Skip Navigation Links
Centers for Disease Control and Prevention
CDC Home Search Health Topics A-Z

National Center for Chronic Disease Prevention and Health Promotion
Home | About Us | Contact Us

Contact Information:

National Center for Chronic Disease Prevention and Health Promotion

Division of Adult and Community Health
Health Care and Aging Studies Branch

Arthritis Program
Mailstop K-51
4770 Buford Highway NE
Atlanta, GA 30341-3724
Phone: 770.488.5464
Fax: 770.488.5964
Email Us


Arthritis Types — Overview

Arthritis Basics

bullet Arthritis Types — Overview
bullet Management
bullet Risk Factors
bullet Key Public Health Messages
bullet Frequently Asked Questions (FAQs)

See Also:
bullet Quick Stats
bullet Arthritis: At A Glance


Content Overview:  

I. Background

  • Fibromyalgia is a disorder of unknown etiology characterized by widespread pain, abnormal pain processing, sleep disturbance, fatigue and often psychological distress. People with fibromyalgia may also have other symptoms; such as,
    • Morning stiffness
    • Tingling or numbness in hands and feet
    • Headaches, including migraines
    • Irritable bowel syndrome
    • Problems with thinking and memory (sometimes called "fibro fog")
    • Painful menstrual periods and other pain syndromes
  • The American College of Rheumatology (ACR) 1990 criteria are used for clinical diagnosis classification. Diagnosis is based on the presence of widespread pain (at least 3 months duration) and tenderness on 11 of 18 pressure points. Full criteria.*
  • May often co-occur (up to 25-65%) with other rheumatic conditions such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS).

Back to top
Back to Overview

II. Prevalence

  • The prevalence of fibromyalgia is about 2%, affecting an estimated 5.0 million adults in 2005. Prevalence was much higher among women than men (3.4% versus 0.5%).1
  • Most people with fibromysialgia are women (Female: Male ratio 7:1). However, men and children also can have the disorder.
  • Most people are diagnosed during middle age and prevalence increases with age.

Back to top
Back to Overview

III. Incidence

  • No incidence data found.

NOTE: for the following sections using data based on ICD9-CM codes, there is no specific single code for fibromyalgia. According to coding rules, fibromyalgia is coded to 729.1 which is labeled “Myocitis and Myalgia, unspecified” and can include other conditions. Thus, numbers based on ICDM9-CM code 729.1 for mortality, ambulatory care and hospitalizations may be overestimates.

Back to top
Back to Overview

IV. Mortality

  • ~23 deaths per year from 1979–1998. [Unpublished CDC data]
    • Crude numbers of deaths coded as underlying cause-of-death as 729.1 rose from 8 in 1979 to a high of 45 in 1997.
    • In 1998,”Myositis and Myalgia, Unspecified” accounted for only 0.45% (42/9367) of all deaths attributed to arthritis and other rheumatic conditions.

Back to top
Back to Overview

V. Hospitalizations

  • In 1997, ~7,440 hospitalizations listed ICD9-CM code 729.1 as the principal diagnosis.2
  • People with fibromyalgia have approximately 1 hospitalization every 3 years.3

Back to top
Back to Overview

VI. Ambulatory Care

  • 2.2 million ambulatory care visits.4
    • 1.8 million Physician Office visits.
    • 187,000 Outpatient Department visits.
    • 266,000 Emergency Department visits.
  • Medical and psychiatric co-morbidity are stronger determinants of high physician use than functional co-morbidity among patients with fibromyalgia.5

Back to top
Back to Overview

VII. Costs

  • Average yearly service utilization costs/person = $2,274.3
  • Total annual costs (direct and indirect)/person = $5,945.6
  • Medications, complimentary and alternative medicine and diagnostic tests are the largest components of direct medical costs among women with fibromyalgia.7

Back to top
Back to Overview

VIII. Impact on health-related quality of life (HRQOL)

  • Fibromyalgia patients scored lowest on 7 of 8 subscales (except role-emotional) of the SF-36 compared to patients with other chronic diseases.8,9
  • Fibromyalgia patients scoring their perceived "present quality of life" averaged a score of 4.8 (1 = low to 10 = highest).10
  • Standard, generic HRQOL instruments may not be sensitive enough to capture quality-of-life issues for many people with fibromyalgia.
  • Adults with fibromyalgia are 3.4 times more likely to have major depression than peers without fibromyalgia.11

