Fibromyalgia

Fibromyalgia affects millions of people and can create unexplained muscle pain, exhaustion and sleep difficulties. Thes symptoms can seriously disrupts your daily life. They can also appear without a clear cause and leave you feeling unsure of what to do.

Fibromyalgia is a lifelong condition, but treatment can reduce your discomfort. Learn about the symptoms and ways to manage your condition.

Key Takeaways: Fibromyalgia

• Fibromyalgia is a chronic pain condition that affects muscles and soft tissues.
• Fibromyalgia causes lifelong pain and fatigue and most often develops in women and people of middle age.
• Anxiety and depression are linked to fibromyalgia, but the relationship is complicated.

What Is Fibromyalgia?

Fibromyalgia is a chronic disorder. It causes widespread pain in your muscles and the soft tissues around your joints. It’s also linked to fatigue, mood problems and sleep disturbances.

Fibromyalgia sounds like chronic fatigue syndrome, a disorder that causes exhaustion that doesn’t improve with rest. But these conditions are different. Pain is the primary sign of fibromyalgia. Fatigue is the chief complaint with chronic fatigue syndrome. It’s possible, however, to have both conditions.

How Common Is Fibromyalgia?

According to the American College of Rheumatology, fibromyalgia affects roughly 2 to 4 percent of American adults. Women are most at risk and typically develop symptoms between ages 30 and 55.

Fibromyalgia is also more common in people who:

• Experience brain or spinal cord trauma
• Have a close relative with fibromyalgia
• Have obesity
• Have other chronic rheumatic conditions (lupus, osteoarthritis, rheumatoid arthritis)
• Smoke

What Causes Fibromyalgia?

The cause of fibromyalgia isn’t clear. The condition runs in families, so your genes may be involved. Some research suggests that an imbalance in your brain chemicals — like dopamine and serotonin — may change how your body responds to painful stimuli. In fact, research shows that people with fibromyalgia experience more pain-induced blood flow to the brain than individuals without this condition.

Some doctors also believe these factors are fibromyalgia triggers:

• Anxiety
• Injury
• Not enough sleep
• Some viral infections
• Stress

But there is growing evidence that fibromyalgia may be an autoimmune disease, a type of condition where your immune system attacks your body. Studies show that people with fibromyalgia have high levels of certain antibodies that put pain-sensing nerves into overdrive.

What Are Fibromyalgia Symptoms?

Pain is the most common fibromyalgia symptom. It’s possible to feel achy all over. But you’re most likely to feel sharp pain at trigger points. Trigger points are specific spots on your body that are most sensitive to pressure, such as where your ligaments, muscles and tendons attach to joints or in some soft tissues.

You’re most likely to feel pain in your:

• Back
• Elbow
• Forearm
• Hip
• Jaw
• Knee
• Neck
• Shoulder

If you have fibromyalgia, you may feel fatigue and have trouble sleeping. Research shows people with fibromyalgia don’t get enough deep sleep. You may also wake up frequently during the night, so you won’t feel well-rested in the morning.

Additionally, fibromyalgia is associated with other symptoms, including:

• Anxiety
• Cognitive and memory problems
• Depression
• Digestion problems like heartburn or irritable bowel syndrome (IBS)
• Headaches
• Mood problems
• Morning stiffness
• Numbness and tingling in your hands and feet
• Painful menstrual periods
• Restless leg syndrome
• Sensitivity to bright lights or loud noises
• Temperature sensitivity
• Urinary problems linked to irritable or overactive bladder

There is a link between fibromyalgia and anxiety, depression and stress. But the connection between these conditions is unclear and, potentially, complicated. It’s a bit like the chicken and the egg. Anxiety and depression can make pain worse while chronic discomfort increases anxiety and depression.

How Is Fibromyalgia Diagnosed?

Fibromyalgia is difficult to diagnose. We can’t detect it with a blood test or an X-ray. Instead, doctors rely on your symptoms and a physical exam to determine if you have the condition. During the exam, your doctor will put pressure on 19 different tender spots across your body to assess your pain level. Tender spots include your elbows, hips, knees, neck and shoulders.

In addition to long-standing fatigue and sleep troubles, a fibromyalgia diagnosis requires:  

• Pain in at least 11 of 19 tender points
• Pain on both sides of the body, above and below the waist
• Widespread muscle pain for at least three months

Although blood tests and X-rays can’t detect fibromyalgia, your doctor may recommend them to identify or rule out any other causes for your symptoms.

What Are The Treatments For Fibromyalgia?

Finding a doctor who is familiar with fibromyalgia is an important first step. Family medicine providers, internists, pain doctors, physiatrists, physical medicine and rehabilitation specialists, and rheumatologists can all treat fibromyalgia. Ask your primary care provider for a recommendation.

Your doctor will rule out any infections or other autoimmune disorders that may cause the same symptoms. Following recommendations from the American Pain Society Fibromyalgia Panel, your provider can work with you to design a care plan that includes:

• Cognitive behavioral therapy to help change negative thought patterns
• Medication (anti-anxiety medication and antidepressants, fatigue medication, muscle relaxants, pain medicine, sleeping medication)
• Patient education
• Physical therapy (gentle aerobics, massage, stretching)

The Food & Drug Administration also approved three medications — duloxetine (Cymbalta^®), milnacipran (Savella^®) and pregabalin (Lyrica^®) — to treat fibromyalgia specifically.

What Are Some Self-Care Tips For Managing Fibromyalgia?

In addition to medication and other medical therapies, you can take steps on your own to manage your fibromyalgia symptoms. To reduce your discomfort, try these tactics:

• Adopt lifestyle changes: Talk with your doctor about a healthy diet and safe exercise regimen. It may be hard to exercise when you’re tired and achy. But physical activity and stretching can improve your energy and ease pain.
• Find a support group: Fibromyalgia is a lifelong condition. A support group can help you connect with people who struggle with the same symptoms. Together with a mental health therapist, support groups can help you manage the anxiety and depression that often accompany fibromyalgia.
• Get enough sleep: Set a regular bedtime and wake time. To avoid negative impacts on your sleep, avoid alcohol or anything with caffeine before bed. Don’t eat or exercise within a few hours of bedtime. Try a Swedish foam bed or a bed with air pockets to relieve nighttime pressure on your trigger points.
• Reduce stress: Limit stress to make it easier to deal with discomfort. Consider acupuncture, deep breathing, meditation, listening to music, tai chi or yoga.

Educating yourself about fibromyalgia can also be helpful. Learn more about the condition and how to manage it from online support groups, self-help sites and medical resources, including the Arthritis Foundation and Fibromyalgia Network.