The Essential Guide to Fibromyalgia
Pain that feels like it comes from everywhere, with no specific cause. Difficulty thinking through the steps of your favorite recipe, or struggling to recall the name of someone who you used to work with. Feelings of helplessness, anxiety and isolation as you wonder if you’ll ever be able to resume the activities you once enjoyed.
These are the symptoms of fibromyalgia, a common but somewhat perplexing condition that affects up to five million Americans. The exact causes of fibromyalgia are still being studied, but the condition (and its symptoms) are very much real.
If you have been diagnosed with fibromyalgia, you may have been told that you’ll have to live with high levels of pain for the rest of your life. That’s not necessarily true. The results of clinical trials and brand new research are changing the way that doctors understand and treat this condition. Let’s take a look at the latest information we have about living with and managing fibromyalgia.
Consider this our 101 guide into everything you need to know about fibromyalgia pain and symptoms. In this deep-dive we will cover:
- What is fibromyalgia?
- What does the pain of fibromyalgia feel like?
- What causes fibromyalgia?
- What are other fibromyalgia symptoms?
- How is fibromyalgia diagnosed?
- Who is most likely to have fibromyalgia?
- Is there a cure for fibromyalgia?
- Can you treat fibromyalgia?
- What is the long-term prognosis for fibromyalgia?
What is fibromyalgia?
Fibromyalgia is a common condition that causes widespread pain throughout your body. Difficulty sleeping, fatigue, and memory issues can also occur. Some people who have fibromyalgia may have experienced a physically or emotionally traumatic event prior to the onset of their symptoms. For others, fibromyalgia may appear without any discernible “trigger” event.
What does the pain of fibromyalgia feel like?
Before we explore what fibromyalgia feels like, we need to better understand pain itself. Feeling pain involves a complex system that starts with a painful stimulus that gets communicated to your brain. Other factors such as your pain tolerance influence how powerful the pain feels and how your body responds.
Researchers suggest that people with fibromyalgia are experiencing a misfire in the system that processes pain signals in the brain. Normal pain is processed as severe pain, causing the brain to create a sensation of whole-body pain. However, it isn’t necessarily starting with a stimulus in your body that you can identify.
This pain is very much real, but it’s different from the pain you’d feel from, say, scraping your knee. This is because pain that doesn’t seem to have a source can be frustrating. You know your pain is real, but you don’t know why it’s happening. And since there’s no primary pain trigger, you can’t predict when the pain might end.
What causes fibromyalgia?
Researchers are still working to understand what causes fibromyalgia. Causes seem to vary from person to person, but there are some common threads. The cause of fibromyalgia could be related to injuries or viruses that change the way that your brain perceives pain.
What are other fibromyalgia symptoms?
Fibromyalgia can cause other symptoms and health conditions. These symptoms might be directly related to your pain (such as having a hard time sleeping and feeling exhausted). It’s also not unusual for fibromyalgia to be connected with anxiety and depression.
Other symptoms and conditions linked to fibromyalgia may include:
- Chronic fatigue
- Frequent headaches
- Sleep disturbances
- Irritable bowel syndrome (IBS)
- Dry eye
- Memory loss/impaired cognition
- Depression, anxiety, and other mental health conditions
How is fibromyalgia diagnosed?
It’s estimated that fibromyalgia affects up to two percent of the United States population, making it relatively common. Unfortunately, that doesn’t mean that getting diagnosed is simple or straightforward. Complicating things further, fibromyalgia often occurs with other chronic conditions, such as rheumatoid arthritis or osteoarthritis.
As Dr. Jacob Hascalovici, MD, PhD, Chief Medical Officer at Clearing explains, because there isn’t a single blood test or diagnostic marker for the disease, the process of making this diagnosis can be long. For the most part, getting a clinical diagnosis means ruling out all other common, treatable causes of your symptoms. This process can take some time, which is why you should see a doctor right away if you’re having symptoms of fibromyalgia.
Guidelines for getting a clinical diagnosis of fibromyalgia include:
- Widespread pain in your body that has lasted for three months or more.
- Chronic fatigue paired with a fuzzy memory and other cognitive problems.
- Experiencing pain in a number of areas of your body on a weekly basis.
“One of the biggest mistakes I see is that patients delay the treatment of generalized pain while searching for a diagnosis,” Dr. Hascalovici says. He also adds that early treatment of chronic pain symptoms can improve your long-term outcomes.
Who is more likely to have fibromyalgia?
Fibromyalgia can affect anyone, including children. However, there are some factors that can increase your likelihood of having the condition. Fibromyalgia more commonly affects women, and it tends to be diagnosed in middle age.
People with lupus and certain types of arthritis are at a higher risk for fibromyalgia. If you know a family member with fibromyalgia, your chances of being diagnosed with it also increase. Chronic migraines and headaches, though not symptoms of fibromyalgia, occur at a higher rate within the fibromyalgia community. Also, stressful events such as a car accident can be a trigger for this condition.
Is there a cure for fibromyalgia?
There is currently no cure for fibromyalgia, but that doesn’t mean that pain and other symptoms can’t be treated. In fact, getting a diagnosis and treatment plan from a health professional is critical for managing your symptoms. It could also possibly keep your pain from spreading. Prompt treatment can also help keep you active, so that you don’t lose your ability to do the things that you enjoy.
