Fibromyalgia
Fibromyalgia is a chronic condition characterized by widespread muscle and joint pain, fatigue, sleep disturbances, cognitive difficulties, and mood issues. Although its exact cause is unknown, fibromyalgia involves abnormal processing of pain signals by the central nervous system, leading to heightened sensitivity to pain. Symptoms often follow physical or emotional trauma, infection, or may appear without an identifiable trigger. Women are more commonly affected, and fibromyalgia frequently coexists with conditions such as irritable bowel syndrome, migraines, osteoarthritis, and rheumatoid arthritis.
Causes and Risk Factors
- Genetics: Family history increases susceptibility.
- Abnormal pain processing: Changes in neurotransmitters and pain receptors heighten sensitivity.
- Infections: Illnesses can trigger or worsen symptoms.
- Physical or emotional trauma: Accidents, surgery, or severe stress may precipitate onset.
- Coexisting conditions: Irritable bowel syndrome, migraines, arthritis, lupus, and chronic fatigue syndrome.
- Hormonal imbalances: Fluctuations may play a role.
Symptoms
- Widespread pain: A constant dull ache lasting at least three months, on both sides of the body.
- Fatigue: Persistent tiredness not relieved by rest.
- Cognitive difficulties (“fibro fog”): Problems with concentration, memory, and focus.
- Sleep disturbances: Nonrestorative sleep, frequent awakenings, sleep disorders.
- Emotional issues: Anxiety and depression may both result from and exacerbate symptoms.
- Other signs: Headaches or migraines, abdominal pain, dry eyes/mouth, numbness/tingling, temperature sensitivity, morning stiffness.
Diagnosis
- Medical history and symptom review: Detailed discussion of pain, fatigue, sleep, and cognitive complaints.
- Physical exam: Assessment of tender points (or use of the Widespread Pain Index and Symptom Severity score).
- Duration: Symptoms present for at least three months.
- Exclusion of other conditions: Blood tests and imaging to rule out rheumatoid arthritis, lupus, thyroid disorders, and other causes.
Treatment
Medications
- Pain relievers: Acetaminophen or nonsteroidal anti-inflammatory drugs for mild pain.
- Antidepressants: Duloxetine and milnacipran improve pain and fatigue.
- Anti-seizure drugs: Gabapentin and pregabalin reduce certain types of pain.
Lifestyle and Home Remedies
- Regular exercise: Low-impact activities such as walking, yoga, or tai chi.
- Stress management: Meditation, deep breathing, and relaxation techniques.
- Sleep hygiene: Consistent bedtime routine and restful environment.
- Balanced diet: Nutrient-rich foods to support overall health.
Therapies
- Physical therapy: Exercises to increase strength, flexibility, and reduce pain.
- Occupational therapy: Strategies to perform daily tasks with less stress on the body.
- Cognitive behavioral therapy: Techniques to cope with pain and stress.
Complementary Treatments
- Acupuncture
- Massage therapy
- Chiropractic care
Sources
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- Centers for Disease Control and Prevention
- National Center for Complementary and Integrative Health
- Goldenberg DL. Clinical manifestations and diagnosis of fibromyalgia in adults.
- American College of Rheumatology
- National Library of Medicine