Fibromyalgia is a musculoskeletal disorder with some symptoms similar to those of the late effects of polio. Individuals with fibromyalgia have a history of chronic, generalized pain, throughout the body or at multiple sites. Other common associated symptoms are nonrestorative sleep, fatigue, morning stiffness, difficulty concentrating or thinking clearly and certain gastrointestinal difficulties. The exact cause of fibromyalgia is unknown, but studies show that people with the disorder have a heightened sensitivity to pain. Brain imaging studies have shown evidence of altered signaling in neural pathways.
Diagnosis is based on symptoms and physical exam. There are no specific tests for fibromyalgia. There is no cure, so treatment focuses on relieving symptoms. Treatment includes a combination of psychological and behavioral therapy, medications, and self-management approaches, such as pacing and physical exercise, yoga or tai chi. Medications may reduce pain and improve sleep. Several antidepressants and anti-seizure medications have been approved for treating fibromyalgia. Analgesics may be used for additional pain relief (www.niams.nih.gov/health-topics/fibromyalgia, accessed 4/30/2024).
A study of polio survivors was performed to determine the occurrence and clinical characteristics of fibromyalgia (Trojan & Cashman, 1995). Using the 1990 American College of Rheumatology criteria to identify patients with fibromyalgia and borderline fibromyalgia (defined as a history of chronic, generalized pain, and five to ten specific tender points on physical examination), 10.5% had fibromyalgia, and another 10.5% had borderline fibromyalgia. Survivors with fibromyalgia were more likely to complain of generalized fatigue than those without fibromyalgia, and half of the polio survivors with fibromyalgia reported improvement with amitriptyline. Checking for and treating fibromyalgia should be incorporated into the management of the late effects of polio.
Reference
Trojan, D.A., & Cashman, N.R. (1995). Fibromyalgia is common in a postpoliomyelitis clinic. Archives of Neurology, 52, 620-624.