Fibromyalgia

Fibromyalgia is a medical condition that causes pain through the body. According to the Centers for Disease Control and Prevention, fibromyalgia affects about 4 million American adults, with women twice as likely to be affected as men.

What Is Fibromyalgia?

Fibromyalgia is a chronic condition characterized by widespread muscle and joint pain and tenderness, extreme fatigue and trouble sleeping. Symptoms may come and go. They can also move from place to place all over the body. Fibromyalgia does not cause inflammation or damage the muscles or joints, but symptoms can interfere with daily activities and be severe enough to be debilitating.

Causes of Fibromyalgia

The exact causes of fibromyalgia are not clear. Fibromyalgia is not an autoimmune disorder, inflammation-based disease or other known joint or muscle disorder, as reported by the American College of Rheumatology.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases reports that research has shown that people with fibromyalgia have heightened sensitivity to pain. This sensitivity may originate in the pain perception pathways of the nervous system.

Medical conditions that commonly occur together with fibromyalgia include:

• ankylosing spondylitis, arthritis that affects the spine
• chronic back pain
• irritable bowel syndrome
• osteoarthritis
• rheumatoid arthritis
• systemic lupus erythematosus, more commonly known as lupus

In addition, some other factors that may be associated with fibromyalgia include:

• family history, a close relative with the illness
• obesity
• repetitive injuries
• stressful or traumatic life events
• viral infections

Signs and Symptoms of Fibromyalgia

The primary symptoms of fibromyalgia include:

• aching, burning or throbbing pain throughout the body
• difficulty sleeping
• extreme fatigue
• tenderness to the touch

People with fibromyalgia may also have:

• depression or anxiety
• digestive issues such as bloating or constipation
• migraine headaches
• numbness or tingling in hands and feet
• overactive bladder
• problems thinking, concentrating and remembering
• sensitivity to light, noise, odors and temperature
• stiffness in joints and muscles
• temporomandibular disorder, or TMJ, characterized by jaw clicking, facial pain and ringing in the ears 

How Is Fibromyalgia Diagnosed?

Currently, there are no specific diagnostic tests such as imaging studies or laboratory analyses to diagnose fibromyalgia. Diagnosis is based on physical examination and discussion of symptoms.

Diagnostic procedures such as blood tests may be performed to rule out other conditions that can cause similar symptoms, such as rheumatoid arthritis, hypothyroidism (underactive thyroid gland) or lupus.

Treatments for Fibromyalgia

Currently, there is no cure for fibromyalgia. Treatment focuses on managing symptoms. Options may include:

Medications

There are three FDA-approved medications for the treatment of fibromyalgia, including:

• duloxetine and milnacipran, which are drugs in the same class as many antidepressants that may improve symptoms of fibromyalgia even in the absence of clinical depression
• pregabalin, an anti-seizure drug that helps reduce fibromyalgia pain and improve sleep

If needed, prescription or over-the-counter analgesic medications can provide additional pain relief.

Mind-body Approaches

Mind-body interventions incorporate methods to improve physical symptoms of fibromyalgia and promote psychological well-being. Options may include:

• cognitive behavioral therapy to help minimize emotions and thought patterns that may contribute to fibromyalgia symptoms
• complementary and alternative therapies, also known as integrative medicine, which include acupuncture, biofeedback, massage therapy and meditative practices such as yoga, tai chi or guided imagery
• exercise therapies to improve aerobic conditioning and muscle strength
• stress management and relaxation strategies
• techniques to improve sleep quality