Although there's currently no cure for fibromyalgia, there are treatments to help relieve some of the symptoms and make the condition easier to live with.
Fibromyalgia, also called fibromyalgia syndrome (FMS), is a long-term condition that causes pain all over the body.
Symptoms of fibromyalgia
As well as widespread pain, people with fibromyalgia may also have:
increased sensitivity to pain
extreme tiredness (fatigue)
muscle stiffness
difficulty sleeping
problems with mental processes (known as "fibro-fog"), such as problems with memory and concentration
headaches
irritable bowel syndrome (IBS), a digestive condition that causes stomach pain and bloating
If you think you have fibromyalgia, visit a GP. Treatment is available to ease some of its symptoms, although they're unlikely to disappear completely.
How fibromyalgia is treated
Although there's currently no cure for fibromyalgia, there are treatments to help relieve some of the symptoms and make the condition easier to live with.
Treatment tends to be a combination of:
medicine, such as antidepressants and painkillers
talking therapies, such as cognitive behavioural therapy (CBT) and counselling
lifestyle changes, such as exercise programmes and relaxation techniques
Exercise in particular has been found to have a number of important benefits for people with fibromyalgia, including helping to reduce pain.
What causes fibromyalgia?
The exact cause of fibromyalgia is unknown, but it's thought to be related to abnormal levels of certain chemicals in the brain and changes in the way the central nervous system (the brain, spinal cord and nerves) processes pain messages carried around the body.
It's also suggested that some people are more likely to develop fibromyalgia because of genes inherited from their parents.
In many cases, the condition appears to be triggered by a physically or emotionally stressful event, such as:
an injury or infection
giving birth
having an operation
the breakdown of a relationship
the death of a loved one
Who's affected
Anyone can develop fibromyalgia, although it affects around 7 times as many women as men.
The condition typically develops between the ages of 30 and 50, but can occur in people of any age, including children and the elderly.
It's not clear exactly how many people are affected by fibromyalgia, although research has suggested it could be a relatively common condition.
Some estimates suggest nearly 1 in 20 people may be affected by fibromyalgia to some degree.
One of the main reasons it's not clear how many people are affected is because fibromyalgia can be a difficult condition to diagnose.
There's no specific test for the condition, and the symptoms can be similar to a number of other conditions.
Support groups
Many people with fibromyalgia find that support groups provide an important network where they can talk to others living with the condition.
Fibromyalgia Action UK is a charity that offers information and support to people with fibromyalgia.
If you have any questions about fibromyalgia, call the charity's helpline on 0300 999 3333.
The charity also has a network of local support groups you may find helpful and an online community, where you can find out about news, events and ongoing research into the condition.
Fibromyalgia has many symptoms that tend to vary from person to person. The main symptom is widespread pain.
There may be periods when your symptoms get better or worse, depending on factors such as:
your stress levels
changes in the weather
how physically active you are
If you think you have fibromyalgia, visit your GP.
Treatment is available to ease some of the symptoms, although it's unlikely they'll ever disappear completely.
The main symptoms of fibromyalgia are outlined below.
Widespread pain
If you have fibromyalgia, one of the main symptoms is likely to be widespread pain.
This may be felt throughout your body, but could be worse in particular areas, such as your back or neck.
The pain is likely to be continuous, although it may be better or more severe at different times.
The pain could feel like:
an ache
a burning sensation
a sharp, stabbing pain
Extreme sensitivity
Fibromyalgia can make you extremely sensitive to pain all over your body, and you may find that even the slightest touch is painful.
If you hurt yourself, such as stubbing your toe, the pain may continue for much longer than it normally would.
You may hear the condition described in the following medical terms:
hyperalgesia – when you're extremely sensitive to pain
allodynia – when you feel pain from something that should not be painful at all, such as a very light touch
You may also be sensitive to things like smoke, certain foods and bright lights.
Being exposed to something you're sensitive to can cause your other fibromyalgia symptoms to flare up.
Stiffness
Fibromyalgia can make you feel stiff. The stiffness may be most severe when you have been in the same position for a long period of time – for example, when you first wake up in the morning.
