Overview
In fibromyalgia, your muscles and joints hurt throughout your body. It can also cause fatigue and mental symptoms such as memory loss. There is no cure for fibromyalgia, but medical practitioners can help you find treatment options to manage the symptoms.
This article will discuss the signs and symptoms, the triggering and risks, and the best possible treatment options for fibromyalgia.
What is Fibromyalgia?
A chronic pain condition, fibromyalgia involves widespread discomfort throughout the body, fatigue, poor sleep, and difficulties with mood, memory, and concentration. Nearly 2% of the people in the U.S. are affected by it, and women are more likely to be affected than men.
It is unknown what causes fibromyalgia, although scientists are looking for possible explanations. In people with fibromyalgia, pain perception processing may be abnormal, meaning their pain threshold may be lower. According to the CDC, people with fibromyalgia are also more likely to have autoimmune diseases like lupus and rheumatoid arthritis.
Symptoms Of Fibromyalgia
There may be a variety of symptoms experienced by individuals. However, pain sensation is the most common symptom. The muscles and the bone-muscle junctions are most commonly affected. Those are ligaments and tendons.
Your neck and shoulders can be the first part of your body to feel pain. Symptoms include burning, soreness, stiffness, aching, or gnawing pain. Some parts of your muscles may be sore. There are no signs or symptoms of progression. It may feel like arthritis, but it doesn’t worsen over time. Muscles and bones are not damaged by it.
Fibromyalgia can also cause the following symptoms:
- Tiredness (fatigue) of medium to severe severity
- Lack of endurance during exercise
- Insomnia at night
- Mood disorder
- Stress
- Migraines
- Constipation, diarrhea, and belly (abdominal) pain caused by an irritable bowel syndrome
- Leg pain
- Painful menstrual cramps
- Fibrofog (difficulty thinking clearly)
These symptoms can be mistaken for those of other health conditions.
Causes of Fibromyalgia
Fibromyalgia changes are caused by an abnormal increase in pain-signaling chemicals in the brain. Additionally, the pain receptors in the brain become sensitized and may overreact to painful and non-painful stimuli. Several factors may contribute to these changes, including genetics, as there is evidence that fibromyalgia runs in families, and specific genetic mutations may increase the likelihood.
The factors that contribute to the development of fibromyalgia:
Genetics:
Research suggests that fibromyalgia may have a genetic component. Some people may have specific genetic mutations that make them more prone to developing the condition. Moreover, fibromyalgia tends to run in families, suggesting a hereditary component.
Infection or Illnesses:
Certain diseases or illnesses can sometimes trigger or aggravate fibromyalgia. For example, some people report that their symptoms began after a flu or a bacterial infection.
Physical events:
Physical trauma or events, such as injuries, surgery, or physical stress, can sometimes trigger the onset of fibromyalgia. In some cases, fibromyalgia symptoms may not appear until months or even years after the physical event.
Psychological stress:
Emotional or psychological stress can also play a role in developing fibromyalgia. People who have experienced traumatic events, such as abuse or a significant life change, may be more susceptible to developing the condition.
Central nervous system (CNS) abnormalities:
Research suggests that people with fibromyalgia may have abnormalities in how their CNS processes pain signals. The pain receptors in the brain may become sensitized, which can cause them to overreact to painful and non-painful stimuli.
It’s essential to note that fibromyalgia is a complex condition and may have multiple contributing factors. More research is required to identify the underlying mechanisms of fibromyalgia because the condition’s specific cause is still unknown.
Risk of Fibromyalgia
Fibromyalgia risk factors include:
- Gender: Women are more likely to be diagnosed with fibromyalgia.
- A family history: Fibromyalgia can be passed down between parents and siblings.
- In other disorders, fibromyalgia is more likely to develop in people with osteoarthritis, rheumatoid arthritis, or lupus.
- Stress: Stress can’t be measured on a test, but too much stress can be harmful.
- Trauma: Fibromyalgia can develop after physical, emotional, or serious injuries.
Diagnosis of Fibromyalgia
A physical exam and health history are essential to the diagnostic process when a patient presents with symptoms that suggest fibromyalgia.
History for Fibromyalgia
The doctor will also take a detailed health history and ask about the patient’s symptoms. This information will help the provider to understand the nature and severity of symptoms and to determine if they meet the criteria for a diagnosis of fibromyalgia.
