Fibromyalgia

Overview

Definition

Fibromyalgia is a complex disorder. It causes chronic widespread pain that can be disabling.

Fibromyalgia Trigger Points
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Causes

The exact cause of fibromyalgia is unknown. It may be a problem with how the nerves and brain process pain.

Conditions that are commonly associated with fibromyalgia include:

  • Depression and anxiety
  • Chronic headache, such as tension headaches
  • Irritable bowel syndrome (IBS)
  • Dysmenorrhea
  • Female urethral syndrome (irritable bladder)
  • Autoimmune disease, such as lupus or rheumatoid arthritis

Risk Factors

Fibromyalgia is more common in women. Physical or mental stress may also increase your chance of getting it.

SymptomsandDiagnosis

Symptoms

Symptoms and severity of fibromyalgia can vary.

More common symptoms include:

  • Generalized pain and tenderness that can:
    • Be moderate to severe
    • Feel stabbing, shooting, achy, or throbbing
    • Be widespread and chronic
    • Be associated with muscle twitching
  • Fatigue
  • Weakness
  • Poor sleep
  • Reduced physical endurance
  • Problems with concentration, thought, or memory
  • Sensitivity to noises, light, or odors

Factors that may trigger or worsen symptoms include:

  • Physical injury
  • Weather changes, especially cold, damp weather
  • Stress or anxiety
  • Overexertion
  • Medical illness
  • Surgery

Diagnosis

You will be asked about your symptoms and past health. A physical exam will be done. Certain areas can be tender in those with fibromyalgia. Diagnosis is usually based on shared information and exam. The pain needs to be present for at least 3 months.

Treatments

Treatment

The goal of treatment is to relieve or control the symptoms. Talk with your doctor about the best plan for you. Options include:

Therapy Programs

Stress and tension can make pain worse. Therapies that may improve relaxation and improve pain include:

  • Physical therapy
  • Heated pool treatments
  • Alternative treatments, such as massage, acupuncture, relaxation training, trigger point therapy, biofeedback, and yoga
  • Cognitive behavioral therapy (CBT)—to learn how thought patterns can influence pain

Lifestyle Changes

Overall health can affect your symptoms. Your doctor may also recommend lifestyle changes, such as:

  • Eat a healthy diet.
  • Learn new coping skills for physical and mental stress.
  • Keep healthy sleep habits. This includes a regular sleep schedule.
  • Commit to a regular exercise program. Include activity that increases your heart rate, strength training, and flexibility exercises. Walking, biking, and swimming may be good options to start with.

Medicine

Your doctor may recommend the following to help manage symptoms:

  • Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Antidepressants
  • Anticonvulsants
  • Sedatives
  • Muscle relaxants
  • Opioids—if not relieved by other treatments

Prevention

There are no current steps to prevent fibromyalgia.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (FM; Fibromyalgia Syndrome; FMS)

RESOURCES

American College of Rheumatology http://www.rheumatology.org 

The American Fibromyalgia Syndrome Association http://www.afsafund.org 

CANADIAN RESOURCES

The Arthritis Society http://www.arthritis.ca 

Fibromyalgia Information and Local Support http://fibromyalgia.ncf.ca 

References

About fibromyalgia. National Fibromyalgia Association website. Available at: http://www.fmaware.org/about-fibromyalgia. Accessed December 31, 2018.

Carville SF, Arendt-Nielsen S, Bliddal H, et al. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis. 2008;67:536-541.

Fibromyalgia. American College of Rheumatology website. Available at: http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia. Updated May 2015. Accessed December 31, 2018.

Fibromyalgia. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T116339/Fibromyalgia . Updated November 29, 2018. Accessed December 31, 2018.

Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Fibromyalgia/default.asp. Updated July 2014. Accessed December 31, 2018.

Wierville L. Fibromyalgia: diagnosing and managing a complex syndrome. J Am Acad Nurse Pract. 2012;24(4):184-92.

2/17/2009 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T116339/Fibromyalgia : Russell IJ, Perkins AT, Michalek JE; Oxybate SXB-26 Fibromyalgia Syndrome Study Group. Sodium oxybate relieves pain and improves function in fibromyalgia syndrome: a randomized, double-blind, placebo-controlled, multicenter clinical trial. Arthritis Rheum. 2009;60:299-309.

4/14/2009 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T116339/Fibromyalgia : Munguía-Izquierdo D, Legaz-Arrese A. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2008;89:2250-2257.

4/22/2011 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T116339/Fibromyalgia : Sañudo B, Galiano D, Carrasco L, Blagojevic M, de Hoyo M, Saxton J. Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2010;91(12):1838-1843.

4/22/2011 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T116339/Fibromyalgia : Carson JW, Carson KM, Jones KD, Bennett RM, Wright CL, Mist SD. A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia. Pain. 2010;151(2):530-539.