What is fibromyalgia?
Fibromyalgia (fye-bro-mye-AL-ja) is a disorder that causes aches and pain all over the
body. People with fibromyalgia also have "tender points" throughout their bodies.
Tender points are specific places on the neck, shoulders, back, hips, arms, and legs
that hurt when pressure is put on them.
What are the symptoms of fibromyalgia?
In addition to pain, people with fibromyalgia could also have:
● Cognitive and memory problems (sometimes called "fibro fog")
● Trouble sleeping
● Morning stiffness
● Headaches
● Irritable bowel syndrome
● Painful menstrual periods
● Numbness or tingling of hands and feet
● Restless legs syndrome
● Temperature sensitivity
● Sensitivity to loud noises or bright lights
How common is fibromyalgia? Who is mainly affected?
Fibromyalgia affects as many as 5 million Americans ages 18 and older. Most people
with fibromyalgia are women (about 80 - 90 percent). However, men and children also
can have the disorder. Most people are diagnosed during middle age.
Fibromyalgia can occur by itself, but people with certain other diseases, such as
rheumatoid arthritis, lupus, and other types of arthritis, may be more likely to have it.
Individuals who have a close relative with fibromyalgia are more likely to develop it
themselves.
What causes fibromyalgia?
The causes of fibromyalgia are not known. Researchers think a number of factors might
be involved. Fibromyalgia can occur on its own, but has also been linked to:
● Having a family history of fibromyalgia
● Being exposed to stressful or traumatic events, such as
○ Car accidents
○ Injuries to the body caused by performing the same action over and over
again (called "repetitive" injuries)
○ Infections or illnesses
○ Being sent to war
How is fibromyalgia diagnosed?
People with fibromyalgia often see many doctors before being diagnosed. One reason
for this may be that pain and fatigue, the main symptoms of fibromyalgia, also are
symptoms of many other conditions. Therefore, doctors often must rule out other
possible causes of these symptoms before diagnosing fibromyalgia. Fibromyalgia
cannot be found by a lab test.
A doctor who knows about fibromyalgia, however, can make a diagnosis based upon
two criteria:
1. A history of widespread pain lasting more than 3 months. Pain must be present in
both the right and left sides of the body as well as above and below the waist.
2. Presence of tender points. The body has 18 sites that are possible tender points.
For fibromyalgia diagnosis a person must have 11 or more tender points. For a
point to be "tender," the patient must feel pain when pressure is put on the site.
People who have fibromyalgia may feel pain at other sites, too, but those 18 sites
on the body are used for diagnosis.
Your doctor may try to rule out other causes of your pain and fatigue. Testing for some
of these things may make sense to you. For instance, you may find it reasonable that
your doctor wants to rule out rheumatoid arthritis, since that disease also causes pain.
Testing for other conditions -- such as lupus, multiple sclerosis, or sleep apnea -- may
make less sense to you. But fibromyalgia can mimic or even overlap many other
conditions. Talk with your doctor. He or she can help you understand what each test is
for and how each test is part of making a final diagnosis.
How is fibromyalgia treated?
Fibromyalgia can be hard to treat. It's important to find a doctor who has treated others
with fibromyalgia. Many family doctors, general internists, or rheumatologists can treat
fibromyalgia. Rheumatologists are doctors who treat arthritis and other conditions that
affect the joints and soft tissues.
Treatment often requires a team approach. The team may include your doctor, a
physical therapist, and possibly other health care providers. A pain or rheumatology
clinic can be a good place to get treatment. Treatment for fibromyalgia may include the
following:
● Pain management. Three medicines have been approved by the U.S. Food and
Drug Administration (FDA) to treat fibromyalgia. These are pregabalin (Lyrica),
duloxetine (Cymbalta), and milnacipran (Savella). Other medications are being
developed and may also receive FDA approval in the future. Your doctor may
also suggest non-narcotic pain relievers, low-dose antidepressants, or other
classes of medications that might help improve certain symptoms.
● Sleep management. Getting the right amount of sleep at night may help improve
your symptoms. Here are tips for good sleep:
○ Keep regular sleep habits. Try to get to bed at the same time and get up at
the same time every day -- even on weekends and vacations.
○ Avoid caffeine and alcohol in the late afternoon and evening.
○ Time your exercise. Regular daytime exercise can improve nighttime
sleep. But avoid exercising within 3 hours of bedtime, which can be
stimulating, keeping you awake.
○ Avoid daytime naps. Sleeping in the afternoon can interfere with nighttime
sleep. If you feel you cannot get by without a nap, set an alarm for 1 hour.
When it goes off, get up and start moving.
○ Reserve your bed for sleeping. Watching the late news, reading a
suspense novel, or working on your laptop in bed can stimulate you,
making it hard to sleep.
○ Keep your bedroom dark, quiet, and cool.
○ Avoid liquids and spicy meals before bed. Heartburn and late-night trips to
the bathroom do not lead to good sleep.
○ Wind down before bed. Avoid working right up to bedtime. Do relaxing
activities, such as listening to soft music or taking a warm bath, that get
you ready to sleep. (A warm bath also may soothe aching muscles.)
● Psychological support. Living with a chronic condition can be hard on you. If you
have fibromyalgia, find a support group. Counseling sessions with a trained
counselor may improve your understanding of your illness.
● Other treatments. Complementary therapies may help you. Talk to your physician
before trying any alternative treatments. These include:
○ Physical therapy
○ Massage
○ Myofascial release therapy
○ Water therapy
○ Light aerobics
○ Acupressure
○ Applying heat or cold
○ Acupuncture
○ Yoga
○ Relaxation exercises
○ Breathing techniques
○ Aromatherapy
○ Cognitive therapy
○ Biofeedback
○ Herbs
○ Nutritional supplements
○ Osteopathic or chiropractic manipulation
What can I do to try to feel better?
Besides taking medicine prescribed by your doctor, there are many things you can do to
lessen the impact of fibromyalgia on your life. These include:
● Getting enough sleep. Getting enough sleep and the right kind of sleep can help
ease the pain and fatigue of fibromyalgia. Most adults need seven to eight hours
of "restorative" sleep per night. Restorative sleep leaves you feeling well-rested
and ready for your day to start when you wake up. It is hard for people with
fibromyalgia to get a good night's sleep. It is important to discuss any sleep
problems with your doctor, who can recommend treatment for them.
● Exercising. Although pain and fatigue may make exercise and daily activities
difficult, it is crucial to be as physically active as possible. Research has
repeatedly shown that regular exercise is one of the most effective treatments for
fibromyalgia. People who have too much pain or fatigue to do hard exercise
should just begin to move more and become more active in routine daily
activities. Then they can begin with walking (or other gentle exercise) and build
their endurance and intensity slowly.
● Making changes at work. Most people with fibromyalgia continue to work, but
they may have to make big changes to do so. For example, some people cut
down the number of hours they work, switch to a less demanding job, or adapt a
current job. If you face obstacles at work, such as an uncomfortable desk chair
that leaves your back aching or difficulty lifting heavy boxes or files, your
employer may make changes that will enable you to keep your job. An
occupational therapist can help you design a more comfortable workstation or
find more efficient and less painful ways to lift. A number of federal laws protect
the rights of people with disabilities.
● Eating well. Although some people with fibromyalgia report feeling better when
they eat or avoid certain foods, no specific diet has been proven to influence
fibromyalgia. Of course, it is important to have a healthy, balanced diet. Not only
will proper nutrition give you more energy and make you generally feel better, it
will also help you avoid other health problems.
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