Medical Physical Examination of Fibromyalgia
During the physical exam, the healthcare professional will look for signs of tenderness, swelling, or inflammation in various body parts. They may also assess the patient’s range of motion and muscle strength.
Investigations for Fibromyalgia
There are no specific investigations that can definitively diagnose fibromyalgia. However, blood tests may be recommended to rule out medical conditions that can cause similar symptoms. For example, if the patient has fatigue, the healthcare provider may recommend a blood test to check for anemia or thyroid problems.
The diagnosis of fibromyalgia usually involves a differential diagnosis process. Healthcare providers use this method to compare conditions with similar symptoms and eliminate other possible causes of the patient’s symptoms.
The healthcare provider will consider the patient’s physical exam, health history, and other diagnostic tests to make a diagnosis. It’s important to note that diagnosing fibromyalgia can be challenging, and it may take some time to arrive at a definitive diagnosis.
Treatment for Fibromyalgia
Following are some treatment options that can help manage symptoms of the disease:
Medical treatments
Symptoms of Fibromyalgia may be relieved by medications. However, it is important to remember that medications may not completely resolve all of the symptoms associated with fibromyalgia. Additionally, medications may come with side effects, so talk to your doctor and carefully weigh the risks and benefits of each option. Exercise and lifestyle modifications can also help to reduce symptoms of fibromyalgia.
Medications for fibromyalgia
The Food and Drug Administration (FDA) has approved three drugs to treat fibromyalgia. They include:
- Pregabalin (Lyrica), an antiepileptic and gamma agonist that may calm overactive nerves, is a popular pill for treating epilepsy.
- Duloxetine (Cymbalta) inhibits the reuptake of neurotransmitters serotonin and norepinephrine to reduce pain.
- Milnacipran (Savella), another SNRI that reduces pain
The right combination of drugs or dosages for people with fibromyalgia may require them to try several. Tell your doctor if you experience any side effects and how long the medication takes. Several weeks are needed for some drugs to take effect.
Antidepressants
In 2017, the research found that people with low serotonin levels were more likely to develop fibromyalgia. A few fibromyalgia symptoms may be helped by selective serotonin reuptake inhibitors (SSRIs), which increase the amount of serotonin in the brain.
Fibromyalgia patients with pain, fatigue, and sleep problems have little evidence that SSRIs ease these symptoms.
Research suggests that SSRIs might relieve depression in people with depression and anxiety caused by this condition. In some cases, antidepressants may help people manage pain more effectively by improving their mood.
For people with fibromyalgia, doctors prescribe SSRIs such as:
- Prozac, Sarafem (fluoxetine)
- Paxil, Brisdelle, Pexeva (paroxetine)
- Sertraline
Sleeping pills
Fibromyalgia pain can make sleeping difficult, and sleep deprivation can make it worse. Doctors may prescribe sleep medication if strategies like going to bed don’t work.
Narcotic pain medication
Painkillers like opioids change how the brain responds to pain. Fibromyalgia pain can be relieved with them, but they’re not effective. In the abovementioned study, pregabalin relieved pain better than opioids in people with fibromyalgia. However, the Centers for Disease Control and Prevention (CDC) and the American College of Rheumatology warn against opioids for fibromyalgia pain.
In addition to mood shifts, sleep disruptions, and memory problems, fibromyalgia also manifests as a side effect of opioids. To minimize the risks of opioid addiction, it is crucial to speak with a doctor before taking these drugs. Other treatments may be recommended first by the doctor.
Non-narcotic pain medication
Research into other fibromyalgia treatments is ongoing. For example, a 2020 study that included 74 fibromyalgia patients found that intravenous lidocaine produced long-lasting pain relief.
Meditation and Mindfulness
Meditation, particularly mindfulness meditation, which encourages increased awareness of the present moment, may help with fibromyalgia symptoms. According to a 2014 study, mindfulness relieved many fibromyalgia symptoms, including insomnia and stress. There was less pain associated with fibromyalgia among those who practiced mindfulness. Participants also reported a lower perceived burden as well as less severe symptoms. People with fibromyalgia will benefit from mindfulness practices focusing on acceptance, nonattachment, and nonjudgmental awareness. Mental stress, such as anxiety and stress, may also be reduced by meditation. Psychological stress can trigger fibromyalgia.
