Fibromyalgia, sometimes called fibromyalgia syndrome, is a condition that is characterized by widespread pain in the muscles, ligaments, and tendons as well as fatigue and tenderness. The pain tends to be chronic but it can also wax and wane with time. The tenderness occurs in specific areas of the body -- the neck, shoulders, back, hips, and upper and lower extremities -- where even a light touch can be painful. Other symptoms may also occur including cognitive problems and sleep disturbances.
Fibromyalgia affects an estimated 6 million Americans -- one in every 50 people -- and 80-90 percent of them are women. Diagnosis most often occurs in middle age but the symptoms often appear earlier in life. Fibromyalgia is often difficult to diagnose because its symptoms overlap with several other conditions (including rheumatoid arthritis and chronic fatigue syndrome) and as a result many people suffer for years without a diagnosis.
There is no cure for fibromyalgia, but the good news is that is it not progressive or life threatening. Available treatments and self care methods can help improve fibromyalgia symptoms.
The main symptoms of fibromyalgia are pain and stiffness in the muscles and joints, fatigue, and tender spots on the body where even slight pressure causes pain. These tender points tend to occur at the back of your head, your upper back and neck, your upper chest, elbows, hips, and knees.
Sleep disturbances are another common symptom of fibromyalgia. Many people with fibromyalgia have an abnormality in their deep sleep patterns that can prevent them from feeling rested in the morning when they seem to get plenty of sleep. Headaches and facial pain are also very common among people with fibromyalgia.
Cognitive problems including difficulty concentrating and memory impairment are common in people with fibromyalgia and are sometimes referred to as "fibro fog."
Other symptoms that may occur in people with fibromyalgia include:
- irritable bowel syndrome
- interstitial cystitis (irritable bladder)
- pelvic pain
- restless leg syndrome
- sensitivity to noise, light, and temperature,
- numbness or tingling in the hands and feet (paresthesia)
- mood changes
- painful menstrual periods
- dry eyes, skin and mouth
- anxiety and depression
All of these symptoms tend to wax and wane with time along with the pain and tenderness. However, unlike similar diseases, the symptoms do not tend to get progressively worse through the years.
What Causes Fibromyalgia?
The cause of fibromyalgia is unknown, but some of the factors that may be associated with developing fibromyalgia include:
- Genetics: Fibromyalgia tends to run in families. Genes may cause people to react strongly to stimuli that other people would not perceive as painful.
- Stress: Many people believe fibromyalgia may be triggered by physical or emotional stresses such as a car accident or the death of a loved one.
- Injuries: Injuries that are caused by repeating the same motion over and over or trauma to the upper spinal region may be triggers for fibromyalgia.
- Infection: Some researchers believe that a viral or bacterial infection may trigger fibromyalgia.
- Nervous system abnormalities: Problems with the body's "alert system," the sympathetic division of the autonomic nervous system, may lead to fibromyalgia.
The following factors increase your risk of developing fibromyalgia:
- Sex: Fibromyalgia is at least 5 times more common in women than in men.
- Age: Fibromyalgia tends to develop during early and middle adulthood, although it may not be diagnosed right away.
- Sleep disturbances: While sleeping pattern disturbances are thought to be a symptom of fibromyalgia, they may actually be associated with its development. People with restless legs syndrome or sleep apnea can also develop fibromyalgia.
- Family history: If a family member has fibromyalgia, you are at increased risk of developing the condition.
- Other rheumatic disease: If you have another rheumatic disease (a disease of the muscles and connective tissues), such as rheumatoid arthritis, lupus, or ankylosing spondylitis, you may also be more likely to have
If you're experiencing widespread muscle pain and tender spots on your body, with or without other symptoms, it is a good idea to see the doctor to be evaluated for fibromyalgia.
Fibromyalgia can be difficult to diagnose, in part because the symptoms overlap with those of other conditions. In addition, there is no diagnostic test for fibromyalgia, no blood test or genetic screen or imaging procedure that can tell you definitively whether or not you have the disease. Therefore, diagnosis depends on your description of your symptoms and ruling out other possible causes for your symptoms, such as rheumatoid arthritis or multiple sclerosis.
The American College of Rheumatology (ACR) has established guidelines for diagnosing fibromyalgia. To meet the ACR criteria for fibromyalgia, you must:
- Have a history of widespread pain (pain in all four quadrants of the body) lasting for more than 3 months
- Have abnormal tenderness at a minimum of 11 out of 18 possible locations on your body. While tenderness can be experienced at many more body sites, the ACR diagnostic criteria specify that you must have tenderness at 11 of 18 specific body sites that are commonly affected in fibromyalgia.
What you should know: When you go to your doctor with symptoms of fibromyalgia, in addition to taking your medical history and suggesting tests to rule out other condition, the doctor may apply firm pressure at specific points on your head, upper body, and other sites to determine which ones are tender. Some doctors may refer you to a rheumatology specialist for further testing. Other doctors may not be familiar with the ACR criteria or may disagree with the rigid requirements for a fibromyalgia diagnosis.
Fibromyalgia Treatment Options
One of the most important factors in treating fibromyalgia symptoms is finding a doctor who is experienced in treating the condition. Any rheumatologist and many family physicians and general internists are experienced in treating fibromyalgia. You may also want to consider seeing a physical therapist.
Treatment for fibromyalgia usually consists of lifestyle changes and medications.
Things you can do to help improve your fibromyalgia symptoms include:
- Reduce stress: Using stress management techniques to cope with life stress and avoiding overexertion and emotional stress may help improve your symptoms.
- Practice good sleep hygiene: Getting enough sleep is essential to preventing fatigue.
- Exercise regularly: Regular exercise often decreases symptoms of fibromyalgia. Talk to your doctor about the types of exercise that are appropriate for you.
- Eat healthy: Maintaining good nutrition and a healthy weight can help improve symptoms and overall health.
If you experience widespread pain in your body that lasts several months and is accompanied by fatigue or tenderness, see the doctor to be evaluated for fibromyalgia. Your doctor can help determine if you have fibromyalgia or another condition that can cause similar symptoms.