Medical experts are still unclear on the cause of fibromyalgia. Yes, it can be genetic. However, fibromyalgia can also be brought on by certain conditions or events like being born premature, traumatic life events, experiencing severe viral infections, poor sleep habits, or lack of exercise. With that many potential causes, it’s a wonder that more people aren’t diagnosed with it. Researchers believe fibromyalgia amplifies pain by affecting how your brain and spinal cord process painful or non-painful signals (via Cleveland Clinic). This change could result from changes to chemicals in the nervous system, as people with the disease have been found to have abnormally low levels of serotonin, noradrenaline, and dopamine.
Changes in these hormones could be a critical factor in the cause of fibromyalgia (via Cleveland Clinic). Why? Because they play essential roles in regulating mood, appetite, sleep, and stress responses. As mentioned previously, possible triggers for fibromyalgia could include major psychological stressors like abusive relationships, a traumatic breakup, an operation, giving birth, or even the death of a loved one.
There are other conditions doctors associate with fibromyalgia.
Women are twice more likely to develop fibromyalgia, and up to 20% of patients who suffer from other chronic disorders can develop fibromyalgia (via NHS). These other disorders are generally rheumatic – in other words, they usually affect the joints, muscles, and bones. Osteoarthritis causes pain and stiffness to the joints after sustaining any damage. Lupus is when the immune system mistakenly attacks the body’s healthy cells and tissues. Rheumatoid arthritis is when the immune system mistakenly attacks healthy cells in the joints, causing pain and swelling, similar to lupus. Ankylosing spondylitis can cause pain and swelling in parts of the spine, and TMD is short for temporomandibular disorder, which is a condition that can cause pain in the jaw, cheeks, ears, and temples.
These conditions are all tested for when diagnosing fibromyalgia. Other related disorders include irritable bowel syndrome, chronic fatigue syndrome, migraines or other chronic headaches. More disorders you may have to deal with include painful bladder syndrome (also known as interstitial cystitis). There is also anxiety, depression, or postural tachycardia syndrome (POTS). POTS is a condition that affects blood flow. As a result, it can lead to lightheadedness, fainting, elevated heart rates, and chest pain. Those are at least the most common symptoms of POTS. In most of these co-morbidity cases, doctors believe that the issue is due to how the body processes pain signals (via NHS).
Diagnosing the condition can prove difficult, as there are no specific tests for fibromyalgia.
Fibromyalgia symptoms can vary and can easily be mistaken for other diseases like those mentioned above. During the diagnosis phase, a patient can be asked about how severe their symptoms are, how they affect their daily life, and they can be examined for visible signs of other conditions. Swelling in the joints could indicate arthritis, for example, whereas generalized musculoskeletal pain might be more indicative of fibromyalgia (via NHS). It is essential to rule out other conditions causing your symptoms with blood tests, urine tests, x rays, MRIs, and other possible scans. It is worth noting that you could have fibromyalgia along with another condition!
To be diagnosed with fibromyalgia, specific criteria must be met. The most commonly used criteria are the three following criteria: severe pain in three to six different areas of the body (or milder pain in seven or more), consistent levels of pain for a minimum of three months, and no other diagnosed reason for the symptoms. Other indicators might include fatigue, memory and concentration difficulties, poor sleep, depressive symptoms, and IBS (via NHS). It is crucial to identify all possible conditions to help guide your most effective treatment. Tender points were used as a diagnostic tool at one point; read on to learn more about them.
One of the difficulties in diagnosing fibromyalgia is the variety of its symptoms.
Fibromyalgia pain can be intense and unrelenting – there is no doubt that it can disrupt everyday activities with its physical and emotional symptoms. In a National Health Interview survey, 90 percent of participants reported that constant fatigue affects them. This fatigue is not just being tired; the exhaustion limits their ability to function daily. Over 43 percent of participants also reported anxiety and depression severe enough to need medical intervention, and 87 percent reported having pain every day (via NHS).
As mentioned previously, IBS, or irritable bowel syndrome, is also a common affliction amongst people living with fibromyalgia: between 40-70 percent, in fact (via NHS). They can regularly experience diarrhea and/or constipation, belly pain, bloating, gas, and nausea. Other patients with fibromyalgia can experience severe depression and anxiety, which can also explain the sleep issues as well as the memory and concentration problems. Headaches and migraines are also commonly experienced by those diagnosed with fibromyalgia.
Though fibromyalgia may seem like a bit of a jumbled mess of symptoms, there are some known risk factors, and age is one of them (via CDC). Though it can affect people of all ages, including children, most diagnoses will occur during middle age. You are more likely to experience fibromyalgia as you age. If you have lupus or rheumatoid arthritis, you are also more likely to develop fibromyalgia, unfortunately. They have similar symptoms, though blood tests will confirm diagnoses (via CDC).
Other factors have been tied to fibromyalgia, though their association is not as compelling and requires more research. These possible risk factors include sex, as women are twice as likely to develop fibromyalgia as men are, stressful or traumatic events, repetitive injuries, illnesses, family histories of fibromyalgia or related illnesses, and obesity. Keep reading about more information regarding fibromyalgia, including ways to treat it.