Lifestyle changes
Fibromyalgia symptoms can be improved with some self-care strategies. The following tips are included:
- When working at a desk, it is important to sit in a comfortable but ergonomically sound chair
- Posture is important
- Sleep hygiene, including regular bedtimes.
- Pillows and mattresses that are comfortable
Nutritional Strategies
Vitamin D deficiencies may worsen fibromyalgia symptoms. Studies have shown that supplementing vitamin D with 20 weeks duration reduced the pain of women with fibromyalgia who had low vitamin D levels. A study is being conducted to examine whether magnesium deficiency contributes to fibromyalgia and if magnesium supplements might help to reduce the condition’s symptoms.
In addition to soy, S-adenosyl-L-methionine (SAMe), and creatine, other natural substances have been studied to treat fibromyalgia. These products need more evidence to prove their effectiveness.
Excessive amounts of vitamins and minerals (such as vitamin D and magnesium) can be harmful.
Medical Conditions Associated with Fibromyalgia
Chronic Migraine
When migraines occur more than 15 times per month, with migraine symptoms present for at least 8 days, the disease is called chronic migraine. Fibromyalgia and migraines are strongly associated, and as people age, those who have fibromyalgia are more prone to acquire chronic migraines.
Fibromyalgia may cause chronic migraines by altering chemical messengers in the body, specifically the levels of serotonin and norepinephrine, which can lead to headaches. Antidepressants may target these brain chemicals to relieve migraine pain in individuals with fibromyalgia.
Biofeedback is another treatment that may benefit individuals with chronic migraines and tension headaches associated with fibromyalgia. Biofeedback aims to help people control their involuntary body functions, such as heart rate, blood flow, and muscle tension, by providing feedback on their body’s responses to different stimuli.
Individuals can reduce the frequency and intensity of migraines and other headache symptoms by learning to control these functions.
Autoimmune diseases
While fibromyalgia is often associated with inflammatory autoimmune diseases such as rheumatoid arthritis, lupus, Sjögren’s syndrome, and ankylosing spondylitis, fibromyalgia is not considered an autoimmune disease.
Current research suggests that central nervous system abnormalities, including alterations in pain processing and neurotransmitter imbalances, may be the primary cause of fibromyalgia. However, the relationship between fibromyalgia and autoimmune diseases is still being studied and better understood.
Sleeping problems
Sleep disturbances are common in people suffering from fibromyalgia, with up to 90% reporting sleep problems. Painful symptoms can negatively impact sleep quality, duration, and efficiency, leading to daytime sleepiness and fatigue. This can further affect an individual’s quality of life and ability to perform daily activities. Individuals with fibromyalgia must address sleep disturbances with their healthcare provider and develop a personalized treatment plan to improve sleep quality and manage symptoms.
Restless legs syndrome
RLS is a neurological condition marked by an uncontrollable impulse to move the legs, frequently accompanied by painful leg sensations. This can cause sleep disturbances and lead to daytime fatigue. Research suggests that individuals with fibromyalgia may be at a higher risk for developing RLS, with approximately 37% of people with moderate-to-severe RLS symptoms also having fibromyalgia.
Treatments that are effective for fibromyalgia, such as medications that target neurotransmitters like serotonin and norepinephrine, may also be helpful for RLS. This is because RLS is also believed to be associated with neurotransmitter imbalances in the brain.
Medications used for fibromyalgia, such as certain antidepressants and anti-seizure medications, have been shown to improve symptoms of RLS and may also enhance sleep quality.
Irritable Bowel Syndrome
Fibromyalgia and irritable bowel syndrome (IBS) are closely related conditions with many similarities. Both conditions are believed to be associated with chronic stress responses and can be triggered by various factors.
Symptoms of fibromyalgia and IBS often overlap, including chronic pain, fatigue, and cognitive difficulties. In addition, individuals with fibromyalgia are at a higher risk of developing IBS.
Treatment for both conditions often involves lifestyle modifications, such as dietary changes, stress reduction, and exercise. Certain medications for IBS may also be used to manage symptoms such as abdominal pain, bloating, diarrhea, or constipation. For fibromyalgia, certain antidepressants and anti-seizure medications may be used to manage pain, fatigue, and other symptoms.
