Fibromyalgia is the second most common condition affecting the bones and muscles. Often misdiagnosed and misunderstood, patients suffering from fibromyalgia have widespread muscle and joint pain, and fatigue. There is no cure, but pain specialists can help.
When the body hurts, unique signals travel through the spinal cord to the brain where the signals are perceived as pain. Normally, as the body heals, the pain gets better and eventually goes away. However, people with fibromyalgia hurt all over, even when they are not sick or injured.
Fibromyalgia can last a long time, but does not result in tissue damage or death. The term “fibromyalgia” comes from a combination of New Latin and Greek words. From the New Latin fibro-, meaning “fibrous tissues,” from Greek myo-, “muscle,” and Greek algos, “pain;” the term literally means “muscle and fibrous connective tissue pain.”
Fibromyalgia is a chronic (ongoing) medical condition that causes widespread pain in the muscles and soft tissues throughout the body. It is a common rheumatoid disorder of the muscles, connective tissue, and bones; but does not involve the joints. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way the brain processes pain signals.
Doctors describe fibromyalgia pain as a widespread, constant, dull ache that has been present for at least three months. Fibromyalgia causes a heightened pain response to pressure affecting multiple points on the body. The most common locations of fibromyalgia pain are the neck, shoulders, back, chest, hips, buttocks, arms, and legs. Even light pressure at one of these points causes pain. The pain may be worse in the morning and evening. Sometimes, the pain may last all day.
The pain of fibromyalgia may be worse during activity, cold or damp weather, or with anxiety and stress. Fatigue, sleep, memory, and mood issues may also accompany the pain, which affects about 2% to 4% of the U.S. population. Adult females ages 30-50 seem to be affected about twice as often as males; however, anyone can have fibromyalgia.
What Causes Fibromyalgia?
Doctors are not certain what causes fibromyalgia, but it most likely involves a variety of factors working together.
Some doctors believe repeated nerve stimulation causes changes in the brains of patients with fibromyalgia. This change involves an abnormal increase in levels of certain chemicals (neurotransmitters) that signal pain in the brain. Additionally, the brain’s pain receptors appear to develop a memory of the pain, while becoming more sensitive and overreact to pain signals.
Some medical professionals think fibromyalgia results from a problem with how the brain and spinal cord process pain signals from the nerves. Others believe there may be a link between sleep problems and stress, because lack of restful sleep can decrease the body’s production of the chemicals needed to regulate pain.
Fibromyalgia can also result from physical trauma, surgery, infection, or significant psychological stress. In some cases, fibromyalgia symptoms gradually accumulate over time without a specific event triggering the onset.
Many things can cause the body’s pain signals to go awry. Some of the conditions that are likely to cause fibromyalgia include:
Genes. Fibromyalgia seems to run in families. There may be certain genetic mutations that make some people more sensitive to pain and susceptible to developing the disorder. Other genes can also make the patient more likely to feel anxious or depressed, which makes the pain worse.
Infections and other diseases. A painful disease like arthritis appears to increase the chances of getting, or aggravating, fibromyalgia.
Emotional or physical abuse. Children who are abused are more likely to have fibromyalgia when they grow up. Abuse can change the way the brain handles pain and stress.
Posttraumatic stress disorder (PTSD). Some people have PTSD after a traumatic event, like war, an accident, or abuse. These events are linked to fibromyalgia in some cases.
Gender. Fibromyalgia is much more common in women than men. Doctors think this could be related to differences in the way men and women feel and react to pain, as well as how society expects them to respond to pain.
Anxiety and depression. Certain mood disorders seem linked to fibromyalgia; however, there is not definite proof they actually cause the condition.
Lack of exercise. Fibromyalgia is much more common in people who aren’t physically active. Exercise is one of the best treatments to help reduce fibromyalgia pain.
What are the Symptoms of Fibromyalgia?
Fibromyalgia symptoms can vary with each patient; but, chronic pain is the most common symptom. The pain most often affects the muscles, and the points where muscles attach to bones (ligaments and tendons). The pain may begin in one part of the body, such as the neck and shoulders. A primary characteristic of fibromyalgia is the presence of multiple tender points, specifically in the neck, spine, shoulders, and hips. Over time, the whole body may be affected.
Fibromyalgia pain can range from mild to severe, and may feel like a burning, soreness, stiffness, aching, or gnawing pain. There may also be sore spots in certain parts of the muscles.
Patients with fibromyalgia often say their muscles feel like they have been pulled or overworked, and sometimes the muscles twitch or burn. Some patients describe fibromyalgia pain as being similar to arthritis; however, fibromyalgia does not damage the muscles or bones.
In addition to pain, fibromyalgia is associated with sleep disorders. People with fibromyalgia often awake tired, because the pain disrupts their sleep. Many fibromyalgia patients have other sleep disorders, such as restless legs syndrome and sleep apnea.
The lack of sleep, along with the pain, can cause cognitive difficulties that can interfere with the ability to function at home and work. A symptom commonly referred to as “fibro fog” is characterized by impaired concentration, problems with short and long-term memory, impaired speed of performance, inability to multi-task, cognitive overload, and a diminished attention span.
