Imagine experiencing pain all over your body that makes you unable to sleep or have disturbed sleep at night, giving you fatigue, numbness of hands and feet, and recurrent headaches.
Well, this could be fibromyalgia, also called fibromyalgia syndrome, a long-term condition that causes pain all over the body.
In the past, other terms were used to describe the condition, including muscular rheumatism and fibrositis. The condition may even have been misdiagnosed as degenerative joint disease.
We now know that fibromyalgia isn’t linked to inflammatory or degenerative arthritis, even though the symptoms may sometimes be very similar.
Fibromyalgia in itself doesn’t cause any lasting damage to the body’s tissues. However, it’s important to keep as active as you can to avoid weakening of the muscles, which could lead to secondary problems.
How does the condition present?
The main symptoms of fibromyalgia include widespread pain, extreme tiredness (fatigue), sleep disturbance, tingling or numbness of hands and feet, headaches, irritability or feeling miserable, urgent need to urinate, especially at night, irritable or uncomfortable bowels — diarrhoea or constipation and abdominal pain — sometimes separately diagnosed as irritable bowel syndrome.
What causes fibromyalgia?
We don’t yet know exactly what causes fibromyalgia, but research suggests that there’s an interaction between physical, neurological and psychological factors.
The pain we feel is often affected by our emotions and moods — depression or anxiety can make the pain seem worse. At the same time, being in pain can lead to stress, worry or low mood.
Usually, you may feel pain when part of the body is damaged (as in arthritis) or suffers a physical injury. The pain people with fibromyalgia feel is different because it’s not directly caused by damage or injury to the area that’s hurting.
Instead, there’s a problem with the way the brain and nervous system process pain from that area. This doesn’t mean the pain is any less real, but because there’s no physical damage that can be healed there’s no easy way to stop the pain. This is why fibromyalgia pain can be long-lasting (chronic).
Research has shown that people with fibromyalgia are more sensitive to physical pressure. This means that what would be a relatively minor knock for most people could be extremely painful for someone with fibromyalgia.
This increased sensitivity isn’t fully understood but it’s thought that it could be related to changes in the way the nervous system processes pain.
Some researchers have shown using special brain scans that these processes are altered in people with fibromyalgia.
Sleep disturbance may also contribute to this increased sensitivity. Brainwave studies show that people with fibromyalgia often lose deep sleep.
Several things may lead to sleep disturbance, for example, pain from an injury or another condition such as arthritis, stress at work or strain in personal relationships, depression brought by illness or unhappy events.
People with fibromyalgia quite often report that their symptoms started after an illness or accident, or following a period of emotional stress and anxiety.
However, others can’t recall any particular event leading up to the onset of symptoms.
How is fibromyalgia diagnosed?
Fibromyalgia is often difficult to diagnose because the symptoms vary considerably and could have other causes.
The symptoms can be similar to those of other conditions, for example, hypothyroidism or autoimmune conditions such as rheumatoid arthritis.
At present, there are no specific blood tests, X-rays or scans that can confirm the diagnosis of fibromyalgia, and many people with fibromyalgia will have normal results in all these tests.
However, your doctor may suggest you have blood tests to rule out other possible causes of your symptoms and so support the diagnosis of fibromyalgia.
Who is more at risk of fibromyalgia?
Women are reported to be twice as likely to suffer from fibromyalgia as men. Though it’s not scientifically proven, one of the reasons women may be at greater risk is because of factors such as hormonal changes and the potential for higher stress due to menstruation, menopause or pregnancy.
How is this condition treated?
There’s no cure as yet for fibromyalgia, but there are ways of managing your symptoms. Your doctor can suggest treatments and therapies to tackle specific aspects of the condition.
These may include drug treatments but physical and other therapies are also important.
Treatment tends to be a combination of:
Medication such as antidepressants, pregabalin, gabapentin and painkillers.
Talking therapies such as cognitive behavioural therapy and counselling.
Physiotherapy can help you to improve your posture, physical function and quality of life, and gradually become more active.
