What is fibromyalgia?

Fibromyalgia is a long-lasting or chronic disorder that causes muscle pain and fatigue (feeling tired). If you have fibromyalgia, you have pain and tenderness throughout your body. Sometimes you may have two or more chronic pain conditions at the same time, such as:

• Chronic fatigue syndrome.
• Endometriosis.
• Irritable bowel syndrome.
• Interstitial cystitis.
• Temporomandibular joint dysfunction (TMJ).
• Vulvodynia.

Who gets fibromyalgia?

Anyone can get this disorder, though it occurs most often in women and often starts in middle age. If you have certain other diseases, you may be more likely to have fibromyalgia. These diseases include:

• Rheumatoid arthritis.
• Systemic lupus erythematosus (commonly called lupus).
• Ankylosing spondylitis (spinal arthritis).

If you have a family member with fibromyalgia, you may be more likely to get the disorder.

What are the symptoms of fibromyalgia?

The symptoms of fibromyalgia are pain and tenderness throughout your body. Other symptoms may also include:

• Trouble sleeping.
• Morning stiffness.
• Headaches.
• Painful menstrual periods.
• Tingling or numbness in hands and feet.
• Problems with thinking and memory (sometimes called "fibro fog").

What causes fibromyalgia?

Doctors don't know the exact cause of fibromyalgia. Researchers continue to study fibromyalgia and think the following events may contribute to the cause of the disorder:

• Stressful or traumatic events, such as car accidents.
• Repetitive injuries.
• Illness.
• Certain diseases.

Sometimes, fibromyalgia can develop on its own. Fibromyalgia tends to run in families, and some scientists think that a gene or genes could make you more likely to develop fibromyalgia. The genes could make you react strongly to things that other people would not find painful.

Is there a test for fibromyalgia?

Currently there aren't any laboratory tests to diagnose fibromyalgia.

You may see many doctors before receiving the diagnosis. This can happen because the main symptoms of fibromyalgia, pain and fatigue, are similar to many other conditions. Doctors often have to rule out other causes of these symptoms before making a diagnosis of fibromyalgia.

Doctors use guidelines to help diagnose fibromyalgia, which can include:

• A history of widespread pain lasting more than 3 months.
• Physical symptoms including fatigue, waking unrefreshed, and cognitive (memory or thought) problems.
• The number of areas throughout the body in which you had pain in the past week.

How is fibromyalgia treated?

You and your doctor can treat fibromyalgia with medicines, lifestyle changes, and complementary therapy. However, fibromyalgia can be hard to treat. It's important you find a doctor who is familiar with the disorder and its treatment.

Doctors may prescribe one or more of the following medicines to help treat the symptoms of fibromyalgia:

• Ibuprofen, aspirin, or naproxen you can buy over the counter.
• Narcotic medicines to treat severe pain.
• Duloxetine and milnacipran to help the pain and fatigue.
• Pregabalin to help treat nerve pain.

Making lifestyle changes can also help you manage your fibromyalgia, including:

• Getting enough sleep.
• Exercising.
• Adjusting your work demands.
• Eating well.

You can also try complementary therapies such as:

• Massage therapy.
• Movement therapy.
• Chiropractic therapy.
• Acupuncture.
• Diet supplements.

If you are using or would like to try a complementary therapy you should speak with your doctor, who may know more about if it is safe to try.

Who treats fibromyalgia?

Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is.

Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment.

Living with Fibromyalgia

There are many things you can do to while living with fibromyalgia, including:

• Getting enough sleep.
• Exercising.
• Adjusting your work demands.
• Eating well.

Getting Enough Sleep

Getting enough sleep and the right kind of sleep can help ease the pain and fatigue of fibromyalgia. You may have problems such as pain, restless legs syndrome, or brainwave changes that interfere with restful sleep. It is important to discuss any sleep problems with your doctor, who can prescribe or recommend treatment.

Tips for Good Sleep

• Keep regular sleep habits. Try to get to bed and wake up at the same time every day.
• Avoid caffeine and alcohol in the late afternoon and evening. Even though alcohol can make you feel sleepy, drinking any close to bedtime can disturb your sleep.
• Time your exercise. Regular daytime exercise can help improve your nighttime sleep. However, exercise within 3 hours of bedtime can keep you awake.
• Avoid daytime naps. Sleeping in the afternoon can interfere with nighttime sleep. If you feel like you cannot get by without a nap, set an alarm for 1 hour. When it goes off, get up and start moving.
• Reserve your bed for sleeping. Watching TV, reading, or using a laptop or phone in bed can keep you awake.
• Keep your bedroom comfortable. Try to keep your bedroom dark, quiet, and cool.
• Avoid drinking liquids and eating spicy meals before bed. Heartburn and late-night trips to the bathroom can interfere with your sleep.
• Wind down before bed. Avoid working right up to bedtime. Try some relaxing activities that get you ready for sleep, such as listening to soft music or taking a warm bath.

Exercising

Although pain and fatigue may make exercise and daily activities difficult, it is important for you to be as physically active as possible. Research shows that regular exercise is one of the most useful treatments for fibromyalgia. If you have too much pain or fatigue to do exercise, you should begin with walking or other gentle exercise. Over time you can build your strength.

Adjusting Your Work Life

You can continue to work when you have fibromyalgia, but may have to make some changes to do so. For example, you may need to cut down the number of hours they work, switch to a less demanding job, or adapt your current job. An occupational therapist can help you make changes at work. For example, they can help design a more comfortable workstation or find more efficient and less painful ways to lift.

Eating Well

Although some people with fibromyalgia report feeling better when they eat or avoid certain foods, no specific diet has been proven to influence fibromyalgia. Of course, it is important to have a healthy, balanced diet. Not only will proper nutrition give you more energy and make you generally feel better, but it will also help you avoid other health problems.