Treatments for fibromyalgia recommended by a doctor typically include one or more of the following:
- Physical therapy with an emphasis on low-impact high intensity aerobics such as swimming, rowing and elliptical
- Over-the-counter pain relief medications, such as Advil or Aleve
- Prescription strength non-steroidal antiinflammatories (NSAIDs) and muscle relaxants
- Several types of antidepressants (Amitriptyline, Duloxetine, Milnacipran)
- Prescription medication for nerve pain (Gabapentin, Pregabalin)
- Several types of injections to treat focal muscle discomfort and joint pain (Lidocaine, Botox, or Steroids)
Can you treat fibromyalgia pain naturally?
Conventional medical treatments are sometimes not enough to manage fibromyalgia symptoms. According to Dr. Hascalovici, fibromyalgia is best treated using an all-hands-on-deck approach that includes a team of healthcare professionals. The most beneficial treatment plan is one that addresses the physical, social and psychological impacts of chronic pain.
“This can involve naturopathic remedies that are based in science, as well as more conventional treatments such as home exercise and natural supplements,” Dr. Hascalovici adds.
Also, lifestyle changes and complementary therapies frequently recommended for fibromyalgia include:
A 2017 review showed strong evidence for the use of regular exercise in treating fibromyalgia. Combining strength training and aerobic exercise seemed most effective in reducing pain severity in clinical trials. As an added bonus, these types of exercise may help to treat mental health conditions related to fibromyalgia, such as depression.
Appointments with a physical therapist may also be able to help manage fibromyalgia pain. In one clinical trial, women with fibromyalgia participated in a physical therapy (PT) rehab program and showed promising results. This suggested that people in PT are more likely to do physical activities, compared to people who exercised on their own.
Acupuncture is an ancient therapy that involves inserting long, slim needles into pressure points on your body. Research suggests that regular acupuncture treatment is more effective than a placebo at relieving pain from fibromyalgia.
Fibromyalgia pain may be triggered when you’re stressed. This might have to do with the way that chronic stress affects your brain and certain hormones in your body, such as serotonin.
Stress-reduction techniques and therapies, including mindfulness, yoga, Tai Chi, and meditation can be paired with other fibromyalgia treatments. A meditation program was shown to be as effective for reducing stress as other interventions, such as health education.
Cognitive behavioral therapy
Cognitive behavioral therapy is a strategy for coping with chronic pain and changing the way your brain perceives your symptoms. This type of therapy can be delivered in a group setting or with a mental health professional.
Cannabidiol (CBD) is one of the active ingredients of medical marijuana but is also present in the hemp plant. Hemp-derived CBD has gained popularity over the last several years. All 50 states currently have laws that legalize hemp-derived CBD, with varying degrees of restriction.
Using hemp-derived CBD and medical marijuana for the treatment of fibromyalgia has been gaining support from the medical community, too. “I have had a lot of success treating fibromyalgia patients with medical marijuana when used in combination with conventional fibromyalgia treatments,” Dr. Hascalovici says.
Diet and nutrition
Your doctor may also make recommendations about changing your diet. Maintaining a healthy weight through mindful eating can be a way to manage fibromyalgia pain. People with fibromyalgia experience better outcomes when they avoid drug and alcohol dependence.
People who are vegan or who take Vitamins E and C may experience lower pain levels. People who have fibromyalgia are more likely to have low Vitamin D levels. If this is the case for you, your doctor may suggest taking a Vitamin D supplement.
Even with the above methods, total relief of fibromyalgia symptoms is “seldom achieved.” However, the good news is that adaptations and strategies for fibromyalgia pain are being innovated and researched as we speak.
What is the link between fibromyalgia and mental health?
If you have fibromyalgia (or know someone with it), you’ll be familiar with parts of the condition that go far beyond the physical. “Chronic pain doesn't simply affect your body,” Dr. Hascalovici explains. “It is a disease state that is highly associated with behavioral health problems, and it can be very isolating.”
In fact, between 30 and 50 percent of people with fibromyalgia have an existing mental health condition prior to their fibromyalgia diagnosis. Low self-esteem and stress are common to people who have fibromyalgia. Also, a negative body image and feelings of frustration can become a part of your daily life when you live with chronic pain.
You may feel like it’s hard to concentrate at times. This symptom is known as “fibro-fog.” People with the condition report that poor sleep and chronic pain take a toll on their lives.
“Chronic pain sufferers often lose interest in social activities, particularly those that are pain- provoking, and this can create a vicious cycle of social isolation,” Dr. Hascalovici says. As an example, if you are constantly turning down invitations to socialize, the invitations eventually stop arriving, he adds. Having a larger social network and support system is almost always associated with better outcomes in chronic disease care.
Fibromyalgia is not just a pain condition; it also has a mental health side. Understanding this can address the anxiety and depression that can occur when you live with the condition.
What is the long-term prognosis for someone with fibromyalgia?
The good news about fibromyalgia is that having it doesn’t necessarily decrease your life expectancy. With treatment, you can maintain your mobility, manage your symptoms and find ways to change the way your body perceives pain. And with ongoing research, it’s possible that your outlook will continue to improve as new treatments come on the market.
People with fibromyalgia can experience the best of what life has to offer, with the proper treatment and support. Having a strong support system is important and may be one of the biggest indicators of how successful your treatment may be. You can take control of your pain by educating yourself and building a team of medical professionals who can support you.
This article is for informational purposes only and does not constitute professional medical advice. Always seek the advice of your healthcare professional with any questions or concerns you may have regarding your individual needs and medical conditions.