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 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.
As the pain caused in this condition is subjective and cannot be measured, the common myths about this illness are:
The pain and discomfort are all in the mind and is not real.
This condition only affects older women.
The pain experienced is minimal and cannot affect daily life.
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:
There are a lot of symptoms seen in fibromyalgia, some of the common ones are:
Jaw stiffness or pain.
Irritable bowel syndrome (IBS).
Restless leg syndrome (RLS).
Tingling or numbness in hands and feet.
It might also cause:
Breathing and chest troubles.
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.
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.
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:
The base of the skull.
Neck and shoulder.
Lower neck in front.
Edge of upper breast.
Below the elbow.
Above the knee.
These points are no longer used to diagnose this condition.
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).
Thyroid function test.
Cyclic citrullinated peptide test.
The three criteria for diagnosing this condition as proposed by the American College of Rheumatology are:
Pain in the tender points and other symptoms over the last week with fatigue, sleep and memory problems.
The presence of symptoms for three months or more.
Absence of any other health condition that might cause the same problems.
Fibromyalgia is not curable, and treatment is done to manage symptoms. The treatment options include.
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.
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.
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.
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.
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:
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.
Fibromyalgia can be caused by inheritance of specific genes from the families. It can also be caused due to other physical diseases such as arthritis that causes severe pain or any infection due to bacteria or viruses that increases the risk of getting fibromyalgia. Psychological causes are emotional or physical abuse.
The most severe fibromyalgia symptoms include widespread pain, increased sensitivity, joint stiffness, fatigue, muscle weakness, poor sleep quality, headaches, and irritable bowel syndrome. It might also cause cognitive problems in certain people.
Fibromyalgia is one of the chronic diseases that most commonly lasts as a lifelong condition. However, it is not a progressive disease. But, it is also not found to cause any damage to joints, muscles, or organs. Treatment is mainly focussed on symptomatic relief.
Many diseases have the same symptoms of fibromyalgia that can be mistaken as fibromyalgia. That includes seronegative rheumatoid arthritis, ankylosing spondylitis, Lyme disease, polymyalgia rheumatica, and lupus. The main symptom that causes confusion is the widespread presence of pain, along with joint involvement.
Previously, doctors diagnosed fibromyalgia by checking 18 specific points on a person's body to know how many were painful to firm press. Now the patient should have three months of widespread pain without any underlying medical cause. But, the diagnosis can not be made at home. To diagnose fibromyalgia, you would need to run a series of diagnostic tests that would not be possible from home.
The patients affected by fibromyalgia usually experience specific symptoms on a daily basis. But during a flareup attack, the symptoms worsen and appear more frequently for a particular period of time. The common symptoms seen during a fibromyalgia attack include widespread muscle pain and tiredness that makes completing routine activities difficult for the individual.
One of the chief problems faced by people affected with fibromyalgia is interrupted sleep patterns. This eventually leads the person to suffer from extreme sleep deprivation. Sleep deprivation can cause increased appetite, decreased metabolism, and food cravings when the person is awake, and this ultimately leads to weight gain.
Fibromyalgia's chronic pain remains never-ending. The person experiences ongoing headaches, neck pain, joints pain and stiffness, and painful tender points that interrupt sleep. All these symptoms, one or the other, appear on a daily basis.
A person affected by fibromyalgia feels like he or she has got pain that is constantly spreading throughout their entire body, especially at specific parts of the body, like the neck and back. Due to the fatigue caused by fibromyalgia, the person feels like having no energy.
In most of the patients, fibromyalgia does not go away by treatment also. But in certain people with time, fibromyalgia is found to go away. The exact treatment option is not established yet.
The most commonly prescribed medications in fibromyalgia patients are anticonvulsants like Pregabalin and Gabapentin. These are drugs used to treat epilepsy, but they can also improve the pain associated with fibromyalgia in some people. It is essential to note that these drugs should not be self-medicated without a doctor's proper prescription.
When fibromyalgia is left untreated in a person, the patient's long-standing pain in association with fibromyalgia can lead to permanent changes in the way the person's body perceives pain. It can result in increased sensitivity to pain stimuli and abnormal pain sensitivity.
The widespread pain experienced by a person affected by fibromyalgia confuses the disease as an inflammatory disease. But, fibromyalgia is not due to an inflammatory etiology. It is caused due to the abnormal sensory processing by one's central nervous system leading the person to be extremely sensitive to pain and other uncomfortable sensations.
The thyroid disorder, hypothyroidism, often is related to fibromyalgia. It is found to occur together commonly. The cause is not well established yet. But, in studies performed, most patients with fibromyalgia were found to have hypothyroidism and vice versa.
The exact etiology of fibromyalgia is not yet established. However, the root cause of this condition is suggested to be the central nervous system. Here, the brain's pain processing nature is unusual, where there is an increased sensitivity to the perception of normal painful conditions or even painless triggers.
A muscle relaxant named Tizanidine is the most commonly used drug in patients affected with fibromyalgia. This drug has sympatholytic properties in it, too, along with muscle-relaxing features. However, this drug should not be self-medicated without a proper prescription from the doctor.
Yes, fibromyalgia is a disease characterized by widespread musculoskeletal pain with associated symptoms such as fatigue, sleep interruptions, reduced memory retaining ability, and mood swings. However, the primary problem remains the brain's perception of normal painful stimuli as increased pain sensations.
In recent days fibromyalgia has been addressed with a new name known as the chronic fatigue syndrome (CFS), which is used especially in the United States. In other parts of the world, it is referred to as the "myalgic encephalomyelitis."
Apart from symptoms related to muscle fibromyalgia, patients experience various other symptoms such as nausea, vomiting, thyroid problems, depression, anxiety, mood swings, cognitive difficulties, and irritable bowel syndrome. All these symptoms make the affected person feel so ill.
Many foods are found to trigger fibromyalgia, and those include sugar, fructose, coffee, tea, colas, chocolate, yeast containing beverages, gluten foods, dairy products, and vegetables like tomatoes, chilies, American bell peppers, potatoes, and eggplant.
Yes, as one's body gets weak through age, people affected with fibromyalgia will find it challenging to experience fibromyalgia symptoms. Especially, the bones get weak when the person's age increases, and the pain could be more severe in these patients.
Patients with fibromyalgia have difficulties in maintaining their body temperature. Sometimes, the patient experiences too much coldness in their body. Dizziness is known to be reported in many patients. However, some patients are known to feel too much heat in their body. If you are experiencing these symptoms you should consult your doctor for proper treatment.
There is no definitive cure for fibromyalgia. Therefore symptomatic treatment is done in patients by focussing on relieving temporary symptoms of the patient. That includes pain relievers for pain, antidepressants that can ease pain and fatigue, and anticonvulsants to treat pain. Other than this, lifestyle modifications by yoga, acupuncture, and physical therapy can be done.
Last reviewed at:
08 Jun 2019 - 5 min read
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