Fibromyalgia is a long-term or chronic disorder. It’s associated with widespread pain in the muscles and bones, areas of tenderness, and general fatigue. Symptoms like these are considered subjective, meaning they can’t be determined or measured by tests. Because its symptoms are subjective and there isn’t a clear known cause, fibromyalgia is often misdiagnosed as another disease.
The lack of reproducible, objective tests for this disorder plays a role in some doctors questioning the disorder altogether. Although it’s more widely accepted in medical circles now than previously, some doctors and researchers don’t consider fibromyalgia a real condition. According to the Mayo Clinic, this can increase your risk of depression, which stems from a struggle in gaining acceptance for painful symptoms.
Researchers are closer to understanding fibromyalgia, so the stigma that surrounds the condition is disappearing. In the past, many doctors worried that people could use this undetectable pain as an excuse to seek out prescription pain medication. Doctors are now finding that lifestyle changes may be better than medication in treating and managing this condition.
The more that doctors begin to accept this diagnosis, the more likely the medical community is to explore effective ways of treating fibromyalgia.
Fibromyalgia is often associated with areas of tenderness, which are called trigger points or tender points. These are places on your body where even light pressure can cause pain.
Today, these points are rarely used to diagnose fibromyalgia. Instead, they may be used as one way for doctors to narrow their list of possible diagnoses. Doctors use a combination of other consistent symptoms — and possibly some medical tests — to help them determine a cause.
The pain caused by these trigger points can also be described as a consistent dull ache affecting many areas of your body. If you were to experience this pain for at least three months, doctors may consider this a symptom of fibromyalgia.
People with this disorder may also experience:
- trouble sleeping
- sleeping for long periods of time without feeling rested
- inability to focus or difficulty paying attention
- pain or dull aching in the lower abdomen
Symptoms may be a result of the brain and nerves misinterpreting or overreacting to normal pain signals. This may be due to a chemical imbalance in the brain.
A person used to be diagnosed with fibromyalgia if they had widespread pain and tenderness in at least 11 of the known 18 trigger points. Doctors would check to see how many of these points were painful by pressing firmly on them.
Common trigger points include:
- back of the head
- tops of shoulders
- upper chest
- outer elbows
Trigger points are no longer the focus of diagnosis for fibromyalgia. Instead, doctors may make a diagnosis if you report widespread pain for more than three months and have no diagnosable medical condition that can explain the pain.
Medical researchers and doctors don’t know what causes fibromyalgia. However, thanks to decades of research, they’re close to understanding factors that may work together to cause it.
These factors include:
Infections: Prior illnesses may trigger fibromyalgia or make symptoms of the condition worse.
Genetics: Fibromyalgia often runs in families. If you have a family member with this condition, your risk for developing it is higher. Researchers think certain genetic mutations may play a role in this condition. Those genes haven’t yet been identified.
Trauma: People who experience physical or emotional trauma may develop fibromyalgia. The condition has been linked with post-traumatic stress disorder.
Stress: Like trauma, stress can create long-reaching effects your body deals with for months and years. Stress has been linked to hormonal disturbances that could contribute to fibromyalgia.
Doctors also don’t fully understand the factors that cause people to experience the chronic widespread pain associated with the condition. Some theories suggest it may be that the brain lowers the pain threshold. What once wasn’t painful becomes very painful over time.
Another theory suggests that the nerves and receptors in the body become more sensitive to stimulation. That means they may overreact to pain signals and cause unnecessary or exaggerated pain.
Although the causes are unclear, fibromyalgia flare-ups can be the result of stress, physical trauma, or an unrelated systemic illness like the flu. It’s believed the brain and nervous system may misinterpret or overreact to normal pain signals. This incorrect interpretation could be due to an imbalance in brain chemicals.
Other risk factors for fibromyalgia include:
- Gender: According to NIAMS, women account for between 80 and 90 percent of all fibromyalgia cases. The reason for this isn’t known.
- Family history: If you have a family history of the condition, you may be at a greater risk for developing it.
- Disease: Although fibromyalgia isn’t a form of arthritis, having a rheumatic disease like lupus or rheumatoid arthritis may also increase your risk.
Updated guidelines recommend that a diagnosis be made if you experience an ongoing, widespread pain for three months or longer. This also includes pain that has no identifiable cause related to any other conditions.
There isn’t a lab test that can detect fibromyalgia. Instead, blood testing may be used to help rule out other potential causes of chronic pain.
The goal of fibromyalgia treatment is to manage pain and improve quality of life. This is often accomplished through a two-pronged approach of self-care and medication.
Common medications for fibromyalgia include:
Pain relievers: Your doctor may recommend over-the-counter pain relievers, such as ibuprofen (Advil) or acetaminophen (Tylenol). Prescription versions, such as tramadol (Ultram), maybe be used in extreme cases. They’re used sparingly to reduce the risk of side effects and dependence.
