-6203|pmc=|pmid=27584145|via=}}</ref>

*2016, [https://www.ncbi.nlm.nih.gov/pubmed/26272057 The prevalence of severe fatigue in rheumatic diseases: an international study.] <ref>{{Cite journal|last=Overman|first=Cécile L.|last2=Kool|first2=Marianne B.|last3=Da Silva|first3=José A. P.|last4=Geenen|first4=Rinie|date=2016|title=The prevalence of severe fatigue in rheumatic diseases: an international study|url=https://www.ncbi.nlm.nih.gov/pubmed/26272057|journal=Clinical Rheumatology|volume=35|issue=2|pages=409–415|doi=10.1007/s10067-015-3035-6|issn=1434-9949|pmid=26272057|via=}}</ref>

*2016, [http://journals.lww.com/clinicalpain/Abstract/2016/04000/Characteristics_of_Disturbed_Sleep_in_Patients.4.aspx Characteristics of Disturbed Sleep in Patients With Fibromyalgia Compared With Insomnia or With Pain-Free Volunteers] <ref>{{Cite journal|last=Roth|first=Thomas|last2=Bhadra-Brown|first2=Pritha|last3=Pitman|first3=Verne W.|last4=Roehrs|first4=Timothy A.|last5=Resnick|first5=E. Malca|date=2016|title=Characteristics of Disturbed Sleep in Patients With Fibromyalgia Compared With Insomnia or With Pain-Free Volunteers|url=https://journals.lww.com/clinicalpain/Abstract/2016/04000/Characteristics_of_Disturbed_Sleep_in_Patients.4.aspx|journal=The Clinical Journal of Pain|language=en-US|volume=32|issue=4|pages=302–307|doi=10.1097/AJP.0000000000000261|issn=0749-8047|via=}}</ref>

*2016, [https://www.ncbi.nlm.nih.gov/pubmed/26218005 Is Efficacy of Milnacipran in Fibromyalgia Predictable? A Data Mining Analysis of Baseline and Outcome Variables.] <ref>{{Cite journal|last=Abtroun|first=Lilia|last2=Bunouf|first2=Pierre|last3=Gendreau|first3=Roger M.|last4=Vitton|first4=Olivier|date=2016|title=Is the Efficacy of Milnacipran in Fibromyalgia Predictable? A Data-Mining Analysis of Baseline and Outcome Variables|url=https://www.ncbi.nlm.nih.gov/pubmed/26218005|journal=The Clinical Journal of Pain|volume=32|issue=5|pages=435–440|doi=10.1097/AJP.0000000000000284|issn=1536-5409|pmid=26218005|via=}}</ref>

*2017, [https://www.ncbi.nlm.nih.gov/pubmed/28614420# The degree of cardiac baroreflex involvement during active standing is associated with the quality of life in fibromyalgia patients.] <ref>{{Cite journal|last=Zamunér|first=Antonio Roberto|last2=Porta|first2=Alberto|last3=Andrade|first3=Carolina Pieroni|last4=Forti|first4=Meire|last5=Marchi|first5=Andrea|last6=Furlan|first6=Raffaello|last7=Barbic|first7=Franca|last8=Catai|first8=Aparecida Maria|last9=Silva|first9=Ester|date=2017|title=The degree of cardiac baroreflex involvement during active standing is associated with the quality of life in fibromyalgia patients|url=https://www.ncbi.nlm.nih.gov/pubmed/28614420#|journal=PloS One|volume=12|issue=6|pages=e0179500|doi=10.1371/journal.pone.0179500|issn=1932-6203|pmid=28614420|via=}}</ref> (Orthostatic Intollerance)

*2017, [https://www.dovepress.com/evidence-of-both-systemic-inflammation-and-neuroinflammation-in-fibrom-peer-reviewed-fulltext-article-JPR Evidence of both systemic inflammation and neuroinflammation in fibromyalgia patients, as assessed by a multiplex protein panel applied to the cerebrospinal fluid and to plasma] <ref>{{Cite journal|last=Bäckryd|first=Emmanuel|last2=Tanum|first2=Lars|last3=Lind|first3=Anne-Li|last4=Larsson|first4=Anders|last5=Gordh|first5=Torsten|date=2017|title=Evidence of both systemic inflammation and neuroinflammation in fibromyalgia patients, as assessed by a multiplex protein panel applied to the cerebrospinal fluid and to plasma|url=https://www.dovepress.com/evidence-of-both-systemic-inflammation-and-neuroinflammation-in-fibrom-peer-reviewed-fulltext-article-JPR|journal=Journal of Pain Research|language=English|volume=Volume 10|pages=515–525|doi=10.2147/JPR.S128508|issn=1178-7090|via=}}</ref>

*2017, [https://www.ncbi.nlm.nih.gov/pubmed/27583567 Towards a neurophysiological signature for fibromyalgia.] <ref>{{Cite journal|last=López-Solà|first=Marina|last2=Woo|first2=Choong-Wan|last3=Pujol|first3=Jesus|last4=Deus|first4=Joan|last5=Harrison|first5=Ben J.|last6=Monfort|first6=Jordi|last7=Wager|first7=Tor D.|date=2017|title=Towards a neurophysiological signature for fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/27583567|journal=Pain|volume=158|issue=1|pages=34–47|doi=10.1097/j.pain.0000000000000707|issn=1872-6623|pmid=27583567|via=}}</ref>

*2018, [https://www.ncbi.nlm.nih.gov/pubmed/29149437 A Blinded, Randomized, Placebo-Controlled Study to Investigate the Efficacy and Safety of Ferric Carboxymaltose in Iron-Deficient Patients with Fibromyalgia.] <ref>{{Cite journal|last=Boomershine|first=Chad S.|last2=Koch|first2=Todd A.|last3=Morris|first3=David|date=2018|title=A Blinded, Randomized, Placebo-Controlled Study to Investigate the Efficacy and Safety of Ferric Carboxymaltose in Iron-Deficient Patients with Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/29149437|journal=Rheumatology and Therapy|volume=5|issue=1|pages=271–281|doi=10.1007/s40744-017-0088-9|issn=2198-6576|pmid=29149437|via=}}</ref>

===Grant awards and current research===
*Oct 2016, [http://www.uofmhealth.org/news/archive/201610/chronic-pain-researchers-expand-work-75m-award-nih Chronic pain researchers to expand work with $7.5M award from NIH] <ref>{{Cite web|url=https://www.uofmhealth.org/news/archive/201610/chronic-pain-researchers-expand-work-75m-award-nih|title=Chronic pain researchers to expand work with $7.5M award from NIH {{!}} Michigan Medicine|last=|first=|date=Oct 17, 2016|website=www.uofmhealth.org|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>
*Jun 2018, The [[Bateman Horne Center]] will be an ''[https://allofus.nih.gov All of Us]'' recruitment center for people living with ME/CFS and fibromyalgia. ''All of Us'' is a ten year [https://en.wikipedia.org/wiki/Precision_medicine#Precision_Medicine_Initiative Precision Medicine Initiative] project that has been funded $1.5 Billion to recruit one million patients for its bio-bank. The idea is to research all diseases, from the most common to the most rare while taking into account lifestyle, environment, and biology.<ref>{{Cite news|url=http://batemanhornecenter.org/nih-announces-precision-medicine-initiative/|title=NIH Announces Precision Medicine Initiative - Bateman Horne Center|last=Black|first=Rachel|date=2018-06-20|work=Bateman Horne Center|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=https://allofus.nih.gov|title=National Institutes of Health (NIH) — All of Us|website=allofus.nih.gov|language=en|access-date=2018-08-09}}</ref>

=== Psychiatric paradigm ===

*2015, [https://www.ncbi.nlm.nih.gov/pubmed/26190965 Brain "fog," inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin.] <ref>{{Cite journal|last=Theoharides|first=Theoharis C.|last2=Stewart|first2=Julia M.|last3=Hatziagelaki|first3=Erifili|last4=Kolaitis|first4=Gerasimos|date=2015|title=Brain "fog," inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin|url=https://www.ncbi.nlm.nih.gov/pubmed/26190965|journal=Frontiers in Neuroscience|volume=9|pages=225|doi=10.3389/fnins.2015.00225|issn=1662-4548|pmid=26190965|via=}}</ref>

