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Fibromyalgia is a chronic health condition that causes pain and tenderness all over the body. The condition is believed to amplify painful sensations by affecting how the brain and spinal cord process signals. Symptoms may appear gradually over time or after an event like physical trauma, surgery, infection, or significant psychological stress.
Women are more likely to develop fibromyalgia than men. Those with the condition may also experience tension headaches, temporomandibular joint disorders, irritable bowel syndrome, anxiety, and depression.
Although there is no cure for fibromyalgia, various medications can help control symptoms. Exercise, relaxation, and stress-reduction techniques may also be effective in managing the condition.
Symptoms
Fibromyalgia’s main signs and symptoms include:
- Widespread pain. The pain associated with fibromyalgia is typically described as a persistent, dull ache that has lasted for at least three months. For the pain to be classified as widespread, it must affect both sides of the body and occur both above and below the waist.
- Fatigue. People with fibromyalgia often wake up feeling tired, even though they report having slept for long periods of time. Sleep is frequently disrupted by pain, and many patients with fibromyalgia also have other sleep disorders, such as restless legs syndrome and sleep apnea.
- Cognitive difficulties. The “fibro fog” symptom makes it difficult to concentrate, pay attention, and focus on mental work.
Frequently, fibromyalgia coexists with additional conditions, such as:
- Depression or anxiety
- Migraine and other types of headaches
- Painful bladder syndrome or interstitial cystitis
- Temporomandibular joint disorders
- Irritable Bowel Syndrome (IBS)
- Chronic fatigue syndrome
- Postural tachycardia syndrome
Causes
Fibromyalgia is a condition where people are more sensitive to pain due to changes in the brain and spinal cord caused by repeated nerve stimulation. This change is characterized by increased levels of certain chemicals in the brain that signal pain, and pain receptors that become sensitized and overreact to both painful and non-painful signals. The cause of fibromyalgia is not fully understood, but genetic mutations in the genes responsible for forming neurotransmitters that transmit and receive pain signals in the brain may play a role.
These alterations are probably caused by a variety of reasons, including:
- Genetics. Given that fibromyalgia frequently runs in families, specific genetic alterations might increase your risk of getting the condition.
- Infections. Some diseases seem to cause or worsen fibromyalgia.
- Physical or emotional events. A physical occurrence, such a vehicle accident, may occasionally cause fibromyalgia to develop. The disorder may also be brought on by persistent psychological stress.
Risk factors
Fibromyalgia risk factors include:
- Gender. Women are diagnosed with fibromyalgia more frequently than males.
- Family history. If your parent or sibling has fibromyalgia, you might be more likely to get it yourself.
- Other disorders. You may have a higher risk of developing fibromyalgia if you have lupus, rheumatoid arthritis, or osteoarthritis.
Diagnosis
Previously, doctors used to examine 18 specific points on a person’s body to determine the number of painful points when pressed firmly. However, the American College of Rheumatology’s recent guidelines do not mandate a tender point exam for diagnosing fibromyalgia. Instead, the primary criterion for diagnosis is the presence of widespread pain in the body for a minimum of three months.
You must experience pain in four or more of the following five places to meet the requirements:
- Left upper region, including shoulder, arm or jaw
- Right upper region, including shoulder, arm or jaw
- Left lower region, including hip, buttock or leg
- Right lower region, including hip, buttock or leg
- Axial region, which includes neck, back, chest or abdomen
Tests
Your doctor might wish to rule out additional illnesses that could present with same symptoms. Blood testing could consist of:
- Vitamin D
- Celiac serology
- Thyroid function tests
- Complete blood count
- Rheumatoid factor
- Erythrocyte sedimentation rate
- Cyclic citrullinated peptide test
- Anti-nuclear antibody
Your doctor might advise an overnight sleep study if there’s a risk that you have sleep apnea.
Treatment
Treatments for fibromyalgia typically combine medicine with self-care techniques. The focus is on reducing symptoms and enhancing overall health. While there isn’t a single cure for all symptoms, using a number of approaches can help in the long run.
Medications
Medication can help with pain relief from fibromyalgia and sleep improvement. Typical choices are:
- Pain relievers. Painkillers sold over-the-counter, such as acetaminophen, ibuprofen, or naproxen sodium, may be beneficial. Opioid drugs are not advised because they can create serious adverse effects, dependence, and will eventually make the pain worse.
- Antidepressants. Milnacipran with duloxetine could reduce fibromyalgia-related fatigue and pain. To aid in promoting sleep, your doctor may advise amitriptyline or the muscle relaxant cyclobenzaprine.
- Anti-seizure drugs. Certain types of pain can frequently be reduced with the use of medications used to treat epilepsy. Pregabalin was the first medication licensed by the Food and Drug Administration to treat fibromyalgia symptoms, while gabapentin is occasionally effective in easing the condition’s symptoms.
Therapies
Numerous treatments are available to assist lessen the impact that fibromyalgia has on your body and your life. Examples comprise:
- Physical therapy. Engaging with a physical therapist can aid you in learning exercises that can enhance your strength, flexibility, and endurance. Exercises performed in water may provide particular benefits.
- Occupational therapy. If you are experiencing physical strain from your work or certain tasks, an occupational therapist can assist you in modifying your work environment or altering your approach to those tasks in order to reduce the strain on your body.
- Counseling. Speaking with a counselor can boost your self-confidence and offer you coping mechanisms for difficult circumstances.
