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Fibromyalgia

Many conditions can cause widespread musculoskeletal pain. The most common is fibromyalgia, in which pain is often accompanied by fatigue and mental health problems. A similar disorder, sometimes referred to as amplified musculoskeletal pain syndrome, is known to affect children.

 

What is fibromyalgia?

Fibromyalgia is a chronic pain disorder characterized by:

  • widespread body pain
  • fatigue
  • mental health issues

What causes fibromyalgia?

The cause of fibromyalgia remains unclear. Not all doctors agree on how it works, but the most common understanding is that fibromyalgia is a disorder of the central nervous system, which processes sensory information and regulates pain in an abnormal way. The term for this is “central sensitization.”

What are the signs and symptoms of fibromyalgia?

  • chronic, widespread body pain
  • specific tender points on the body
  • fatigue

The main and usually first-noticed symptom is constant, widespread body pain. This pain is present especially in the muscles and joints, and sometimes in the skin. The pain may come and go, flaring up from time to time to a heightened intensity. Patients also have tender points. These are particular areas of the body where even slight pressure can cause extreme pain. Fatigue (frequent, unexplained exhaustion) is also common.

Other symptoms and accompanying conditions vary from patient to patient. These can include:

  • insomnia (sleeplessness)
  • cognitive problems ("foggy" thinking, impaired memory)
  • vision problems or sensitivity to light
  • ringing in the ears
  • sensitivity to sound
  • coordination problems (unexplained clumsiness or poor control of body movement)
  • temporomandibular joint (TMJ) pain or disorders
  • peripheral neuropathies:
    • tingling
    • numbness
    • feelings of vibration in the arms or legs
  • other neurological symptoms
  • irritable bowel syndrome (IBS)
  • bladder or urinary problems
  • restless leg syndrome
  • headaches or migraines
  • anxiety, depression or other psychiatric problems
  • dry eyes or dry mouth

Who gets fibromyalgia?

Fibromyalgia affects women more often than men. Most people first experience symptoms between their late twenties and mid-thirties. It can begin at a later age, however.

How is fibromyalgia diagnosed?

A doctor may suspect someone has fibromyalgia if they say they “hurt all over” or always feel as if they “have the flu.” The doctor will examine the patient and get their medical history to identify:

  • specific tender points on the body
  • the presence of:
    • fatigue
    • non-restorative sleep
    • difficulty concentrating
    • some of the other symptoms or disorders listed above

The doctor must also do tests to rule out other conditions that could cause these symptoms, such as Lyme disease or lupus.

A diagnosis for fibromyalgia can often take a long time. Many fibromyalgia patients also have overlapping conditions, such as migraines or Raynaud's syndrome. This can complicate the diagnosis process. For this reason, the syndrome can go unrecognized for years. This makes fibromyalgia a frustrating condition for both patients and healthcare practitioners.

Does fibromyalgia ever go away?

There is no cure for fibromyalgia, but there are many treatments that can help alleviate pain and other symptoms.

How is fibromyalgia treated?

Successful treatment varies from person to person. Usually, it takes a combination of different therapies, such as:

  • regular aerobic exercise
  • acupuncture
  • physical therapy
  • massage therapy
  • cognitive-behavioral therapy
  • prescription medications

Most medical studies show that fibromyalgia patients who can get into a regular aerobic exercise routine do best. This can be hard for some to do, however, because of their pain and fatigue. If you have fibromyalgia, you should work with your doctors to determine which treatments work best for you.

Prescription medications for fibromyalgia

Prescription medications approved by the FDA for fibromyalgia include:

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

Low doses of another drug, amitriptyline (Elavil) has also been used for fibromyalgia for many years. It is not specifically approved by the FDA for this use. Opioid pain medications should not be used to treat fibromyalgia.

How serious is fibromyalgia?

The condition itself is not life-threatening, but it can negatively affect a person's quality of life. It may lead to decreased physical activity, depression and other problems that can have an impact on your physical and emotional health.

When to see a doctor

If you think you may have fibromyalgia, it is usually best to first meet with your primary care physician (family doctor or general practitioner), since he or she knows your medical history. If your primary doctor has difficulty or uncertainty in establishing a diagnosis, you should seek a referral to a specialist.

Depending on the type of symptoms you have, different types of specialists may be helpful:

  • A rheumatologist can help rule out the diagnosis of lupus, rheumatoid arthritis or other rheumatic disease, in which joint and muscle pain are key problems.
  • A neurologist can help rule out a neurological condition separate from fibromyalgia, if you have difficulty concentrating or if you feel tingling sensations in your arms, hands, legs or feet.
  • Often, consulting multiple clinicians is the best approach. This may include your primary care physician, a physical therapist and, depending on which symptoms you experience, a rheumatologist, neurologist, psychologist and/or pain management specialist.

Get more detailed information on fibromyalgia from the articles and other content below, or select Treating Physicians to find a doctor who treats fibromyalgia.

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