Antidepressants: Antidepressants, such as duloxetine (Cymbalta) and milnacipran (Savella), are sometimes used to help treat anxiety or depression associated with fibromyalgia. These medicines may also help improve sleep quality.
Antiseizure drugs: Gabapentin (Neurontin) was designed to treat epilepsy, but it may help reduce symptoms in people with fibromyalgia. The U.S. Food and Drug Administration also approved pregabalin (Lyrica) for the treatment of fibromyalgia.
In addition to medication, a self-care plan can help you cope with the symptoms of fibromyalgia. Lifestyle changes and alternative remedies for fibromyalgia may reduce pain while making you feel better overall. Many of these alternative treatments focus on lowering stress and reducing pain. You can use most alone or together with mainstream medical treatments.
It’s important to note that most alternative treatments for fibromyalgia haven’t been thoroughly studied. Research to date fails to support their effectiveness. Many reports of success with alternative treatment are anecdotal.
These treatments include:
- physical therapy
- regular exercise
- getting enough sleep at night
- massage therapy
- a balanced, healthy diet
Therapy can potentially reduce stress that triggers the symptoms and depression often associated with this disorder. Group therapy is often the most affordable option, and it gives you an opportunity to meet others who are going through the same issues. Individual therapy is also available if you prefer one-on-one help. Ask your doctor for specific recommendations.
No specific diet has been identified for people with fibromyalgia. Some people report that they feel better by following a diet plan or avoiding certain foods, but research doesn’t support anything definite.
If you’ve been diagnosed with fibromyalgia, try to eat a healthy, balanced diet overall. Proper nutrition can help your body stay healthy and provide a constant supply of good energy. If your diet isn’t balanced and you’re not eating properly, your symptoms may worsen.
Dietary strategies to keep in mind:
- Eat fruits and vegetables.
- Drink plenty of water.
- Eat more plants than meat.
- Reduce your intake of sugar.
- Get regular exercise as best as you can.
- Lose weight or maintain a healthy weight.
You may find that certain foods make your symptoms worse, or that you feel worse after eating a certain food frequently. If that’s the case, it’s a good idea to create a food diary where you can track what you’re eating and how you feel after the meal.
Present this food diary to your doctor. The two of you can work together to identify any foods that aggravate your symptoms. Avoiding those foods may be a good idea. But keep in mind that research hasn’t identified foods that are more likely to aggravate symptoms of fibromyalgia.
There isn’t a cure for fibromyalgia. Instead, treatment focuses on reducing your symptoms and improving your quality of life. This is often accomplished through the use of medications, self-care strategies, and lifestyle changes.
In addition, you may wish to seek out other people with the condition for support and guidance. Many hospitals and community health centers offer group therapy classes. These groups are a great way for people and their families to connect. They provide an opportunity for members to share resources and help guide each other through their journey.
To find a cure, researchers need to understand what causes people to develop this condition. This remains unclear. Research has identified three areas that may contribute to the development of fibromyalgia: genetics, illness, and trauma. A mixture of genetic and lifestyle risk factors may also cause a person to develop the condition.
Fibromyalgia is one of the most common conditions people applying for disability list. It’s possible to get disability benefits if you have fibromyalgia, though this process may take some time.
To qualify for disability benefits because of fibromyalgia, you must:
Be diagnosed: Your doctors have tested for and ruled out every other possible condition that could explain your symptoms.
Experience severe pain: The symptoms are debilitating. They prevent you from performing everyday tasks.
Have experienced symptoms for a long period of time: The condition has impacted your life for at least one year.
Not be able to lead a normal life: You’ll need to provide evidence that your symptoms prevent you from engaging in normal work and activities.
During the process of filing for disability, you have to show that the condition prevents you from returning to work. You also have to show that you aren’t able to return to any of your past jobs or perform any type of work because of your condition. For this reason, you’ll likely have to provide an entire work and employment history.
Fibromyalgia is a chronic condition that causes widespread pain, fatigue, difficulty sleeping, and depression. Fibromyalgia doesn’t have a cure, and researchers don’t understand what causes it. Treatment focuses on medications that can relieve symptoms and lifestyle and alternative treatments that help ease the symptoms.
More than 5 million Americans over the age of 18 have been diagnosed with the condition. Between 80 and 90 percent of people diagnosed with the condition are women. Men and children can also be diagnosed with the disorder. Most people are diagnosed during middle age.
Fibromyalgia is chronic. Most people diagnosed with the condition will experience their symptoms for the rest of their lives. However, some people may experience periods in which their pain and fatigue aren’t as bad.
Written by: Kristeen Cherney and Kimberly Holland
Medically reviewed on Dec 10, 2016 by Brenda B. Spriggs, MD, FACP