Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, and anxiety.
Causes, incidence, and risk factors
The cause is unknown. Possible causes or triggers of fibromyalgia include:
- Physical or emotional trauma
- Abnormal pain response – areas in the brain that are responsible for pain may react differently in fibromyalgia patients
- Sleep disturbances
- Infection, such as a virus, although none has been identified
Fibromyalgia is most common among women aged 20 to 50.
The following conditions may be seen with fibromyalgia or mimic its symptoms:
- Chronic neck or back pain
- Chronic fatigue syndrome
- Hypothyroidism (underactive thyroid)
- Lyme disease
- Sleep disorders
Pain is the main symptom of fibromyalgia. It may be mild to severe.
- Painful areas are called tender points. Tender points are found in the soft tissue on the back of the neck, shoulders, chest, lower back, hips, shins, elbows, and knees. The pain then spreads out from these areas.
- The pain may feel like a deep ache, or a shooting, burning pain.
- The joints are not affected, although the pain may feel like it is coming from the joints.
People with fibromyalgia tend to wake up with body aches and stiffness. For some patients, pain improves during the day and gets worse at night. Some patients have pain all day long.
Pain may get worse with activity, cold or damp weather, anxiety, and stress.
Fatigue, depressed mood, and sleep problems are seen in almost all patients with fibromyalgia. Many say that they can’t get to sleep or stay asleep, and they feel tired when they wake up.
Other symptoms of fibromyalgia may include:
- Irritable bowel syndrome (IBS)
- Memory and concentration problems
- Numbness and tingling in hands and feet
- Reduced ability to exercise
- Tension or migraine headaches
Signs and tests
To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 areas, including
- Arms (elbows)
- Lower back
- Rib cage
Blood and urine tests are usually normal. However, tests may be done to rule out other conditions that may have similar symptoms.
The goal of treatment is to help relieve pain and other symptoms, and to help a person cope with the symptoms.
The first type of treatment may involve:
- Physical therapy
- Exercise and fitness program
- Muscle relaxants
- Pain relievers
- Sleeping aids
Cognitive-behavioral therapy is an important part of treatment. This therapy helps you learn how to:
- Deal with negative thoughts
- Keep a diary of pain and symptoms
- Recognize what makes your symptoms worse
- Seek out enjoyable activities
- Set limits
Support groups may also be helpful.
Other recommendations include:
- Eat a well-balanced diet
- Avoid caffeine
- Practice good sleep routines to improve quality of sleep
- Acupressure and acupuncture
Severe cases of fibromyalgia may require a referral to a pain clinic.
Fibromyalgia is a long-term disorder. Sometimes, the symptoms improve. Other times, the pain may get worse and continue for months or years.
Why does it hurt?
Current thinking centers around a theory called central sensitization. This theory states that people with fibromyalgia have a lower threshold for pain because of increased sensitivity in the brain to pain signals.
Researchers believe repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain’s pain receptors seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals.
Risk factors for fibromyalgia include:
Your sex. Fibromyalgia is diagnosed more often in women than in men. Female reproductive hormones may play a part in how women experience pain.
Family history. You may be more likely to develop fibromyalgia if a relative also has the condition.
Rheumatic disease. If you have a rheumatic disease, such as rheumatoid arthritis or lupus, you may be more likely to develop fibromyalgia.
In general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health.