*2016, [http://bjp.sagepub.com/content/10/3/156.full.pdf+html Explaining unexplained pain to fibromyalgia patients: finding a narrative that is acceptable to patients and provides a rationale for evidence-based interventions] <ref>{{Cite journal|last=Hyland|first=Michael E|last2=Hinton|first2=Claire|last3=Hill|first3=Charlotte|last4=Whalley|first4=Ben|last5=Jones|first5=Rupert CM|last6=Davies|first6=Anthony F|date=2016-07-08|title=Explaining unexplained pain to fibromyalgia patients: finding a narrative that is acceptable to patients and provides a rationale for evidence based interventions|url=http://journals.sagepub.com/doi/pdf/10.1177/2049463716642601|journal=British Journal of Pain|language=en|volume=10|issue=3|pages=156–161|doi=10.1177/2049463716642601|issn=2049-4637|pmid=27583142|via=}}</ref>

*2016, [http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf Fibromyalgia: A Short Commentary iMedPub Journals - Journal of Headache & Pain Management - Frederick Wolfe and Brian Walitt] <ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=Oct 15, 2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|format=PDF|journal=Journal of Headache & Pain Management|volume=|pages=|doi=10.4172/2472-1913.100027|issn=2472-1913|via=iMedPub Journals}}</ref>

===Hyperbaric oxygen therapy===

*2015, [http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0127012 Hyperbaric Oxygen Therapy Can Diminish Fibromyalgia Syndrome] <ref>{{Cite journal|last=Efrati|first=Shai|last2=Golan|first2=Haim|last3=Bechor|first3=Yair|last4=Faran|first4=Yifat|last5=Daphna-Tekoah|first5=Shir|last6=Sekler|first6=Gal|last7=Fishlev|first7=Gregori|last8=Ablin|first8=Jacob N.|last9=Bergan|first9=Jacob|date=2015-05-26|title=Hyperbaric Oxygen Therapy Can Diminish Fibromyalgia Syndrome – Prospective Clinical Trial|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0127012|journal=PLOS ONE|language=en|volume=10|issue=5|pages=e0127012|doi=10.1371/journal.pone.0127012|issn=1932-6203|pmid=26010952|via=}}</ref>

:[http://www.news-medical.net/news/20150603/Women-who-suffer-from-fibromyalgia-benefit-from-hyperbaric-oxygen-therapy.aspx Noted in this News Medical article about the research all the women had concussions.] <ref>{{Cite news|url=https://www.news-medical.net/news/20150603/Women-who-suffer-from-fibromyalgia-benefit-from-hyperbaric-oxygen-therapy.aspx|title=Women who suffer from fibromyalgia benefit from hyperbaric oxygen therapy|date=2015-06-03|work=News-Medical.net|access-date=2018-08-09|language=en}}</ref>

*2016, [https://t.co/BqnFto5mTe Hyperbaric Oxygen Therapy for treating Fibromyalgia: An update] <ref>{{Cite news|url=https://februarystars.co.uk/2016/06/hyperbaric-oxygen-therapy-for-treating-fibromyalgia-an-update/?utm_source=ReviveOldPost&utm_medium=social&utm_campaign=ReviveOldPost|title=Hyperbaric Oxygen Therapy for treating Fibromyalgia: An update|date=2016-06-20|work=February Stars|access-date=2018-08-09|language=en-GB}}</ref>

== Controversies ==
=== Dr. Frederick Wolfe ===
Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.<ref>{{Cite news|url=http://www.nytimes.com/2008/01/14/health/14pain.html?_r=0|title=Drug Approved. Is Disease Real?|last=Berenson|first=Alex|date=Jan 14, 2008|work=The Wall Street Journal|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref><ref>[http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf Fibromyalgia: A Short Commentary - iMedPub Journals - DOI: 10.4172/2472-1913.100027 - Frederick Wolfe and Brian Walitt - Sep. 23, 2016]</ref><ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|journal=Journal of Headache & Pain Management|volume=1|issue=3:27|pages=|via=iMedPub Journals}}</ref><ref>{{Cite news|url=https://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx|title=Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine|last=Cashin-Garbutt|first=April|date=2013-03-22|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Fibromyalgia vs Chiari malformation ===
Some individuals diagnosed with FMS were undergoing surgery for [[Chiari malformation]] (CM). These are two separate conditions; FMS cannot be resolved by undergoing a risky CM surgery.

*2011, [https://www.ncbi.nlm.nih.gov/pubmed/21135714 Is Chiari I malformation associated with fibromyalgia?] <ref>{{Cite journal|last=Watson|first=Nathaniel F.|last2=Buchwald|first2=Dedra|last3=Goldberg|first3=Jack|last4=Maravilla|first4=Kenneth R.|last5=Noonan|first5=Carolyn|last6=Guan|first6=Qingyan|last7=Ellenbogen|first7=Richard G.|date=2011|title=Is Chiari I malformation associated with fibromyalgia?|url=https://www.ncbi.nlm.nih.gov/pubmed/21135714|journal=Neurosurgery|volume=68|issue=2|pages=443–448; discussion 448–449|doi=10.1227/NEU.0b013e3182039a31|issn=1524-4040|pmid=21135714|via=}}</ref>
::Conclusion: Most patients with FM do not have [[CIM]] pathology. Future studies should focus on dynamic neuroimaging of craniocervical neuroanatomy in patients with FM.
*2015, [https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery CFS/FM and Chiari Malformation Surgery] <ref>{{Cite web|url=https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery|title=CFS/FM and Chiari Malformation Surgery|last=Casanova|first=Ken|date=Nov 15, 2015|website=www.massmecfs.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

== Learn more ==
*[https://www.s4me.info/forums/fibromyalgia-and-connective-tissue-disorders.35/ Forum: Fibromyalgia and Connective Tissue Disorders] at [[Science for ME]]
*[[Verywell FMS/CFS]]

=== Ongoing process of diagnosing and categorizing ===

*2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3447191/ Personality and Fibromyalgia Syndrome]<ref>{{Cite journal|last=Malin|first=Katrina|last2=Littlejohn|first2=Geoffrey O|date=2012-09-07|title=Personality and Fibromyalgia Syndrome|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3447191/|journal=The Open Rheumatology Journal|volume=6|pages=273–285|doi=10.2174/1874312901206010273|issn=1874-3129|pmid=23002409|via=}}</ref>

<blockquote>Conclusion: No specific fibromyalgia personality is defined but it is proposed that personality is an important filter that modulates a person’s response to psychological stressors. Certain personalities may facilitate translation of these stressors to physiological responses driving the fibromyalgia mechanism.</blockquote>

*2014, [http://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114 Lyme Disease, Fibromyalgia Link Evaporates] <ref>{{Cite news|url=https://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114|title=Lyme Disease, Fibromylagia Link Evaporates|last=Kuznar|first=Wayne|date=2014-12-14|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref> (See also: [[Chronic lyme disease]])

*2015, [http://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx Fibromyalgia now considered as a lifelong central nervous system disorder] <ref>{{Cite news|url=https://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx|title=Fibromyalgia now considered as a lifelong central nervous system disorder|date=2015-05-18|work=News-Medical.net|access-date=2018-08-09|language=en}}</ref>

*2015, [http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates] <ref>{{Cite news|url=http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html|title=Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates|date=2015-10-24|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2015, [http://www.jneuro.com/neurology-neuroscience/evaluation-of-antiviral-antibodies-against-epsteinbarr-virus-and-neurotransmitters-in-patients-with-fibromyalgia.pdf Evaluation of Antiviral Antibodies against Epstein-Barr Virus and Neurotransmitters in Patients with Fibromyalgia] <ref>{{Cite journal|last=Reshkova|first=V|last2=D|first2=Kalinova|last3=Milanov|first3=Ivan|date=2015-01-01|title=Evaluation of Antiviral Antibodies against Epstein-Barr Virus and Neurotransmitters in Patients with Fibromyalgia|url=https://www.researchgate.net/publication/289245186_Evaluation_of_Antiviral_Antibodies_against_Epstein-Barr_Virus_and_Neurotransmitters_in_Patients_with_Fibromyalgia|journal=Journal of Neurology and Neuroscience|volume=6|pages=35|doi=10.21767/2171-6625.100035}}</ref>

