Pain all over the body, feeling exhausted all the time, and increase in pain when pressure is applied; all these are symptoms of fibromyalgia (FM). Fibromyalgia is a disorder that causes pain in the muscles, tendons, joints, and ligaments. The pain increases when pressure is applied in the areas called “the tender point”. Back of the head, elbow, arm, shoulder, knee, hip joint, and region around the neck are the common tender points.

Fibromyalgia is not like arthritis, as it do not cause swelling and damage to the joints, muscles or other tissues. Rather, it produces pain and tenderness all over the body along with stiffness. Fibromyalgia is more common in women. About 2 – 4 % of population in US is affected with fibromyalgia.

Fibromyalgia is a hereditary disease and found in many members of the same family and the risk of fibromyalgia increases with age. The symptoms of fibromyalgia, in most cases, appear after a physical or emotional trauma, but in many, there seem to be no triggering event or agent. Fibromyalgia is often referred to as fibromyalgia syndrome as it is a combination of symptoms.

The exact cause of fibromyalgia is still under wraps. Mostly it is triggered by

  • A physical or an emotional stressful situation or event
  • Accident or repetitive injuries
  • Infection or illness may also trigger or aggravate fibromyalgia.
  • It is found to run in families.
  • Genes along with conditions like arthritis, spine disorder, and stress, trigger fibromyalgia.
  • Changes in neurotransmitters (brain chemicals) may also cause fibromyalgia.
  • People with fibromyalgia may have low level of serotonin that affects mood, sleep, and reduces the perception of pain.
  • They have high level substance P, which delivers pain message to the brain.
  • Abnormality in autonomic nervous system releases hormone that affects the way a person perceives pain.
  • Lack of sleep also tends to aggravate fibromyalgia.

Fibromyalgia is a syndrome rather than a disease. A syndrome is a group of signs and related medical condition that occur together, but are not related to any specific identifiable cause. In addition to pain in the tender points and fatigue, other medical condition and fibromyalgia symptoms are:

  • Pain gets worse with any activity or stress
  • Deep ache or burning sensation in the tender points
  • Muscle tightness or spasms
  • Lack of sleep or Sleep disturbances
  • Memory problem called as “fibro fog”
  • Headaches & jaw pain
  • Morning stiffness
  • Lightheadedness or difficulty balancing
  • Dry eyes or difficulty focusing on nearby object
  • Numbness or tingling
  • Itchy or dry skin
  • Irritable bowel syndrome
  • Chronic fatigue syndrome
  • Restless leg syndrome
  • Depression & anxiety
  • Post traumatic stress disorder
  • Osteoarthritis
  • Sensitive to temperature, loud noise, and bright light
  • Chest pain, rapid or irregular heartbeat, and shortness of breath
  • Digestive problems
  • Urinary issues
  • In women, pelvic pain, pain during menstruation, and pain during sex

Diagnosing people with fibromyalgia is quite difficult because the main symptoms of fibromyalgia, pain and fatigue, are most of the time overlapped with other medical conditions. Therefore, doctors have to rule out the presence of other associated condition before actually giving the diagnosis as fibromyalgia.

And secondly, there is no specific laboratory test to diagnose fibromyalgia. Standard lab tests fail to find the exact reason for pain. However, a doctor experienced in diagnosing fibromyalgia may diagnose fibromyalgia based on the pain and tenderness in the tender points.

According to the American college of Rheumatology (ACR) there are 18 tender points in our body to meet the diagnostic criteria, a patient with fibromyalgia should have atleast 11 tender points (this is not always correct as men are not this tender).

Symptoms and associated syndromes form the main criteria for diagnosis. While diagnosing, the focus should be on the features of the pain to differentiate it from arthritis pain. For instance, hypothyroidism and polymyalgia rheumatic (aching and stiff joint in older people) resembles fibromyalgia.

In such condition, doctor may perform blood test to check the level of Thyroid stimulating hormone (TSH) and Erythrocyte sedimentation rate (ESR) to distinguish fibromyalgia.

Fibromyalgia do not cause any permanent damage, although the symptoms may include pain and tenderness, it does not damage any of the body muscle and is not life threatening. There is no complete cure for fibromyalgia, but the symptoms can be minimized to feel better.

On approaching a doctor, he might first go with a painkiller and medicine that improves sleep. Drugs such as acetaminophen and non-steroid anti-inflammatory drugs (NSAID) are prescribed. NSAIDs are ineffective when taken alone. If the patient is depressed, doctor may also prescribe anti-depressant drugs like tricyclic antidepressant, selective serotonin reuptake inhibitors, and mixed reuptake inhibitors.

Benzodiazepine drug helps patients with fibromyalgia to relax the painful muscles and stabilize the irregular waves that interfere with proper sleep.

Physical therapy and counseling may be necessary for patients to regain muscle strength and reduce pain and also to cope up with the disease.

Other things that the patient can follow for fibromyalgia treatment to feel better are:

  • Do low-aerobic exercises like swimming, water exercise, stationary cycling etc
  • Cut out stress
  • Get peaceful sleep for as much time required
  • Do not take alcohol and caffeine as they interfere with sleep
  • Maintain a equal level of activity every day
  • Schedule time for eating, sleeping, and exercising
  • If depressed, contact a therapist who will teach to cope up with the disease

A patient with fibromyalgia can still lead a normal life and can enjoy doing every activity that a non-fibromyalgia person does. Few things that a fibromyalgia patient should take care are – scheduling his rest time, exercising as much required, eating on time, and knowing more about the disease and its management. Along with therapeutic options, self-management is an integral part of coping with fibromyalgia that gives a meaningful improvement in symptoms and daily function.