Found It! Just When You Thought One was Enough…

There was quite a bit of discussion after the Take A Breath post. One of the questions that arose was about what other conditions did FM sufferers have to endure?

So, I remembered that during my previous research, I had come across some of this information – so, off I went to sift through all my downloads and page histories. And I found it!

There are specific conditions which are frequently comorbid (occurring simultaneously) with FM, including osteoarthritis, autoimmune disease, lupus, myalgic encephalomyelitis/chronic fatigue syndrome, migraines, irritable bowel syndrome, sleep problems, mood disturbances, nueroendocrine disorders, and hypothyroidism.¹ Patients with FM were 2.14 to 7.05 times more likely to have one or more of the following comorbid conditions: depression, anxiety, headache, irritable bowel syndrome, chronic fatigue syndrome, systemic lupus erythematosus, and rheumatoid arthritis.²

A 2007 survey showed the following prevalence of comorbid disorders:³

• Low back pain – 63%
• Recurrent headaches – 47%
• Arthritis – 46%
• Muscle spasm – 46%
• Tingling – 46%
• Balance problems – 45%
• Irritable bowel syndrome – 44%
• Numbness - 44%
• Chronic fatigue – 40%
• Bloating – 40%
• Depression – 40%
• Anxiety - 38%
• Sinus problems – 37%
• Tooth disorders – 32%
• Restless legs – 32%
• Tinnitus – 30%
• Jaw pain – 29%
• Bladder problems – 26%
• Rashes – 25%

Upon examination, no structural changes or muscular inflammation is detectable despite a widespread decreased pain threshold and peripheral sensitization indicative of changes in pain pathways.

Another site I found merely listed comorbid conditions and symptoms, without any statistics or references but, for the sake of completeness, here they are:

• Allergy
• Ankylosing spondylitis
• Autonomic Disturbances
• Blurred vision
• Body temperature changes
• Bowel disturbances, Leaky Gut Syndrome (LGS) and Small intestinal bacterial overgrowth (SIBO)
• Bruising
• Bruxism
• Candidiasis
• Cardiovascular disturbance (POTS and NMH)
• Chemical Sensitivities
• Cognitive Dysfunction
• Cold intolerance
• Constipation
• Depression or anxiety, reactive
• Disordered sleep
• Dizziness
• Fatigue/malaise
• Flu-like symptoms
• Food Intolerance
• Gastrointestinal distress
• Hearing loss,
• Hypothyroidism
• Idiopathic chest pain
• Idiopathic edema
• Impotence
• Insomnia as a primary condition to FM
• Interstitial cystitis
• Irritable bladder
• Irritable bowel syndrome and other abdominal symptoms
• Livedo reticularis (mottled skin).
• ME/CFS (CFID)
• Migraine or severe headache
• Muscle, stiffness
• Muscle Weakness
• Muscles, uncoordinated
• Myofascial pain syndrome
• Neuralgia
• Neuropathy
• Non-restorative Sleep
• Oral ulcers (secondary to dry mouth)
• Pelvic dysfunction
• Piriformis syndrome (causing symptoms of sciatica)
• Shortness of breath (secondary to restricted chest wall motion, or cardiovascular insufficiency)
• Skin Lesions
• Raynaud’s phenomenon
• Rheumatoid arthritis
• Restless Leg Syndrome and its counterpart periodic limb movement during sleep
• Sexual dysfunction
• Seizure
• Sjögren’s
• Systemic Lupus Erythematosus
• Tinnitus
• TMD/TMJ
• Vulvodynia

Scary looking lists, aren’t they? The conditions/symptoms in purple are mine. What’s everyone else got? (but if you name it, you have to explain the condition – another opportunity to learn!)

There are several conditions which mimic FM and should be ruled out and/or treated.⁴ They include hypothyroidism, polymyalgia rheumatica, autoimmune disorders, hepatitis C, sleep apnea, chiari malformation, and celiac disease.

1. Clauw DJ, Crofford LJ. Chronic widespread pain and fibromyalgia: what we know, and what we need to know. Best Pract Res Clin Rheumatol. 2003;17:685-701; and McBeth J, Silman AJ, Gupta A, Chiu YH, Ray D, Morriss R, Dickens C, King Y, Macfarlane GJ.  Moderation of psychosocial risk factors through dysfunction of the hypothalamic-pituitary-adrenal stress axis in the onset of chronic widespread musculoskeletal pain: findings of a population-based prospective cohort study.  Arthritis Rheum. 2007 Jan;56(1):360-71.
2. Weir P, Harlan GA, Nkoy FL, Jones SS, Hegmann KT, Gren LH, Lyon JL. The Incidence of Fibromyalgia and Its Associated Comorbidities: A Population-Based Retrospective Cohort Study Based on International Classification of Diseases, 9th Revision Codes. JCR: Journal of Clinical Rheum. 2006 June; 12 (3): 124-28.
3. Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L.  An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord. 2007 Mar 9;8:27; and Kato K, Sullivan PF, Evengard B, Pedersen NL. Chronic widespread pain and its comorbidities: a population-based study. Arch Intern Med. 2006;166:1649-1654.
4. Clauw DJ. Fibromyalgia. In: Loeser JD, Butler SH, Chapman CR, Turk DC, eds. Bonica’s Management of Pain, 4th edition. Philadelphia, Pa: Lippincott Williams and Wilkins. 2008.

Chronic Comic 101