Many people who have fibromyalgia also have tension headaches and temporomandibular joint (TMJ) disorders. And, some feel more pain when they try to relax, and less when they are active, busy, or exercising.
Irritable Bowel Symptoms (abdominal pain and bloating, diarrhea, and constipation).
Numbness and tingling in the hands and feet.
Painful menstrual periods.
Fibromyalgia patients may also experience a heightened sensitivity to noises, bright lights, odors, temperature, and touch, symptoms similar to a severe migraine headache. The frustration of dealing with a condition that is often misunderstood can also lead to depression and health-related anxiety.
How is Fibromyalgia Diagnosed?
Because all the symptoms of fibromyalgia can appear as other health problems, it is essential to obtain a proper diagnosis. Unfortunately, there are no definitive lab tests that can confirm a diagnosis of fibromyalgia. Instead, because the symptoms are so similar to other conditions, a doctor will want to rule out illnesses such as an underactive thyroid, arthritis, and lupus before diagnosing fibromyalgia.
As part of the diagnosis, a doctor will inquire about previous medical issues with the patient and close family members. In some cases, blood tests may be ordered to check hormone levels and for signs of inflammation, as well as X-rays. During a physical examination, the doctor will check for the presence or absence of tender spots on the patient when applying light pressure to specific locations on the body.
Generally speaking, if a patient has had widespread pain for more than three months, with no other underlying medical condition that could cause the pain, fibromyalgia could be the diagnosis. Furthermore, to classify pain as “widespread,” the patient must experience pain on both sides of the body, both above and below the waist.
How is Fibromyalgia Treated?
There is no cure for fibromyalgia, but the symptoms can be managed. Some mild cases may get better with simple stress reduction or lifestyle changes. Since patients often experience both physical discomfort and psychological/emotional hardships, a successful treatment plan includes both the body and the mind.
Sometimes, it may take a variety of medications to help control fibromyalgia symptoms. Many patients find that exercise, relaxation, and stress-reduction measures help reduce the pain. The treatments include:
Antidepressants often help ease the pain and fatigue associated with fibromyalgia. Sometimes a muscle relaxant can help promote sleep.
Anti-seizure drugs are medications that treat epilepsy and are often useful in reducing certain types of pain.
Pain relievers, both over-the-counter and prescription, may help reduce pain. Narcotics are cautiously prescribed, because they often lead to dependence and may worsen the pain over time.
Sleeping aids to help promote a restful night’s rest.
Treatments and Procedures
Acupuncture is a Chinese medical system based on restoring a normal balance of life forces by inserting very fine needles through the skin to various depths. Western theories of acupuncture believe the needles cause changes in blood flow and levels of neurotransmitters in the brain and spinal cord.
Chiropractic manipulations are targeted adjustments and manipulations that can help correct certain pain signal transmissions.
Counseling. Talking with a counselor can help strengthen the patient’s belief in their abilities, and teach strategies for dealing with stressful situations and difficult emotions.
Exercise therapy and low-impact activities build endurance, stretch and strengthen muscles, and improve the ability to move. Types of exercise that can fight pain and stress by releasing endorphins include aerobic exercise, yoga, tai chi, Pilates, biking, swimming, and walking. Exercise can help promote better sleep. And, some fibromyalgia patients find that pain is lessened while they are moving, rather than being inactive.
Heat or Cold packs can help relieve pain in some cases.
Lifestyle changes such as stress reduction and relaxation techniques can help relieve pain. In particular, anxiety and depression need to be treated to reduce stress.
Massage therapy is one of the oldest methods of health care in practice today. It involves the use of different manipulative techniques to move the body’s muscle and soft tissue. Massage can reduce the heart rate, relax muscles, improve range of motion, and increase production of the body’s natural painkillers. It often helps relieve stress and anxiety.
Occupational therapy. An occupational therapist can help make adjustments to the patient’s work area, or the way certain tasks are performed, to lessen stress on the body.
Physical therapy. A physical therapist can teach exercises to improve strength, flexibility, and stamina. Water-based exercises tend to be particularly helpful.
Transcutaneous Electrical Nerve Stimulation (TENS) is a device that sends a weak electrical current via adhesive patches with small electrodes attached to the skin near the area of pain. The stimulation may interrupt or mask pain signals, preventing them from reaching the brain.
Trigger point injections can be effective for treating muscle spasms. The method involves injecting a local anesthetic and steroid into a “trigger point.”
Often by relieving stressful situations for the patient, fibromyalgia may improve, and medications may not be necessary. However, even with treatment, many fibromyalgia patients will continue to experience symptoms, especially if they have stressful lives. Those who can keep working and fulfilling their social obligations, despite their pain, do best.
Living with Fibromyalgia
Fibromyalgia is a chronic condition, but it is manageable. Medicines and lifestyle changes can help manage the symptoms. These include getting enough sleep and exercise.
The National Fibromyalgia Association suggests ways to help decrease fibromyalgia symptoms:
Novus Spine & Pain Center is in Lakeland, Florida, and specializes in treating fibromyalgia pain. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.