What Is Fibromyalgia?

Fibromyalgia is a chronic condition that causes widespread pain throughout the body's muscles and other soft tissues. It can cause fatigue and cognitive issues, such as difficulty thinking. Fibromyalgia affects around 5% of the world's population.

The official classification of fibromyalgia is unclear—it is known as a disorder, disease, health problem, or syndrome, depending on the source.

This article discusses fibromyalgia's symptoms, potential causes, treatment options, and tips for living with the condition.

What Are the Symptoms of Fibromyalgia?

The primary symptom of fibromyalgia is widespread pain and tenderness to touch.

Additional symptoms can include:

• Anxiety
• Depression
• Difficulty concentrating
• Difficulty sleeping
• Digestive issues
• Fatigue
• Headaches
• Increased sensitivity to temperature changes, light, noise, and odors
  
• Loss of memory
• Mood disorders
  
• Numbness/tingling in the hands and feet
• Stiffness
• Temporomandibular joint syndrome (TMJ or TMD)
  

Fibromyalgia

What Causes Fibromyalgia?

The exact cause of fibromyalgia is unknown, but it is likely due to a problem with how the brain processes pain. Research suggests that people with fibromyalgia have a lower pain threshold and experience an increased intensity of pain signals or how the brain interprets pain sensations.

Certain risk factors can increase a person's chances of developing fibromyalgia. These include:

• Age (older adults have a higher risk)
• Family history of fibromyalgia
• Obesity
• Post-traumatic stress disorder (PTSD)
• Sex (people assigned female at birth are at an increased risk)
• Traumatic events (such as a motor vehicle accident)
  
• Viral infections
  

Prior diagnosis of certain medical conditions also increases the risk of developing fibromyalgia. These include:

• Ankylosing spondylitis
• Chronic back pain
• Irritable bowel syndrome
• Osteoarthritis
• Rheumatoid arthritis
• Systemic lupus erythematosus
  

How Do You Know If You Have Fibromyalgia?

There is no specific test that healthcare providers use to diagnose fibromyalgia. Diagnosis is primarily based on a thorough review of your symptoms.

According to the American College of Rheumatology, criteria for a fibromyalgia diagnosis are based on your scores on the Widespread Pain Index (WPI), Symptom Severity Scale, and the number of tender points on the body—as well as the absence of other health conditions that could explain your symptoms.

Symptoms assessed in these scales include:

• Cognitive issues
• Difficulty sleeping
• Fatigue
• Mood shifts
• Pain
  
• Waking up unrefreshed
  

X-rays and blood tests are often performed to rule out other medical conditions that can cause similar symptoms, such as rheumatoid arthritis or lupus.

How Is Fibromyalgia Treated?

Treatment for fibromyalgia includes medications, physical activity, stress management or relaxation techniques, and cognitive behavioral therapy (CBT).

Medications

The three drugs approved by the Food and Drug Administration (FDA) for treating fibromyalgia are:

• Cymbalta (duloxetine)
• Savella (milnacipran)
• Lyrica (pregabalin)

Tylenol (acetaminophen) or prescription-strength pain relievers can help reduce fibromyalgia symptoms during flare-ups.

A healthcare provider might also prescribe other drugs—such as antidepressants or anti-seizure medications—to treat additional symptoms of fibromyalgia, including sleep difficulties and anxiety or depression.

Some medications treat both sleep issues and pain, including:

• Flexeril (cyclobenzaprine)
• Neurontin (gabapentin)
• Lyrica (pregabalin)
• Elavil (amitriptyline)

Physical Activity

People with fibromyalgia often have decreased strength and endurance, but regular physical activity helps address these issues and improves heart and lung health. Exercise also releases endorphins, chemicals in the brain that improve mood and decrease pain perception.

Choose low-intensity exercises, such as:

• Biking
• Dancing
• Stretching
• Swimming
• Tai chi
• Walking
• Water aerobics
  
• Yoga
  

You can need to work with a physical therapist to develop an individualized exercise program.

Stress Management and Relaxation Techniques

Fibromyalgia often causes mental and emotional distress. Incorporating stress management and relaxation techniques into your daily activities can help.

Examples include:

• Aromatherapy
• Biofeedback therapy
• Diaphragmatic breathing
• Hobbies
• Journaling
  
• Meditation
  
• Progressive muscle relaxation
  
• Reading
  

Cognitive Behavioral Therapy

CBT has been proven effective in improving the quality of life for people with fibromyalgia.

Benefits can include:

• Decreased pain
• Decreased symptoms of anxiety and depression
• Improved memory
• Improved sleep
• Increased alertness
  

Complementary and Alternative Treatments for Fibromyalgia

Complementary alternative treatments have been reported to help some people with fibromyalgia manage their symptoms. However, more research is needed to prove their effectiveness.

Examples include:

• Acupuncture
• Massage therapy
• Meditation
• Mind-body therapy
• Vitamins
  

Living Well With Fibromyalgia

Making a few changes to your lifestyle can improve your overall well-being when you're living with fibromyalgia.

Improve your sleep with these tips:

• Avoid caffeine and nicotine.
• Follow a consistent sleep schedule.
• Keep the room cool.
• Stop using electronics at least 30 minutes before bed.
• Use room-darkening shades.
  

Additional steps you can take include:

• Consider joining a support group.
• Eat a well-balanced diet.
• Follow your healthcare provider's instructions for medications and follow-up visits.
• Set reasonable expectations for yourself, listen to your body, and take frequent breaks throughout the day.
• Identify triggers of symptom flare-up, avoiding them whenever possible.
• Pace yourself throughout the day, performing more challenging tasks when your energy is higher.
• Stay physically active.
  

Outlook for Fibromyalgia

To ensure that you receive treatment that will give you the best chance of improving your fibromyalgia symptoms, start by finding a healthcare provider who has expertise in this condition.

Fibromyalgia is often treated by rheumatologists (medical doctors who specialize in diagnosing and treating patients with musculoskeletal and autoimmune diseases), pain management providers, and some primary care providers.

For additional tools and resources, and help finding a rheumatologist who treats fibromyalgia in your area, check out the National Fibromyalgia Association website.