Fibromyalgia

What is fibromyalgia?

Fibromyalgia is a chronic, widespread pain in muscles and soft tissues surrounding the joints throughout the body. The disease is fairly common, affecting approximately 2 to 4 percent of the U.S. population, mostly middle-aged women.

Although its symptoms are similar to other joint diseases, such as arthritis, fibromyalgia is actually a form of soft tissue or muscular rheumatism that causes pain in the muscles and soft tissues.

What causes or triggers fibromyalgia?

Although the cause of fibromyalgia is unknown, researchers believe there may be a link with sleep disturbance, psychological stress, or immune, endocrine, or biochemical abnormalities. Fibromyalgia mainly affects the muscles and the points at which the muscles attach to the bone (at the ligaments and tendons).

What are the symptoms of fibromyalgia?

Pain is the most common and chronic symptom of fibromyalgia. Pain may begin in one area of the body, such as the neck and shoulders, but eventually the entire body may become affected. The pain ranges from mild to severe and may be described as burning, soreness, stiffness, aching, or gnawing pain. Fibromyalgia usually is associated with characteristic tender spots of pain in the muscles. The following are other common symptoms of fibromyalgia. However each individual may experience symptoms differently. Symptoms may include:

• Moderate to severe fatigue

• Decreased exercise endurance

• Sleep problems at night

• Depressed mood

• Anxiety

• Headaches

• Irritable bowel symptoms, such as abdominal pain and bloating, diarrhea, and constipation 

• Restless legs

• Painful menstrual periods

The symptoms of fibromyalgia may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How is fibromyalgia diagnosed?

There are no laboratory tests that can confirm a diagnosis of fibromyalgia. Instead, diagnosis is usually based on reported symptoms and physical exam findings. The American College of Rheumatology has published diagnostic criteria that help your health care provider make the correct diagnosis. The criteria define fibromyalgia as widespread pain for more than three months and describe 18 tender points on the body. The criteria suggest that to confirm a diagnosis you must have at least 11 tender points on exam.

What is the treatment for fibromyalgia?

Specific treatment for fibromyalgia will be determined by your doctor based on:

• Your age, overall health, and medical history

• Extent of the condition

• Your tolerance for specific medications, procedures, and therapies

• Expectation for the course of the condition

• Your opinion or preference

Although there's no cure for fibromyalgia, the disease can often be successfully managed with proper treatment, as fibromyalgia doesn't cause damage to tissues. Treatment may include:

• Anti-inflammatory medications (to relieve pain and improve sleep)

• Duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella), which are medications that are approved specifically for treating fibromyalgia

• Antidepressants

• Other painkillers

• Exercise and physical therapy (to stretch muscles and improve cardiovascular fitness)

• Relaxation techniques

• Heat treatments

• Occasional cold applications

• Massage