What is fibromyalgia?
Fibromyalgia is a chronic pain disorder. Fibromyalgia symptoms include widespread pain in muscles and other soft tissues, trouble sleeping, and extreme fatigue. Some patients have emotional and mental health problems. It’s common for patients to have numerous tender points (painful to touch or pressure) throughout the body. The pain may come and go, but fatigue and overuse can make the pain and stiffness worse.
Who gets fibromyalgia?
In the United States, 2 to 4% of the population—about 6 to 12 million people—have fibromyalgia. Anyone can develop it, but there are certain trends:
Fibromyalgia is 2 to 7 times more common in women than men.
Fibromyalgia develops most commonly in middle age. However, it can also begin during the teenage years or later in life.
People with a mother, father or sibling with fibromyalgia are eight times more likely to develop the condition.
Fibromyalgia does not appear to affect one race or ethnic background more than another.
What are some conditions related to fibromyalgia?
Conditions with symptoms and characteristics similar to or overlapping with fibromyalgia include:
Chronic fatigue syndrome—a condition characterized by extreme fatigue, sleep problems, and intolerance to exertion
Chronic pain—a state of persistent pain for weeks, months or years due to an injury, long-term disease, or a condition like fibromyalgia
Regional pain syndrome—a chronic disorder oftentimes triggered by direct damage to the nervous system
Interstitial cystitis—a chronic, painful inflammation of the bladder with no known cause
Temporomandibular disorder—also known as TMJ syndrome or simply TMJ, this painful disorder involves the jaw joint and surrounding muscles
How does fibromyalgia affect quality of life?
Measuring health-related quality of life is a standard way to find out how an illness impacts people with the condition. It can help guide effective treatments and disease management. Quality of life includes physical, mental and social well-being. The health-related quality of life for people with fibromyalgia is lower than with other chronic conditions. This is based on responses to multiple self-reporting and clinical questionnaires.
Factors contributing to lower quality of life in adults with fibromyalgia include:
Disability, which seems to depend on the extent of psychological problems the patient experiences
Co-existing rheumatic and musculoskeletal conditions including rheumatoid arthritis, lupus, and ankylosing spondylitis
Co-existing mental health conditions including depression and anxiety
Higher healthcare costs from disease treatment, doctor visits, and hospital stays. One-third of fibromyalgia patients spend $100 to $1,000 per month on office visits alone.
Studies show greater self-efficacy is related to better physical ability and quality of life. Self-efficacy is belief in one’s ability to reach a goal or overcome a challenge. Physical activity, eating right, and healthy coping strategies are signs of good self-efficacy.
Can you die from fibromyalgia?
Fibromyalgia is not a life-threatening condition. It also does not cause physical damage to the body. However, it is associated with significant sleep problems and mental health conditions like depression. Severe depression can be life threatening because of the risk of suicide. The rate of suicide deaths is greater in people with fibromyalgia. It is critical for fibromyalgia patients to seek treatment for a mood disorder in addition to physical symptoms.
Fibromyalgia patients can enjoy a more normal life and a better outlook. The key is consistent and comprehensive treatment in a supportive, low-stress environment.
What causes fibromyalgia?
The cause of fibromyalgia is not known, but most studies indicate it is related to how the nervous system processes pain. People with fibromyalgia are more sensitive to pain; they respond to a pain stimulus to a greater degree than people without fibromyalgia.
Some of the genes studied in fibromyalgia research are involved in making and breaking down neurotransmitters in the brain. Neurotransmitters are natural chemicals that pass signals between nerve cells. This includes pain signals. The underlying problem in fibromyalgia may stem from abnormal pain processing in the brain. As such, some experts describe fibromyalgia as central pain amplification disorder—the brain’s ‘pain sensation’ volume is set abnormally high.
Fibromyalgia is not an autoimmune or inflammatory disease. However, people who have a musculoskeletal autoimmune disease, like rheumatoid arthritis, have a greater risk of developing fibromyalgia.
Factors that may trigger the condition include:
Emotional or physical stress, such as a car accident, abuse, child neglect, or exposure to war or other type of traumatic event
Sleep problems such as insomnia
How is fibromyalgia diagnosed?
A patient’s symptom and medical history are the basis of a fibromyalgia diagnosis. Previously, a patient had to have a certain number of tender points for a fibromyalgia diagnosis. This is no longer necessary, but healthcare providers may still consider the number of pain points in the diagnosis.
Healthcare providers may diagnose fibromyalgia in patients with the following signs and symptoms:
Widespread pain in certain areas. There are up to 19 points on the body that may feel tender in a fibromyalgia patient. The neck, shoulders, chest, lower back, thighs, and arms are commonly affected, as well as joints.
Not feeling refreshed after sleep
Thinking and memory problems
Emotional problems including mood disorders
Symptoms lasting at least three months
There is no specific test for fibromyalgia, but blood and imaging tests can help rule out other possible causes. Although fibromyalgia is not a joint disease, it can cause arthritis-like joint pain and fatigue. For this reason, many people see a rheumatologist for diagnosis. Pain specialists, family medicine doctors, and other doctors can treat people with fibromyalgia too. It’s important to find a doctor with experience treating patients with fibromyalgia.
What are common treatments for fibromyalgia?
There is no cure for fibromyalgia; the goal of treatment is to improve the patient’s symptoms and functional abilities. The U.S. Food and Drug Administration has approved drugs specifically for treating fibromyalgia symptoms. However, it is equally important to treat any underlying conditions that can make fibromyalgia worse. Examples include depression, anxiety, or a sleep disorder.
Common and evidence-based fibromyalgia treatments include:
Counseling including talk therapy
Medications to control pain, manage mood disorders, and improve sleep
Physical activity, particularly aerobic exercise
Self-help strategies including good sleep hygiene, mindfulness, stress management, and a healthy diet
Medications for fibromyalgia contain active ingredients originally prescribed for other conditions but have since proven useful for fibromyalgia sufferers. These include:
Antidepressants and medicines originally prescribed for anxiety or panic disorder
Pain control medicines including duloxetine (Cymbalta), milnacipran (Savella), pregabalin (Lyrica), gabapentin (Neurontin), and amitriptyline (Elavil) work by muting or disrupting abnormal pain signals
Sleep medicines including low-dose tricyclic antidepressants
Additional fibromyalgia facts
The fact that people with fibromyalgia do not look like they have an illness has hampered its acceptance as a medical condition. With more research and medicines approved specifically for fibromyalgia, the outlook is rapidly changing. Music performer Lady Gaga’s 2017 disclosure of her fibromyalgia has helped lead the way to greater recognition.