Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have “tender points” on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.
Fibromyalgia, or fibromyalgia syndrome, is a conditionthat causes aches and pain all over the body. People with fibromyalgia often experience other symptoms, such as extreme tiredness or sleeping, mood, or memory problems.
Fibromyalgia affects more women than men. The pain, extreme tiredness, and lack of sleep that fibromyalgia causes can affect your ability to work or do daily activities. Treatment can help relieve
pain and help prevent flare-ups of symptoms.
Fibromyalgia is a long-lasting or chronic disorder that causes muscle pain and fatigue (feeling tired). If you have fibromyalgia, you have pain and tenderness throughout your body. Sometimes you may have two or more chronic pain conditions at the same time, such as:
- Chronic fatigue syndrome.
- Endometriosis.
- Irritable bowel syndrome.
- Interstitial cystitis.
- Temporomandibular joint dysfunction (TMJ).
- Vulvodynia.
People with fibromyalgia may also have other symptoms, such as
- Trouble sleeping
- Morning stiffness
- Headaches
- Painful menstrual periods
- Tingling or numbness in hands and feet
- Problems with thinking and memory (sometimes called “fibro fog”)
No one knows what causes fibromyalgia. Anyone can get it, but it is most common in middle-aged women. People with rheumatoid arthritis and other autoimmune diseases are particularly likely to develop fibromyalgia. There is no cure for fibromyalgia, but medicine can help you manage your symptoms. Getting enough sleep, exercising, and eating well may also help.
What Are the Symptoms of Fibromyalgia?
Symptoms of fibromyalgia include:
- Chronic muscle pain, muscle spasms, or tightness
- Moderate or severe fatigue and decreased energy
- Insomnia or waking up feeling just as tired as when you went tosleep
- Stiffness upon waking or after staying in one position for too long
- Difficulty remembering, concentrating, and performing simple mental tasks (“fibro fog”)
- Abdominal pain, bloating, nausea, and constipation alternating withdiarrhea (irritable bowel syndrome)
- Tension or migraine headaches
- Jaw and facial tenderness
- Sensitivity to one or more of the following: odors, noise, bright lights, medications, certain foods, and cold
- Feeling anxious or depressed
- Numbness or tingling in the face, arms, hands, legs, or feet
- Increase in urinary urgency or frequency (irritable bladder)
- Reduced tolerance for exercise and muscle pain after exercise
- A feeling of swelling (without actual swelling) in the hands and feet
Fibromyalgia symptoms may intensify depending on the time of day — morning, late afternoon, and evening tend to be the worst times. Symptoms may also get worse with fatigue, tension, inactivity, changes in the weather, cold or drafty conditions, overexertion, hormonal fluctuations (such as just before your period or during menopause), stress, depression, or other emotional factors.
Who gets fibromyalgia?
Anyone can get this disorder, though it occurs most often in women and often starts in middle age. If you have certain other diseases, you may be more likely to have fibromyalgia. These diseases include:
- Rheumatoid arthritis.
- Systemic lupus erythematosus (commonly called lupus).
- Ankylosing spondylitis (spinal arthritis).
If you have a family member with fibromyalgia, you may be more likely to get the disorder.
What causes fibromyalgia?
Doctors don’t know the exact cause of fibromyalgia. Researchers continue to study fibromyalgia and think the following events may contribute to the cause of the disorder:
- Stressful or traumatic events, such as car accidents.
- Repetitive injuries.
- Illness.
- Certain diseases.
Sometimes, fibromyalgia can develop on its own. Fibromyalgia tends to run in families, and some scientists think that a gene or genes could make you more likely to develop fibromyalgia. The genes could make you react strongly to things that other people would not find painful.
Is there a test for fibromyalgia?
Currently there aren’t any laboratory tests to diagnose fibromyalgia.
You may see many doctors before receiving the diagnosis. This can happen because the main symptoms of fibromyalgia, pain and fatigue, are similar to many other conditions. Doctors often have to rule out other causes of these symptoms before making a diagnosis of fibromyalgia.
Doctors use guidelines to help diagnose fibromyalgia, which can include:
- A history of widespread pain lasting more than 3 months.
