Overview of Fibromyalgia and Treatment

Fibromyalgia affects 2-4% of people, more often women than men. Doctors diagnose fibromyalgia based on the patient’s symptoms and a few examination techniques. This condition causes widespread pain and tenderness of the body. Often associated with fatigue and sleep problems, fibromyalgia is a common cause of chronic disability.

What are the symptoms of fibromyalgia?

Fibromyalgia causes pain and tenderness that comes and goes, and moves about the body. Most patients report tender areas (tender points) that are associated with fatigue and sleep problems. Other symptoms associated with fibromyalgia include headaches, digestive problems, waking up feeling unrefreshed, problems with memory, and cognitive issues. The symptoms of fibromyalgia vary in intensity, and they wax and wane with time. Stress is known to worsen these symptoms.

What causes fibromyalgia?

Experts are unsure about the cause of fibromyalgia. Researchers know that fibromyalgia tends to run in families, and certain genes predispose people to getting this condition. There appears to be some risk and triggering factors for fibromyalgia. These include injury, spine disorders, arthritis, emotional stress, and physical stress.

How is fibromyalgia diagnosed?

The doctor will ask you questions about your symptoms, and take a detailed medical history. During the physical examination, the doctor may press on certain areas of your body checking for tender points. While no diagnostic tests confirm fibromyalgia, the doctor may order certain x-rays and blood tests to rule out other conditions that can be confused with fibromyalgia. Fibromyalgia is often mistaken for lupus or rheumatoid arthritis. However, these rheumatic diseases produce inflammation of the tissues and joints, and can be picked up on blood testing.

How is fibromyalgia treated?

There is no cure for fibromyalgia, but the symptoms are treated with medications and non-drug regimens. Options include:

 

  • Antidepressant drugs – Two drugs known to change brain chemicals (norepinephrine and serotonin) also work by controlling pain levels. These are Cymbalta (duloxetine) and Savella (milnacipran), which are FDA-approved for fibromyalgia.
  • Anticonvulsant drugs – Pregabalin and Neurontin work by blocking the overactivity of nerve cells that are involved in pain signal transmission. These drugs work by decreasing nerve activities.

 

  • Pain medicine – Acetaminophen, ibuprofen, and naproxen are three drugs used to control the pain associated with fibromyalgia.

 

  • Acupuncture and dry needling – Many studies show that alternative therapies like dry needling and acupuncture work to manage fibromyalgia symptoms.

 

  • Cognitive behavioral therapy (CBT) – This treatment focuses on understanding how thoughts affect a patient’s symptoms. With CBT, the patient learns reduction skills to lessen pain.

 

  • Reduce stress – Develop a plan to limit overexertion and avoid emotional stress. Give yourself time to relax, and learn to say no. Stress management techniques include meditation and deep-breathing exercises.

 

  • Get enough sleep – Fatigue can make chronic pain worse. Be sure to get enough sleep, practice good sleep hygiene, and take naps frequently.

 

  • Get regular exercise – Exercise will increase energy and decrease symptoms. Appropriate activities include biking, swimming, walking, and water sports. A physical therapist can work with you to develop a good exercise program.

 

  • Eat healthy – Avoid excessive alcohol and caffeine, eat fruits and vegetables, and drink plenty of water.