- Symptoms
- Treatment
- Causes
- Tender points
- Pain
- Risk factors
- Autoimmunity
- In women
- In men
- Diagnosis
- Diet
- Living with fibromyalgia
Your quality of life can be affected when you live with pain, fatigue, and other fibromyalgia symptoms on a daily basis. But despite misunderstandings, you find help managing this chronic condition.
Fibromyalgia is a long-term, or chronic, condition. It causes symptoms such as:
- musculoskeletal pain, or pain in the muscles and bones
- tenderness
- general fatigue
- sleep and cognitive disturbances
This condition can be hard to understand, even for healthcare professionals. Its symptoms mimic those of other conditions, and there are no tests to definitively confirm a diagnosis. As a result, fibromyalgia is often misdiagnosed.
In the past, some healthcare professionals even questioned whether fibromyalgia was real. Today, it’s much better understood.
Around 4 million adults in the United StatesTrusted Source, or around 2 percent, have been diagnosed with fibromyalgia. Most fibromyalgia cases are diagnosed in females. Most people get diagnosed in middle age, but fibromyalgia can also affect children.
Some of the stigmas that previously surrounded fibromyalgia have eased, but it can still be challenging to treat. Medications, therapy, and lifestyle changes can help you manage your symptoms and improve your quality of life.
You may also experience remission-type periods in which your pain and fatigue improve.
Fibromyalgia symptoms
Fibromyalgia causes what’s now referred to as regions of pain.
Some of these regions overlap with the areas of tenderness traditionally known as tender points or trigger points. However, some of these previously noted areas of tenderness are not included in the regions of pain.
The pain feels like a consistent, dull ache. A healthcare professional will consider a diagnosis of fibromyalgia if you’ve experienced musculoskeletal pain in four out of the five regions of pain outlined in the 2016 revision to the fibromyalgia diagnostic criteria.
Current diagnostic criteria refer to fibromyalgia pain as multisite pain. In contrast, the 1990 fibromyalgia diagnostic criteria defined fibromyalgia pain as chronic widespread pain.
In addition, the diagnostic process now focuses on the severity of pain and the areas of musculoskeletal pain. In the past, the duration of pain was the focal point of a fibromyalgia diagnosis.
Other symptoms of fibromyalgia include:
- fatigue
- trouble sleeping
- nonrestorative sleep, or sleeping for long periods of time without feeling rested
- headaches
- trouble focusing or paying attention
- dry eyes
- rash
- itching
- pain or a dull ache in the lower abdomen
- bladder problems, such as interstitial cystitis
- depression
- anxiety
The condition can affect your emotions as well as your physical health. Discover more signs and symptoms of fibromyalgia.
Fibro fog
Fibro fog or brain fog is a term some people use to describe the fuzzy feeling they get. Signs of fibro fog include:
- memory lapses
- difficulty concentrating
- trouble staying alert
According to a 2015 literature review, some people find mental fogginess from fibromyalgia more upsetting than the physical pain. Get tips for managing fibro fog.
Fibromyalgia treatment
There’s no cure for fibromyalgia at the moment.
Instead, treatment focuses on reducing symptoms and improving quality of life with medications, self-care strategies, and lifestyle changes.
In addition, you may wish to seek out support and guidance. This may involve joining a support group or seeing a therapist.
Fibromyalgia medication
Medications can relieve pain and help you sleep better. Common medications for fibromyalgia include pain relievers, antiseizure drugs, and antidepressants.
Pain relievers
Fibromyalgia pain can be uncomfortable enough and consistent enough to interfere with your daily routine. Do not just settle for pain. Talk with a healthcare professional about ways to manage it.
If your pain is mild, one option is to take over-the-counter pain relievers, such as:
- acetaminophen (Tylenol)
- aspirin
- ibuprofen (Advil, Motrin)
- naproxen (Aleve, Naprosyn)
These medications can lower your pain levels, reduce discomfort, and help you better manage your condition. They may even help you sleep better.
Many of them bring down inflammation, too. Though inflammation is not a primary symptom of fibromyalgia, you may experience it if you have a related condition such as rheumatoid arthritis (RA).
Please note that nonsteroidal anti-inflammatory drugs (NSAIDs) do have side effects. Caution is advised if NSAIDs are used for an extended period, as is usually the case when you’re managing a chronic pain condition.
