Fibromyalgia is described as inflammation of the fibrous or connective tissue of the body. Widespread muscle pain, fatigue, and multiple tender points characterize these conditions. Fibromyalgia is more common than previously thought, with as many as 3-6% of the population affected by the disorder. Fibromyalgia is more prevalent in adults than children, with more women affected than men, particularly women of childbearing age.

The exact cause of fibromyalgia is not known. Sometimes it occurs in several members of a family, suggesting that it may be an inherited disorder. People with fibromyalgia are most likely to complain of three primary symptoms: muscle and joint pain, stiffness, and fatigue. Pain is the major symptom with aches, tenderness, and stiffness of multiple muscles, joints, and soft tissues. The pain also tends to move from one part of the body to another. It is most common in the neck, shoulders, chest, arms, legs, hips, and back. Although the pain is present most of the time, and may last for years, the severity of the pain changes and is dependent on individual patient perception.

Symptoms of fatigue may result from the individual's chronic pain coupled with anxiety about the problem and how to find relief. The inflammatory process also produces chemicals that are known to cause fatigue. Other common symptoms are tension headaches, difficulty swallowing, recurrent abdominal pain, diarrhea, and numbness or tingling of the extremities. Stress, anxiety, depression, or lack of sleep can increase symptoms. Intensify of symptoms is variable, ranging from gradual improvement to episodes of recurrent symptoms.

Diagnosis is difficult and frequently missed because symptoms of fibromyalgia are vague and generalized. Coexisting nerve and muscle disorders such as rheumatoid arthritis, spinal arthritis, or Lyme disease may further complicate the diagnostic process. Presently, there are no tests available to specifically diagnose fibromyalgia. The diagnosis is usually made after ruling out other medical conditions with similar symptoms and using criteria physicians and researchers have defined.

In 1990, the American College of Rheumatology developed standards for fibromyalgia that health care practitioners can use to diagnose this condition. According to these standards, a person is thought to have fibromyalgia if he or she has widespread pain in combination with tenderness in at least 11 of the 18 sites known as trigger points. Trigger point sites include the base of the neck, along the backbone, in front of the hip and elbow, and at the rear of the knee and shoulder.

There is no known cure for fibromyalgia. Therefore, the goal of treatment is successful symptom management. Treatment usually requires a combination of therapies, exercise, proper rest, and diet. A patient's clear understanding of his or her role in the recovery process is imperative for successful management of this condition. In 2004, a study demonstrated that a drug called paroxeteine HCI(Paxil CR) in controlled release tablet form significantly reduced symptoms in fibromyalgia patients. As of spring 2004, there were no FDA-approved treatments for fibromyalgia.

• 46. The word "tender" is closest in meaning to
  • a. vulnerable
  • b. yielding
  • c. gentle
  • d. sensitive
• 47. The word "severity" is closest in meaning to
  • a. intensity
  • b. danger
  • c. heaviness
  • d. length of time
• 48. The word "perception" is closest in meaning to
  • a. appreciation
  • b. impression
  • c. pain
  • d. background
• 49. The phrase "coupled with" is closest in meaning to
  • a. accompanied by
  • b. unified to
  • c. formed from
  • d. transformed into
• 50. The word "vague" is closest in meaning to
  • a. precise
  • b. painful
  • c. indistinct
  • d. explicit
• 51. The phrase "ruling out" is closest in meaning to
  • a. measuring
  • b. diagnosing
  • c. treating
  • d. eliminating
• 52. The word "imperative" is closest in meaning to
  • a. useful
  • b. urgent
  • c. immediate
  • d. crucial
• 53. The word "demonstrated" is closest in meaning to
  • a. exhibited
  • b. presented
  • c. showed
  • d. displayed
• 54. According to the text, fibromyalgia is
  • a. diagnosed more often than before
  • b. not very common
  • c. quite common recently
  • d. more widespread than before
• 55. According to the text, which group is the most susceptible to fibromyalgia?
  • a. male adults
  • b. female adults
  • c. male children
  • d. female children
• 56. What is suspected as a cause of fibromyalgia?
  • a. It might be genetic.
  • b. It could be caused by Lyme disease.
  • c. It might be caused by severe muscle pain.
  • d. Its cause is completely unknown.
• 57. What is NOT mentioned as a symptom of fibromyalgia?
  • a. neck pain
  • b. fatigue
  • c. lack of sleep
  • d. trouble swallowing
• 58. What other ailments can often increase the intensity of fibromyalgia's symptoms?
  • a. arthritis
  • b. Lyme disease
  • c. diarrhea
  • d. depression
• 59. Why is the diagnosis of fibromyalgia difficult?
  • a. The symptoms are often intermittent.
  • b. The possibility of other diseases has to be excluded first.
  • c. The patient must exhibit at least 11 symptoms.
  • d. The patient usually has other disorders at the same time.
• 60. The next paragraph in this article will probably discuss
  • a. causes of fibromyalgia
  • b. diagnosis of fibromyalgia
  • c. specific treatments of fibromyalgia
  • d. symptoms of fibromyalgia