The Condition:

Fibromyalgia Syndrome (FS) is a chronic rheumatological disorder that affects between 2 and 4 percent of the general population. It is more common in women (3:1 ratio) and affects people in every age group and socioeconomic class. The core features of FS are:

• generalized pain - musculoskeletal pain throughout the body
• tender points- extreme tenderness in specific sites in the body known as fibromyalgic tender points

Secondary symptoms include difficulties with sleep, stiffness and persistent fatigue. A wide range of associated conditions may also occur including headache, bowel and bladder difficulties, numbness and tingling and emotional distress.

The cause or causes of FS are currently unknown but in some individuals the disorder appears to occur "out of the blue" and in others it is preceded by injury or illness.

A significant problem facing those with FS is credibility. People with FS typically do not look ill and often they can perform most or all of the self care tasks that we all do. However, they are unable to sustain repetitive activities or other types of continuous work for as long as the rest of us. If they push themselves and persist with such an activity beyond their tolerances, they experience a "flare-up" of their symptoms and may not be able to function at all for a period of time.

Other difficulties arise when co-workers become impatient with them, ignore them or are hostile toward them. Thus, interpersonal relationships within the workplace may adversely affect the person's attitude about themself and their work. These workers also fear that because of their limitations they are not wanted and will be laid off or fired at the earliest opportunity. This too can severely inhibit the individual's ability to readjust to the workplace and may lead to permanent total disability. Permanent disability, especially in younger workers, represents an unfortunate loss for both the individual and society. A return to work is a vital part of the overall rehabilitation process and a supportive workplace is key.

Some Solutions:

In order to increase the chances of a person with FS successfully returning to work a number of straightforward measures can be taken:

1. Educate those who work and share responsibilities with the individual about FS. It is important that they understand that the symptoms and limitations are not being "put on".
    
2. Encourage a positive, receptive attitude by co-workers. It is important that the person receives emotional support and encouragement for their efforts to return to work. This does not mean being overly solicitous or condescending: Empathy not sympathy.
    
3. Recognize that work re-entry may be very slow. If the individual is allowed to take on too much work too quickly they will almost certainly fail. Both work hours and work load should initially be at a level that the person can reasonably manage (not what they wish they could manage or you want them to manage). These should then be gradually increased in order to maximize the chances that the worker will succeed. Pushing them too hard too quickly will be counter-productive.
    
4. Make appropriate ergonomic adjustments. Proper seating, table height, proximity of materials, work load demands, etc. should be addressed. They should also shift their body position regularly to reduce stress on specific muscle groups.
    
5. Allow the worker to pace his or her activities. They should not push themselves to persist with a task to the point at which they become uncomfortable.