Fibromyalgia can lead to widespread pain, sleep problems, and other symptoms.
Symptoms of fibromyalgia can be confused with those of arthritis, or joint inflammation. However, unlike arthritis, it does not cause joint or muscle inflammation and damage. It is seen as a rheumatic condition, in other words, one that causes soft tissue pain or myofascial pain.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), around 5 million adults aged 18 years or over in the United States (U.S.) experience fibromyalgia, and 80 to 90 percent of fibromyalgia patients are women.
- Fibromyalgia causes widespread pain, fatigue, and other types of discomfort.
- Symptoms resemble those of arthritis, but fibromyalgia affects the soft tissue, not the joints.
- The cause is unknown, but risk factors include traumatic injury, rheumatoid arthritis, and genetic factors.
- There is no cure, but medications, exercise, acupuncture, and behavioral therapy can help relieve symptoms.
Here are some key points about fibromyalgia. More detail is in the main article.
Common symptoms include:
- widespread body-wide pain
- jaw pain and stiffness
- pain and tiredness in the face muscles and adjacent fibrous tissues
- stiff joints and muscles in the morning
- irregular sleep patterns
- irritable bowel syndrome (IBS)
- painful menstrual periods
- tingling and numbness in the hands and feet
- restless leg syndrome (RLS)
- sensitivity to cold or heat
- difficulties with memory and concentration known as "fibro-fog"
The following are also possible:
- problems with vision
- pelvic and urinary problems
- weight gain
- cold or flu-like symptoms
- skin problems
- chest symptoms
- depression and anxiety
- breathing problems
Symptoms can appear at any time during a person's life, but they are most commonly reported around the age of 45 years.
Causes and risk factors
The exact cause of fibromyalgia is unclear, but there is a range of likely risk factors.
- a stressful, traumatic physical or emotional event, such as a car accident
- repetitive injuries
- rheumatoid arthritis or other autoimmune diseases
- central nervous system (CNS) problems
- the way our genes regulate how we process painful stimuli
Fibromyalgia may also be hereditary. Females who have a close relative with fibromyalgia have a higher risk of experiencing it themselves.
It can take some time to confirm a diagnosis of fibromyalgia, because the symptoms resemble those of other conditions. These conditions must first be ruled out before diagnosing fibromyalgia.
There are no laboratory tests for the condition, and this, too, can lead to delayed or missed diagnosis.
The American College of Rheumatology has established three criteria for diagnosing fibromyalgia.
- Pain and symptoms over the previous week, out of 19 identified body parts, plus levels of fatigue, unsatisfactory sleep, or cognitive problems
- Symptoms that have been ongoing for at least 3 months
- No presence of another health problem that would explain the symptoms
Treatment and outlook
Medical attention is needed, because fibromyalgia can be difficult to manage. As it is a syndrome, each patient will experience a different set of symptoms, and an individual treatment plan will be necessary.
Treatment will usually include some or all of the following:
Around 20 percent of people with fibromyalgia try acupuncture within the first 2 years. It may work, but more research is needed.
- an active exercise program
- low-dose anti-depressants
- behavior modification therapy
- chiropractic care
- physical therapy
Patients should adhere to the doctor's instructions for best results.
Drugs for fibromyalgia
Drugs may be recommended to treat certain symptoms.
These may include over-the counter (OTC) pain relievers, such as non-steroidal anti-inflammatories (NSAIDs).
Antidepressants, such as duloxetine, or Cymbalta, and milnacipran, or Savella, may help reduce pain. Anti-seizure drugs, such as gabapentin also known as Neurontin, and pregabalin, or Lyrica, may be prescribed.
However, a review has suggested that patients often stop using these drugs because they are not effective in relieving pain or because of their adverse effects.
Patients should tell the doctor about any other medications they are taking, to avoid side-effects and interactions with other drugs.
A combination of aerobic exercise and resistance training, or strength training, has been linked to a reduction in pain, tenderness, stiffness, and sleep disturbance, in some patients.
If exercise is helping with symptoms, it is important to maintain consistency in order to see progress. Working out with a partner or personal trainer may help to keep the exercise program active.
Some patients have experienced improvements in their quality of life after starting acupuncture therapy for fibromyalgia. The number of sessions required will depend on the symptoms and their severity.
One study found that 1 in 5 people with fibromyalgia use acupuncture within 2 years of diagnosis. The researchers concluded that it "may improve pain and stiffness." However, they call for more studies.
Behavior modification therapy
Behavior modification therapy is a form of cognitive behavioral therapy (CBT) that aims to reduce negative, stress- or pain-increasing behaviors and improve positive, mindful behaviors. It includes learning new coping skills and relaxation exercises.
There is no definitive cure for fibromyalgia, but more treatment options and clearer diagnostic criteria are now available.
Symptoms can improve significantly, as long as the patient follows their treatment plan.