The perception of fibromyalgia has changed considerably in the last few years.

Where some, including doctors, used to believe the condition was “all in the head,” fibromyalgia now is a recognized disorder that is taken very seriously by the medical community.

Bridgeview resident Catherine Montagano is glad about that. Before she was diagnosed with the condition more than 10 years ago, she went through an ordeal of frustration.

“You go from doctor to doctor ... trying to tell them about these terrible pains you’re having and how you can’t sleep,” she said. “It was very frustrating. ... I had pain in my neck, in my elbows, my knees, my feet, in the front of my chest, and sometimes my arms would start to go numb.”

Montagano was having other confusing symptoms, as well, such as feeling tired all day long, when she used to be an active person, full of energy and drive.

“I was very athletic,” she said. “I raised two boys and ran a day care. All of a sudden, it just hit me. ... It was a burning sensation in my joints. It almost felt like a bad case of the flu, but your body hurts all over.”

She finally got the diagnosis of fibromyalgia from her neurologist and made an immediate appointment to see Advocate South Suburban Hospital rheumatologist Dr. Majid Serushan, who is still her physician.

Serushan said about 20 percent of the patients in his office suffer from fibromyalgia. The pain they describe ranges from mild to disabling, he said.

“Different patients describe the pain differently,” he said. “It may be severe or a burning sensation. It’s not in one specific place. It’s diffuse, widespread pain.”

Serushan said the most common complaints are of pain in the neck, shoulders, the sides of the elbows, around the hips, in the lower back and on the inside of the knees. Other symptoms, he said, include fatigue, headaches, numbness and tingling, difficulty sleeping, some cognitive impairment and depression.

The symptoms of fibromyalgia that once were thought to result from problems in the muscles now are known to be neurological in origin. New research suggests that “all in the head” might not be such an inaccurate statement, although the new interpretation of that cliche would refer to an altered brain processing of pain, not a psychosomatic illness.

A recent review article in “Scientific American” explained fibromyalgia as a condition that results from nerves in the brain and spinal cord originating or amplifying pain. The central nervous systems of patients with fibromyalgia appear “to both heighten the response to painful stimuli and perceive normally nonpainful stimuli as painful,” the article states.

The National Institutes of Health recently released research findings that showed people with fibromyalgia have altered pain processing in certain areas of the brain. They feel pain more intensely and don’t respond well to narcotic pain killers.

Doctors will prescribe fibromyalgia medications to help with the pain, insomnia and other symptoms. Some work and some don’t, but most agree that other methods for dealing with the condition are very important, as well.

The “Scientific American” review article stated that “while medications can help alleviate symptoms, patients rarely see significant symptom improvement without also adopting self-management approaches like stress reduction, quality sleep and exercise.”

Keeping stress as low as possible is huge.

“They need to get stress out of their lives,” Serushan said.

Getting good sleep also seems to be crucial. Serushan said some of the problems with memory, concentration, thinking ability and depression that fibromyalgia patients experience may stem from lack of quality sleep.

“We emphasize sleeping well,” Serushan said. “There should be no interruptions during sleep.”

Aerobic exercises are also important in treatment of the condition, he said, as well as stretching and strengthening activities.

Montagano, 53, said she is managing her fibromyalgia with exercise, medication and trying to lower her stress the best she can. When she encounters a particularly stressful situation, she said, she can actually feel the pain starting in her shoulders and going down her body.

“There are days I have to shut down,” she said, “and I have to tell myself it’s OK. I feel that I’m still young and I should be out there doing things, but when I don’t allow myself that time to rest, it takes that much longer to feel better. ... It can be very debilitating.”

Montagano said she would have a much harder time dealing with fibromyalgia if it weren’t for the support and understanding of her husband, her two sons, extended family and good friends.

“You just want to be able to function,” she said, “and that’s the frustrating thing.”