MARK S. SCHWARTZ
JEFFREY M. THOMPSON
Relaxation therapies with surface electromyographic (EMG) biofeedback are part of acceptable treatment protocols for fibromyalgia syndrome (FMS) and related diagnoses. Patient education literature from the American College of Rheumatology (ACR), the American Fibromyalgia Syndrome Association, and journal articles support these treatments for FMS and related conditions (McCain, 1990; Thompson, 1990, 2000; see also the "Resources" section at the end of the chapter). These treatments are most effective as components of a multidisciplinary treatment program.
These patients are very commonly seen by practitioners (particularly mental health professionals) who use biofeedback for reasons in addition to muscle pain (e.g., history of emotional trauma, psychological problems, irritable bowel syndrome "IBS", anxiety disorders, migraine headaches, depression). Thus it is important to have an understanding of the multiple facets of this disorder. (As in other chapters, italics on first use of a term indicate that the term is included in the glossary at the chapter's end.)
The most widely used term and the term now accepted by the ACR is "fibromyalgia syndrome" (FS or FMS; abbreviated in this chapter as FMS) (Wolfe et al., 1990). However, the disorder is often referred to only as "fibromyalgia." Specific criteria for diagnosis are found in many references, including those by Thompson (2000), Wolfe et al. (1990), and Okifugi and Turk (1999); they include widespread pain of greater than 3 months' duration and 11 of 18 "tender points." The history of the terms is discussed by Thompson (1990, 2000). There is abundant literature discussing other related diagnoses and terms, and how they are different from, overlap, and blend into FMS (Thompson, 1990, 2000; Wolfe et al., 1990).
Gradual onset of symptoms is typical among persons diagnosed with FMS. However, substantial subsets of these patients report physical or emotional traumas that immediately precede or seem to precipitate the FMS onset. The nature of the relationship is unclear. Physical traumas include motor vehicle accidents, surgery, work-related injuries, and viral illness (Aaron et al., 1997).