Fibromyalgia 

Fibromyalgia causes bodywide pain and extreme tiredness. It can be confused with arthritis because it may cause pain in joints, muscles and soft tissues. But doctors consider fibromyalgia a pain disorder. It’s not life-threatening, but the symptoms can affect many aspects of daily life, including sleep and memory. People with fibromyalgia are 20% more likely to also have depression or chronic anxiety. That’s why it’s important to use complementary therapies and seek professional help to manage emotional symptoms.   

People with rheumatoid arthritis, lupus or other autoimmune diseases are more likely to develop fibromyalgia, which is not an autoimmune disease. Symptoms usually appear between ages 30 and 55. Although fibromyalgia is more common in adults, children (especially adolescent girls) can develop fibromyalgia. 
 

Causes

Fibromyalgia’s cause is not clear. Researchers think that people with certain genes are affected by a trigger (e.g., physical or emotional stress or an illness). Then, the pain signals sent through their central nervous system (brain and spinal cord) get turned up too high, called centralized pain or central amplification. That’s why people with fibromyalgia react more strongly to pressure, heat, sound or light than people without the condition.

Symptoms

Imagine having a bad case of the flu with extreme tiredness, pain throughout the body and fuzzy thinking. That’s how some people with fibromyalgia describe the disease.

Pain and Tenderness

Pain may start in one area, such as the neck and shoulders, and spread to other areas over time. The pain affects both sides of the body, above and below the waist. It can be mild or severe. Sensitivity to touch (tenderness) is another hallmark of fibromyalgia pain. The American College of Rheumatology identified 18 “tender points” (9 pairs) on the body that can be very sensitive to touch for people with fibromyalgia.  

The pain has been described as burning, aching, stabbing, tingling, throbbing, soreness or numbness (loss of feeling). It may change based on the time of day, activity level, weather (especially cold or damp conditions), sleep patterns and stress. Although the pain can come and go, some people report that some pain is always present.

Fatigue and Sleep Problems

Sleep problems vary from person to person. Some find it hard to fall asleep or they wake up often during the night. Others wake up feeling unrefreshed, even after sleeping through the night. Research shows that poor sleep can worsen pain. These symptoms can cause people to confuse fibromyalgia with another condition called chronic fatigue syndrome (CFS).

Some people with fibromyalgia have low energy and feel tired all the time. The fatigue can be severe and pose more of a problem than the pain.

Memory and Thinking Problems

The term “fibro fog” is often used to describe; difficulty paying attention or performing simple mental tasks and being forgetful or having poor judgment. 

These problems may come and go and happen most often when someone is very stressed or fatigued. People with fibromyalgia may have trouble learning, understanding and remembering.

Track your Fibromyalgia symptoms with this pain tracker.
 

Health Effects

Fibromyalgia tends to happen together with other health conditions. It is not clear if one causes the other. These related health problems include:

Restless Leg. This condition causes uncomfortable feelings in the legs and the need to move them often. It’s more common in people with fibromyalgia and can be related to their sleep problems.

Depression. Living with widespread pain and tiredness can be very stressful. This may lead some people with fibromyalgia to develop chronic anxiety or become depressed. Anxiety and depression, in turn, can make pain and fatigue worse.

Headaches. Tension headaches, migraines and pain in the jaw or face may affect people with fibromyalgia. 

Stomach and Bowel Problems. People with fibromyalgia have a greater risk of developing irritable bowel syndrome than people without the condition. They are more likely to get bloated, feel cramping and stomach pain, or have episodes of constipation and diarrhea.

Overactive Bladder. Some people may feel the need to urinate more often than is necessary. 

Endometriosis. People with fibromyalgia are at a higher risk of developing this condition, which occurs when tissue that normally lines the uterus grows outside of it. It can cause painful and irregular menstrual cycles. 

Diagnosis

Fibromyalgia can’t be diagnosed with laboratory tests. An accurate fibromyalgia diagnosis is based on a medical history, a physical examination and details about symptoms, including:

• Widespread pain index (WPI) score: The WPI lists 19 areas of the body where it’s common for people with fibromyalgia to have pain and tenderness. 
• Symptom severity (SS) score that’s based on scoring these areas on a scale of 0–3: 
  • Fatigue. 
  • Sleep patterns.
  • Problems related to memory, thinking, focusing and problem solving.
  • Physical symptoms such as headache, weakness, dizziness, numbness/tingling, bowel problems and hair loss. 

These symptoms must be present for at least three months. The doctor may run blood tests and take X-rays to rule out other conditions that cause chronic pain and fatigue. 

Treatment

There is no cure for fibromyalgia. The goal is to tackle different symptoms (pain, fatigue, sleep and emotional problems) at the same time. Treatment options for fibromyalgia help to reduce pain, stress and fatigue, treat depression, improve sleep and help people understand what triggers symptoms and how to manage them. In some cases, fibromyalgia may require a healthcare team that may include a primary care physician, a rheumatologist, a physical therapist and a mental health professional.

Medication
Three medications are specifically approved to treat fibromyalgia. Duloxetine (Cymbalta) and milnacipran(Savella) work by changing the levels of certain chemicals in the brain that help control pain. Pregabalin (Lyrica) targets brain chemicals that affect how much pain you experience.

Other medications can be used to treat pain, sleep and mood. These include anti-inflammatories, antidepressants and sleep medicines.

Cognitive Behavioral Therapy
This therapy has been proven effective for managing fibromyalgia symptoms. With the help of a trained mental health counselor, a person learns how to change negative thought patterns and behaviors to relieve pain, promote better sleep and improve functioning. 

Relaxation Techniques
These techniques focus on deep breathing and the release of muscle tension can ease pain and relieve stress. Massage therapy can also promote relaxation and pain relief.

Mindfulness/Meditation Practices
These practices can be done either alone or in groups led by a certified professional. They include focused attention on physical sensations (body scanning), chanting/mantras, thoughtful walking or visualization.

Exercise
Movement can be medicine. Engaging in moderate exercise a few days a week can help to reduce pain, improve sleep and daily functioning, increase energy and boost mood. Make sure to talk to your doctor before beginning an exercise program.

Self Care

Practicing these habits can help to improve fibromyalgia symptoms.

Get restful sleep
Set a regular schedule to go to sleep and wake up and keep your room cool, dark and quiet at bedtime. Don’t drink coffee, tea or soda containing caffeine in the evening or even in the afternoon if you’re sensitive to caffeine. Some foods like chocolate have small amounts of caffeine. Don’t exercise too close to bedtime (at least three hours before).

Reduce stress
Find ways to reduce or avoid stress by finding a support group, listening to music, sharing your feelings with friends and family and enjoying hobbies. 

Choose a healthy lifestyle 
Eating healthy food, doing regular exercise, drinking in moderation and not smoking can help to promote good overall health.