Fibromyalgia is a real, chronic condition characterized by widespread musculoskeletal pain (1). It is also accompanied by fatigue, tenderness, insomnia, and depression.

Because the symptoms of fibromyalgia are subjective and are difficult to measure (i.e., mimic those of other conditions), it is often misdiagnosed as another disease. Hence, you should consult a doctor who has experience treating fibromyalgia.

Sometimes fibromyalgia can strike for no apparent reason. In different situations, secondary fibromyalgia may arise due to chronic sleep deprivation, arthritis, hypothyroidism, viral infections, Lyme disease, or other conditions.

Doctors believe fibromyalgia is more likely to affect adult women. However, men and children can also be diagnosed with the disorder. Most people are diagnosed during middle age.

There is currently no cure for fibromyalgia. However, several medications can help mitigate symptoms.

 

Is Fibromyalgia Real?

Fibromyalgia is real (2).

The most pervasive myth about fibromyalgia is that “it’s all in your head.” The lack of reproducible, objective tests for fibromyalgia causes some doctors to question the disorder altogether and assume that the symptoms are not real. Nevertheless, it’s more widely accepted now that fibromyalgia is an actual condition.

Researchers are beginning to understand fibromyalgia, so the stigma that clouds the condition is disappearing. The more that doctors start to accept fibromyalgia diagnosis, the more likely the medical community is to explore practical ways of treating fibromyalgia.

 

 

Symptoms

Widespread pain. Widespread dull pain is one of the main symptoms of fibromyalgia (1). The pain is often felt throughout the entire body and can be triggered by the slightest touch. Fibromyalgia pain is often described as a constant dull ache that persists for at least three months.

Fatigue, insomnia, and depression. Fibromyalgia patients often wake up tired, even after long periods of sleep because sleep is often disrupted by pain. Furthermore, many patients with fibromyalgia have other sleep disorders, such as sleep apnea and restless leg syndrome.

Cognitive difficulties. “Fibro fog” is a symptom of fibromyalgia that impairs memory and concentration (3). You may have short-term memory loss and are unable to concentrate.

Symptoms may begin following physical trauma, infection, surgery, or significant psychological stress. In other cases, symptoms gradually accumulate with no single triggering event.

Symptoms may be due to the brain misinterpreting or overreacting to standard pain signals, possibly as a result of a chemical imbalance in the brain.

Fibromyalgia symptoms may appear milder in men than in women. However, in reality, they may be as widespread in both genders, and recent studies indicated that the severity of symptoms might be the same in all people.

Fibromyalgia often co-exists with other painful disorders, such as:

  • Tension headaches
  • Jaw pain
  • Irritable bowel syndrome
  • Painful urination
  • Numbness and tingling in hands and feet
  • Painful menstruation

The symptoms might also be due to other underlying problems, including:

  • Rheumatic disorders. Certain conditions, such as rheumatoid arthritis, lupus, and Sjogren’s syndrome may begin with generalized pain and aches.
  • Mental disorders, such as depression and anxiety, may feature widespread pain and aches.
  • Neurological conditions such as myasthenia gravis and multiple sclerosis may also cause numbness and tingling in the extremities of the body.

 

Why does it hurt?

While the cause of fibromyalgia is unknown, we do know that it is a complex, diffuse pain syndrome characterized by muscular tenderness on trigger points.

Researchers believe that repetitive nerve stimulation rewires the brains of people with fibromyalgia. The abnormal level of pain neurotransmitters in the brain cause a misinterpretation of pain signals. The brain mistakenly thinks there could be heightened sensitivity or perception of pain. Another theory proposes that the brain may lower the pain threshold; what once wasn’t painful becomes unbearably painful.

 

 

Risk Factors

Risk factors of fibromyalgia include:

  • Antecedent infections or diseases may trigger or worsen fibromyalgia symptoms.
  • Family history. Fibromyalgia often runs in families. If your immediate family member has this condition, you have a higher risk of developing it.
  • Women account for approximately 90 percent of all fibromyalgia cases.
  • Physical or emotional trauma. People may develop fibromyalgia shortly after experiencing physical or emotional trauma.
  • Stress has been linked to hormonal fluctuations that may contribute to fibromyalgia.
  • People with rheumatic diseases such as rheumatoid arthritis, lupus, or spinal arthritis (ankylosing spondylitis), have a high risk of fibromyalgia.

 

Complications

The widespread pain and lack of sleep associated with fibromyalgia can interfere with your ability to function optimally. The frustration of dealing with an oft-misunderstood condition also can trigger depression and anxiety.

 

Diagnosis

Fibromyalgia is not a simple condition to diagnose because there is no apparent cause to look for. It cannot be quickly diagnosed with a simple laboratory test, and neither can it be detected with a blood test or an X-ray.

Hence, your doctor may need to do blood tests to rule out other conditions that may have similar symptoms. Blood tests may include:

  • Complete blood count
  • Erythrocyte sedimentation rate
  • Thyroid function tests
  • Vitamin D levels
  • Cyclic citrullinated peptide test
  • Rheumatoid factor

Your doctor may also physically examine your joints and muscles, as well as perform a neurological exam to look for other related nerve disorders.

Three criteria have been established by the American College of Rheumatology for fibromyalgia diagnosis:

  1. Pain and other symptoms over the past week, based on the total number of trigger points out of 19 identified body parts.
  2. Symptoms that have been ongoing at a constant level for at least three months.
  3. Absence of identifiable underlying medical condition that may cause the symptoms.

Treatment

There isn’t a cure for fibromyalgia. Fibromyalgia is a difficult condition to control.

