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Fibromyalgia

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What is it?

Fibromyalgia is a chronic condition that causes pain, stiffness, and tenderness of the muscles, tendons, and joints.

Fibromyalgia is also characterized by restless sleep, awakening feeling tired, chronic fatigue, anxiety, depression, and disturbances in bowel function.

Fibromyalgia (formerly known as fibrositis) is sometimes referred to as fibromyalgia syndrome and abbreviated FMS.

The universal symptom of fibromyalgia is pain.

The pain in fibromyalgia is not caused by tissue inflammation. Instead, patients seem to have an increased sensitivity to many different sensory stimuli and an unusually low pain threshold.

Minor sensory stimuli that ordinarily would not cause pain in individuals can cause disabling, sometimes severe pain in patients with fibromyalgia.

The body pain of fibromyalgia can be aggravated by noise, weather change, and emotional stress.

The pain of fibromyalgia is generally widespread, involving both sides of the body. Pain usually affects the neck, buttocks, shoulders, arms, the upper back, and the chest.

"Tender points" are localized areas of the body that are tender to light touch. Fibromyalgia tender points, or pressure points, are commonly found around the elbows, shoulders, knees, hips, back of the head, and the sides of the breastbone.

Fibromyalgia affects predominantly women (more than 80 per cent of those affected are women) and most people are diagnosed during middle age.

Less commonly, fibromyalgia can also affect men, children, and the elderly. It can occur independently or can be associated with another disease, such as systemic lupus or rheumatoid arthritis.

 

What causes it?

The cause is unknown. Research indicates there is disturbance of deep sleep in people with fibromyalgia.

People can develop fibromyalgia if their sleep is disturbed repeatedly. Therefore anything that causes sleep problems may eventually lead to it. (eg people with arthritis may develop fibromyalgia because the pain and stress of that original condition may have disturbed their sleep pattern (this is called secondary fibromyalgia).

Emotional upsets and depression may also bring about fibromyalgia.

In some patients the onset of fibromyalgia can be traced to a recent trauma or accident. This is called reactive fibromyalgia.

The problem with fibromyalgia is that once the complaints start, the continuing sleep disturbance can result in a vicious cycle of pain and distress. This can lead on to depression.

Research indicates that fibromyalgia may be linked to a lack of growth hormone production by the brain or to a lack of exercise.

Fibromyalgia has been linked to:

  • Stressful or traumatic events, such as car accidents
  • Emotional stress or depression
  • Repetitive injuries
  • Damage to joints
  • Muscle tension
  • Pain from an injury or trauma
  • Illness and certain diseases
  • Inflammatory arthritis (for example, rheumatoid arthritis)

Fibromyalgia can also occur on its own.

Some scientists think a gene or genes might be involved in fibromyalgia. The genes could make a person react strongly to things that other people would not find painful.

 

Common treatments

Fibromyalgia can be difficult to treat. It's important to find a doctor who is familiar with the disorder and its treatment. Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues.

Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers.

Since the symptoms of fibromyalgia are diverse and vary among patients, treatment programs must be individualized for each patient.

Fibromyalgia treatment programs are most effective when they combine patient education, stress reduction, regular exercise and medications. Recent studies have verified that the best outcome for each patient results from a combination of approaches that involves the patient in customization of the treatment plan.

 

Treatment may include:

Patient education to help patients understand and cope with the diverse symptoms. This is usually provided by hospital support groups, community groups and peak organizations such as Arthritis Australia.

Stress reduction

Relaxation – such as deep breathing and visualization (mental pictures).

Exercise – low-impact aerobic exercises, such as swimming, cycling, walking and stationary cross-country ski machines can be effective fibromyalgia treatments.

Diet – some dietary changes may promote a more restful sleep.

Medication – as prescribed by a medical professional.

Acupuncture – the ancient Chinese practice of putting small, thin needles into the skin at specific points on the body to block the pain signal has been reported to be effective in treating some patients with fibromyalgia.

Message therapy – this is also beneficial for some patients. There are limited scientific studies that show massage reduces arthritis pain. However many people with arthritis find it a useful way to relax and reduce muscle tension.

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About Pain does not provide medical advice, diagnosis or treatment