What is Fibromyalgia?
Fibromyalgia is a disorder that predominantly results in chronic pain throughout the body.
The name of this condition translates literally to ligament, tendon, and muscle pain. It’s traits are similar to those of arthritis and for this reason fibromyalgia is often compared to the inflammatory condition.
It can occur in individuals of any age or gender. However, women are more likely to be affected than men, between 75 and 90 percent of sufferers are female. Increasing age also heightens your risk of contracting fibromyalgia. (1)
Symptoms
The exact underlying cause or causes of fibromyalgia remains unknown. It is also not classified as an autoimmune, joint, muscle or inflammatory disease. (2)
There are several theories as to why fibromyalgia occurs. Genetics may play a role in your likelihood of contracting it, although they are not the only cause.
Certain types of trauma have been associated with the onset of fibromyalgia. These include physical injuries (e.g. car accident) and emotional distress. (3)
Another hypothesis has pointed towards pain processing which is regulated by the central nervous system (CNS).
People with this disorder experience pain more intensely than those without. Chemical imbalances in the brain and blood may also be involved. (4)
The frequency and intensity of symptoms can differ depending on the person. Signs of fibromyalgia can consist of the following: (5, 6)
Widespread Pain
A key indicator of fibromyalgia is widespread pain. This is varying degrees of discomfort felt throughout your body. Certain areas may be more painful than others. Fibromyalgia pain is persistent, although it might get better or worse in cycles.
Pain due to the disorder can manifest in different ways. You might experience it as burning, aching or sharp and stabbing.
Sensitivity
Fibromyalgia can cause you to feel pain more intensely than normal. For example, a mild injury can result in extreme pain and continue to hurt for much longer than it really should. A light touch can also cause severe discomfort in a person with fibromyalgia.
You might also notice that you are sensitive to certain stimuli. Excessively bright lights, certain types of food, or other variables can provoke a flare up of your existing symptoms.
Numbness and Tingling
Numbness and tingling, also known as pins and needles, can occur in some fibromyalgia patients.
This symptom can also manifest as irritation or burning in your feet and hands.
Fatigue and Tiredness
Fatigue is another classic sign of fibromyalgia. Depending on the person, fatigue can be mild to severe.
You might feel too exhausted to perform your daily activities. Fatigue caused by the condition may occur very suddenly, draining you of all energy stores.
Fibromyalgia can also result in disturbed sleep. Even after resting for lengthy periods, you might still feel tired.
Cognitive Impairment
The disorder can impair your cognitive processes, like thought and memory. This symptom is often referred to as “fibro-fog”.
Your concentration and ability to pay attention can be affected. You might also have difficulty learning and remembering new things.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome is a condition which causes digestive issues. It usually manifests as abdominal pain and bloating.
You can also suffer from constipation or diarrhea with IBS. Individuals with fibromyalgia are more likely to develop IBS. (7)
Headaches
Fibromyalgia can result in stiff muscles due to chronic pain. If your shoulders or neck are badly affected, you may experience headaches.
These headaches can be mild or severe. Some people experience migraines, which can also cause nausea, vomiting and an aversion to bright lights.
Stages
Fibromyalgia does not progress in distinct stages. Symptoms appear to fluctuate over time, worsening or improving in recurring waves. (8)
This disorder can be difficult to diagnose. There are no tests (e.g. laboratory, imaging, etc) that can determine if you have fibromyalgia.
Diagnostic criteria specify three requirements for a fibromyalgia diagnosis. Firstly, that widespread body pain has been present for over three months. Secondly, that you are experiencing fatigue and cognitive impairment.
The final criterion is that your doctor cannot discover any other reason for your symptoms.
If you present with signs of fibromyalgia, your doctor will likely take the following steps to confirm a diagnosis: (9)
Excluding Other Conditions
Fibromyalgia can appear similar to other diseases. Your doctor will want to rule out the possibility of another condition causing your symptoms.
Your doctor may check for illnesses including: thyroid dysfunction, multiple sclerosis, depression and rheumatoid arthritis.
Tests to exclude these as well as other ailments can include blood tests and neurological exams.
Symptom Evaluation
Your doctor will ask you to detail the duration and specifics of your symptoms. Describe how pain, fatigue and any other issues you are experiencing affect your daily life.
