Living with fibromyalgia : A study of the consequences for daily activities

• Fibromyalgia (FM) is a chronic generalized muscle pain syndrome. This thesis is a study of 116 patients with FM, twenty living in the USA and the rest in Sweden, all meeting the classification criteria proposed by the American College of Rheumatology, and 39 patients with chronic regio!Jal muscle pain. The purpose was to explore the consequences of the fibromyalgia syndrome for the activities of daily life. The consequences of the syndrome have, been described from the patients' perspective. Data have been collected through different types of questionnaires, 250 semi-structured diaries, and qualitative analysis of 40 semi-structured interviews. A five-year follow-up study was performed to collect data on changes over time in symptoms and psychosocial consequences.The results show that the fibromyalgia syndrome influences daily life profoundly. Both pain and muscular fatigue are continuous, though there are changes in severity, both during the day and over longer periods. Most activities are difficult to perform, at least over a prolonged period. The time structure of the day is disrupted and most patients have to adjust habits and roles in order to manage their life situation. There is acontradiction between the level of disability experienced by the patients and their healthy and non-disabled appearance. This leads to misunderstandings and influences the selfimage. The results in this thesis indicate the importance of early intervention, where the patient is given information about the condition and support to adjust to the limitations, thus preventing unnecessary disabilities and handicaps from evolving.The comparison between patients with chronic regional muscle pain and fibromyalgia indicates that there is a quantitative, rather than a qualitative, difference between the two conditions.

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MEDICIN

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