- Physical symptoms including fatigue, waking unrefreshed, and cognitive (memory or thought) problems.
- The number of areas throughout the body in which you had pain in the past week.
How is fibromyalgia treated?
You and your doctor can treat fibromyalgia with medicines, lifestyle changes, and complementary therapy. However, fibromyalgia can be hard to treat. It’s important you find a doctor who is familiar with the disorder and its treatment.
Only three medications, duloxetine, milnacipran, and pregabalin are approved by the U.S. Food and Drug Administration (FDA) for the treatment of fibromyalgia. Duloxetine was originally developed for and is still used to treat depression. Milnacipran is similar to a drug used to treat depression but is FDA approved only for fibromyalgia. Pregaballin is a medication developed to treat neuropathic pain (chronic pain caused by damage to the nervous system).
Doctors may prescribe one or more of the following medicines to help treat the symptoms of fibromyalgia:
- Ibuprofen, aspirin, or naproxen you can buy over the counter.
- Narcotic medicines to treat severe pain.
- Duloxetine and minacipran to help the pain and fatigue.
- Pregabalin to help treat nerve pain.
- Doctors also treat fibromyalgia with a variety of other medications such as Gabapentin developed and approved for other purposes.
Making lifestyle changes can also help you manage your fibromyalgia, including:
- Getting enough sleep.
- Exercising.
- Adjusting your work demands.
- Eating well.
You can also try complementary therapies such as:
- Massage therapy.
- Movement therapy.
- Chiropractic therapy.
- Acupuncture.
- Diet supplements.
If you are using or would like to try a complementary therapy you should speak with your doctor, who may know more about if it is safe to try.
Who treats fibromyalgia?
Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is.
Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment.
Living with fibromyalgia
There are many things you can do to while living with fibromyalgia, including:
- Getting enough sleep.
- Exercising.
- Adjusting your work demands.
- Eating well.
Getting Enough Sleep
Getting enough sleep and the right kind of sleep can help ease the pain and fatigue of fibromyalgia. You may have problems such as pain, restless legs syndrome, or brainwave changes that interfere with restful sleep. It is important to discuss any sleep problems with your doctor, who can prescribe or recommend treatment.
Tips for Good Sleep
- Keep regular sleep habits. Try to get to bed and wake up at the same time every day.
- Avoid caffeine and alcohol in the late afternoon and evening. Even though alcohol can make you feel sleepy, drinking any close to bedtime can disturb your sleep.
- Time your exercise. Regular daytime exercise can help improve your nighttime sleep. However, exercise within 3 hours of bedtime can keep you awake.
- Avoid daytime naps. Sleeping in the afternoon can interfere with nighttime sleep. If you feel like you cannot get by without a nap, set an alarm for 1 hour. When it goes off, get up and start moving.
- Reserve your bed for sleeping. Watching TV, reading, or using a laptop or phone in bed can keep you awake.
- Keep your bedroom comfortable. Try to keep your bedroom dark, quiet, and cool.
- Avoid drinking liquids and eating spicy meals before bed. Heartburn and late-night trips to the bathroom can interfere with your sleep.
- Wind down before bed. Avoid working right up to bedtime. Try some relaxing activities that get you ready for sleep, such as listening to soft music or taking a warm bath.
Exercising
Although pain and fatigue may make exercise and daily activities difficult, it is important for you to be as physically active as possible. Research shows that regular exercise is one of the most useful treatments for fibromyalgia. If you have too much pain or fatigue to do exercise, you should begin with walking or other gentle exercise. Over time you can build your strength.
Adjusting Your Work Life
You can continue to work when you have fibromyalgia, but may have to make some changes to do so. For example, you may need to cut down the number of hours they work, switch to a less demanding job, or adapt your current job. An occupational therapist can help you make changes at work. For example, they can help design a more comfortable workstation or find more efficient and less painful ways to lift.
Eating well
Although some people with fibromyalgia report feeling better when they eat or avoid certain foods, no specific diet has been proven to influence fibromyalgia. Of course, it is important to have a healthy, balanced diet. Not only will proper nutrition give you more energy and make you generally feel better, it will also help you avoid other health problems.
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