Patient Articles

Fibromyalgia

What Is Fibromyalgia?

Fibromyalgia or fibromyalgia syndrome (FMS) causes ongoing (chronic) fatigue and pain in all parts of the body.

Why Is there Confusion or Uncertainty About Fibromyalgia?

Pain is a sensation that in part serves the purpose of getting the brain to pay attention to the painful body part.  Thus, physicians expect that there should be a relationship between the severity of pain and the damage to the tissues at that site. Fortunately, in fibromyalgia there is no damage in the painful areas. However, that leaves a disconnect – there is severe pain perceived, but no damage. This disconnect between the severity of pain and the absence of tissue damage has been a cause of confusion about fibromyalgia.

What Causes Fibromyalgia?

About 2% of Americans may have FMS. Women develop the FMS more often than men. FMS begins usually when people are between 30 and 55 years old. But even teenagers and children can have FMS.

The cause of FMS is not known. But FMS often begins

     
  • After trauma such as falls and motor vehicle accidents
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  • When people have a lot of stress or deal with anxiety or depression
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  • After a person had a viral infection or Lyme disease
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  • When people fight rheumatic diseases such as rheumatoid arthritis and lupus

Therefore, researchers think that in people with FMS the nervous system becomes too sensitive to pain. It could also be that FMS is caused by changes in the way nerve signals travel or hormones work.

How Is Fibromyalgia Diagnosed?

To find whether you have FMS, doctors check the number of specific tender points throughout your body. But experienced doctors will use much additional information to make a diagnosis.

Fibromyalgia may be difficult to diagnose correctly for physicians unfamiliar with the diagnosis. The symptoms of FMS may be similar to those of many other diseases. Also, FMS often occurs together with other health complaints such as irritable bowel syndrome, bladder problems, headaches, TMJ dysfunction, dizziness, sadness, and learning difficulties. Therefore, it is best to find a rheumatologist who knows FMS well.

What Is the Treatment?

FMS treatment has become much better in recent years. New medications include Lyrica® (pregabolin), Savella® (milnaciprin), and Cymbalta® (duloxetine).

Many other medications are available for treating people with FMS. You may have to try a number of these to find which one is best for you. Keep a log with the medications you have tried. Also write down how they have (or have not) worked for you. Then share the information in your log with your doctor. Together, you can find the best way to manage your FMS.

FMS Medications Can Have Serious Side Effects

FMS medications can make you tired, drowsy, or have blurry vision. You need to find out how a medication affects you before driving or operating machinery. Sometimes, changing the dose of the medication may become necessary.

Some medications may alter your appetite, which can make you gain weight. Some people taking Lyrica® do not feel full, even after they have eaten enough. They need to control their portion size; they cannot rely on feeling full. Some patients taking Lyrica® also may retain fluid.

Medications that affect the nervous system may become stronger or less effective when combined with others. Medications also may need to be started or stopped carefully. It is important that you follow your doctor’s advice and tell your doctor when your medication does not work well for you.

Cognitive Therapy

Cognitive behavioral therapy (CBT) can greatly help people with FMS. Therapy takes place for each person individually or in groups. Individual therapy meets your exact needs. Group therapy can connect you with others who live with FMS.

The mind can be a very powerful tool in your treatment, because FMS is caused by too much activity in the nervous system. A cognitive behavioral therapist can teach you ways to change your response to pain. This improves your sense of control, gives you more energy, and makes you feel more hopeful.

Helpful Lifestyle Changes

Lifestyle changes can also help with FMS. Because pain and fatigue make it hard to stay active, it is easy to get out of shape when you have FMS. But not exercising can start a vicious cycle. The less fit you become, the harder it becomes to be active.

Engaging in exercise such as walking or water aerobics can make a big difference. But FMS often occurs together with other physical problems. Therefore, it may be best to begin an exercise program with the help of a physical therapist.

It is important to begin an exercise program slowly. Otherwise you may feel like a “marine in boot camp” the day after being active. If your program causes too much discomfort, tell your physical therapist or doctor. Maybe your program needs to be adjusted. Maybe you just need a pat on the back!

Setting Realistic Goals

Even with medication, you may not become completely pain-free. A more realistic goal is to have enough pain relief so that you can engage in most of your activities most of the time. Triumphing over FMS means managing chronic pain, stiffness, and fatigue in the best way possible. Today, we understand FMS better and have more effective treatments. You can take charge over this stubborn disorder!

Resources

Fibromyalgia Resources

Find out more about FMS online at:
National Fibromyalgia Association
Fibromyalgia Network