However, there are treatments to help relieve some of the symptoms and improve your quality of life. Medications may be combined with self-care, lifestyle modification, and alternative therapies. As it is merely a syndrome, each patient will experience a unique set of symptoms, and an individual treatment plan will be necessary. The ‘best’ treatment is whatever works for a particular patient.

Medications

Medications may help reduce pain and improve sleep. Common choices include:

  • Pain relievers. OTC pain relievers such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB) or naproxen sodium (Aleve) may help. Prescription pain relievers such as tramadol (Ultram) may be recommended for extreme cases.
  • Antidepressants,g., duloxetine (Cymbalta) and milnacipran (Savella), may ease the symptoms associated with fibromyalgia.
  • Anti-seizure drugs. Medications designed to treat epilepsy are often used in reducing certain types of pain. Gabapentin (Neurontin) may help reduce fibromyalgia symptoms. Another option is pregabalin (Lyrica), which is FDA-approved treatment for fibromyalgia. These medications prevent sensitive nerves from sending too many pain signals to the brain.

You should tell your doctor about the other medications that you are taking to avoid side-effects and interactions.

Therapy

A variety of treatments can help reduce the effect that fibromyalgia inflicts on your body and life. Examples include:

  • Physical therapy. A physical therapist can teach you stretches that will improve your strength, stamina, and flexibility. Water-based activities might be particularly beneficial.
  • Occupational therapy. An occupational therapist can assist you in making adjustments to your workstation or the way you perform specific tasks that will reduce stress on your body.
  • Talking with a counselor can help you acquire strategies for dealing with stressful situations. Behavior modification therapy is a form of cognitive-behavioral therapy (CBT) that aims to reduce harmful, stress- or pain-inducing behaviors. It will also teach you mindfulness and coping skills.

Therapy can potentially reduce the stress that triggers the symptoms of fibromyalgia.

Alternative medicine

Complementary therapies for pain and stress management have become more prevalent in recent years for chronic illnesses, such as fibromyalgia.

Several of these treatments do appear to relieve stress and pain. But more research studies are needed to prove their efficacy.

  • Acupuncture is a Chinese medical system that involves inserting very fine needles through the skin to various depths. It causes changes in blood flow and levels of neurotransmitters in the brain and spinal cord. Some studies indicate that acupuncture helps relieve pain and stiffness, while others show no benefit (4, 5).
  • Massage therapy. This involves the use of different manipulative techniques to move your body’s muscles and soft tissues. Massage can relax muscles, reduce heart rate, improve range of motion, and increase the production of the body’s natural painkillers. It often helps relieve stress and anxiety.

Self-care

Lifestyle changes and home remedies may help you cope with the symptoms of fibromyalgia. The main focus is to reduce pain and lower stress levels.

Here are several self-care strategies that you may try:

  • Reduce stress. Allow yourself to relax – that may mean learning how to say no without feeling guilty. Limit or avoid emotional stress and overexertion. You should also try stress management strategies, such as meditation or deep-breathing exercises.
  • Get adequate sleep. Because fatigue is a common symptom of fibromyalgia, getting sufficient sleep is essential. Also, you should practice good sleep habits, such as going to bed and getting up at the same time each day. Improving your sleep habits may allow you to get restful sleep and reduce fatigue.
  • Exercise regularly. Initially, exercise may increase your pain, but staying active is effective in reducing symptoms. Appropriate exercise may include low-impact activities such as walking, swimming, biking, and water aerobics. Stretching and relaxation exercises are also helpful.
  • Pace yourself. Keep your activity on a moderate level. Moderation means not overdoing in on your good days, but likewise, don’t limit activities when symptoms flare.
  • Coping and support. Even if you and your doctor comprehend your symptoms, it can be challenging to make friends and family understand what you’re going through. They may think the condition is not real. But it’s possible to educate them about your symptoms. If you can inform others of how the disease affects you, they might be more sympathetic.

It’s important to note that most self-care strategies have not been scientifically proven to be useful for fibromyalgia.

Diet modification

A healthy, balanced diet may improve the symptoms of fibromyalgia. If you find that certain foods aggravate your symptoms, write it down in a food diary so that you know what foods to avoid.

Some dietary strategies to adopt:

  • High-energy foods that are low in sugar. Whole foods such as almonds, beans, broccoli, oatmeal, avocado, and tofu are high in fiber but little in sugar. These can help reduce tiredness and boost energy throughout the day.
  • Avoid gluten. Gluten sensitivity can contribute to fibromyalgia. Eliminating foods that contain gluten from the diet may reduce pain and inflammation, even if you don’t have celiac disease.
  • Avoid fermentable oligo-di-mono-saccharides and polyols (FODMAP). FODMAPs are carbohydrates that are fermented by gut bacteria. A diet low in FODMAP could reduce pain levels in people with fibromyalgia.
  • Avoid additives and excitotoxins. Additives and excitotoxins such as aspartame and monosodium glutamate (MSG) should be eliminated from your diet.
  • Go vegetarian. There’s evidence that eating a vegetarian diet or a vegan diet might offer some symptom relief.

CBD oil

Research suggests that cannabidiol ease symptoms of fibromyalgia such as pain and fatigue in some people. CBD oil may help to relieve pain caused by fibromyalgia. However, the United States Food and Drug Administration (FDA) has not approved the medicinal use of CBD for fibromyalgia.

Essential oils

These essential oils may ease fibromyalgia symptoms. Dilute with a carrier oil when applied directly to the skin.

The best essential oils for fibromyalgia include:

Other essential oils to try:

 

 

The Bottom Line

Living with fibromyalgia can be challenging. You may experience debilitating levels of pain and fatigue that interferes with activity. But yet, your family and friends, and even your doctor may not understand that your pain is real. There is no definitive cure. Nevertheless, symptoms can improve if you follow your treatment plan.