The Complexities of Fibromyalgia

The Complexities of Fibromyalgia


Aldino L. Pierotti, III, M.D.
Medical Director
The Anti-Aging and Longevity Center of Pittsburgh


What is Fibromyalgia?

Fibromyalgia is the medical term that describes a complex clinical disorder characterized by symptoms of chronic widespread soft tissue pain, morning stiffness, insomnia, headaches, depression, anxiety, and severe, deep pain. It is a debilitating condition sometimes described as “arthritis of the muscles” and almost always includes fatigue.

What causes it?

The underlying cause of Fibromyalgia is unknown. It is suspected that it is due to a breakdown in cellular energy production. Research is ongoing to understand the exact cause and new treatment options. To date, researchers agree that Fibromyalgia patients have an enhanced pain sensitivity and response originating from the central nervous system. Fibromyalgia is almost always associated with Chronic Fatigue Syndrome. Traumatic injury or illness may trigger the condition. In addition, research is continuing to determine if other factors may lead to its development including genetics, environmental factors, autoimmune dysfunction, nutritional deficiencies, and connective tissue disease.


Who gets Fibromyalgia?

Fibromyalgia afflicts 8 million to 12 million Americans, predominantly women between the ages of 35 to 54 years. Chronic Fatigue & Immune Dysfunction Syndrome (CFIDS), which is closely associated with Fibromyalgia, is characterized by severe, unrecoverable exhaustion, un-refreshed sleep, and the inability to function in daily activities. CFIDS usually affects patients before they ever progress to Fibromyalgia. Typically, those patients are women between the ages of 30 and 55 years, and 2 million to 4 million people are estimated to be afflicted. These conditions, despite appearing predominantly in middle aged women, do not discriminate – children, those in the prime of their lives, elderly, men and women have been diagnosed with this condition. My youngest patient is 8 years old, my oldest is 90.


What are the signs and symptoms?

As mentioned above, Fibromyalgia is a condition that produces chronic pain in the soft tissues that may include the muscles, ligaments, and tendons. It takes hold of its sufferers and creates intolerable muscle pain, severe fatigue, sleep disturbances, cognitive problems, and often precipitates susceptibility to multiple infections. It also may produce a number of other symptoms including: temperature sensitivities, numbness and tingling that may travel throughout the body, fatigue, insomnia, concentration problems, gastric upset, headaches, joint discomfort, and depression.



How is it diagnosed?

Fibromyalgia is plaguing millions worldwide, but unfortunately has been and continues to be commonly misdiagnosed and untreated. Diagnosis is difficult. Currently there is not a medical test available that will clearly diagnose the condition. Fibromyalgia does not provide a clear physical, visual trait that can easily be recognized by a physician. This is due to the fact that it arises from a combination of multiple imbalances in the immune and endocrine systems of the body. It is often misdiagnosed as Multiple Sclerosis or Rheumatoid Arthritis, although the occurrence of this misdiagnosis is decreasing as we gain better understanding of Fibromyalgia and CFIDS.

Are there levels of severity?

Frequency, degree, and location of pain vary from day to day for Fibromyalgia patients. It is important to understand that on any given day a Fibromyalgia patient’s level of discomfort may range from mild muscle stiffness to extreme, radiating pain that is so severe they feel completely debilitated and unable to carry out simple daily activities.

How is it treated?

Treatment is tailored to the individual patient since the underlying cause and symptoms are different in each patient. Traditionally, most physicians just treat the symptoms, thus masking the underlying problem. This is why it is difficult to diagnose and effectively manage. There is no “shoebox” treatment or single test that will diagnose and “fix” everyone with this disease. Since the severity of the condition varies from person to person and day to day, the treatment plan must focus on the determination of the underlying causes and eradicating the causes to alleviate the symptoms in order to meet the lifestyle goals of the patient. Treatment requires the assistance of a knowledgeable physician. Treatment can include improving the quality of sleep, correcting hormone imbalances, optimizing the immune system, and eradicating any chronic underlying infections. Nutritional counseling, conditioning and exercise programs, therapies such as acupressure and massage, stress management and relaxation in conjunction with the above can optimize the patient.

That is a difficult question. Until we truly understand all the factors that contribute to the development of Fibromyalgia and are able to determine what emotional and physiologic stressors trigger it, we cannot prevent it. Currently the medical advances are focused on accurately diagnosing and effectively treating this complicated, multi-system disease.



For more information, contact Dr. Pierotti at the

Anti-Aging, Longevity, and Preventive Medicine Center of Pittsburgh,

5840 Ellsworth Avenue, Suite 304

Pittsburgh, PA  15232


Call him at (412) 404-2939.

You can also visit their website at