Fibromyalgia may not have a cure, but you can treat and manage it.
Fibromyalgia is a chronic, long-term diagnosis, which means it will unfortunately not be cured. However, with dedicated management and medication, it can be treated. Furthermore, the condition does not necessarily have to change the quality of the patient’s life. Typically, a rheumatologist or a doctor specializing in the treatment of fibromyalgia and other types of arthritis should be responsible for creating a healthcare plan. This plan may include medications, whether over the counter or prescription drugs, aerobic and muscle-strengthening exercises, and stress management techniques, such as meditation or massage. It is also essential to develop good sleep hygiene and undergo cognitive behavioral therapy (CBT) to treat any underlying depression. CBT is a form of talk therapy meant to change our thoughts and actions.
The European League against Rheumatism (EULAR) recommends against using non-steroidal anti-inflammatory drugs to treat fibromyalgia, mainly because their effect is weak for fibromyalgia users and not intended for the long run. Antidepressants like duloxetine, pregabalin, and milnacipran may help reduce pain, oddly enough (via EULAR). Furthermore, your doctor may prescribe anti-seizure drugs (via EULAR). However, research shows that patients tend to stop using these drugs because of their side effects. These medical treatments can all help manage pain and self-management strategies. Keep reading for more information about how you can apply these treatments to your daily life if you deal with fibromyalgia.
Self-management education workshops are great strategies for anyone dealing with fibromyalgia.
Self-management programs and education workshops are interactive programs in the community that can teach patients how to manage their fibromyalgia (or other chronic conditions). In fact, the CDC even promotes some of them! The Chronic Disease Self-Management Program is proven to improve the quality of life of adults with arthritis, and any state or national partners with CDC funding and disseminate this program (via CDC). It is also available as a Spanish curriculum. What will you do? Well, it is a practical self-management education workshop for anyone with arthritis, diabetes, and lung and heart disease. It covers appropriate exercise techniques, medications, effective communications about the diseases, nutrition, and evaluating new treatments. Research indicates that participants reported improvements in exercise, ability to participate in social activities, lowered depression rates, reduced pain levels, and increased confidence in their ability to manage their conditions.
The CDC also has a list of “Promising Programs.” These have some evidence to document health benefits but are still not entirely widespread. For example, “Better Choices, Better Health” is the online version of the Chronic Disease Self-Management Program. There is a “Better Choices, Better Health for Arthritis” curriculum and a mailed curriculum toolkit. Other self-paced self-management programs with similar structures include the Arthritis Self-Management Program by Dr. Kate Lorig (also available in Spanish) and the Arthritis Tool Kit (via CDC).
This article mentions that fibromyalgia is a chronic illness with many factors. Therefore, it makes sense that there can be many related complications to being diagnosed with fibromyalgia, such as frequent hospitalizations. You are twice more likely to be hospitalized if you have fibromyalgia than someone without it (via CDC). Also called fibro fog, mental fog can cause lasting memory and cognitive problems that interfere with concentrating for an extended period (via CDC).
You may experience a lower quality of life in general, especially since those diagnosed with fibromyalgia tend to experience higher rates of major depression. Adults with fibromyalgia are more than three times more likely to have major depression than adults without, so it is vital to screen and treat for depression. People with fibromyalgia also experience higher death rates from suicide and injuries. Not only that, but you have a higher incidence of other rheumatic conditions. This often co-occurs with other types like osteoarthritis, rheumatoid arthritis, lupus, or ankylosing spondylitis.
Physical activity is vital in managing fibromyalgia pain.
Getting physically active may sound like the absolute last thing you want to do when your whole body aches. However, experts recommend getting moderate activity for a minimum of 150 minutes per week (via CDC). Walking, swimming, or biking 30 minutes a day for five days a week can reduce the risk of developing other chronic diseases like heart disease or diabetes. Think about strengthening muscles and increasing flexibility and balance!
If the thought of how to properly exercise eludes you, join a physical activity program designed explicitly for arthritis or mobility issues. Cost does not need to be a factor. Why? Because you can find free tips and courses for managing fibromyalgia pain online! There are plenty of joint-friendly movements that are low-impact exercises. That means they put less stress on the body and reduce the risk of injury. Think SMART: Start Slow and Modify. The Activities should be joint-friendly, Recognize safe places, and Talk to exercise specialists (via CDC). Most importantly, if you feel sharp pain or unusual pain, stop and see your doctor.
Consider some holistic or natural treatments for pain relief.
Over the counter and prescription drugs can be miracle workers. The advances in modern technology are nothing to scoff at, but sometimes it may be worth looking at alternatives or additional treatments to supplement your current medical treatment plan. Many natural treatments aim to lower stress and reduce pain. Physical therapy can be a great option for joint strengthening, for example (via Healthline). Acupuncture involves the insertion of very fine needles to various depths into strategic parts of the body and can cause a change in the physiological response of the body.
