Scientists estimate that around 5 million adults in the United States are affected by fibromyalgia. Although men and children can have the disorder, it is more often seen in women. Most people with the condition are diagnosed during middle age.
When fibromyalgia pains flare up, every activity can seem more difficult. All people experience flares differently, and there can be different triggers depending on the person.
What is a fibromyalgia flare-up?
Life stress or stressful events may trigger a fibromyalgia flare-up.
Some people with fibromyalgia may experience certain symptoms on a regular basis.
However, the pain associated with fibromyalgia tends to fluctuate and worsen.
When symptoms temporarily increase in number or intensity, it is called a flare or flare-up.
Flare-ups can happen without warning and are mostly likely to occur if a person with fibromyalgia is stressed or under a lot of pressure.
A flare-up can last anywhere from a few days to weeks at a time.
Potential flare-up triggers
Certain factors may trigger a fibromyalgia flare-up, such as changes in:
- physical or psychological stress
- temperature or weather
Stressful events, surgery, or accidents can make fibromyalgia symptoms worse. Flare-ups can also be caused by a lack of sleep or doing too much or too little exercise.
Symptoms of fibromyalgia
The main symptom of fibromyalgia is widespread pain. The condition causes pain, stiffness, and tenderness of the muscles, tendons, and joints. The individual symptoms differ from one person to another. Symptoms can vary in intensity and come and go.
Symptoms of fibromyalgia may include:
- pain throughout the body, particularly in the back or neck
- extreme sensitivity to pain, bright lights, smoke, and certain foods
- stiffness when staying in the same position for long periods
- muscles spasms
- extreme tiredness
- poor quality sleep
- trouble with remembering, learning, paying attention, and concentrating referred to as "fibro fog"
- slow or confused speech
- frequent headaches or migraines
- irritable bowel syndrome
Someone with fibromyalgia may sometimes experience clumsiness, dizzy spells, feeling too hot or cold, painful periods, restless legs syndrome, and numbness or tingling in hands and feet.
Doctors used to refer to tender or trigger points that cause flare-ups, but these are no longer widely used. The American College of Rheumatology has newer criteria to diagnose fibromyalgia.
Although some triggers for fibromyalgia are beyond a person's control, others can be managed and flare-ups prevented. It is often easier to prevent a flare than treat one.
Below are several lifestyle changes and tips that may help relieve symptoms and make fibromyalgia easier to live with day to day.
Keeping a log of triggers
Keeping a log of daily activities and routines may help to identify triggers of fibromyalgia flare-ups
Triggers for fibromyalgia vary from person to person. Maintaining a log of activities, meals, sleep times and duration, and symptoms of fibromyalgia may help to identify particular triggers.
Recording these activities might highlight patterns of what triggers a flare. This might help a person with fibromyalgia find out how to better manage or avoid those triggers.
Reducing stress and relaxing
Stress makes symptoms of fibromyalgia worse. Many people with fibromyalgia experience stress and feelings of depression, anxiety, and frustration. People may benefit from trying to avoid or limit exposure to stressful situations and making time to relax.
While techniques such as meditation or deep breathing may help manage stress, it is important that people with fibromyalgia do not avoid physical activity altogether. People with fibromyalgia who quit work or stop exercising do not do as well as those that stay active.
Options to assist with stress management are available and include cognitive behavioral therapy (CBT), group therapy, and feedback from qualified health professionals.
Getting enough sleep
Fatigue is one of the main symptoms of fibromyalgia. It is essential that a person with fibromyalgia get enough sleep.
Sleep hygiene practices that may help include going to bed and getting up at the same time every day and limiting napping during the day.
Sometimes, people with fibromyalgia experience restless legs syndrome and pain that can interfere with sleep. A doctor can recommend treatments for these problems, which may aid restful sleep.
Regular physical activity can often decrease or improve symptoms of fibromyalgia. Although exercise may increase symptoms of pain at first, it may help prevent pain over time.
Activities that are recommended for people with fibromyalgia include walking, biking, swimming, and water aerobics. Maintaining good posture habits, stretching, and relaxation exercises may also help.
For maximum effect, it is recommended that people with fibromyalgia begin with gentle exercise, such as walking, and build up endurance and intensity slowly.
Resistance and strengthening exercises may improve muscle strength, physical disability, depression, and quality of life. They can also improve tiredness, function, and boost mood in people with fibromyalgia.
Not doing too much
While regular physical activity is recommended to help manage fibromyalgia symptoms, it is crucial to limit overexertion not to do too much.
Moderation is the key. If a person with fibromyalgia does too much on days where their symptoms are good, they may end up having more bad days. However, on bad days, individuals should still try to be as active as they can. Keeping activity levels as even as possible provides the best outcome.
Although there is no specific diet recommended for people with fibromyalgia, there are certain foods that appear to make fibromyalgia symptoms worse.
Try an elimination diet, in which you exclude certain food groups each week to see if symptoms improve. If symptoms get better after ruling out a certain type of food, they may well be connected to fibromyalgia symptoms.
Maintaining proper nutrition will help boost energy levels and help avoid other health problems.
Fibromyalgia and Social Security
Many people with fibromyalgia find themselves unable to work or resume a normal standard of living.
For such people, Social Security rulings in the United States dictate that so long as a medical or osteopathic doctor can determine that the disease causes medically determinable impairment (MDI), the condition will qualify as a disability for Social Security payments.
This means that a doctor should be able to confirm:
- a history of widespread pain
- a minimum of 11 tender points following examination
- repeated instances of at least six fibromyalgia symptoms
- evidence that other explanations or conditions have been ruled out.
The Social Security Administration (SSA) requires medical documentation dating back 12 months related to the disease, and may conducts interviews with relatives, friends, neighbors, and past employers to confirm the diagnosis.
In some cases, the SSA may fund a consultation to confirm the debilitating nature of the disease.
Treatment for fibromyalgia is often tailored and may include a combination of medication and lifestyle changes.
Treating fibromyalgia flares can be tricky. Preventing a flare developing in the first place is less complicated than treating a flare.
Fibromyalgia has several symptoms, which means that no one treatment will fix them all. Also, a treatment that works for one person may not work for another.
Various treatments in different combinations may have to be tried before someone finds a plan that works for them. The treatment plan will often be a blend of medication and lifestyle changes.
Medications that may help reduce fibromyalgia pain and improve sleep include:
- anti-seizure drugs
- naltrexone, which is an anti-opioid medication, may be helpful
Talking therapies such as CBT aim to alter the way a person thinks about things and may help tackle fibromyalgia in a more positive way. Psychotherapy can also help someone with fibromyalgia help understand and deal with their thoughts and feelings.
There is little evidence to show that alternative treatments such as acupuncture, massage, and aromatherapy help with fibromyalgia. However, these methods might help with relaxation and stress.
There is no cure for fibromyalgia. However, medication and lifestyle changes can help treat fibromyalgia and reduce the likelihood of flares. Fibromyalgia is a condition that can be managed and people with the disorder can live a full life.
Participating in regular exercise is one of the most effective ways that fibromyalgia flares can be avoided and pain can be managed.