Causes and Treatment of Fibromyalgia

Fibromyalgia is an often misunderstood—even unrecognized—disorder that causes widespread muscle pain and tenderness which tends to come and go and move about the body. This common and chronic condition typically is associated with fatigue and sleep disturbances.

Fast facts

• Fibromyalgia affects 2-4% of the population, predominantly women.
• Fibromyalgia is diagnosed based on patient symptoms and physical examination. There is no laboratory, radiographic, or other diagnostic test, but these can be used to exclude other conditions.
• Medication, while important, is not the only treatment. Patient education, exercise, self management skills and alternative therapies help treat fibromyalgia symptoms.

Fibromyalgia

Fibromyalgia is defined by chronic widespread muscular pain and symptoms such as fatigue sleep disturbances, stiffness, cognitive and memory problems, and symptoms of depression and anxiety. More localized pain conditions often occur in patients with fibromyalgia, including migraine or tension headaches, temporomandibular disorder, irritable bowel syndrome, gastroesophageal reflux disorder, irritable bladder, and pelvic pain syndromes. The symptoms of fibromyalgia and associated conditions can vary in intensity and wax and wane over time. Stress often worsens these symptoms.

Causes of Fibromyalgia

The causes of fibromyalgia may be different in different people.

• However, it is very likely that there are certain types of genes that can predispose people to developing fibromyalgia and other co-occurring conditions.
• There is usually some triggering factor, such as spine disorders, arthritis, trauma, and other types of physical stressors.
• Emotional stressors also may play a triggering role.
• The result is changes in the way the body communicates with the spinal cord and brain associated with altered levels of chemicals and proteins in the central nervous system.
• For the person with fibromyalgia, it is as though the “volume control” is turned up too high in the brain’s pain processing areas.

Diagnosis of Fibromyalgia

• Patients can be diagnosed accurately based on the symptoms they experience.

• Physical exam findings of tenderness may aid in the diagnosis but are not essential.
• There are no diagnostic tests, such as X-rays, blood tests or muscle biopsies, for this condition.
• Occasionally, fibromyalgia can be confused with other rheumatic disorders such as rheumatoid arthritis or lupus, but again there is a difference as these conditions cause inflammation in the joints and tissues.
• Patients with fibromyalgia typically have fatigue, awake unrefreshed, and have difficulty thinking clearly.
• Fibromyalgia patients also have other bodily symptoms affecting many other organs such as headache, gastrointestinal discomfort, bladder problems and numbness or tingling.
• The diagnosis of fibromyalgia is made taking into account the overall burden of symptoms in patients with widespread body pain and no other explanation for the pain.

Treatment of Fibromyalgia

There is no cure for fibromyalgia, so it must be managed as a chronic condition. Management should include both medication and non-drug treatments for symptoms.

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