It can also cause your muscles to spasm, which is when they contract (squeeze) tightly and painfully.
Fatigue
Fibromyalgia can cause extreme tiredness (fatigue). This can range from a mild tired feeling to the exhaustion often experienced during a flu-like illness.
Severe fatigue may come on suddenly and can drain you of all your energy. If this happens, you may feel too tired to do anything at all.
Poor sleep quality
Fibromyalgia can affect your sleep. You may often wake up tired, even when you have had plenty of sleep.
This is because the condition can sometimes prevent you sleeping deeply enough to refresh you properly.
You may hear this described as non-restorative sleep.
Cognitive problems ('fibro-fog')
Cognitive problems are issues related to mental processes, such as thinking and learning.
If you have fibromyalgia, you may have:
trouble remembering and learning new things
problems with attention and concentration
slowed or confused speech
Headaches
If fibromyalgia has caused you to experience pain and stiffness in your neck and shoulders, you may also have frequent headaches.
These can vary from being mild headaches to severe migraines, and could also involve other symptoms, such as feeling sick.
Irritable bowel syndrome (IBS)
Some people with fibromyalgia also develop irritable bowel syndrome (IBS).
IBS is a common digestive condition that causes pain and bloating in your stomach. It can also lead to constipation or diarrhoea.
Other symptoms
Other symptoms that people with fibromyalgia sometimes experience include:
dizziness and clumsiness
feeling too hot or too cold – this is because you're not able to regulate your body temperature properly
an overwhelming urge to move your legs (restless legs syndrome)
tingling, numbness, prickling or burning sensations in your hands and feet (pins and needles, also known as paraesthesia)
in women, unusually painful periods
anxiety
depression
Depression
In some cases, having the condition can lead to depression.
This is because fibromyalgia can be difficult to deal with, and low levels of certain hormones associated with the condition can make you prone to developing depression.
Depression can cause many symptoms, including:
constantly feeling low
feeling hopeless and helpless
losing interest in the things you usually enjoy
If you think you may be depressed, it's important to get help from a GP or your fibromyalgia healthcare professional, if you have been seeing one.
It's not clear why some people develop fibromyalgia. The exact cause is unknown, but it's likely that a number of factors are involved.
Here are some of the main factors thought to contribute to the condition.
Abnormal pain messages
One of the main theories is that people with fibromyalgia have developed changes in the way the central nervous system processes the pain messages carried around the body.
This could be the result of changes to chemicals in the nervous system.
The central nervous system (brain, spinal cord and nerves) transmits information all over your body through a network of specialised cells.
Changes in the way this system works may explain why fibromyalgia results in constant feelings of, and extreme sensitivity to, pain.
Chemical imbalances
Research has found people with fibromyalgia have abnormally low levels of the hormones serotonin, noradrenaline and dopamine in their brains.
Low levels of these hormones may be a key factor in the cause of fibromyalgia, as they're important in regulating things like:
mood
appetite
sleep
behaviour
your response to stressful situations
These hormones also play a role in processing pain messages sent by the nerves. Increasing the hormone levels with medication can disrupt these signals.
Some researchers have also suggested that changes in the levels of some other hormones, such as cortisol, which is released when the body is under stress, may contribute to fibromyalgia.
Sleep problems
It's possible that disturbed sleep patterns may be a cause of fibromyalgia, rather than just a symptom.
Fibromyalgia can prevent you sleeping deeply and cause extreme tiredness (fatigue).
People with the condition who sleep badly can also have higher levels of pain, suggesting that these sleep problems contribute to the other symptoms of fibromyalgia.
Genetics
Research has suggested genetics may play a small part in the development of fibromyalgia, with some people perhaps more likely than others to develop the condition because of their genes.
If this is the case, genetics could explain why many people develop fibromyalgia after some sort of trigger.
Possible triggers
Fibromyalgia is often triggered by a stressful event, including physical stress or emotional (psychological) stress.
Possible triggers for the condition include:
an injury
a viral infection
giving birth
having an operation
the breakdown of a relationship
being in an abusive relationship
the death of a loved one
But in some cases fibromyalgia does not develop after any obvious trigger.
Associated conditions
There are several other conditions often associated with fibromyalgia.
Generally, these are rheumatic conditions (affecting the joints, muscles and bones), such as:
osteoarthritis – when damage to the joints causes pain and stiffness
lupus – when the immune system mistakenly attacks healthy cells and tissues in various parts of the body
rheumatoid arthritis – when the immune system mistakenly attacks healthy cells in the joints, causing pain and swelling
ankylosing spondylitis – pain and swelling in parts of the spine
temporomandibular disorder (TMD) – a condition that can cause pain in the jaw, cheeks, ears and temples
Conditions like these are usually tested for when diagnosing fibromyalgia.
If you think you have fibromyalgia, visit your GP. Diagnosing fibromyalgia can be difficult, as there's no specific test to diagnose the condition.
The symptoms of fibromyalgia can vary and are similar to those of several other conditions.
During diagnosis, you'll be asked about how your symptoms are affecting your daily life.
Your body will also be examined to check for visible signs of other conditions – for example, swollen joints may suggest arthritis, rather than fibromyalgia.
Ruling out other conditions
If your GP thinks you may have fibromyalgia, they'll first have to rule out all other conditions that could be causing your symptoms.
These conditions may include:
chronic fatigue syndrome (also known as ME) – a condition that causes long-term tiredness
rheumatoid arthritis – a condition that causes pain and swelling in the joints
multiple sclerosis (MS) – a condition of the central nervous system (the brain and spinal cord) that affects movement and balance
Tests to check for some of these conditions include urine and blood tests, although you may also have X-rays and other scans.
If you're found to have another condition, you could still have fibromyalgia as well.
Criteria for diagnosing fibromyalgia
For fibromyalgia to be diagnosed, certain criteria usually have to be met.
The most widely used criteria for diagnosis are:
you either have severe pain in 3 to 6 different areas of your body, or you have milder pain in 7 or more different areas
your symptoms have stayed at a similar level for at least 3 months
no other reason for your symptoms has been found
The extent of the pain used to be assessed by applying gentle pressure to certain "tender points", where any pain is likely to be at its worst. But this is less common nowadays.
Diagnosing other conditions
It's also possible to have other conditions alongside your fibromyalgia, such as:
depression
anxiety
irritable bowel syndrome (IBS)
If your symptoms suggest that you have another condition as well as fibromyalgia, you may need further tests to diagnose these.
Identifying all possible conditions will help guide your treatment.
Treatment for fibromyalgia tries to ease some of your symptoms and improve quality of life, but there's currently no cure.
Your GP will play an important role in your treatment and care. They can help you decide what's best for you, depending on what you prefer and the available treatments.
In some cases, several different healthcare professionals may also be involved in your care, such as a:
rheumatologist – a specialist in conditions that affect muscles and joints
neurologist – a specialist in conditions of the central nervous system
psychologist – a specialist in mental health and psychological treatments
Fibromyalgia has numerous symptoms, meaning that no single treatment will work for all of them.
Treatments that work for some people will not necessarily work for others.
You may need to try a variety of treatments to find a combination that suits you.
This will normally be a combination of medication and lifestyle changes.
Information and support
You may find it helpful to research fibromyalgia to improve your understanding of the condition.
Many people also find support groups helpful. Just talking to someone who knows what you're going though can make you feel better.
You can visit UK Fibromyalgia's support group section for a list of fibromyalgia support groups across the country.
Fibromyalgia Action UK is a charity that offers information and support to anyone who has fibromyalgia.
It has a telephone service (0300 999 3333) you can call with any questions about the condition.
It also has a network of local support groups you may find helpful.
There's also an online community where you can find out about news, events and ongoing research.
Medication
You may need to take several different types of medicines for fibromyalgia, including painkillers and antidepressants.
Painkillers
Simple painkillers that are available over the counter from a pharmacy, such as paracetamol, can sometimes help relieve the pain associated with fibromyalgia.
But these are not suitable for everyone, so make sure you read the manufacturer's instructions that come with the medication before using them.
If over-the-counter painkillers are not effective, your GP (or another healthcare professional treating you) may prescribe a stronger painkiller, such as codeine or tramadol.
But these painkillers can be addictive and their effect tends to weaken over time.
This means that your dose may need to be gradually increased and you could experience withdrawal symptoms if you stop taking them.
Other side effects include diarrhoea and extreme tiredness (fatigue).
Antidepressants
Antidepressant medication can also help relieve pain for some people with fibromyalgia.
They boost the levels of certain chemicals that carry messages to and from the brain, known as neurotransmitters.
Low levels of neurotransmitters may be a factor in fibromyalgia, and it's believed that increasing their levels may ease the widespread pain associated with the condition.
There are different types of antidepressants. The choice of medicine largely depends on the severity of your symptoms and any side effects the medicine may cause.
Antidepressants used to treat fibromyalgia include:
tricyclic antidepressants, such as amitriptyline
serotonin-noradrenaline reuptake inhibitors (SNRIs), such as duloxetine and venlafaxine
selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and paroxetine
A medication called pramipexole, which is not an antidepressant but also affects the levels of neurotransmitters, is sometimes used as well.
Antidepressants can cause a number of side effects, including:
feeling sick
a dry mouth
drowsiness
feeling agitated, shaky or anxious
dizziness
weight gain
constipation
For information on the side effects of your particular medication, check the patient information leaflet that comes with it.
Medication to help you sleep
As fibromyalgia can affect your sleeping patterns, you may want medicine to help you sleep.
If you're sleeping better, you may find that other symptoms are not as severe.
Speak to your GP if you think you could benefit from a medicine like this.
They may recommend an over-the-counter remedy, or prescribe a short course of a stronger medication.
Some antidepressants may also improve your sleep quality.
Read more about treating insomnia for information on good sleeping techniques and medicines to help you sleep.
Muscle relaxants
If you have muscle stiffness or spasms (when the muscles contract painfully) as a result of fibromyalgia, your GP may prescribe a short course of a muscle relaxant, such as diazepam.
These medicines may also help you sleep better because they can have a sedative (sleep-inducing) effect.
Anticonvulsants
You may also be prescribed an anticonvulsant (anti-seizure) medicine, as these can be effective for those with fibromyalgia.
The most commonly used anticonvulsants for fibromyalgia are pregabalin and gabapentin.
These are normally used to treat epilepsy, but research has shown they can improve the pain associated with fibromyalgia in some people.
Some common side effects of pregablin and gabapentin include:
dizziness
drowsiness
swelling of your hands and feet (oedema)
weight gain
Antipsychotics
Antipsychotic medicines, also called neuroleptics, are sometimes used to help relieve long-term pain.
Studies have shown that these medications may help conditions like fibromyalgia, but further research is needed to confirm this.
Possible side effects include:
drowsiness
tremors (shaking)
restlessness
Other treatment options
As well as medication, there are other treatment options that can be used to help cope with the pain of fibromyalgia.
These include:
swimming, sitting or exercising in a heated pool or warm water (known as hydrotherapy or balneotherapy)
an individually tailored exercise programme
cognitive behavioural therapy (CBT) – a talking therapy that aims to change the way you think about things, so you can tackle problems more positively
psychotherapy – a talking therapy that helps you understand and deal with your thoughts and feelings
relaxation techniques
psychological support – any kind of counselling or support group that helps you deal with issues caused by fibromyalgia
Alternative therapies
Some people with fibromyalgia try complementary or alternative treatments, such as:
acupuncture
massage
manipulation
aromatherapy
There's little scientific evidence that such treatments help in the long term.
But some people find certain treatments help them relax and feel less stressed, allowing them to cope with their condition better.
Research into some complementary medicines, such as plant extracts, has found they're not effective in treating fibromyalgia.
If you decide to use any complementary or herbal remedies, check with your GP first.
Some remedies can react unpredictably with other medication or make it less effective.
Treating other conditions
If you have been diagnosed with fibromyalgia and another condition, such as depression or irritable bowel syndrome (IBS), you may need to have separate treatment for these.
For example, additional counselling or medication may be recommended.
If you have fibromyalgia, there are several ways to change your lifestyle to help relieve your symptoms and make your condition easier to live with.
Your GP, or another healthcare professional treating you, can offer advice and support about making these changes part of your everyday life.
There are organisations to support people with fibromyalgia that may also be able to offer advice.
Visit UK Fibromyalgia's support group section for a list of support groups across the country.
You may also find it helpful to talk to other people with fibromyalgia on this online community.
Below are some tips that may help relieve symptoms of fibromyalgia.
You can also read more information about living with pain.
Exercise
As extreme tiredness (fatigue) and pain are 2 of the main symptoms of fibromyalgia, you may find that you're not able to exercise as much as you'd like.
But an exercise programme specially suited to your condition can help you manage your symptoms and improve your overall health.
Your GP or physiotherapist may be able to refer you to a health professional who specialises in helping people with fibromyalgia work out an exercise plan.
The plan is likely to involve a mixture of aerobic and strengthening exercises.
Aerobic exercise
Aerobic activities are any kind of rhythmic, moderate-intensity exercises that increase your heart rate and make you breathe harder.
Examples include:
walking
cycling
swimming
Research suggests that aerobic fitness exercises should be included in your personalised exercise plan, even if you cannot complete these at a high level of intensity.
For example, if you find jogging too difficult, you could try brisk walking instead.
A review of a number of studies found aerobic exercises may improve quality of life and relieve pain.
As aerobic exercises increase your endurance (how long you can keep going), these may also help you function better on a day-to-day basis.
Resistance and strengthening exercises
Resistance and strengthening exercises are those that focus on strength training, such as lifting weights.
These exercises need to be planned as part of a personalised exercise programme. If they're not, muscle stiffness and soreness could be made worse.
A review of a number of studies concluded that strengthening exercises may improve:
muscle strength
physical disability
depression
quality of life
People with fibromyalgia who completed the strengthening exercises in these studies said they felt less tired, could function better and experienced a boost in mood.
Improving the strength of your major muscle groups can make it easier to do aerobic exercises.
Find out more about health and fitness
Pacing yourself
If you have fibromyalgia, it's important to pace yourself. This means balancing periods of activity with periods of rest, and not overdoing it or pushing yourself beyond your limits.
If you do not pace yourself, it could slow down your progress in the long term.
Over time, you can gradually increase your periods of activity while making sure they're balanced with periods of rest.
If you have fibromyalgia, you'll probably have some days when your symptoms are better than others.
Try to maintain a steady level of activity without overdoing it, but listen to your body and rest whenever you need to.
Avoid any exercise or activity that pushes you too hard as this can make your symptoms worse.
If you pace your activities at a level that's right for you, rather than trying to do as much as possible in a short space of time, you should make steady progress.
For example, it may help to start with gentler forms of exercise, such as tai chi, yoga and pilates, before attempting more strenuous aerobic or strengthening exercises.
Relaxation
If you have fibromyalgia, it's important to regularly take time to relax or practise relaxation techniques.
Stress can make your symptoms worse or cause them to flare up more often. It could also increase your chances of developing depression.
There are many relaxation aids available, including books, tapes and courses, although deep-breathing techniques or meditation may be just as effective.
Try to find time each day to do something that relaxes you. Taking time to relax before bed may also help you sleep better at night.
Talking therapies, such as counselling, can also be helpful in combating stress and learning to deal with it effectively.
Your GP may recommend you try this as part of your treatment.
Find out more about stress management
Better sleeping habits
Fibromyalgia can make it difficult to fall asleep or stay asleep, known as insomnia.
If you have problems sleeping, it may help to:
get up at the same time every morning
try to relax before going to bed
try to create a bedtime routine, such as taking a bath and drinking a warm, milky drink every night
avoid caffeine, nicotine and alcohol before going to bed
avoid eating a heavy meal late at night
make sure your bedroom is a comfortable temperature and is quiet and dark
avoid checking the time throughout the night
READ ORIGINAL ARTICLE