Pelvic pain
Fibromyalgia and pelvic pain are positively correlated, and fibromyalgia patients are more likely to experience symptoms such as bladder irritability, menstrual cramps, and pelvic pain. For the pain and discomfort brought on by fibromyalgia and pelvic pain to be effectively managed, a thorough strategy is necessary to consider both physical and mental issues.
It is most likely because chronic pain is frequently a symptom of fibromyalgia, a central nervous system illness. The same neural pathways that generate pain in other body areas can cause pelvic pain.
Treatment options for fibromyalgia-associated pelvic pain include medication, physical therapy, exercise, relaxation techniques, and cognitive behavioural therapy.
Depression and Anxiety
People with fibromyalgia also experience mental or emotional problems, particularly depression and anxiety. A study published in Neuropsychopharmacology Reports in 2018 found that nearly 97% of fibromyalgia participants in Japan had co-occurring mental health issues.
The link between fibromyalgia, pain, and mood disorders is complex and poorly understood. However, it is thought that the neurotransmitters serotonin and norepinephrine, which regulate pain and mood, may be disrupted in people with fibromyalgia. This is why many of the medications prescribed for fibromyalgia, such as certain types of antidepressants, work by increasing the levels of these neurotransmitters in the brain.
Antidepressants (SSRIs) and (SNRIs) have effectively decreased pain and improved mood in some people with fibromyalgia. Other medications, such as anticonvulsants and muscle relaxants, can also help manage pain and other symptoms associated with fibromyalgia.
Obesity
The relationship between obesity and fibromyalgia is complex and should not be ignored. Fibromyalgia is characterized by chronic pain, often leading to a sedentary lifestyle. This can result in weight gain, which may further aggravate fibromyalgia symptoms—being overweight places more mechanical strain on joints, leading to more pain and discomfort. However, exercise is beneficial for fibromyalgia patients.
Studies show that women with fibromyalgia who engage in low-intensity physical activity experience reduced pain, fatigue, and anxiety levels. Therefore, maintaining a healthy weight and engaging in regular physical activity may help manage fibromyalgia symptoms and improve overall quality of life.
Temporomandibular joint syndrome (TMJ)
Some fibromyalgia patients develop temporomandibular joint syndrome (TMJ). TMJ issues can cause jaw pain. Your jaw will pop or snap when you open and close your mouth. You might find it difficult to open your mouth completely when chewing or speaking. TMJ can result in ear pain and headaches around the ear in addition to headaches.
When to Consult a Doctor for Fibromyalgia?
Getting body aches for unexplained reasons might indicate an undiagnosed condition like fibromyalgia. If you have fibromyalgia symptoms, consult a doctor for the diagnosis and best treatment choices to manage the symptoms and help relieve pain.
Your doctors online have a team of professionals that have diagnosed several patients with hidden signs of fibromyalgia and treated them most appropriately. You can also get help from our doctors today!
FAQ About Fibromyalgia Answered by Your Doctors Online Team
The severity of fibromyalgia symptoms can lead to disability, depending on the individual’s circumstances. If fibromyalgia symptoms are severe enough to keep them from working, they may qualify for disability benefits.
Pain relief for fibromyalgia varies from person to person, so patients need to consult with their doctors to determine the best option for them. Some commonly recommended medications for fibromyalgia include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and strength pain relievers such as tramadol and duloxetine. Some people with fibromyalgia also find relief with alternative treatments such as acupuncture, massage, and yoga.
Research is ongoing further to understand the effects of CBD oil on fibromyalgia. CBD oil may be an effective treatment for some people and offer an alternative to traditional medication. Consult your doctor before using CBD oil.
Fibromyalgia pain is often aggravated by stress, lack of sleep, physical activity, or changes in the weather. Other factors that can increase pain levels include certain foods, loud noises, and strong smells.
The top five supplements for fibromyalgia are vitamin D, magnesium, B12, omega-3 fatty acids, and CoQ10. These supplements can reduce inflammation, improve energy levels, and reduce stress, which can all reduce pain.
Chronic Fatigue Syndrome (CFS) is similar to fibromyalgia as they cause widespread pain and fatigue. CFS can also cause cognitive difficulties, sleep disturbances, and headaches.
There are four parent stages of Fibromyalgia (FM):
1) localized FM with classic symptoms;
2) generalized FM with ongoing pain and some additional symptoms
3) Symptoms of advanced FM include growing pain, sleep disturbances, and chemical sensitivity; and 4) Secondary FM is associated with certain diseases.