*2015, ''Question:'' [http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html 'Is Fibromyalgia a Psychosomatic Illness?'] via CelesteCooper.com ''Answer:'' "Fibromyalgia is NOT a psychosomatic illness."<ref>[http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html Is Fibromyalgia a Psychosomatic Illness? Med Student Asks Celeste Cooper by Celeste Cooper - CelesteCooper.com Sep 4, 2015]</ref>

*2015, [https://onlinelibrary.wiley.com/doi/full/10.1002/acr.22626 Understanding the Association of Fatigue With Other Symptoms of Fibromyalgia: Development of a Cluster Model] <ref>{{Cite journal|last=Lukkahatai|first=Nada|last2=Walitt|first2=Brian|last3=Espina|first3=Alexandra|last4=Gelio|first4=Alves|last5=Saligan|first5=Leorey N.|date=2015-12-21|title=Understanding the Association of Fatigue With Other Symptoms of Fibromyalgia: Development of a Cluster Model|url=https://onlinelibrary.wiley.com/doi/full/10.1002/acr.22626|journal=Arthritis Care & Research|language=en|volume=68|issue=1|pages=99–107|doi=10.1002/acr.22626|issn=2151-464X|pmid=26017904|via=}}</ref>

*2016, [http://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination Diagnosing Fibromyalgia May Be Possible Using Noninvasive Eye Examination] <ref>{{Cite news|url=https://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination|title=Diagnosing Fibromyalgia May Be Possible with Noninvasive Eye Exam|date=2016-09-09|work=Fibromyalgia News Today|access-date=2018-08-09|language=en-US}}</ref>

*2016, [http://bjpo.rcpsych.org/content/2/4/275 The association between borderline personality disorder, fibromyalgia and chronic fatigue syndrome: systematic review] <ref>{{Cite journal|last=Penfold|first=Sarah|last2=Denis|first2=Emily St|last3=Mazhar|first3=Mir Nadeem|date=Jul 2016|title=The association between borderline personality disorder, fibromyalgia and chronic fatigue syndrome: systematic review|url=https://www.cambridge.org/core/journals/bjpsych-open/article/association-between-borderline-personality-disorder-fibromyalgia-and-chronic-fatigue-syndrome-systematic-review/119F3075289EBCC85D454D8D182DB1A6|journal=BJPsych Open|language=en|volume=2|issue=4|pages=275–279|doi=10.1192/bjpo.bp.115.002808|issn=2056-4724}}</ref>

<blockquote>There does not appear to be firm and consistent evidence to support the hypothesis that the prevalence of BPD ([[Borderline Personality Disorder]]) would be higher in individuals with fibromyalgia compared with the general population.</blockquote>

*2016, [https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780 Microglia in Fibromyalgia & Chronic Fatigue Syndrome] <ref>{{Cite news|url=https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780|title=Microglia in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*2016, [http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/ Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders?] <ref>{{Cite news|url=http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/|title=Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders? - Simmaron Research|date=2016-03-21|work=Simmaron Research|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://consultqd.clevelandclinic.org/2016/03/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic Why Fibromyalgia Is Neuropathic] <ref>{{Cite news|url=https://consultqd.clevelandclinic.org/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&utm_medium=social&utm_source=twitter&utm_content=160308+fibromyalgia+neuropathic&dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic|title=Why Fibromyalgia Is Neuropathic|date=2016-03-08|work=Consult QD|access-date=2018-08-09|language=en-US}}</ref>

*2016, [https://www.ncbi.nlm.nih.gov/pubmed/27583567 Towards a neurophysiological signature for fibromyalgia] <ref>{{Cite journal|last=López-Solà|first=Marina|last2=Woo|first2=Choong-Wan|last3=Pujol|first3=Jesus|last4=Deus|first4=Joan|last5=Harrison|first5=Ben J.|last6=Monfort|first6=Jordi|last7=Wager|first7=Tor D.|date=2017|title=Towards a neurophysiological signature for fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/27583567|journal=Pain|volume=158|issue=1|pages=34–47|doi=10.1097/j.pain.0000000000000707|issn=1872-6623|pmid=27583567|via=}}</ref> (With MRI images.)

<blockquote>Discovered a brain signature that identifies fibromyalgia sufferers with 93 percent accuracy.</blockquote>

*2017, [http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain]<ref>{{Cite news|url=http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html|title=Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain|last=Liptan|first=Ginevra|date=2017-04-11|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2018, [http://www.jrheum.org/content/early/2018/07/09/jrheum.180083 Primary and Secondary Fibromyalgia Are The Same: The Universality of Polysymptomatic Distress] <ref>{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|last3=Rasker|first3=Johannes J.|last4=Häuser|first4=Winfried|date=2018-07-15|title=Primary and Secondary Fibromyalgia Are The Same: The Universality of Polysymptomatic Distress|url=http://www.jrheum.org/content/early/2018/07/09/jrheum.180083|journal=The Journal of Rheumatology|language=en|pages=jrheum.180083|doi=10.3899/jrheum.180083|issn=0315-162X|pmid=30008459}}</ref>

<blockquote>PFM and SFM are equivalent regarding symptom burden.</blockquote>

=== Blood tests ===

*2013, [http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html New Fibromyalgia Blood Test is 99% Accurate] <ref>{{Cite news|url=http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html|title=New Fibromyalgia Blood Test is 99% Accurate|date=2013-07-31|work=National Pain Report|access-date=2018-08-09|language=en-US}}</ref>

*2014, [http://www.prohealth.com/library/showarticle.cfm?libid=18837 Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”] <ref>{{Cite news|url=https://www.prohealth.com/library/pridgen-reports-fibromyalgia-antiviral-trial-results-very-positive-predicts-new-approach-will-be-game-changer-32620|title=Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”|last=|first=|date=2014-03-25|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2015, [http://www.ncbi.nlm.nih.gov/pubmed/25377646 Cytokine and chemokine profiles in fibromyalgia, rheumatoid arthritis, and systemic lupus erythematosus: a potentially useful tool in differential diagnosis.] <ref>{{Cite journal|last=Wallace|first=Daniel J.|last2=Gavin|first2=Igor M.|last3=Karpenko|first3=Oleksly|last4=Barkhordar|first4=Farnaz|last5=Gillis|first5=Bruce S.|date=2015|title=Cytokine and chemokine profiles in fibromyalgia, rheumatoid arthritis and systemic lupus erythematosus: a potentially useful tool in differential diagnosis|url=https://www.ncbi.nlm.nih.gov/pubmed/25377646|journal=Rheumatology International|volume=35|issue=6|pages=991–996|doi=10.1007/s00296-014-3172-2|issn=1437-160X|pmc=|pmid=25377646|via=}}</ref>

*2016, [https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html Blood Test for Fibromyalgia: FM/a Test Ⓡ is now available, Q&A] <ref>{{Cite web|url=https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html|title=Blood Test for Fibromyalgia: FM/a Test ® Is Real, Q&A|last=Cooper|first=Celeste|date=May 3, 2016|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2016, [http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/ Fibromyalgia blood testing covered by rising number of insurance companies] <ref>{{Cite news|url=http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/|title=Fibromyalgia blood testing covered more of insurance companies|last=Campbell|first=Julie|date=2016-04-08|work=Live Insurance News|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

*2017, [http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches] <ref>{{Cite news|url=https://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=Business Wire|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

=== Brain scans ===

*2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds] <ref>{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|publisher=ANAPSID|via=Chronic Neuroimmune Diseases|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}</ref>

*2012, [https://www.sciencedaily.com/releases/2012/11/121111153426.htm Fibromyalgia and the brain: New clues reveal how pain and therapies are processed] <ref>{{Cite news|url=https://www.sciencedaily.com/releases/2012/11/121111153426.htm|title=Fibromyalgia and the brain: New clues reveal how pain and therapies are processed|last=|first=|date=Nov 11, 2012|work=ScienceDaily|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}</ref>

