Immune Disorders

Fibromyalgia or Fibromyalgia Syndrome (FMS)

Written by
Dr. Sneha Kannan
and medically reviewed by Dr. Durgesh Srivastava

Published on Jun 04, 2019 and last reviewed on Jun 08, 2019   -  5 min read

Abstract

Abstract

Fibromyalgia or fibromyalgia syndrome is a chronic or long-lasting condition, which is characterized by muscle pain, joint pain, fatigue, sleep problems, memory loss, and mood swings.

Fibromyalgia or Fibromyalgia Syndrome (FMS)

What Is Fibromyalgia?

Fibromyalgia or fibromyalgia syndrome is a chronic or long-lasting condition, which is characterized by muscle pain, joint pain, fatigue, sleep problems, memory loss, and mood swings. It affects women more than men and starts during middle adulthood. It is believed that this condition increases the sensation of pain experienced by a person by altering the way the brain processes signals of pain. There is no permanent cure for this disease, but medicines give substantial symptomatic relief.

These symptoms begin after an injury, surgery, infection, or a lot of mental stress. The other symptoms that are commonly seen in fibromyalgia patients are tension headaches, temporomandibular joint (TMJ) disorders, anxiety, depression, and irritable bowel syndrome. It is now been described as “central pain amplification disorder,” as this increases the pain sensation in the brain.

Fibromyalgia is considered a benign condition because even though it affects the quality of life, it is not fatal and does not cause heart attacks, stroke, cancer, or physical deformities. The presence of rheumatic diseases like osteoarthritis, lupus, ankylosing spondylitis, and rheumatoid arthritis increases the risk of fibromyalgia.

What Are the Common Misconceptions About Fibromyalgia?

As the pain caused in this condition is subjective and cannot be measured, the common myths about this illness are:

  1. The pain and discomfort are all in the mind and is not real.

  2. This condition only affects older women.

  3. The pain experienced is minimal and cannot affect daily life.

What Causes Fibromyalgia?

Is it still not clear what causes fibromyalgia, but it is believed to be caused due to some problem in the nervous system, which makes some people more sensitive to pain when certain triggers come into play. These triggers can be:

  • Spine problems.

  • Arthritis.

  • Physical stress.

  • Emotional stress.

  • Trauma.

  • Genetics.

  • Infection.

What Are the Symptoms of Fibromyalgia?

There are a lot of symptoms seen in fibromyalgia, some of the common ones are:

It might also cause:

  • Vision problems.

  • Dizziness.

  • Pelvic problems.

  • Weight gain.

  • Nausea.

  • Urinary problems.

  • Depression.

  • Anxiety.

  • Breathing and chest troubles.

  • Skin problems.

Who Is Commonly Affected?

As mentioned earlier, this disease is more common in women than in men. It is usually diagnosed between 35 and 45 years of age, but the symptoms of pain begin much earlier in life.

Why Does It Hurt so Much?

It is believed that repeated nerve stimulation causes the following changes:

  • An abnormal increase in the levels of neurotransmitters, which are chemicals in the brain that signals pain.

  • And the pain receptors in the brain become more sensitive to pain and start overreacting to pain signals.

What Are the Tender Points Used to Diagnose Fibromyalgia?

It can be tricky to diagnose this condition, as the pain can be caused due to many other reasons. So to diagnose fibromyalgia, doctors used to check for pain and tenderness in at least 11 points out of the 18 (9 pairs) known tender points, when a patient complains of pain all over the body from a long time. The tender points are:

  1. The base of the skull.

  2. Neck and shoulder.

  3. Lower neck in front.

  4. Edge of upper breast.

  5. Below the elbow.

  6. Inner shoulder.

  7. Hip bone.

  8. Buttocks.

  9. Above the knee.

Fibromyalgia or Fibromyalgia Syndrome

These points are no longer used to diagnose this condition.

How Is Fibromyalgia Diagnosed?

When a patient complains of widespread pain for three months and longer, and if blood tests show no abnormality like hypothyroidism, then the doctor might diagnose the condition to be fibromyalgia. There is no specific lab test to diagnose this condition, but the other blood tests performed are:

  • Complete blood count (CBC).

  • Erythrocyte sedimentation rate (ESR).

  • Rheumatoid factor.

  • Thyroid function test.

  • Cyclic citrullinated peptide test.

The three criteria for diagnosing this condition as proposed by the American College of Rheumatology are:

  1. Pain in the tender points and other symptoms over the last week with fatigue, sleep and memory problems.

  2. The presence of symptoms for three months or more.

  3. Absence of any other health condition that might cause the same problems.

What Are the Treatment Options for Fibromyalgia?

Fibromyalgia is not curable, and treatment is done to manage symptoms. The treatment options include.

Medications

  • Painkillers - Acetaminophen or Paracetamol, Ibuprofen, and Naproxen sodium.

  • Antidepressants - Duloxetine and Milnacipran are used to reduce pain and fatigue.

  • Antiepileptic drugs - Gabapentin and Pregabalin are also helpful in treating pain.

Therapies

  • Physiotherapy - Water-based exercises and other exercises might help increase strength and flexibility.

  • Counseling - As this condition can be stressful, counseling will help deal with it.

  • Occupational therapy - It will help you make changes to your workplace, which might reduce stress.

Alternative Medicine

  • Acupuncture - Here, very fine needles are inserted in the skin to restore the normal balance of life forces. It also helps change the levels of blood and neurotransmitters in the brain, which might relieve some of the symptoms.

  • Massage - Massage helps relax your muscles, improve flexibility, and helps the body produce natural painkillers.

  • Yoga and meditation - Breathing and relaxation techniques help control symptoms.

Home Remedies

  • Avoid overexerting yourself and reduce emotional stress.

  • Get sufficient sleep every day.

  • Exercises like walking, swimming, and water aerobics might reduce pain, so do them regularly.

  • Eat a balanced diet.

  • Be as active as possible.

What Are the Foods That Are Beneficial and Foods to Be Avoided?

It is said that a vegetarian diet is better, as it is low in fat and protein and is high in fiber, beta carotene, antioxidants, and minerals. Foods that can be beneficial are:

  • Food that is rich in antioxidants like kidney beans, dark chocolate, cilantro, artichokes, and berries.

  • Food that contains iron and ferritin like green leafy vegetables, shellfish, red meat, and pumpkin seeds.

  • Fish like salmon, tuna, red meat, turkey, etc., that are rich in amino acids.

  • Foods containing Coenzyme Q10 like soy oil, beef, peanuts, and sardines.

  • Anti-inflammatory vegetables like kale, spinach, arugula, and bok choy.

  • Fruits low in the glycemic index like apples, berries, peaches, and citrus fruits.

Food items to be avoided that can cause flare-ups are:

  • Bread.

  • Sugary beverages.

  • Pasta.

  • Cakes.

  • Cereals.

  • Candy.

Chronic pain and sleep disturbances associated with this illness generally interfere with the patient’s daily activity and work, which can result in depression and anxiety. If you are suffering from widespread pain without any obvious cause, it is best to consult a rheumatologist online.

Last reviewed at:
08 Jun 2019  -  5 min read

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