Fibromyalgia: Symptoms, causes, and treatment

Fibromyalgia is a common and chronic syndrome that causes bodily pain and mental distress.

Symptoms of fibromyalgia can be confused with those of arthritis, or joint inflammation. However, unlike arthritis, it has not been found to cause joint or muscle inflammation and damage. It is seen as a rheumatic condition, in other words, one that causes soft tissue pain or myofascial pain.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), around 5 million adults aged 18 years or over in the United States experience fibromyalgia, and 80 to 90 percent of fibromyalgia patients are women.

Fast facts on fibromyalgia:

Here are some key points about fibromyalgia. More detail is in the main article.

Fibromyalgia causes widespread pain, fatigue, and other types of discomfort.

Symptoms resemble those of arthritis, but fibromyalgia affects the soft tissue, not the joints.

The cause is unknown, but risk factors include traumatic injury, rheumatoid arthritis and other autoimmune disorders, such as lupus, and genetic factors.

There is no cure, but medications, exercise, acupuncture, and behavioral therapy can help relieve symptoms and improve sleep quality.

Symptoms

Fibromyalgia can lead to widespread pain, sleep problems, and other symptoms.
Fibromyalgia can lead to widespread pain, sleep problems, and other symptoms.

Common symptoms include:

widespread pain

jaw pain and stiffness

pain and tiredness in the face muscles and adjacent fibrous tissues

stiff joints and muscles in the morning

headaches

irregular sleep patterns

irritable bowel syndrome (IBS)

painful menstrual periods

tingling and numbness in the hands and feet

restless leg syndrome (RLS)

sensitivity to cold or heat

difficulties with memory and concentration, known as “fibro-fog”

fatigue

The following are also possible:

problems with vision

nausea

pelvic and urinary problems

weight gain

dizziness

cold or flu-like symptoms

skin problems

chest symptoms

depression and anxiety

breathing problems

Symptoms can appear at any time during a person’s life, but they are most commonly reported around the age of 45 years.

Treatment

Around 20 percent of people with fibromyalgia try acupuncture within the first 2 years. It may work, but more research is needed.
Around 20 percent of people with fibromyalgia try acupuncture within the first 2 years. It may work, but more research is needed.

Medical attention is needed because fibromyalgia can be difficult to manage. As it is a syndrome, each patient will experience a different set of symptoms, and an individual treatment plan will be necessary.

Treatment may include some or all of the following:

an active exercise program

acupuncture

psychotherapy

behavior modification therapy

chiropractic care

massage

physical therapy

low-dose anti-depressants, although these are not a first-line treatment

People with fibromyalgia need to work with their doctor to come up with a treatment plan that provides the best results.

Drugs

Drugs may be recommended to treat certain symptoms.

These may include over-the-counter (OTC) pain relievers. However, the European League Against Rheumatism (EULAR) issued a recommendation against using non-steroidal anti-inflammatory drugs (NSAIDs) to treat fibromyalgia in their updated 2016 guidelines.

Antidepressants, such as duloxetine, or Cymbalta, and milnacipran, or Savella, may help reduce pain. Anti-seizure drugs, such as gabapentin also known as Neurontin, and pregabalin, or Lyrica, may be prescribed.

However, a review has suggested that patients often stop using these drugs because they are not effective in relieving pain or because of their adverse effects.

Patients should tell the doctor about any other medications they are taking to avoid side-effects and interactions with other drugs.

Exercise

A combination of aerobic exercise and resistance training, or strength training, has been linked to a reduction in pain, tenderness, stiffness, and sleep disturbance, in some patients.

If exercise is helping with symptoms, it is important to maintain consistency in order to see progress. Working out with a partner or personal trainer may help to keep the exercise program active.

Acupuncture

Some patients have experienced improvements in their quality of life after starting acupuncture therapy for fibromyalgia. The number of sessions required will depend on the symptoms and their severity.

One study found that 1 in 5 people with fibromyalgia use acupuncture within 2 years of diagnosis. The researchers concluded that it may improve pain and stiffness. However, they call for more studies.

Behavior modification therapy

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