*2015, [https://www.verywell.com/unique-brain-connectivity-in-fibromyalgia-715630 Unique Brain Connectivity in Fibromyalgia - Increased Importance Assigned to Pain] <ref>{{Cite news|url=https://www.verywellhealth.com/how-lyrica-changes-the-fibromyalgia-brain-715767|title=How Lyrica Changes the Fibromyalgia Brain|last=Dellwo|first=Adrienne|date=Apr 30, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}</ref>

*2015, [http://onlinelibrary.wiley.com/doi/10.1002/art.39043/abstract The Somatosensory Link in Fibromyalgia: Functional Connectivity of the Primary Somatosensory Cortex Is Altered by Sustained Pain and Is Associated With Clinical/Autonomic Dysfunction] <ref>{{Cite journal|last=Kim|first=Jieun|last2=Loggia|first2=Marco L.|last3=Cahalan|first3=Christine M.|last4=Harris|first4=Richard E.|last5=Beissner|first5=Florian|last6=Garcia|first6=Ronald G.|last7=Kim|first7=Hyungjun|last8=Barbieri|first8=Riccardo|last9=Wasan|first9=Ajay D.|date=2015-04-27|title=The Somatosensory Link in Fibromyalgia: Functional Connectivity of the Primary Somatosensory Cortex Is Altered by Sustained Pain and Is Associated With Clinical/Autonomic Dysfunction|url=https://onlinelibrary.wiley.com/doi/abs/10.1002/art.39043|journal=Arthritis & Rheumatology|language=en|volume=67|issue=5|pages=1395–1405|doi=10.1002/art.39043|issn=2326-5191|pmc=|pmid=25622796|via=}}</ref>

==See also==
*[[Lady Gaga]]

==References==
<references />

[[Category:Diagnoses]]
[[Category:Comorbidities]]

Lady Gaga

2018-08-12T16:26:32Z

77.111.246.7:/* Instagram */ x

[[File:Gaga.jpg|200px|thumb|right| Lady Gaga arriving at the ''Gaga: Five Foot Two'' press conference during the [https://en.wikipedia.org/wiki/2017_Toronto_International_Film_Festival 2017 Toronto International Film Festival]]]
'''Stefani Joanne Angelina Germanotta'''
(born March 28, 1986), known professionally as [https://en.wikipedia.org/wiki/Lady_Gaga Lady Gaga], is an [[American]] singer, songwriter, and actress. She is known for her unconventionality and provocative work as well as visual experimentation.<ref>{{Cite journal|date=2018-08-11|title=Lady Gaga|url=https://en.wikipedia.org/w/index.php?title=Lady_Gaga&oldid=854464046|journal=Wikipedia|language=en}}</ref>

==Borderline positive for Lupus==
*Jun 3, 2010, [http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html Lady Gaga's 'borderline positive' comment sheds light on lupus]<ref>{{Cite news|url=http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html|title=Lady Gaga's 'borderline positive' comment sheds light on lupus - CNN.com|last=Park|first=Madison|date=Jun 3, 2010|work=CNN Health|access-date=2018-08-12|archive-url=|archive-date=|dead-url=|language=en}}</ref>

<blockquote>"And the truth is I don't show any signs, any symptoms of [[lupus]]. But I have tested borderline positive for the disease. So as of right now ... I do not have it. But I have to take good care of myself."</blockquote>

<blockquote>"There is not a single lab test that is specific for lupus," said Gilkeson, who chairs the Lupus Foundation of America's medical-scientific advisory council. "You have to use the combination of the lab tests plus the clinical signs and symptoms."</blockquote>

== Chronic pain ==
=== Instagram ===
*Nov 18, 2016, [https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control Instagram post of Stefani using an infared sauna and cold packs for chronic pain.]<ref>{{Cite web|url=https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control|title=Lady Gaga on Instagram: “I was so overwhelmed by the empathy, confessions & personal stories of chronic pain in response to my previous post I thought what the…”|last=Germanotta|first=Stefani|date=Nov 28, 2016|website=Instagram|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref>

== Fibromyalgia ==
In 2017 she released a new documantary, [https://en.wikipedia.org/wiki/Gaga:_Five_Foot_Two Gaga: Five foot two].<ref>{{Cite journal|date=2018-07-26|title=Gaga: Five Foot Two|url=https://en.wikipedia.org/w/index.php?title=Gaga:_Five_Foot_Two&oldid=852101917|journal=Wikipedia|language=en}}</ref> Throughout the film, she was seen suffering from [[chronic pain]], which was later revealed to be the effect of a long-term condition called [[fibromyalgia]]. In the film she told the doctor that she has been suffering from severe pain the last 5 years.<ref>{{Cite news|url=https://www.elle.com/culture/celebrities/a12274279/lady-gaga-five-foot-two-netflix-trailer/|title=Lady Gaga Opens Up About Her Fibromyalgia Pain in a New Documentary Trailer|last=Friedman|first=Megan|date=2017-09-19|work=ELLE|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=http://www.latimes.com/entertainment/movies/la-et-mn-lady-gaga-documentary-five-foot-two-20170920-story.html|title=Lady Gaga wants you to feel her pain in the Netflix documentary 'Five Foot Two'|last=Kaufman|first=Amy|date=Sep 20, 2017|website=latimes.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref> It resulted in Gaga canceling the last ten shows of [https://en.wikipedia.org/wiki/Joanne_World_Tour Joanne World Tour].<ref>{{Cite news|url=https://twitter.com/ladygaga/status/959683091781464064|title=Cancellation of the final 10 dates of the European leg of Joanne World Tour.|last=Lady Gaga|first=|date=Feb 2, 2018|work=Twitter|access-date=2018-08-12|archive-url=|archive-date=|dead-url=|at=11:00 PM|language=en}}</ref><ref>{{Cite web|url=https://abcnews.go.com/Entertainment/lady-gaga-cancels-remainder-world-tour-due-severe/story?id=52813826|title=Lady Gaga cancels remainder of world tour due to 'severe pain'|last=News|first=A. B. C.|date=2018-02-04|website=ABC News|language=en|access-date=2018-08-10}}</ref>

=== Twitter ===
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907571825294675968 In our documentary the #chronicillness #chronicpain I deal w/ is #Fibromyalgia I wish to help raise awareness & connect people who have it.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907571825294675968|title=In our documentary the #chronicillness #chronicpain I deal w/ is #Fibromyalgia I wish to help raise awareness & connect people who have it.|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:49 AM}}</ref>
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907755622162223104 Thought ice helped #Fibromyalgia. I was wrong & making it worse. Warm/Heat is better. Electric Heated Blanket, Infrared Sauna, Epsom Baths.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907755622162223104|title=Thought ice helped #Fibromyalgia. I was wrong & making it worse. Warm/Heat is better. Electric Heated Blanket, Infrared Sauna, Epsom Baths.|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:59 PM}}</ref>

== Online presence ==
*[https://www.facebook.com/ladygaga Facebook]
*[https://www.instagram.com/ladygaga/ Instagram]
*[https://twitter.com/ladygaga Twitter]
*[https://www.ladygaga.com/ Website]
*[https://www.youtube.com/channel/UCNL1ZadSjHpjm4q9j2sVtOA YouTube]

== Learn more ==
*[https://en.wikipedia.org/wiki/Lady_Gaga Wikipedia]

== References ==
<references />

Lady Gaga

2018-08-12T16:25:33Z

77.111.246.7:/* Twitter */ title added

[[File:Gaga.jpg|200px|thumb|right| Lady Gaga arriving at the ''Gaga: Five Foot Two'' press conference during the [https://en.wikipedia.org/wiki/2017_Toronto_International_Film_Festival 2017 Toronto International Film Festival]]]
'''Stefani Joanne Angelina Germanotta'''
(born March 28, 1986), known professionally as [https://en.wikipedia.org/wiki/Lady_Gaga Lady Gaga], is an [[American]] singer, songwriter, and actress. She is known for her unconventionality and provocative work as well as visual experimentation.<ref>{{Cite journal|date=2018-08-11|title=Lady Gaga|url=https://en.wikipedia.org/w/index.php?title=Lady_Gaga&oldid=854464046|journal=Wikipedia|language=en}}</ref>

