Fibromyalgia - Clinical Definition
A minimum of 600,000 people are affected by Fibromyalgia (FM) in Canada. FM is characterized by its main symptoms of chronic, widespread pain and profound fatigue. In order to be clinically diagnosed with FM, an individual must have:
- widespread pain in all four quadrants of their body for a minimum of 3 months; and
- at least 11 of the 18 specified tender points clustered around the neck, shoulder, chest, hip, knee, and elbow regions. Over 75 other tender points have been found to exist but are not used for diagnostic purposes.
The selection criteria were shown to be 88% accurate in their ability to identify patients with FM. Other common health problems include a sleep disorder, irritable bowel and bladder, cognitive and memory impairment, muscle spasms, headaches, nerve irritation, reduced coordination, multiple chemical sensitivity (odors, noise, bright lights, medications, foods), and decreased physical endurance.
Researchers have noted a significant overlap between FM and CFS. A majority of these patients meet both diagnostic criteria for FM and CFS. Dr. Don Goldberg, chief of rheumatology at Newton-Wellesley Hospital in Massachusetts, indicated recently at a patient conference that the clinical overlap between CFS and FM is so great that a patient's diagnosis may depend on what the patient tells his/her doctor, on the patient's perception of the illness, on the apparent trigger for the onset, and on the type of doctor the patient sees. Dr. Goldberg has noted numerous similarities between CFS and FM in studies of physiology, sleep abnormalities, cognitive difficulties, psychiatric co-morbidity, blood flow to the brain, growth hormones, the HPA axis, stress, and much more.
Chronic Fatigue Syndrome - Clinical Definition
A minimum of 100,000 Canadians are affected by CFS (also known as Myalgic Encephalomyelitis). CFS is a serious and complex illness that affects many body systems. The cardinal characteristic of CFS is a debilitating pathological exhaustion not reversed by rest, no matter how much one has. This situation results in a substantial reduction of previous levels of activity. In order to be clinically diagnosed with CFS, an individual must meet both of the following criteria:
- clinically evaluated, unexplained persistent or relapsing chronic fatigue that is of new or definite onset, is not the result of ongoing exertion, is not substantially alleviated by rest and results in substantial reduction of previous levels of occupational, educational, social or personal activities; and
- four or more of the following key symptoms are concurrently present for 6 months or longer:
- substantial impairment in short-term memory or concentration (attention deficit, memory lapses, frequently using the wrong word, spatial disorientation);
- sore throat;
- extreme joint and muscle pain without swelling or redness;
- headaches of a new type, pattern or severity;
- unrefreshing sleep (hypersomnia or insomnia, nightmares);
- painful lymph nodes;
- post-exertional malaise lasting more than 24 hours.
Profound exhaustion, the hallmark of the disorder, can come on suddenly or gradually and persists or recurs throughout the period of illness. Unlike the short-term disability of an acute infection, CFS symptoms by definition linger for at least 6 months and often for years.
CFS often begins abruptly, but sometimes the onset is gradual. In about one-third of cases, the sudden onset follows a respiratory, gastrointestinal, or other acute infection with flu-like symptoms. Other cases develop after emotional or physical traumas such as bereavement or surgery.
If you think you suffer from a combination of the above symptoms, print this page and bring it to your doctor's office on your next visit.
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