Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals.
Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.
Women are more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.
While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help. If you have pain all over and are chronically fatigued, you may want to ask your doctor about the possibility of having fibromyalgia.
What are the symptoms of fibromyalgia?
The primary symptoms of fibromyalgia include:
– Widespread pain. The pain associated with fibromyalgia often is described as a constant dull ache that has lasted for at least three months. To be considered widespread, the pain must occur on both sides of your body and above and below your waist.
– Fatigue. People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain, and many patients with fibromyalgia have other sleep disorders, such as restless legs syndrome and sleep apnea.
– Cognitive difficulties. A symptom commonly referred to as “fibro fog” impairs the ability to focus, pay attention and concentrate on mental tasks.
– Other problems. Many people who have fibromyalgia also may experience depression, headaches, and pain or cramping in the lower abdomen.
What causes fibromyalgia?
The causes of fibromyalgia are unknown, but there are probably a number of factors involved. Some possibilities include:
– Genetics. Because fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing the disorder.
– Infections. Some illnesses appear to trigger or aggravate fibromyalgia.
– Physical or emotional trauma. Post-traumatic stress disorder has been linked to fibromyalgia.
– Changes in how your brain and spinal cord process pain. Sensitivity in the central nervous system may be a primary cause of fibromyalgia.
When to see your doctor
It’s a good idea to see your doctor if you have persistent, unexplained pain all over your body. Other symptoms that may prompt you to seek medical advice include:
– Fatigue
– Sleep problems
– Headaches
– Memory issues
– Anxiety
– Depression
– Numbness or tingling in your hands and feet
– Pain or cramps in your abdomen
Keep in mind there is no diagnostic test for fibromyalgia, and the disorder is diagnosed primarily by ruling out other conditions. Be prepared to talk to your doctor about your symptoms and medical history.
Getting ready for your appointment
These suggestions may help you prepare for your appointment and make the most of your time with your doctor:
| To prepare for your appointment | Do this |
|---|---|
| Make a list of your symptoms, including those that seem unrelated to the reason for your appointment. | How often have you experienced the symptoms? How severe are they? Does anything improve or worsen the symptoms? |
| Make a list of key medical information, including other conditions with which you’ve been diagnosed and any medications, vitamins or supplements you’re taking. | Include the doses and how often you take them. |
| Take a family member or friend along, if possible. | Someone who accompanies you can help you remember what the doctor says. |
| Write down questions to ask your doctor. | List your most important questions first to make sure they get answered. For fibromyalgia, some basic questions to ask your doctor include: |
| -What tests will you do to rule out other possible causes? | |
| -Are there any treatments or self-care steps that could improve my symptoms? | |
| -I have these other health conditions. How do they relate to fibromyalgia? | |
| -What specialists might help me manage my symptoms? |
What you can expect from your doctor
During the physical exam, your doctor will try to rule out other medical problems, such as thyroid disease or lupus, which could be causing your symptoms. After the exam, your doctor may ask:
– Where do you feel pain? Is it all over or in specific areas?
– How long have you had this pain?
– How often do you feel pain? Is it constant or does it come and go?
– Does anything make the pain better or worse?
– Is the pain interfering with your ability to work and do everyday activities?
– Do you feel unusually fatigued?
– Are you having difficulty sleeping?
– Are you experiencing numbness or tingling in your hands and feet?
– Are you noticing memory problems or an inability to concentrate?
– Do you feel depressed or anxious?
– Have you ever been diagnosed with any other medical conditions?
Your doctor may order blood work and imaging tests, such as X-rays and MRIs, to rule out other conditions.
Diagnosing fibromyalgia
To be diagnosed with fibromyalgia, you must have had widespread pain for more than three months — with no underlying medical condition that could cause the pain. Common sites for pain include:
| Common sites for fibromyalgia pain |
|---|
| – Your back |
| – Your shoulders |
| – Your neck |
| – Your chest |
| – Your hips |
| – Your arms |
| – Your legs |
You must also have experienced some combination of these other symptoms:
– Fatigue
– Waking up feeling tired or unrefreshed
– Cognitive issues, known as “fibro fog”
– Headaches
– Pain or cramping in your abdomen
– Depression
– Anxiety
– Numbness or tingling in your hands and feet
While there is no single diagnostic test for fibromyalgia, your doctor may administer 18 specific trigger points in your body to see how many areas are sensitive to mild pressure. If you have tenderness or pain in at least 11 of the 18 sites, that can help confirm a fibromyalgia diagnosis.
Some of the 18 trigger points that could indicate fibromyalgia include:
| Trigger points for diagnosing fibromyalgia |
|---|
| – Back of your head |
| – Front sides of your neck |
| – Upper back near shoulder blades |
| – Upper chest |
| – Outside of elbows |
| – Sides of hips |
| – Inner knees |
Fibromyalgia treatment
While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Your doctor also may suggest self-care measures to reduce pain and fatigue.
Medications
Medications may include:
– Pain relievers. Over-the-counter pain relievers — such as ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others) — may help alleviate your discomfort.
– Anti-seizure drugs. Drugs designed to treat epilepsy are sometimes effective in reducing certain types of pain.
– Antidepressants. These medications may help improve mood, sleep and fatigue. Amitriptyline and duloxetine (Cymbalta) are antidepressant medications that are FDA-approved for treating fibromyalgia.
– Anti-anxiety drugs. Medications such as buspirone can help ease anxiety associated with fibromyalgia.
– Muscle relaxants. These medications, such as cyclobenzaprine, relax muscle spasms.
Self-care
Self-care measures that may help include:
– Exercise. Get regular aerobic exercise. The endorphins released by aerobic activity boost your mood and relieve stress. Simple activities like walking can be beneficial. Start slowly and gradually step up your activity level.
– Physical therapy. A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. Aquatic exercise can help decrease fibromyalgia pain.
– Stress reduction. Reduce stress through relaxation techniques such as yoga or meditation. Massages also can help relieve stress and ease muscle tension.
– Fatigue fighters. Avoiding caffeine late in the day and improving sleep habits can help overcome fatigue.
Coping and support
Learning how to minimize symptoms and cope with the challenges of fibromyalgia is key. Some suggestions include:
– Set limits. Balance activity with rest. Don’t overdo it on good days so that you can have energy on more-challenging days. Listen to your body.
– Find support. Having family and friends you can count on for support and understanding can help you cope with fibromyalgia. Some communities have local support groups.
– Educate yourself. Arm yourself with information about your condition. Knowledge is empowering.
– Pace yourself. Allow yourself time for rest and relaxation. Avoid taking on too much at once.
Conclusion
If you have widespread pain and fatigue that has lasted for more than three months, see your doctor. Be prepared to describe your symptoms and medical history in detail. Tests may be ordered to rule out other conditions. If other causes are eliminated and you have experienced sufficient symptoms, your doctor may diagnose fibromyalgia. Though fibromyalgia is chronic, medication and self-care measures can help control symptoms.