==Borderline positive for Lupus==
*Jun 3, 2010, [http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html Lady Gaga's 'borderline positive' comment sheds light on lupus]<ref>{{Cite news|url=http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html|title=Lady Gaga's 'borderline positive' comment sheds light on lupus - CNN.com|last=Park|first=Madison|date=Jun 3, 2010|work=CNN Health|access-date=2018-08-12|archive-url=|archive-date=|dead-url=|language=en}}</ref>

<blockquote>"And the truth is I don't show any signs, any symptoms of [[lupus]]. But I have tested borderline positive for the disease. So as of right now ... I do not have it. But I have to take good care of myself."</blockquote>

<blockquote>"There is not a single lab test that is specific for lupus," said Gilkeson, who chairs the Lupus Foundation of America's medical-scientific advisory council. "You have to use the combination of the lab tests plus the clinical signs and symptoms."</blockquote>

== Chronic pain ==
=== Instagram ===
*Nov 18, 2016, [https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control Instagram post with Stefani using an infared sauna and cold packs for chronic pain.]<ref>{{Cite web|url=https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control|title=Lady Gaga on Instagram: “I was so overwhelmed by the empathy, confessions & personal stories of chronic pain in response to my previous post I thought what the…”|last=Germanotta|first=Stefani|date=Nov 28, 2016|website=Instagram|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref>

== Fibromyalgia ==
In 2017 she released a new documantary, [https://en.wikipedia.org/wiki/Gaga:_Five_Foot_Two Gaga: Five foot two].<ref>{{Cite journal|date=2018-07-26|title=Gaga: Five Foot Two|url=https://en.wikipedia.org/w/index.php?title=Gaga:_Five_Foot_Two&oldid=852101917|journal=Wikipedia|language=en}}</ref> Throughout the film, she was seen suffering from [[chronic pain]], which was later revealed to be the effect of a long-term condition called [[fibromyalgia]]. In the film she told the doctor that she has been suffering from severe pain the last 5 years.<ref>{{Cite news|url=https://www.elle.com/culture/celebrities/a12274279/lady-gaga-five-foot-two-netflix-trailer/|title=Lady Gaga Opens Up About Her Fibromyalgia Pain in a New Documentary Trailer|last=Friedman|first=Megan|date=2017-09-19|work=ELLE|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=http://www.latimes.com/entertainment/movies/la-et-mn-lady-gaga-documentary-five-foot-two-20170920-story.html|title=Lady Gaga wants you to feel her pain in the Netflix documentary 'Five Foot Two'|last=Kaufman|first=Amy|date=Sep 20, 2017|website=latimes.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref> It resulted in Gaga canceling the last ten shows of [https://en.wikipedia.org/wiki/Joanne_World_Tour Joanne World Tour].<ref>{{Cite news|url=https://twitter.com/ladygaga/status/959683091781464064|title=Cancellation of the final 10 dates of the European leg of Joanne World Tour.|last=Lady Gaga|first=|date=Feb 2, 2018|work=Twitter|access-date=2018-08-12|archive-url=|archive-date=|dead-url=|at=11:00 PM|language=en}}</ref><ref>{{Cite web|url=https://abcnews.go.com/Entertainment/lady-gaga-cancels-remainder-world-tour-due-severe/story?id=52813826|title=Lady Gaga cancels remainder of world tour due to 'severe pain'|last=News|first=A. B. C.|date=2018-02-04|website=ABC News|language=en|access-date=2018-08-10}}</ref>

=== Twitter ===
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907571825294675968 In our documentary the #chronicillness #chronicpain I deal w/ is #Fibromyalgia I wish to help raise awareness & connect people who have it.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907571825294675968|title=In our documentary the #chronicillness #chronicpain I deal w/ is #Fibromyalgia I wish to help raise awareness & connect people who have it.|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:49 AM}}</ref>
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907755622162223104 Thought ice helped #Fibromyalgia. I was wrong & making it worse. Warm/Heat is better. Electric Heated Blanket, Infrared Sauna, Epsom Baths.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907755622162223104|title=Thought ice helped #Fibromyalgia. I was wrong & making it worse. Warm/Heat is better. Electric Heated Blanket, Infrared Sauna, Epsom Baths.|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:59 PM}}</ref>

== Online presence ==
*[https://www.facebook.com/ladygaga Facebook]
*[https://www.instagram.com/ladygaga/ Instagram]
*[https://twitter.com/ladygaga Twitter]
*[https://www.ladygaga.com/ Website]
*[https://www.youtube.com/channel/UCNL1ZadSjHpjm4q9j2sVtOA YouTube]

== Learn more ==
*[https://en.wikipedia.org/wiki/Lady_Gaga Wikipedia]

== References ==
<references />

Lady Gaga

2018-08-12T16:22:08Z

77.111.246.7:/* Fibromyalgia */ tweet

[[File:Gaga.jpg|200px|thumb|right| Lady Gaga arriving at the ''Gaga: Five Foot Two'' press conference during the [https://en.wikipedia.org/wiki/2017_Toronto_International_Film_Festival 2017 Toronto International Film Festival]]]
'''Stefani Joanne Angelina Germanotta'''
(born March 28, 1986), known professionally as [https://en.wikipedia.org/wiki/Lady_Gaga Lady Gaga], is an [[American]] singer, songwriter, and actress. She is known for her unconventionality and provocative work as well as visual experimentation.<ref>{{Cite journal|date=2018-08-11|title=Lady Gaga|url=https://en.wikipedia.org/w/index.php?title=Lady_Gaga&oldid=854464046|journal=Wikipedia|language=en}}</ref>

==Borderline positive for Lupus==
*Jun 3, 2010, [http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html Lady Gaga's 'borderline positive' comment sheds light on lupus]<ref>{{Cite news|url=http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html|title=Lady Gaga's 'borderline positive' comment sheds light on lupus - CNN.com|last=Park|first=Madison|date=Jun 3, 2010|work=CNN Health|access-date=2018-08-12|archive-url=|archive-date=|dead-url=|language=en}}</ref>

<blockquote>"And the truth is I don't show any signs, any symptoms of [[lupus]]. But I have tested borderline positive for the disease. So as of right now ... I do not have it. But I have to take good care of myself."</blockquote>

<blockquote>"There is not a single lab test that is specific for lupus," said Gilkeson, who chairs the Lupus Foundation of America's medical-scientific advisory council. "You have to use the combination of the lab tests plus the clinical signs and symptoms."</blockquote>

== Chronic pain ==
=== Instagram ===
*Nov 18, 2016, [https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control Instagram post with Stefani using an infared sauna and cold packs for chronic pain.]<ref>{{Cite web|url=https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control|title=Lady Gaga on Instagram: “I was so overwhelmed by the empathy, confessions & personal stories of chronic pain in response to my previous post I thought what the…”|last=Germanotta|first=Stefani|date=Nov 28, 2016|website=Instagram|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref>

== Fibromyalgia ==
In 2017 she released a new documantary, [https://en.wikipedia.org/wiki/Gaga:_Five_Foot_Two Gaga: Five foot two].<ref>{{Cite journal|date=2018-07-26|title=Gaga: Five Foot Two|url=https://en.wikipedia.org/w/index.php?title=Gaga:_Five_Foot_Two&oldid=852101917|journal=Wikipedia|language=en}}</ref> Throughout the film, she was seen suffering from [[chronic pain]], which was later revealed to be the effect of a long-term condition called [[fibromyalgia]]. In the film she told the doctor that she has been suffering from severe pain the last 5 years.<ref>{{Cite news|url=https://www.elle.com/culture/celebrities/a12274279/lady-gaga-five-foot-two-netflix-trailer/|title=Lady Gaga Opens Up About Her Fibromyalgia Pain in a New Documentary Trailer|last=Friedman|first=Megan|date=2017-09-19|work=ELLE|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=http://www.latimes.com/entertainment/movies/la-et-mn-lady-gaga-documentary-five-foot-two-20170920-story.html|title=Lady Gaga wants you to feel her pain in the Netflix documentary 'Five Foot Two'|last=Kaufman|first=Amy|date=Sep 20, 2017|website=latimes.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref> It resulted in Gaga canceling the last ten shows of [https://en.wikipedia.org/wiki/Joanne_World_Tour Joanne World Tour].<ref>{{Cite news|url=https://twitter.com/ladygaga/status/959683091781464064|title=Cancellation of the final 10 dates of the European leg of Joanne World Tour.|last=Lady Gaga|first=|date=Feb 2, 2018|work=Twitter|access-date=2018-08-12|archive-url=|archive-date=|dead-url=|at=11:00 PM|language=en}}</ref><ref>{{Cite web|url=https://abcnews.go.com/Entertainment/lady-gaga-cancels-remainder-world-tour-due-severe/story?id=52813826|title=Lady Gaga cancels remainder of world tour due to 'severe pain'|last=News|first=A. B. C.|date=2018-02-04|website=ABC News|language=en|access-date=2018-08-10}}</ref>

