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Fibromyalgia

Overview

Fibromyalgia is a medical condition causing extensive musculoskeletal pain and is often associated with fatigue, memory issues, mood problems, and trouble sleeping. This disorder is believed to intensify feelings of discomfort by influencing how the spinal cord and brain process both painful and non-painful impulses.

The symptoms usually start following an event like surgery, physical trauma, infection, and major mental stress. In certain situations, the symptoms slowly accumulate with time without any prompting event.

Females have an increased possibility of developing fibromyalgia compared to men. The majority of individuals with the condition also experience tension headaches, irritable bowel syndrome, temporomandibular joint (TMJ) disorders, depression, and anxiety.

Although fibromyalgia has no known cure, a range of medications can be used to manage symptoms. Moreover, relaxation, exercise, and stress-reducing strategies may be beneficial.

By Able Health I Medically reviewed by Dr. Alireza Estedlal

Page last reviewed: February 2024 I Next review due: February 2026

What is Fibromyalgia?

Fibromyalgia is a chronic disorder that triggers pain and tenderness all over the body. It also leads to musculoskeletal fatigue and pain.

Individuals who have fibromyalgia often have symptoms that appear and disappear in cycles known as flare-ups. In some cases, it might be exhausting and difficult to manage and live with the condition. The fluctuations between good sensations and abrupt symptoms flare-ups can be overwhelming. In general, your feelings and fibromyalgia are real.

The actual causes of fibromyalgia are unknown. However, research has shown that certain medical problems, stress, and some life changes may be the contributing factors. Also, if one of your parents has the disorder, then the possibility of developing it is higher.

New emerging pain in the body, particularly in the muscles, is normally the first symptom of fibromyalgia. Trusting your instincts and listening to your body is thus important. You should also see a specialist if you experience any new pain, exhaustion, and other related signs, even if they appear and disappear.

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Symptoms

The main fibromyalgia symptoms are:

  • Widespread pain: Fibromyalgia pain is often defined as a persistent dull ache that has endured for 3 months. The discomfort must happen on both sections of the body, below and over the waist, for it to be regarded as widespread.
  • Fatigue: Individuals who have fibromyalgia often wake up feeling tired despite sleeping for an extended period. Pain usually interferes with sleep, and most people with the condition experience sleeping disorders like sleep apnoea and restless legs syndrome.
  • Cognitive difficulties: Commonly known as ‘fibro fog,’ this symptom affects a person’s ability to concentrate, pay attention, or focus on mental tasks.

Typically, fibromyalgia exists alongside other conditions like:

  • Chronic fatigue syndrome

  • Irritable bowel syndrome

  • Migraine and other kinds of headaches

  • Temporomandibular joint disorders

  • Interstitial cystitis or painful bladder syndrome

  • Depression

  • Anxiety

  • Postural tachycardia syndrome

 

Causes

According to researchers, recurrent nerve stimulation results in changes in the spinal cord and brain of individuals with fibromyalgia. The adjustment includes an abnormal rise in levels of particular brain chemicals signalling pain.

Furthermore, the pain receptors of the brain appear to develop a kind of pain memory and become more sensitized. This means that painful and non-painful signals can cause them to overreact.

Other factors that can also trigger such changes are:

  • Genetics: Given that fibromyalgia is genetic, certain hereditary mutations can increase the risks of developing the condition.
  • Infections: Certain diseases are likely to contribute to or worsen fibromyalgia.
  • Physical or emotional events:Infections: Sometimes, physical events like car crashes and prolonged mental stress can trigger fibromyalgia.

Risk factors

Some of the risk factors associated with fibromyalgia are:

  • Gender: Fibromyalgia is more common in women compared to men.
  • Family history: Having a close family member with fibromyalgia increases the risk of developing the condition.
  • Other conditions: Rheumatoid arthritis, osteoarthritis and lupus are likely to increase the risks of fibromyalgia.

Complications

Fatigue, pain, and inadequate sleep caused by fibromyalgia can disrupt a person’s capacity to function significantly at home or work. In addition, the challenge of dealing with a frequently misunderstood disorder can lead to depression and anxiety.

Fibromyalgia Diagnosis: How is it Diagnosed?

Previously, healthcare providers diagnosed fibromyalgia by checking 18 precise points on the body to determine those that are painful when firmly pushed. However, the American College of Rheumatology new guidelines do not necessitate tender point examination.

As an alternative, the primary factor required for diagnosing fibromyalgia is widespread pain over the body for about 3 months. In order to meet the diagnosis criteria, one has to experience discomfort in at least 4 out of 5 of these areas:

  • Left upper part (arm, shoulder, jaw)

  • Right upper part (arm, shoulder, jaw)

  • Left lower part (leg, hip, buttock)

  • Right lower part (leg, hip, buttock)

  • Axial area (chest, abdomen, back, neck)

Tests

To rule out disorders with the same symptoms, medical providers can perform blood tests such as:

  • Complete blood count

  • Cyclic citrullinated peptide test

  • Erythrocyte sedimentation rate

  • Rheumatoid factor

  • Anti-nuclear antibody

  • Thyroid function tests

  • Celiac serology

  • Vitamin D

If the doctor suspects sleep apnoea, an overnight sleep study may be recommended.

Fibromyalgia Treatment

Generally, fibromyalgia treatments involve medicines and self-care measures, focusing on reducing symptoms and promoting overall health. While there is no single treatment that is effective for all symptoms, trying a range of approaches can be beneficial.

Medications

Drugs can help ease fibromyalgia pain and enhance sleep quality. Some of the common medication choices are:

  • Pain relievers: Over-the-counter painkillers, including ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, and others) and naproxen sodium (Aleve, others) can be helpful. However, opioid drugs are usually not advised since they can result in major side effects, reliance, and aggravated pain with time.
  • Antidepressants: Milnacipran (Savella) and duloxetine (Cymbalta) can help relieve fatigue and pain caused by fibromyalgia. The medical provider can also recommend the muscle relaxant cyclobenzaprine or amitriptyline to improve sleep.
  • Anti-seizure medications: Drugs intended for treating epilepsy are usually helpful in minimizing some kinds of pain. Medicines like gabapentin (Neurontin) may be used to reduced fibromyalgia symptoms, whereas pregabalin (Lyrica) was the first medication approved by the FDA for fibromyalgia treatment.

Therapies

A range of therapies may be helpful in reducing the impact of fibromyalgia on the body and overall life. They include:

  • Physical therapy: You can learn significant exercises that will boost your flexibility, strength, and stamina with the help of a physical therapist. Water-based activities may also be beneficial.
  • Occupational therapy: With the help of an occupational therapist, you can make some vital changes to your work environment, or how you do particular tasks to reduce strain on your body.
  • Counselling: Speaking to a counsellor may help build confidence in your capabilities and learn strategies for handling stressful conditions.

Coping with Fibromyalgia: Tips and Strategies for Managing Symptoms

Although it can be difficult to live with fibromyalgia, there are different coping tips to help you manage symptoms and enhance your well-being. Developing aninclusive self-care program addressing physical, psychological and emotional health requirements is essential for people with fibromyalgia.