Meditation, yoga, tai chi, and massage therapy can be additional natural remedies, though their effectiveness has not been thoroughly studied or proven (via Healthline). Though most people think of yoga when they hear the word ‘meditation,’ the practice may include walking, gardening, or other gentle forms of movement. It is essentially just an active form of meditation where the movement guides you into a deeper connection with your body. Other types of meditation include mindfulness, spiritual, focused, mantra, transcendental, progressive, and visualization meditation. Tai chi is a popular, gentle form of exercise that increases body awareness, cognition, improves balance, flexibility, and coordination.
If you have fibromyalgia, try eating a balanced diet.
Though research has not proven that any specific diet improves fibromyalgia symptoms, some people still report feeling better when following a set diet. This makes sense, considering that even someone in excellent health will feel better if they follow a balanced diet, so let’s go over some of those balanced nutrition principles. Fruits and vegetables should be the main staples, along with whole grains, dairy, and lean protein. Water is essential to keep our bodies hydrated, and we should eat more plants than meat. Reduce the amount of sugar in your diet and exercise as often as possible (while keeping it reasonable, of course!).
A recent study showed that cutting out fermentable oligo-di-monosaccharides and polyols (FODMAP) could positively impact pain levels for people with fibromyalgia (via Healthline). Some ingredients or foods might make things worse for some individuals, like gluten or MSG (via Healthline). If some meals make you feel lethargic or increase any pain levels, track what you eat and share it with your healthcare professional to determine the best course of action. The following steps might be an elimination diet or an allergy panel if deemed necessary.
You may hear about ‘tender points,’ but they no longer indicate fibromyalgia.
At one point, doctors thought fibromyalgia would cause more pain in some regions of the body than others, specifically the back of the head, inner knees, and outer elbows. Pain can also be more elevated in the neck and shoulders, the hips, and the upper chest. Doctors formerly diagnosed fibromyalgia by applying pressure to these points and evaluating the patient’s reactions. However, with more research available, doctors no longer use this as a diagnostic tool for fibromyalgia. Furthermore, they don’t use tenderness as a reliable indicator of fibromyalgia (via Medical News Today).
Pain is a very subjective term with widely varying thresholds. It also presents differently in individuals, with different people reacting differently to the same pain level. As Mr. Adam Felman stated in Medical News Today, “Instead of specific areas or points of pain, fibromyalgia is identified by the severity and chronic nature of the pain (via Medical News Today).” Keep reading to discover more information about fibromyalgia, and what to do if you have it.
Some vitamins and supplements could also be beneficial to those who have fibromyalgia.
We have limited research available on the subject of vitamins and supplements benefiting fibromyalgia symptoms. However, researchers do know that some vitamins and herbal supplements can help with fibromyalgia symptoms in some form. At the very minimum, their effect is not detrimental to anyone’s health and cannot worsen the symptoms. For example, both vitamin D and magnesium tend to be low in individuals with fibromyalgia. Vitamin D can affect nerve and muscle function, which can logically be associated with the chronic pain of fibromyalgia. A vitamin D supplement could be a safe intervention after discussion with your healthcare professional.
SAMe, or S-adenosylmethionine, is a naturally occurring hormone in the body. You can also purchase it as an over-the-counter dietary supplement. It can help treat depression and the chronic pain that comes with osteoarthritis (via Everyday Health). In one study from the Journal of Clinical Psychology, taking SAMe offered pain relief from fibromyalgia, fatigue, and stiffness. Melatonin may be a familiar hormone, as sleep aids commonly use it. Less commonly, people may also take SAMe for depression, fatigue, and fibromyalgia (via Everyday Health). There is more research from the Mayo Clinic that you can discover about this topic.
Polymyalgia and fibromyalgia may sound similar (and even seem) similar, so how do we tell them apart?
Both polymyalgia and fibromyalgia symptoms display muscle pain, stiffness, and fatigue. However, there are significant enough differences between the two that you can tell them apart. Polymyalgia (or polymyalgia rheumatica PMR) is also a musculoskeletal condition, like fibromyalgia. However, with PMR, you would feel pain and stiffness in your shoulders, upper arm muscles, and hips. This soreness will be most prominent after resting or sleeping. Though fibromyalgia can cause pain in these areas, it is typically more widespread and severe (via Healthline). Fibromyalgia symptoms typically involve a longer list, such as extreme fatigue, sleep problems, brain fog, and gastrointestinal problems.
Older adults (65+) typically develop polymyalgia rheumatica, which is rare in people under 50 (via Healthline). However, fibromyalgia is less selective about whom it affects, and you are already familiar with a fibromyalgia diagnosis. Doctors mainly use an elevated inflammatory blood test to diagnosis polymyalgia rheumatica. That, and the symptoms of pain in the shoulders and hips. Oddly, medical professionals diagnose polymyalgia rheumatica more frequently in specific seasons. What does that mean? There could be a link between the two that scientists should research. If there is a potentially indicating an environmental factor, there could be a way to cure it, or better treat it.