=== Twitter ===
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907571825294675968 In our documentary the #chronicillness #chronicpain I deal w/ is #Fibromyalgia I wish to help raise awareness & connect people who have it.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907571825294675968|title=Lady Gaga on Twitter|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:49 AM}}</ref>
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907755622162223104 Thought ice helped #Fibromyalgia. I was wrong & making it worse. Warm/Heat is better. Electric Heated Blanket, Infrared Sauna, Epsom Baths.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907755622162223104|title=Lady Gaga on Twitter|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:59 AM}}</ref>

== Online presence ==
*[https://www.facebook.com/ladygaga Facebook]
*[https://www.instagram.com/ladygaga/ Instagram]
*[https://twitter.com/ladygaga Twitter]
*[https://www.ladygaga.com/ Website]
*[https://www.youtube.com/channel/UCNL1ZadSjHpjm4q9j2sVtOA YouTube]

== Learn more ==
*[https://en.wikipedia.org/wiki/Lady_Gaga Wikipedia]

== References ==
<references />

Lady Gaga

2018-08-12T15:35:51Z

77.111.246.7:/* Instagram */ real life, real name

[[File:Gaga.jpg|200px|thumb|right| Lady Gaga arriving at the ''Gaga: Five Foot Two'' press conference during the [https://en.wikipedia.org/wiki/2017_Toronto_International_Film_Festival 2017 Toronto International Film Festival]]]
'''Stefani Joanne Angelina Germanotta'''
(born March 28, 1986), known professionally as [https://en.wikipedia.org/wiki/Lady_Gaga Lady Gaga], is an [[American]] singer, songwriter, and actress. She is known for her unconventionality and provocative work as well as visual experimentation.<ref>{{Cite journal|date=2018-08-11|title=Lady Gaga|url=https://en.wikipedia.org/w/index.php?title=Lady_Gaga&oldid=854464046|journal=Wikipedia|language=en}}</ref>

==Borderline positive for Lupus==
*Jun 3, 2010, [http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html Lady Gaga's 'borderline positive' comment sheds light on lupus]<ref>{{Cite news|url=http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html|title=Lady Gaga's 'borderline positive' comment sheds light on lupus - CNN.com|last=Park|first=Madison|date=Jun 3, 2010|work=CNN Health|access-date=2018-08-12|archive-url=|archive-date=|dead-url=|language=en}}</ref>

<blockquote>"And the truth is I don't show any signs, any symptoms of [[lupus]]. But I have tested borderline positive for the disease. So as of right now ... I do not have it. But I have to take good care of myself."</blockquote>

<blockquote>"There is not a single lab test that is specific for lupus," said Gilkeson, who chairs the Lupus Foundation of America's medical-scientific advisory council. "You have to use the combination of the lab tests plus the clinical signs and symptoms."</blockquote>

== Chronic pain ==
=== Instagram ===
*Nov 18, 2016, [https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control Instagram post with Stefani using an infared sauna and cold packs for chronic pain.]<ref>{{Cite web|url=https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control|title=Lady Gaga on Instagram: “I was so overwhelmed by the empathy, confessions & personal stories of chronic pain in response to my previous post I thought what the…”|last=Germanotta|first=Stefani|date=Nov 28, 2016|website=Instagram|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref>

== Fibromyalgia ==
In 2017 she released a new documantary, [https://en.wikipedia.org/wiki/Gaga:_Five_Foot_Two Gaga: Five foot two].<ref>{{Cite journal|date=2018-07-26|title=Gaga: Five Foot Two|url=https://en.wikipedia.org/w/index.php?title=Gaga:_Five_Foot_Two&oldid=852101917|journal=Wikipedia|language=en}}</ref> Throughout the film, she was seen suffering from [[chronic pain]], which was later revealed to be the effect of a long-term condition called [[fibromyalgia]]. In the film she told the doctor that she has been suffering from severe pain the last 5 years.<ref>{{Cite news|url=https://www.elle.com/culture/celebrities/a12274279/lady-gaga-five-foot-two-netflix-trailer/|title=Lady Gaga Opens Up About Her Fibromyalgia Pain in a New Documentary Trailer|last=Friedman|first=Megan|date=2017-09-19|work=ELLE|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=http://www.latimes.com/entertainment/movies/la-et-mn-lady-gaga-documentary-five-foot-two-20170920-story.html|title=Lady Gaga wants you to feel her pain in the Netflix documentary 'Five Foot Two'|last=Kaufman|first=Amy|date=Sep 20, 2017|website=latimes.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref> It resulted in Gaga canceling the last ten shows of [https://en.wikipedia.org/wiki/Joanne_World_Tour Joanne World Tour].<ref>{{Cite web|url=https://abcnews.go.com/Entertainment/lady-gaga-cancels-remainder-world-tour-due-severe/story?id=52813826|title=Lady Gaga cancels remainder of world tour due to 'severe pain'|last=News|first=A. B. C.|date=2018-02-04|website=ABC News|language=en|access-date=2018-08-10}}</ref>

=== Twitter ===
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907571825294675968 In our documentary the #chronicillness #chronicpain I deal w/ is #Fibromyalgia I wish to help raise awareness & connect people who have it.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907571825294675968|title=Lady Gaga on Twitter|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:49 AM}}</ref>
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907755622162223104 Thought ice helped #Fibromyalgia. I was wrong & making it worse. Warm/Heat is better. Electric Heated Blanket, Infrared Sauna, Epsom Baths.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907755622162223104|title=Lady Gaga on Twitter|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:59 AM}}</ref>

== Online presence ==
*[https://www.facebook.com/ladygaga Facebook]
*[https://www.instagram.com/ladygaga/ Instagram]
*[https://twitter.com/ladygaga Twitter]
*[https://www.ladygaga.com/ Website]
*[https://www.youtube.com/channel/UCNL1ZadSjHpjm4q9j2sVtOA YouTube]

== Learn more ==
*[https://en.wikipedia.org/wiki/Lady_Gaga Wikipedia]

== References ==
<references />

American

2018-08-12T15:34:23Z

77.111.246.7:correct

#REDIRECT [[United States]]

American

2018-08-12T15:33:06Z

77.111.246.7:create

#REDIRECT [[America]]

Lady Gaga

2018-08-12T15:32:40Z

77.111.246.7:x

[[File:Gaga.jpg|200px|thumb|right| Lady Gaga arriving at the ''Gaga: Five Foot Two'' press conference during the [https://en.wikipedia.org/wiki/2017_Toronto_International_Film_Festival 2017 Toronto International Film Festival]]]
'''Stefani Joanne Angelina Germanotta'''
(born March 28, 1986), known professionally as [https://en.wikipedia.org/wiki/Lady_Gaga Lady Gaga], is an [[American]] singer, songwriter, and actress. She is known for her unconventionality and provocative work as well as visual experimentation.<ref>{{Cite journal|date=2018-08-11|title=Lady Gaga|url=https://en.wikipedia.org/w/index.php?title=Lady_Gaga&oldid=854464046|journal=Wikipedia|language=en}}</ref>

==Borderline positive for Lupus==
*Jun 3, 2010, [http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html Lady Gaga's 'borderline positive' comment sheds light on lupus]<ref>{{Cite news|url=http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html|title=Lady Gaga's 'borderline positive' comment sheds light on lupus - CNN.com|last=Park|first=Madison|date=Jun 3, 2010|work=CNN Health|access-date=2018-08-12|archive-url=|archive-date=|dead-url=|language=en}}</ref>

<blockquote>"And the truth is I don't show any signs, any symptoms of [[lupus]]. But I have tested borderline positive for the disease. So as of right now ... I do not have it. But I have to take good care of myself."</blockquote>

<blockquote>"There is not a single lab test that is specific for lupus," said Gilkeson, who chairs the Lupus Foundation of America's medical-scientific advisory council. "You have to use the combination of the lab tests plus the clinical signs and symptoms."</blockquote>

== Chronic pain ==
=== Instagram ===
*Nov 18, 2016, [https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control Instagram post with Lady Gaga using an infared sauna and cold packs for chronic pain.]<ref>{{Cite web|url=https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control|title=Lady Gaga on Instagram: “I was so overwhelmed by the empathy, confessions & personal stories of chronic pain in response to my previous post I thought what the…”|last=Germanotta|first=Stefani|date=Nov 28, 2016|website=Instagram|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref>

== Fibromyalgia ==
In 2017 she released a new documantary, [https://en.wikipedia.org/wiki/Gaga:_Five_Foot_Two Gaga: Five foot two].<ref>{{Cite journal|date=2018-07-26|title=Gaga: Five Foot Two|url=https://en.wikipedia.org/w/index.php?title=Gaga:_Five_Foot_Two&oldid=852101917|journal=Wikipedia|language=en}}</ref> Throughout the film, she was seen suffering from [[chronic pain]], which was later revealed to be the effect of a long-term condition called [[fibromyalgia]]. In the film she told the doctor that she has been suffering from severe pain the last 5 years.<ref>{{Cite news|url=https://www.elle.com/culture/celebrities/a12274279/lady-gaga-five-foot-two-netflix-trailer/|title=Lady Gaga Opens Up About Her Fibromyalgia Pain in a New Documentary Trailer|last=Friedman|first=Megan|date=2017-09-19|work=ELLE|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=http://www.latimes.com/entertainment/movies/la-et-mn-lady-gaga-documentary-five-foot-two-20170920-story.html|title=Lady Gaga wants you to feel her pain in the Netflix documentary 'Five Foot Two'|last=Kaufman|first=Amy|date=Sep 20, 2017|website=latimes.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref> It resulted in Gaga canceling the last ten shows of [https://en.wikipedia.org/wiki/Joanne_World_Tour Joanne World Tour].<ref>{{Cite web|url=https://abcnews.go.com/Entertainment/lady-gaga-cancels-remainder-world-tour-due-severe/story?id=52813826|title=Lady Gaga cancels remainder of world tour due to 'severe pain'|last=News|first=A. B. C.|date=2018-02-04|website=ABC News|language=en|access-date=2018-08-10}}</ref>

=== Twitter ===
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907571825294675968 In our documentary the #chronicillness #chronicpain I deal w/ is #Fibromyalgia I wish to help raise awareness & connect people who have it.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907571825294675968|title=Lady Gaga on Twitter|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:49 AM}}</ref>
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907755622162223104 Thought ice helped #Fibromyalgia. I was wrong & making it worse. Warm/Heat is better. Electric Heated Blanket, Infrared Sauna, Epsom Baths.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907755622162223104|title=Lady Gaga on Twitter|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:59 AM}}</ref>

== Online presence ==
*[https://www.facebook.com/ladygaga Facebook]
*[https://www.instagram.com/ladygaga/ Instagram]
*[https://twitter.com/ladygaga Twitter]
*[https://www.ladygaga.com/ Website]
*[https://www.youtube.com/channel/UCNL1ZadSjHpjm4q9j2sVtOA YouTube]

== Learn more ==
*[https://en.wikipedia.org/wiki/Lady_Gaga Wikipedia]

== References ==
<references />

Lady Gaga

2018-08-12T15:23:13Z

77.111.246.7:lupus info

[[File:Gaga.jpg|200px|thumb|right| Lady Gaga arriving at the ''Gaga: Five Foot Two'' press conference during the [https://en.wikipedia.org/wiki/2017_Toronto_International_Film_Festival 2017 Toronto International Film Festival]]]
'''Stefani Joanne Angelina Germanotta'''
(born March 28, 1986), known professionally as [https://en.wikipedia.org/wiki/Lady_Gaga Lady Gaga], is an American singer, songwriter, and actress. She is known for her unconventionality and provocative work as well as visual experimentation.<ref>{{Cite journal|date=2018-08-11|title=Lady Gaga|url=https://en.wikipedia.org/w/index.php?title=Lady_Gaga&oldid=854464046|journal=Wikipedia|language=en}}</ref>

==Borderline positive for Lupus==
*Jun 3, 2010, [http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html Lady Gaga's 'borderline positive' comment sheds light on lupus]<ref>{{Cite news|url=http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html|title=Lady Gaga's 'borderline positive' comment sheds light on lupus - CNN.com|last=Park|first=Madison|date=Jun 3, 2010|work=CNN Health|access-date=2018-08-12|archive-url=|archive-date=|dead-url=|language=en}}</ref>

<blockquote>"And the truth is I don't show any signs, any symptoms of [[lupus]]. But I have tested borderline positive for the disease. So as of right now ... I do not have it. But I have to take good care of myself."</blockquote>

<blockquote>"There is not a single lab test that is specific for lupus," said Gilkeson, who chairs the Lupus Foundation of America's medical-scientific advisory council. "You have to use the combination of the lab tests plus the clinical signs and symptoms."</blockquote>

== Chronic pain ==
=== Instagram ===
*Nov 18, 2016, [https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control Instagram post with Lady Gaga using an infared sauna and cold packs for chronic pain.]<ref>{{Cite web|url=https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control|title=Lady Gaga on Instagram: “I was so overwhelmed by the empathy, confessions & personal stories of chronic pain in response to my previous post I thought what the…”|last=Germanotta|first=Stefani|date=Nov 28, 2016|website=Instagram|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref>

== Fibromyalgia ==
In 2017 she released a new documantary, [https://en.wikipedia.org/wiki/Gaga:_Five_Foot_Two Gaga: Five foot two].<ref>{{Cite journal|date=2018-07-26|title=Gaga: Five Foot Two|url=https://en.wikipedia.org/w/index.php?title=Gaga:_Five_Foot_Two&oldid=852101917|journal=Wikipedia|language=en}}</ref> Throughout the film, she was seen suffering from [[chronic pain]], which was later revealed to be the effect of a long-term condition called [[fibromyalgia]]. In the film she told the doctor that she has been suffering from severe pain the last 5 years.<ref>{{Cite news|url=https://www.elle.com/culture/celebrities/a12274279/lady-gaga-five-foot-two-netflix-trailer/|title=Lady Gaga Opens Up About Her Fibromyalgia Pain in a New Documentary Trailer|last=Friedman|first=Megan|date=2017-09-19|work=ELLE|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=http://www.latimes.com/entertainment/movies/la-et-mn-lady-gaga-documentary-five-foot-two-20170920-story.html|title=Lady Gaga wants you to feel her pain in the Netflix documentary 'Five Foot Two'|last=Kaufman|first=Amy|date=Sep 20, 2017|website=latimes.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref> It resulted in Gaga canceling the last ten shows of [https://en.wikipedia.org/wiki/Joanne_World_Tour Joanne World Tour].<ref>{{Cite web|url=https://abcnews.go.com/Entertainment/lady-gaga-cancels-remainder-world-tour-due-severe/story?id=52813826|title=Lady Gaga cancels remainder of world tour due to 'severe pain'|last=News|first=A. B. C.|date=2018-02-04|website=ABC News|language=en|access-date=2018-08-10}}</ref>

=== Twitter ===
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907571825294675968 In our documentary the #chronicillness #chronicpain I deal w/ is #Fibromyalgia I wish to help raise awareness & connect people who have it.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907571825294675968|title=Lady Gaga on Twitter|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:49 AM}}</ref>
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907755622162223104 Thought ice helped #Fibromyalgia. I was wrong & making it worse. Warm/Heat is better. Electric Heated Blanket, Infrared Sauna, Epsom Baths.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907755622162223104|title=Lady Gaga on Twitter|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:59 AM}}</ref>

== Online presence ==
*[https://www.facebook.com/ladygaga Facebook]
*[https://www.instagram.com/ladygaga/ Instagram]
*[https://twitter.com/ladygaga Twitter]
*[https://www.ladygaga.com/ Website]
*[https://www.youtube.com/channel/UCNL1ZadSjHpjm4q9j2sVtOA YouTube]

== Learn more ==
*[https://en.wikipedia.org/wiki/Lady_Gaga Wikipedia]

== References ==
<references />

Lady Gaga

2018-08-12T15:18:01Z

77.111.246.7:/* Fibromyalgia */ x

[[File:Gaga.jpg|200px|thumb|right| Lady Gaga arriving at the ''Gaga: Five Foot Two'' press conference during the [https://en.wikipedia.org/wiki/2017_Toronto_International_Film_Festival 2017 Toronto International Film Festival]]]
'''Stefani Joanne Angelina Germanotta'''
(born March 28, 1986), known professionally as [https://en.wikipedia.org/wiki/Lady_Gaga Lady Gaga], is an American singer, songwriter, and actress. She is known for her unconventionality and provocative work as well as visual experimentation.

==Borderline positive for Lupus==
*Jun 3, 2010, [http://edition.cnn.com/2010/HEALTH/06/03/lupus.lady.gaga/index.html Lady Gaga's 'borderline positive' comment sheds light on lupus]

<blockquote>"And the truth is I don't show any signs, any symptoms of lupus. But I have tested borderline positive for the disease. So as of right now ... I do not have it. But I have to take good care of myself."</blockquote>

<blockquote>"There is not a single lab test that is specific for lupus," said Gilkeson, who chairs the Lupus Foundation of America's medical-scientific advisory council. "You have to use the combination of the lab tests plus the clinical signs and symptoms."</blockquote>

== Chronic pain ==
=== Instagram ===
*Nov 18, 2016, [https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control Instagram post with Lady Gaga using an infared sauna and cold packs for chronic pain.]<ref>{{Cite web|url=https://www.instagram.com/p/BM-GxxBBY_n/?utm_source=ig_embed&utm_campaign=embed_loading_state_control|title=Lady Gaga on Instagram: “I was so overwhelmed by the empathy, confessions & personal stories of chronic pain in response to my previous post I thought what the…”|last=Germanotta|first=Stefani|date=Nov 28, 2016|website=Instagram|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}</ref>

== Fibromyalgia ==
In 2017 she released a new documantary, [https://en.wikipedia.org/wiki/Gaga:_Five_Foot_Two Gaga: Five foot two].<ref>{{Cite journal|date=2018-07-26|title=Gaga: Five Foot Two|url=https://en.wikipedia.org/w/index.php?title=Gaga:_Five_Foot_Two&oldid=852101917|journal=Wikipedia|language=en}}</ref> Throughout the film, she was seen suffering from [[chronic pain]], which was later revealed to be the effect of a long-term condition called [[fibromyalgia]]. In the film she told the doctor that she has been suffering from severe pain the last 5 years.<ref>{{Cite news|url=https://www.elle.com/culture/celebrities/a12274279/lady-gaga-five-foot-two-netflix-trailer/|title=Lady Gaga Opens Up About Her Fibromyalgia Pain in a New Documentary Trailer|last=Friedman|first=Megan|date=2017-09-19|work=ELLE|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en-US}}</ref><ref>{{Cite web|url=http://www.latimes.com/entertainment/movies/la-et-mn-lady-gaga-documentary-five-foot-two-20170920-story.html|title=Lady Gaga wants you to feel her pain in the Netflix documentary 'Five Foot Two'|last=Kaufman|first=Amy|date=Sep 20, 2017|website=latimes.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-10}}</ref> It resulted in Gaga canceling the last ten shows of [https://en.wikipedia.org/wiki/Joanne_World_Tour Joanne World Tour].<ref>{{Cite web|url=https://abcnews.go.com/Entertainment/lady-gaga-cancels-remainder-world-tour-due-severe/story?id=52813826|title=Lady Gaga cancels remainder of world tour due to 'severe pain'|last=News|first=A. B. C.|date=2018-02-04|website=ABC News|language=en|access-date=2018-08-10}}</ref>

=== Twitter ===
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907571825294675968 In our documentary the #chronicillness #chronicpain I deal w/ is #Fibromyalgia I wish to help raise awareness & connect people who have it.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907571825294675968|title=Lady Gaga on Twitter|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:49 AM}}</ref>
*Sep 12, 2017, [https://twitter.com/ladygaga/status/907755622162223104 Thought ice helped #Fibromyalgia. I was wrong & making it worse. Warm/Heat is better. Electric Heated Blanket, Infrared Sauna, Epsom Baths.]<ref>{{Cite news|url=https://twitter.com/ladygaga/status/907755622162223104|title=Lady Gaga on Twitter|last=Lady Gaga|first=|date=Sep 12, 2017|work=Twitter|access-date=2018-08-10|archive-url=|archive-date=|dead-url=|language=en|at=Time 4:59 AM}}</ref>

== Online presence ==
*[https://www.facebook.com/ladygaga Facebook]
*[https://www.instagram.com/ladygaga/ Instagram]
*[https://twitter.com/ladygaga Twitter]
*[https://www.ladygaga.com/ Website]
*[https://www.youtube.com/channel/UCNL1ZadSjHpjm4q9j2sVtOA YouTube]

== Learn more ==
*[https://en.wikipedia.org/wiki/Lady_Gaga Wikipedia]

== References ==
<references />

MEadvocacy

2018-08-03T04:07:31Z

77.111.246.7:fix display title error

[http://www.meadvocacy.org/ MEadvocacy] is a project of May12.org, a 501(c)(3) not-for-profit corporation whose mission is to raise global awareness and education for complex immunological and neurological diseases, including [[Myalgic Encephalomyelitis]] (ME).<ref>[http://www.may12.org May12.org]</ref> [[Mary Ann Kindel]] and Joni Comstock, both American patient advocates, launched the project in 2014.<ref>http://www.meadvocacy.org/about ME Advocacy: About</ref>

Their mission as an all volunteer organization is to advocate for Recognition, Definition and Research for Myalgic Encephalomyelitis.

MEadvocacy's current goals are to promote and support activities such as:

* Getting Myalgic Encephalomyelitis officially recognized as its own distinct disease in the US. ME has a 60 year history and has been classified as a neurological disease in the World Health Organization's International Classification of Diseases since 1969.

* Getting a single clear ME expert definition for diagnosis and research, adopted as the official definition for ME. Examples are the Canadian Consensus Criteria (CCC), the International Consensus Criteria (ICC) or an even better definition with the CCC and/or ICC as starting points. ME experts must be used in decision-making as the current “CFS” literature provides a misleading picture of the disease.

* Getting government funding to study this devastating disease, in the amount of $250 million annually – an amount on par with similar diseases such as Multiple Sclerosis.

==Online presence==
*[http://www.meadvocacy.org/blog MEadvocacy Blog]
*[https://www.facebook.com/MEadvocacy.org/ MEadvocacy Facebook]
*[http://twitter.com/meadvocacy_org MEadvocacy Twitter]

==See also==
*[[Mary Ann Kindel]]

==References==
<references />

[[Category:Blogs]]
{{DEFAULTSORT:MEadvocacy}}

Fibromyalgia

2018-08-03T03:35:22Z

77.111.246.7:/* Comorbidities */ internal link

Talk:Iron

2018-08-03T03:13:35Z

77.111.246.7:replied

Found a few relevant references:

https://www.ncbi.nlm.nih.gov/pubmed/29149437

ferric carboxymaltose in fybromyalgia

http://www.biomedsearch.com/nih/Relationship-between-iron-status-recrudescent/7588847.html

http://www.biomedsearch.com/nih/Response-to-replacement-iron-therapy/10898136.html

iron for HSV

----

:The Fibro study is interesting. Only because I tried it years ago and it didn't work. Sometimes I think nothing works on me because I have both Fibro and ME/CFS. I posted it on the Fibro page. Thanks for sharing this!--[[Special:Contributions/77.111.246.7|77.111.246.7]] 23:13, 2 August 2018 (EDT)