Fibromyalgia

What is fibromyalgia?

Fibromyalgia is a disorder that causes aches and pain all over the body. It is a chronic (ongoing) condition of pain, stiffness, and usually fatigue.

Fibromyalgia affects several million people in the US. It is usually diagnosed in middle age although symptoms may start at an earlier age. It affects women more often than men. Although it is uncommon, it does sometimes occur in children.

How does it occur?

What fibromyalgia is exactly, or what causes it, is not known. Fibromyalgia has been linked to:

• emotional or physical stress
• anxiety
• depression
• traumatic events such as a car accident
• infections or other illness
• lack of restful sleep

Women who have a family member with fibromyalgia are more likely to have it themselves. It is not known if this is due to hereditary or environmental factors.

Researchers are working to find possible causes of the symptoms. One theory is that fibromyalgia causes a lower pain threshold. This may be because the brain has gotten more sensitive to the chemicals that send pain signals, or there are more of these chemicals than normal.

What are the symptoms?

Pain is the main symptom. The aches, pains, and stiffness may be different day to day or week to week. The pain may move from one part of the body to another. It is most common in the neck, chest, arms, legs, hips, and back.

Other common symptoms are:

• tiredness
• headaches
• problems with the digestive system, especially trouble swallowing, abdominal pain, an upset stomach, or diarrhea

You may have:

• trouble sleeping
• problems with thinking and remembering things
• depression
• anxiety
• dizziness or lightheadedness
• painful menstrual periods
• restless legs

People with fibromyalgia are tender throughout the body. The tenderness is most noticed at specific places on the neck, shoulders, back, hips, arms, and legs. These places are called tender points. These points hurt when pressure is put on them.

The symptoms may get worse when you exert yourself too much or when the weather is damp and cold. Younger adults with fibromyalgia are more likely to have chronic headaches or anxiety. Their symptoms may get worse more easily from weather, mental stress, or poor sleep.

How is it diagnosed?

Your healthcare provider will ask about your medical history and your patterns of symptoms. He or she will examine you, looking for places that are tender. There is no one test that diagnoses fibromyalgia. However, you may have blood tests to make sure you don’t have any conditions that cause symptoms similar to fibromyalgia, such as rheumatoid arthritis.

How is it treated?

The most successful treatment is a healthy diet, regular exercise, and rest.

• Your diet should include a large variety of fruits and vegetables. These foods provide trace elements and minerals that help the muscles. Also, the fiber in fruits and vegetables helps the digestive system.
• Exercise affects the levels of many biochemicals in the body, particularly in the nervous system. This may be why symptoms of fibromyalgia often get better if you exercise regularly. Because much of the pain of fibromyalgia is in the muscles and joints, you should begin an exercise program gradually. Ask your healthcare provider or a physical therapist for an exercise plan. Include good warm-ups and cool-downs. Do types of exercise that do not hurt your joints.
• Rest is as important as diet and exercise. Make sure you get enough restful sleep. In the evening avoid stimulating foods and drinks (such as coffee and soft drinks with caffeine) and certain medicines (for example, decongestants).

If diet, exercise, and rest do not relieve your symptoms, your healthcare provider may prescribe medicine to help relieve some of the symptoms. There is no medicine that can cure fibromyalgia. However, some medicines may help some of the symptoms, such as:

• nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, for pain (NSAIDs, such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.)
• muscle relaxants help prevent muscle spasm and strain caused by the pain
• antidepressants, which may help you sleep better and may also help relieve pain
• pregabalin (Lyrica) for pain caused by problems with nerves
• duloxetine (Cymbalta) and milnacipran (Savella) for depression or pain caused by the nervous system

Your provider can help to find other ways to reduce your pain and tiredness, such as heat or massage therapy.

How long will the effects last?

Fibromyalgia is a chronic problem. The symptoms sometimes get better and at other times get worse, but you will likely keep having symptoms for months to years. Although the illness can cause a lot of discomfort, it does not damage your joints, muscles, or other tissues, and it does not shorten your life.

How can I take care of myself?

• Get regular exercise, according to your healthcare provider's recommendations. A lack of physical activity can worsen your pain.
• Eat a healthy diet that includes a lot of whole grains, fruits, and vegetables. Healthy foods will give you energy, help you feel better, aid your digestion, and help you avoid other health problems. Nutritional supplements may be helpful for some people, but talk to your healthcare provider before using supplements.
• Practice good sleep habits. Work to establish a regular, night-time sleep pattern. Make sure you get enough sleep every night.
• Do not smoke.
• Avoid doing too much at one time. Break up daily activities with periods of rest.
• Treat painful areas with a heating pad on a low setting or an ice pack wrapped in a towel, whichever works best for you. Some people find that switching between heat and cold is helpful.
• Try to practice new ways to react to pain and manage stress. For example, try relaxation exercises or meditation. A therapist may be able to help with this.
• If your provider recommended or prescribed medicine, take it exactly as directed. Ask your provider how soon the medicine should start helping you feel better. Let your provider know if it has helped. If it hasn’t, you may need a different dose or a different medicine.
• Keep your follow-up appointments. It is helpful to you and your provider to keep track of how your symptoms change over time and whether your treatments are helping your symptoms.
• For more information, contact:

  National Institute of Arthritis and Musculoskeletal and Skin Diseases
  (NIAMS)
  Phone: 1-877-22-NIAMS (1-877-226-4267)
  Web site: http://www.niams.nih.gov

How can I help prevent fibromyalgia?

Doctors don’t know how to prevent fibromyalgia. However, as with many medical problems, staying as healthy as possible with regular exercise, a good diet, and enough rest may be the best prevention.