Opioids have also been prescribed for pain relief. However, researchTrusted Source has not shown them to be effective over time. Also, the dosage for narcotics is typically increased rapidly, which can pose a health risk for people prescribed these drugs.
Tramadol (Ultram) is one of the opioids most closely associated with fibromyalgia relief. However, some experts do not consider it a traditional opioid, and any possible benefits for fibromyalgia could be due to it also being a serotonin-norepinephrine reuptake inhibitor (SNRI).
According to a 2020 studyTrusted Source, there’s not enough evidence to support or oppose the use of tramadol in fibromyalgia. More research on opioids is needed.
Antiseizure drugs
Pregabalin (Lyrica), an antiseizure drug, was the first medication the Food and Drug Administration (FDA) approved for fibromyalgia. It blocks nerve cells from sending out pain signals.
Gabapentin (Neurontin) was designed to treat epilepsy, but it may also help reduce symptoms in people with fibromyalgia. Gabapentin has not been FDA-approved to treat fibromyalgia and is considered an off-label drug.
OFF-LABEL DRUG USE
Off-label drug use means a drug that’s approved by the Food and Drug Administration (FDA) for one purpose is used for a different purpose that has not yet been approved.
However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs but not how doctors use drugs to treat their patients. So your doctor can prescribe a drug however they think is best for your care.
Antidepressants
Antidepressants such as duloxetine (Cymbalta) and milnacipran (Savella) are sometimes used to treat pain and fatigue from fibromyalgia. These medications may also work on rebalancing neurotransmitters and help improve sleep.
The FDA has approved both duloxetine and milnacipran for the treatment of fibromyalgia.
Other medications
Other drugs that are not FDA-approved to treat fibromyalgia, such as sleep aids, can help with specific symptoms. Muscle relaxers, which were once used, are no longer recommended.
Researchers are also investigating a few experimental treatments that may help people with fibromyalgia in the future.
Natural remedies for fibromyalgia
If medications do not relieve your symptoms entirely, you can look for alternatives.
Many natural remedies focus on lowering stress and reducing pain, and they can help you feel better both mentally and physically. You can use them alone or together with traditional medical treatments.
Natural remedies for fibromyalgia include:
- occupational and physical therapy, which improves your strength and reduces stress on your body
- acupuncture
- massage therapy
- meditation
- yoga, which you should approach with caution if you have hypermobility
- tai chi
- exercise
- stress-reduction techniques
- a balanced, nutrient-rich diet
- 5-hydroxytryptophan (5-HTP), an amino acid
Therapy can potentially reduce the stress that triggers fibromyalgia symptoms. Group therapy may be the most affordable option, and it can give you a chance to meet others who are going through the same issues.
Individual therapy is also available if you prefer one-on-one help. Cognitive behavioral therapy (CBT) is one approach for managing stressful situations.
It’s important to note that most alternative treatments for fibromyalgia have not been thoroughly studied or proven effective. Ask a healthcare professional about the benefits and risks before trying some of these treatments.
Fibromyalgia causes
Healthcare professionals and researchers do not know what causes fibromyalgia.
According to the latest research, the cause appears to involve a genetic disposition complemented by one or more triggers (such as infection, trauma, or stress).
Experts do not fully understandTrusted Source what causes the chronic widespread nature of fibromyalgia pain, either.
One theory is that the brain lowers the pain threshold. Sensations that were not painful before become very painful over time.
Another theory is that the brain and nerves may misinterpret or overreact to normal pain signals. They become more sensitive, to the point where they cause unnecessary or exaggerated pain. This may be due to a chemical imbalance in the brain or an abnormality in the dorsal root ganglion, which is a cluster of neurons in the spine.
Genes
Fibromyalgia often runs in families. If you have a family member with this condition, you’re at a higher risk for developing it.
Researchers think certain gene mutations may play a role. They’ve identified a few possible genes that affect the transmission of chemical pain signals between nerve cells.
Infections
A past illness could trigger fibromyalgia or make its symptoms worse. Infections that have possible links to fibromyalgia include:
- flu
- pneumonia
- Epstein-Barr virus
- gastrointestinal infections, such as those caused by the bacteria Salmonella and Shigella
Trauma
People who go through severe physical or emotional trauma may develop fibromyalgia. The condition has been linked to post-traumatic stress disorder (PTSD).
Stress
Like trauma, stress can have long-lasting effects on your body. Stress has been linked to hormonal changes that could contribute to fibromyalgia.