Potential Triggers
The onset of fibromyalgia has been linked to traumatic physical or emotional events.
Tell your doctor if you have been involved in an accident or have post-traumatic stress disorder (PTSD).
You will also be asked if anyone in your family has been diagnosed with fibromyalgia.
Treatment
Treatment for fibromyalgia aims to alleviate symptoms and improve quality of life. Your doctor will also make sure to address other conditions you may have.
People with the disorder are more likely to have certain illnesses, such as irritable bowel syndrome, depression, and rheumatoid arthritis. (10)
Treatment depends on the severity of your symptoms and your overall health. Your doctor will recommend one or more of the following:
Exercise
Staying active can help you manage fibromyalgia. Exercising several times a week can contribute towards improved mood and physical function. (11)
Healthy Sleep Practices
Implementing healthy sleep habits can reduce symptoms. Try to establish set times to sleep and wake up.
Avoid food and drink which can keep you up at night, such as coffee and sugary snacks. Your doctor may also prescribe one or more forms of medication to help you sleep. (12)
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) aims to change behaviors and thought patterns. A therapist can work with you on your own or in a group setting.
This type of therapy can promote self-management skills when it comes to living with fibromyalgia.
CBT has been proven to benefit how patients cope with pain and achieve personal goals. (13)
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
SNRIs are drugs typically prescribed to manage depression and anxiety. People with fibromyalgia tend to have lower levels of serotonin and norepinephrine.
These are chemical messengers in the brain which play a role in regulating pain. SNRIs help promote levels of these two important neurotransmitters to reduce pain levels. (14)
Milnacipran and duloxetine are two types of SNRIs prescribed for fibromyalgia. They are approved by the US food and drug administration (FDA) as a treatment for the condition. (15)
SNRIs can also help patients manage depression. Fibromyalgia patients are three times more likely to suffer from this disorder. (16)
However, duloxetine can increase your risk of depression.
Milnacipran can also cause side effects including but not limited to: insomnia, nausea, and high blood pressure.
Pregabalin
Like milnacipran and duloxetine, pregabalin is approved by the FDA to treat fibromyalgia. (17)
It is an anticonvulsant drug, initially prescribed to manage seizures and pain from nerve damage. Pregabalin can also alleviate the chronic pain associated with fibromyalgia.
You may experience drowsiness, weight gain, and difficulty concentrating on this medication. Other possible effects include dry mouth, dizziness, and blurry vision.
FAQ
What is fibromyalgia? Fibromyalgia is a chronic condition that causes pain throughout your body.
What are the signs of fibromyalgia? The primary signs of fibromyalgia are widespread pain, fatigue and cognitive impairment. You may also experience sensitivity to external stimuli, headaches, irritable bowel syndrome, and numbness or tingling.
How do you develop fibromyalgia? The exact cause of fibromyalgia is still unknown. Genetics, physical or emotional trauma, chemical imbalances and abnormal pain processing may all play a role in the onset of the disorder.
How are you diagnosed for fibromyalgia? There is no specific test for fibromyalgia. Your doctor will rule out other conditions that can cause similar symptoms through appropriate testing. You will be asked to thoroughly detail your symptoms and family medical history.
What is the best treatment for fibromyalgia? Treatment can include exercise, healthy sleep habits, and cognitive behavioral therapy. Medication to treat fibromyalgia include serotonin-norepinephrine reuptake inhibitors and pregabalin.
What are the long term complications of fibromyalgia? Long term complications can include lower quality of life and increased risk of major depression. (18)
Is fibromyalgia considered a disability? It is difficult to quality for disability with fibromyalgia alone, this is because of no established diagnostic tests for the condition. However, if your diagnosis comes from a specialist, such as a rheumatologist, you are more likely to obtain eligibility. (19)
Is there any cure for fibromyalgia? No, there is no cure, although symptoms can be managed with treatment. (20)
Is fibromyalgia life threatening? Fibromyalgia is not a life threatening disorder. However, affected individuals are more at risk of death from injuries and suicide. (21, 22)
Summary
Fibromyalgia can be a difficult diagnosis to receive. However, you can improve your quality of life with self-care and treatment.
You and your doctor can determine what treatment options are personally best for you. Seek support to adjust your lifestyle (e.g. more exercise) to reduce symptoms.
Additionally, you should learn to identify activities and stimuli that worsen your symptoms. (23)