Back to top
Back to Overview

IX. Unique characteristics

  • Causes and/or risk factors for fibromyalgia are unknown, but some things have been loosely associated with disease onset:
    • Stressful or traumatic events, such as car accidents, post traumatic stress disorder (PTSD)
    • Repetitive injuries
    • Illness (e.g. viral infections)
    • Certain diseases (i.e., SLE, RA, chronic fatigue syndrome)
    • Genetic predisposition12,13
  • People with fibromyalgia react strongly (abnormal pain perception processing) to things that other people would not find painful.
  • Multidisciplinary treatment is recommended, including screening and treatment for depression, although evidence is insufficient to make global recommendations
    • Aerobic exercise and anti-depressant therapy have scientific evidence for effectiveness in reducing disease symptoms.14

Back to top
Back to Overview

X. References

  1. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 2008;58(1):26–35.
  2. Lethbridge-Cejku M, Helmick CG, Popovic JR. Hospitalizations for arthritis and other rheumatic conditions: Data from the 19976 National Hospital Discharge Survey. Medi Care 2003;41(12):1367–13673.
  3. Wolfe F, Anderson J, Harkness D, et al. A prospective, longitudinal, multicenter study of service utilization and costs in fibromyalgia. Arthritis Rheum 1997;40(9):1553–1555.
  4. Hootman JM, Helmick CG, Schappert S. Magnitude and characteristics of arthritis and other rheumatic conditions on ambulatory medical care visits, United States, 1997. Arthritis Care Res 2002;47(6):571–581.
  5. Bernatsy S, Dobkin PL, DeCivita M, Penrod JR. Co-morbidity and physician use in fibromyalgia. Swiss Med Wkly 2005;135(5-6):76–81.
  6. Robinson RL, Birnbaum HG, Morley MA, et al. Economic cost and epidemiolgical characteristics of patients with fibromyalgia claims. J Rheumatol 2003;30(6):1318–13125.
  7. Penrod JR, Bernatsky S, Adam V, Baron M, Dayan N, Dobkin PL. Health services costs and their determinants in women with fibromyalgia. J Rheumatol 2004;31(7):1391–1398.
  8. Picavet HSJ, Hoeymans N. Health related quality of life in multiple musculoskeletal diseases: SF-36 and EQ-5D in the DMC3 study. Ann Rheum Dis 2004;63:723–729.
  9. Schlenk EA, Aelen JA, Dunbar-Jacob J, et al. Health-related quality of life in chronic disorders: A comparison across studies using the MOS SF-36. Qual Life Res 1998;7(1):57–65.
  10. Bernard Al, Prince A, Edsall P. Quality of life issues for fibromyalgia patients. Arthritis Care Res 2000;13(1):42–50.
  11. Patten SB, Beck CA, Kassam A, Williams JV, Barbui C, Metz LM. Long-term medical conditions and major depression: strength of association for specific conditions in the general population. Can J Psychiatry 2005;50(4):195–202.
  12. Arnold LM, Hudson JI, Hess EV, Ware AE, Fritz DA, Auchenbach MB, Starck LO, keck PE. Family study of fibromyalgia. Arthritis Rheum 2004;50(3):944-952.
  13. Neumann L, Buskila D. Epidemiology of fibromyalgia. Curr Pain Headache Rep 2003;7(5):362–368.
  14. Rossy LA, Buckelew SP, Dorr N, Hagglund KJ, Thayer JF, McIntosh MJ, Hewett JE, Johnson JC. A meta-analysis of fibromyalgia treatment interventions. Ann Behav Med 1999;21(2):180–191.

Back to top
Back to Overview

XI. Resources

Back to top
Back to Overview

* Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.

Page last reviewed: June 8, 2008
Page last modified: January 11, 2008
Content Source: Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion

Privacy Policy | Accessibility

Home | Contact Us | Site Map

CDC Home | Search | Health Topics A-Z

United States Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion