A Closer Look at Fibromyalgia

The hallmark symptoms of fibromyalgia are chronic muscle pain, fatigue, sleep and memory problems, and tenderness at certain points on the body. Emotional and physical stress may trigger the condition, but genetic factors also play a role. Not everyone who has fibromyalgia will have all the disorder’s characteristics, and some symptoms may lie in remission for a time. Living with it can be challenging. However, research is ongoing, and several medications are available for managing symptoms.

Keep reading to learn more about fibromyalgia symptoms, what may cause it, and treatment options.

Fibromyalgia is a widespread chronic pain condition affecting an estimated 4 million adults in the United States. Another name for it is fibromyalgia syndrome.

Clinicians initially considered fibromyalgia a rheumatological condition because joint pain is a common symptom. More recent research suggests it is a pain processing condition involving the brain and how it interprets signals from the rest of the body.

Fibromyalgia is often associated with widespread muscle pain that does not go away. Certain areas of the body, called “tender points,” may be more sensitive to touch than others.

You may experience these symptoms daily or occasionally with varying intensity:

• tenderness, which may affect both sides of the:
  • neck
  • shoulders
  • chest
  • lower back
  • lower and upper arms
  • lower and upper legs
• muscle pain and stiffness
• fatigue
• numbness and tingling in feet and hands
• decreased tolerance for exercise
• digestive problems, such as diarrhea or constipation
• migraine or tension headache
• sleep disturbances

These symptoms, which can also vary in frequency and intensity, include:

• anxiety
• depression
• difficulty thinking clearly
• difficulty with memory

Contact your doctor straight away if you are experiencing symptoms that persist. Getting professional medical help is the best way to get an accurate diagnosis.

The cause of fibromyalgia is unknown, but research indicates that people with fibromyalgia process pain signals uniquely.

Some experts describe fibromyalgia as a central pain amplification disorder, meaning the brain’s pain sensation volume is set too high. This makes people feel pain that others would not feel. People with this condition respond to a pain stimulus to a greater degree than people without fibromyalgia.

Fibromyalgia is partly genetic. You are eight times more likely to develop fibromyalgia if your mother, father, or sibling has it. Several genes are probably involved because it does not follow a clear inheritance pattern.

Factors that can increase the chance of developing fibromyalgia include:

• older age
• female sex assigned at birth, as it is twice as common in females than males  
• first-degree relative with fibromyalgia
• obesity
• having a rheumatic condition, such as:
  • ankylosing spondylitis
  • rheumatoid arthritis
  • lupus

Fibromyalgia has also developed in people following a traumatic injury, illness, or event.

Doctors base a fibromyalgia diagnosis on your symptoms, physical exam, medical history, and the results of certain tests. The American College of Rheumatology (ACR) fibromyalgia diagnostic criteria include:

• generalized pain, at present, in at least 4 of 5 regions listed above
• widespread pain index (WPI) of at least 7 out of 10 and symptom severity scale (SSS) of at least 5 for:
  • fatigue
  • not feeling refreshed after sleep
  • deficits in concentration, thinking, or memory
• symptoms lasting at least 3 months

An alternate ACR criterion is a WPI of 4–6 and SSS of at least 9.

Clinicians also order blood tests and perhaps imaging tests to help narrow the diagnosis and rule out other potential causes of symptoms. Tests may include the FM/a test, which analyzes certain white blood cell markers. These markers can help distinguish fibromyalgia from rheumatoid arthritis.

Learn more about diagnostic tests for fibromyalgia diagnosis here.

The goal of treating fibromyalgia is to reduce symptoms and increase function. To reduce symptoms, doctors may prescribe a combination of these types of medications:

• antidepressants, such as duloxetine (Cymbalta), fluoxetine (Prozac), or milnacipran (Savella)
• antiseizure medications, such as gabapentin (Neurontin) and pregabalin (Lyrica)
• pain relievers
• sleep medications

Learn about complementary and alternative treatments for fibromyalgia here.

Fibromyalgia is not a life threatening condition. It also does not cause physical damage to the body. However, the condition can be a burden and reduce a person’s quality of life. Depression, a complication of fibromyalgia, can be life threatening because of the risk of suicide. It is vital for people with fibromyalgia to seek treatment for a mood disorder in addition to physical symptoms.

Consistent and comprehensive treatment in a supportive, low-stress environment can help increase the quality of life.

Complications of fibromyalgia can include:

• decreased quality of life
• depression
• rheumatic conditions, such as rheumatoid arthritis, systemic lupus, and osteoarthritis
• excess weight gain

Here are some other questions that people have asked about fibromyalgia.

The tender points come in pairs that can involve both sides of the body. There are four pairs on the front (8 points) and five pairs on the back (10 points). These include:

• front of neck
• upper chest
• elbows
• knees
• behind your ear toward the back of your head
• trapezius muscles
• shoulder blades
• hips
• buttocks

Many primary care doctors and internists treat fibromyalgia, as do certain specialists, such as a rheumatologist. Neurologists and pain medicine doctors may also treat fibromyalgia, as it has roots in the central nervous system. Just make sure your doctor has experience treating the condition.

Fibromyalgia is often a lifelong condition, but it does not worsen with time or cause damage. Medical treatment and self-care can help relieve symptoms, which may make it easier to function and cope with the condition.

Possibly. Studies from 2014 and 2017 show that most people with fibromyalgia met the criteria for somatic symptom disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).

The FM/a blood test is one of several tests a doctor may order when evaluating potential symptoms of fibromyalgia. It measures the amount of certain immune markers after stimulating specific cells in the blood sample.

Fibromyalgia is a condition marked by chronic pain, which tends to occur in specific areas of the body. Fatigue, sleep problems, and difficulty with memory and thinking may also be present. The cause of fibromyalgia is not completely understood.

Fibromyalgia does not cause physical damage, but it can disrupt quality of life and cause depression. People with fibromyalgia may benefit from talk therapy. Treatment options include medications to reduce pain and other symptoms, self-care, and potential lifestyle changes.