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Fibromyalgia is a complex, chronic disorder which currently has no known cause or cure. The symptoms most identified with Fibromyalgia are pain and fatigue. However, Fibromyalgia can also cause a range of other symptoms such as body stiffness, gastro-intestinal and urinary problems, sleep difficulties and headaches. These symptoms can come and go, intensify or decrease, as well as move around the body. As such, this disorder is very difficult to identify and is frequently misdiagnosed. Fibromyalgia is not life-threatening. However, depending on the severity of the symptoms, the disorder can be extremely or completely debilitating and create huge challenges in the daily life of the patient.
The cause of Fibromyalgia is not known, but the vast majority of sufferers are women and it tends to run in families. It is generally believed to be a condition of the brain, and there is a wide variability in how patients develop Fibromyalgia, what their symptoms are, and how they respond to treatment. Popular theories are that Fibromyalgia can be triggered and exacerbated by illness, injury, stress, and sleep interruptions.
One of the most frustrating aspects of this disorder is the difficulty in diagnosing it. First, diseases such as multiple sclerosis and lupus, which Fibromyalgia frequently mimics, must be ruled out. Then the doctor can use the diagnostic criteria established by the American College of Rheumatology (ACR) in 1990 for an official diagnosis.
There are many symptoms of fibromyalgia and they tend to vary from person to person. The symptoms can also come and go over time, although it is unlikely they will ever disappear altogether.
Your symptoms may sometimes get better or worse, depending on factors such as:
changes in the weather
your stress levels
how physically active you are
The main symptoms of fibromyalgia are outlined below.
If you have fibromyalgia, one of your main symptoms is likely to be widespread pain. This may be felt throughout your body, but could be worse in particular areas, such as your back or neck. The pain is likely to be continuous, although it may be better or more severe at different times. The pain could feel like:
an ache
a burning sensation
a sharp stabbing pain
Fibromyalgia can cause you to become extremely sensitive to pain all over your body, and you may find that even the slightest touch is very painful. If you hurt yourself, for example if you stub your toe, you may find that the pain continues for much longer than it normally would. You may hear this described in the following medical terms:
hyperalgesia - when you are extremely sensitive to pain
allodynia - when you feel pain from something that should not be painful at all, such as a very light touch
If you have fibromyalgia, you may find you are very sensitive to other things as well, such as smoke, certain foods and bright lights. Being exposed to something you are sensitive to can cause your other fibromyalgia symptoms to flare up.
Fibromyalgia can make you feel stiff. The stiffness may be most severe when you have been in the same position for a long period of time, such as when you first wake up in the morning.
Fibromyalgia can also cause your muscles to spasm, which is when they contract (squeeze) tightly and painfully. This can affect your sleep (see below).
Fatigue (extreme tiredness) as a result of fibromyalgia can range from a mild, tired feeling to the exhaustion often experienced during a flu-like illness. Sometimes, severe fatigue may come on very suddenly and can drain you of all your energy. If this occurs, you may feel too tired to do anything at all.
Fibromyalgia can affect your sleep. You may find you often wake up tired even when you have had plenty of sleep. This is because fibromyalgia can sometimes prevent you from sleeping deeply enough to refresh you properly. You may hear this described as ‘non-restorative sleep’.
Cognitive problems are problems with mental processes, such as thinking and learning. If you have fibromyalgia, you may have:
trouble remembering and learning new things
problems with attention and concentration
slowed or confused speech
If you have pain and stiffness in your neck and shoulders from fibromyalgia, you may also have frequent headaches. These can vary from being mild headaches to severe migraines, which may also involve other symptoms, such as nausea (feeling sick).
If you have fibromyalgia, you may develop irritable bowel syndrome (IBS) as well. IBS is a common digestive condition that causes pain and bloating in your stomach. It can also cause constipation (when you are unable to empty your bowels) and diarrhoea (passing loose stools).
Other symptoms of fibromyalgia can include:
not being able to regulate your body temperature (feeling too hot or too cold)
restless legs syndrome (unpleasant sensations in your legs and feeling like you need to move your legs to get some relief)
tingling, numbness, prickling, or burning sensations in your hands and feet (paresthesia)
tinnitus (the perception of a noise in one or both ears that comes from inside your body)
unusually painful periods (in women)
anxiety
depression (see below)
It is possible for fibromyalgia to lead to depression. This is because the condition can be difficult to deal with, and low levels of certain hormones, such as serotonin, can make you prone to developing depression. Depression can cause many symptoms, including:
constantly feeling low
a lack of interest in the things that you usually enjoy
feeling tearful
If you think that you may be depressed, it is important to get help from your GP, or your fibromyalgia healthcare professional.
In general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health.
Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include:
Analgesics. Acetaminophen may ease the pain and stiffness caused by fibromyalgia. However, its effectiveness varies. Tramadol is a prescription pain reliever that may be taken with or without acetaminophen. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen or naproxen sodium — in conjunction with other medications.
Antidepressants. Duloxetine and milnacipran may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or fluoxetine (Prozac) to help promote sleep.
Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia.
Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations.
Self-care is critical in the management of fibromyalgia.
Reduce stress. Develop a plan to avoid or limit overexertion and emotional stress. Allow yourself time each day to relax. That may mean learning how to say no without guilt. But try not to change your routine completely. People who quit work or drop all activity tend to do worse than those who remain active. Try stress management techniques.
Get enough sleep. Because fatigue is one of the main characteristics of fibromyalgia, getting sufficient sleep is essential. In addition to allotting enough time for sleep, practice good sleep habits, such as going to bed and getting up at the same time each day and limiting daytime napping.
Exercise regularly. At first, exercise may increase your pain. But doing it gradually and regularly often decreases symptoms. Appropriate exercises may include walking, swimming, biking and water aerobics. A physical therapist can help you develop a home exercise program. Stretching, good posture and relaxation exercises also are helpful.
Pace yourself. Keep your activity on an even level. If you do too much on your good days, you may have more bad days. Moderation means not "overdoing it" on your good days, but likewise it means not self-limiting or doing "too little" on the days when symptoms flare.
Maintain a healthy lifestyle. Eat healthy foods. Limit your caffeine intake. Do something that gives you hope, enjoyable and fulfilling every day, like reading the Bible.