Fibromyalgia is a chronic disorder that causes pain in the muscles, tendons, joints, and ligaments. The pain increases when slight pressure is applied in the areas called “the tender points.” The back of the head, the elbows, the shoulders, the knees, the hip joints, and the region around the neck are the common tender points.

Fibromyalgia is considered an arthritis-related condition; however, fibromyalgia does not cause swelling or damage to the joints, muscles, or other tissues. Rather, it produces pain, tenderness, and stiffness all over the body and, if not treated, can significantly interfere with someone’s ability to participate in daily activities.

Typically, fibromyalgia is more common in women. About two to four percent of the population in the United States is affected with fibromyalgia. Fibromyalgia is also hereditary, often found in many members of the same family, and the risk of fibromyalgia increases with age. In most cases, the symptoms of fibromyalgia appear after a physical or emotional trauma, such as an automobile accident or a death in the family.

However, in many fibromyalgia cases there is not an apparent triggering agent or event. Fibromyalgia is often referred to as fibromyalgia syndrome, not disease, because it presents with a set of signs and symptoms that occur together sometimes with no known cause or identifiable reason.

The exact cause of fibromyalgia is still a mystery and in many cases there is not an apparent triggering event. Cases of fibromyalgia syndrome where a cause can be identified include the following:

• A physically or emotionally stressful situation, accident, or event can trigger altered levels of chemicals and proteins causing glitches in the way the body communicates with the spinal cord and brain as though the “volume control” is turned up too high in the brain’s pain processing center

 

• Repetitive injuries such as carpel tunnel syndrome or an injury to the spine or neck

 

• Infection, such as a virus or bacteria, or illness especially one with a fever

 

• Genetic predisposition, combined with other conditions such as arthritis or a spine disorder

 

• Changes in neurotransmitters, also called brain chemicals, specifically low levels of serotonin which affects mood, sleep, and reduces the perception of pain as well as high levels of substance P, which is responsible for delivering pain messages to the brain

 

• An abnormality in the autonomic nervous system, which is responsible for releasing hormones that affect how a person responds to stress – this altered hormone level impacts the perception of pain when a person is faced with stress

In addition to pain in the tender points and overall fatigue, other symptoms of fibromyalgia include the following:

• Pain gets worse with any high-impact activity or additional stress

• Deep ache or burning sensation in the tender points

• Muscle tightness or spasms

• Lack of sleep/sleep disturbances, especially trouble with Stage 4 sleep – a restful stage when the body repairs itself

• Slow or muddled thinking and memory, often called “fibro fog”

• Headaches and jaw pain

• Morning stiffness

• Lightheadedness or difficulty balancing

• Dry eyes or difficulty focusing on nearby objects

• Numbness or tingling

• Itchy or dry skin

• Sensitivity to temperature, loud noise, and bright light

• Chest pain, rapid or irregular heartbeat, and shortness of breath

• Digestive problems

• Urinary issues

• In women, pelvic pain, increased pain during menstruation, and pain during sex

Associated Medical Conditions

Many of the following conditions also present with fibromyalgia:

• Irritable bowel syndrome

 

• Chronic fatigue syndrome

 

• Restless leg syndrome

 

• Depression & anxiety

 

• Post traumatic stress disorder

 

• Osteoarthritis

Diagnosis

Diagnosing people with fibromyalgia can be difficult because the main symptoms of fibromyalgia – pain and fatigue – are fairly common and frequently overlap with other medical conditions. Therefore, doctors have to rule out the presence of other associated conditions before actually giving a fibromyalgia diagnosis. Also, there is no specific laboratory test to diagnose fibromyalgia because standard lab tests are unable to find an exact reason for pain.

According to the American College of Rheumatology, or ACR, there are two primary criteria for establishing a diagnosis of fibromyalgia. There are eighteen tender points in the body that may be affected in fibromyalgia; for a diagnosis a patient should have at least eleven tender points. A patient should also have a history of widespread pain, affecting all four quadrants of the body, and lasting for more than three months. While diagnosing, the doctor focuses on the features of the pain by confirming that it is widespread and testing the tender points in order to differentiate it from arthritis pain.

There is no complete cure for fibromyalgia. Although the symptoms include pain and tenderness; fibromyalgia does not harm muscle, cause permanent damage to the body, and it is not life-threatening. The symptoms can be minimized significantly especially if the patient cooperates with his or her health care team. A team typically includes the doctor, possibly a physical therapist, other health professionals, and most importantly, makes self-care their very first priority.

When receiving a diagnosis from a doctor, the doctor might first suggest an analgesic. An analgesic is a painkiller and medicine that improves sleep. Over-the-counter acetaminophen and tramadol are analgesics or the physician may prescribe a stronger narcotic. Non-steroidal Anti-Inflammatory Drugs, or NSAIDs, like aspirin, ibuprofen and naproxen sodium, are prescribed to treat any inflammation. However, NSAIDs are generally ineffective when taken alone.

Low dosages of antidepressants have proven to be some of the most useful drugs for treating fibromyalgia. Tricyclic antidepressants help promote restorative sleep and relax painful muscles. Selective Serotonin Reuptake Inhibitors, or SSRIs, promote the release of serotonin, the body’s natural mood booster. SSRIs also have been successful in reducing fatigue. Mixed reuptake inhibitors raise both serotonin and norepinephrine. Mixed reuptake inhibitors seem to perform better than SSRIs for alleviating pain. Benzodiazepine relaxes the painful muscles and stabilizes the irregular waves that interfere with proper sleep.

Physical therapy may be necessary for patients to regain muscle strength and reduce physical pain. Also, counseling may be recommended to reduce emotional pain and to learn tools to cope with additional stress. The patient can also be proactive by engaging in the following:

• Participate in low-aerobic exercises like swimming, water exercise, or stationary cycling

• Minimize or cut out stress as much as possible

• Take steps to get enough and high-quality sleep each night

• Do not consume alcohol and caffeine because they interfere with sleep

• Maintain an equal level of activity every day

• Schedule time for eating to regulate blood sugar level

• If depressed, contact a therapist to learn new coping skills