Fibromyalgia is a chronic condition that causes pain, stiffness, and tenderness of muscles, tendons, and joints. These symptoms are often accompanied by restless sleep, chronic fatigue, anxiety, depression, and disturbances in bowel function. The cause and cure for fibromyalgia are unknown, but medications and alternative treatments can help reduce symptoms. Fibromyalgia is sometimes referred to as fibromyalgia syndrome.
Commonly Associated With
Fibromyositis; FM; Fibrositis
The exact cause of fibromyalgia is unknown, but it’s thought to be related to abnormal levels of certain chemicals in the brain and changes in the way the central nervous system (the brain, spinal cord, and nerves) processes pain messages carried around the body.
It’s also suggested that some people are more likely to develop fibromyalgia because of genes inherited from their parents.
In many cases, the condition appears to be triggered by a physically or emotionally stressful event, such as:
● an injury or infection
● giving birth
● having an operation
● the breakdown of a relationship
● the death of a loved one
Common symptoms include:
● widespread pain
● jaw pain and stiffness
● pain and tiredness in the face muscles and adjacent fibrous tissues
● stiff joints and muscles in the morning
● irregular sleep patterns
● irritable bowel syndrome (IBS)
● painful menstrual periods
● tingling and numbness in the hands and feet
● restless leg syndrome (RLS)
● sensitivity to cold or heat
● difficulties with memory and concentration, known as “fibro-fog”
The goals of treatment are to help relieve pain and other symptoms and to help the person cope with the symptoms.
The first type of treatment may involve:
• Physical therapy
• Exercise and fitness program
• Stress-relief methods, including light massage and relaxation techniques
If these treatments do not work, your provider may also prescribe an antidepressant or muscle relaxant. Sometimes, combinations of medicines are helpful.
• The goal of these medicines is to improve your sleep and help you better tolerate pain.
• Medicine should be used along with exercise and behavior therapy.
• Duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella) are medicines that are approved specifically for treating fibromyalgia.
Other medicines are also used to treat the condition, such as:
• Anti-seizure drugs, such as gabapentin
• Other antidepressants, such as amitriptyline
• Muscle relaxants, such as cyclobenzaprine
• Pain relievers, such as tramadol
If you have sleep apnea, a device called continuous positive airway pressure (CPAP) may be prescribed.
Cognitive-behavioral therapy is an important part of treatment. This therapy helps you learn how to:
• Deal with negative thoughts
• Keep a diary of pain and symptoms
• Recognize what makes your symptoms worse
• Seek out enjoyable activities
• Set limits
Complementary and alternative treatments may also be helpful. These may include:
• Tai chi
Support groups may also help.
Things you can do to help take care of yourself include:
• Eat a well-balanced diet.
• Avoid caffeine.
• Practice a good sleep routine to improve the quality of sleep.
• Exercise regularly. Start with low-level exercise.
There is no evidence that opioids are effective in the treatment of fibromyalgia, and studies have suggested possible adverse effects.
Referral to a clinic with interest and expertise in fibromyalgia is encouraged.
Exams and Tests
To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain with one or more of the following:
• Ongoing problems with sleep
• Thinking or memory problems
It is not necessary for the health care provider to find tender points during the exam to make a diagnosis.
Results from the physical exam, blood and urine tests, and imaging tests are normal. These tests may be done to rule out other conditions with similar symptoms. Studies of breathing during sleeping may be done to find out if you have a condition called sleep apnea.
Fibromyalgia is common in every rheumatic disease and complicates diagnoses and therapy. These disorders include: