is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue
, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain
Symptoms sometimes begin after a physical trauma, surgery
or significant psychological stress
. In other cases, symptoms gradually accumulate over time with no single triggering event.
Many people who have fibromyalgia also have tension headaches
, temporomandibular joint (TMJ
) disorders, irritable bowel syndrome
, anxiety and depression.
While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.
Symptoms of fibromyalgia include:
•Widespread pain. The pain associated with fibromyalgia often is described as a constant dull ache that has lasted for at least three months. To be considered widespread, the pain must occur on both sides of your body and above and below your waist.
•Fatigue. People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain, and many patients with fibromyalgia have other sleep disorders
, such as restless legs syndrome
and sleep apnea.
•Cognitive difficulties. A symptom commonly referred to as "fibro fog" impairs the ability to focus, pay attention and concentrate on mental tasks.
Fibromyalgia often co-exists with other painful conditions, such as:
•Irritable bowel syndrome
•Migraine and other types of headaches
•Interstitial cystitis or painful bladder
•Temporomandibular joint disorders
Doctors don't know what causes fibromyalgia, but it most likely involves a variety of factors working together. These may include:
•Genetics. Because fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing the disorder.
•Infections. Some illnesses appear to trigger or aggravate fibromyalgia.
•Physical or emotional trauma. Fibromyalgia can sometimes be triggered by a physical trauma, such as a car accident. Psychological stress may also trigger the condition.
Why does it hurt?
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
•Family history. You may be more likely to develop fibromyalgia if a relative also has the condition.
•Other disorders. If you have osteoarthritis
, rheumatoid arthritis
, you may be more likely to develop fibromyalgia.
The pain and lack of sleep associated with fibromyalgia can interfere with your ability to function at home or on the job. The frustration of dealing with an often-misunderstood condition also can result in depression
and health-related anxiety.
In the past, doctors would check 18 specific points on a person's body to see how many of them were painful when pressed firmly. Newer guidelines don't require a tender point exam. Instead, a fibromyalgia diagnosis can be made if a person has had widespread pain for more than three months — with no underlying medical condition that could cause the pain.
While there is no lab test to confirm a diagnosis of fibromyalgia, your doctor may want to rule out other conditions that may have similar symptoms. Blood tests may include:
•Complete blood count
•Erythrocyte sedimentation rate
•Cyclic citrullinated peptide
•Thyroid function tests
In general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health. No one treatment works for all symptoms.
Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include:
•Pain relievers. Over-the-counter pain relievers such as acetaminophen
(Tylenol, others), ibuprofen
(Advil, Motrin IB, others) or naproxen sodium
(Aleve, others) may be helpful. Your doctor might suggest a prescription pain reliever such as tramadol
). Narcotics are not advised, because they can lead to dependence and may even worsen the pain over time.
(Cymbalta) and milnacipran
(Savella) may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline
or the muscle
to help promote sleep.
•Anti-seizure drugs. Medications designed to treat epilepsy
are often useful in reducing certain types of pain. Gabapentin
(Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin
) was the first drug approved by the Food and Drug Administration to treat fibromyalgia.
A variety of different therapies can help reduce the effect that fibromyalgia has on your body and your life. Examples include:
•Physical therapy. A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. Water-based exercises might be particularly helpful.
•Occupational therapy. An occupational therapist
can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body.
•Counseling. Talking with a counselor can help strengthen your belief
in your abilities and teach you strategies for dealing with stressful situations.