Understanding fibromyalgia

Have you been told that you might have fibromyalgia? If so, then you could be one of the more than five million Americans who suffer from this chronic pain condition.

Chronic pain is no laughing matter. According to the World Health Organization, one out of every five people around the globe has some type of chronic pain: In fact, people with fibromyalgia usually have to deal with it for the rest of their lives after a diagnosis is made.

Researchers say that many people with chronic pain conditions, like chronic low back pain and fibromyalgia, may have a lower threshold for pain. This problem may be due to a “short-circuit” in the nervous system that makes painful feelings seem worse than they are. It may even cause things to hurt that wouldn’t normally feel painful.
Not only do chronic pain sufferers often feel more pain than non-sufferers, they may also have pain long after the original reason for feeling pain has gone away. Chronic pain disorders don’t usually cause damage to a person’s joints, muscles, or organs, though, even if the pain is bad.

In 1987, experts placed fibromyalgia in a group with other chronic pain syndromes. This grouping was based on the fact that fibromyalgia patients feel things that are similar to what people feel with other chronic pain conditions. For example, being touched with a non-painful item (like a cotton ball) might cause an “ouch” response, or an item that normally causes minor pain (such as a simple pinprick) could be felt as severe pain. These pain levels may differ, though, from person to person.

It’s not just fatigue and pain

Fibromyalgia doesn’t only make people feel tired and achy. Other symptoms may include:

  • Morning stiffness
  • Numbness or tingling in hands/feet
  • Digestive problems, like:
    • Irritable bowel syndrome
    • Heartburn
    • Stomach pain
    • Constipation
  • Insomnia
  • Restless leg syndrome
  • Headaches and jaw pain
  • Sensitivity to bright lights, weather changes, loud noises and/or odors
  • Memory and concentration problems (“fibro fog”)
  • Depression

Diagnosis

Getting a diagnosis of fibromyalgia can take time, and it isn’t always easy. The diagnosis is usually made after a health care professional listens to a person’s medical history and does a physical examination. Since there is no specific medical test to diagnose fibromyalgia (like a blood test or an X-ray), or to separate it from other conditions with similar symptoms (like diabetes or osteoarthritis.), some health care providers may dismiss a patient’s complaints as “all in his (or her) head.” This still happens today, even though the American Medical Association recognized fibromyalgia as a true medical condition in 1987, and experts from the American College of Rheumatology agreed on a list of symptoms in 1990 to help in making the diagnosis.

A fibromyalgia diagnosis is based on both of these findings:

  • A history of widespread pain that lasts for more than three months in four different areas of the body (above and below the waist, and on the left and right sides)
  • Pain with slight pressure applied to 11 out of 18 specific tender points on the body, in areas like the shoulders, neck, buttocks, hips, knees, and forearms

The pain of fibromyalgia ranges from mild to severe, affecting muscles, tendons, and joints. Several areas are usually “under fire” at the same time, and the pain can move from place to place.

Making a diagnosis of fibromyalgia almost always requires a high level of patience for both healthcare providers and patients alike. In fact, it can often take six months to a year – or even longer – to reach a final answer. That’s because so many other medical conditions need to be ruled out first.

Around 80% of people with fibromyalgia are women, and about half of the people with fibromyalgia also have depression. Many women who have been diagnosed often have other family members with fibromyalgia, too.

Treatment

People with fibromyalgia often need a team approach for treatment. For example, they may see a rheumatologist (a doctor who treats joint and soft tissue problems), a pain specialist, and a physical therapist, as well as their primary care doctor, and a mental health provider.

Health care providers are likely to treat fibromyalgia with a mix of medication and non-medication methods. Currently, a few prescription medications have been approved by the FDA for the treatment of fibromyalgia. Other treatment options include:

  • NSAIDS, such as ibuprofen
  • Antidepressants, like amitriptyline and fluoxetine, to help with pain and sleep issues
  • Non-drug treatments, like:
    • Exercise
    • Massage
    • Chiropractics
    • Acupuncture

Hope for the future

Researchers are trying to understand why people develop fibromyalgia. A few studies are looking for a gene that might be linked with fibromyalgia in certain people. Other researchers are looking for new ways to treat fibromyalgia: It’s a very challenging task!

Fibromyalgia can be a painful and isolating condition, but with time and patience, treatment is possible.

Find out more information at the resources listed below.

Resources

National Fibromyalgia Association
http://www.fmaware.org

National Fibromyalgia Partnership
http://www.fmpartnership.org

National Fibromyalgia Research Association
http://www.nfra.net

Fibromyalgia-symptoms.org
http://www.fibromyalgia-symptoms.org

National Institutes of Health
http://health.nih.gov (search on “fibromyalgia”)