What is Fibromyalgia?
Fibromyalgia is a long-term (chronic) condition that can be challenging to deal with. However, many people find that treatment and lifestyle changes can help them handle their symptoms and improve their quality of life.
This illness can be tough to understand, even for healthcare providers. Its symptoms mimic those of other conditions, and there aren’t any actual tests to confirm the diagnosis. Because of this, fibromyalgia is frequently misdiagnosed.
Fibromyalgia is a complex illness and it has over 200+ symptoms and co-existing conditions.
Pain in the muscles, joints and bones (musculoskeletal pain) is generally the number one health complaint people experience with fibromyalgia. In addition to this, the most common symptoms of fibromyalgia are:
- Regions of tenderness
- General tiredness and fatigue
- Cognitive issues (brain fog, memory, concentration)
- Sleep problems and disturbances
- Stiffness in joints
In the past, some health care providers questioned whether fibromyalgia was real and many believed that it was psychological. Today, it is much better understood by healthcare professionals.
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How Common is Fibromyalgia?
- After osteoarthritis, fibromyalgia is the 2nd most common ailment affecting the musculoskeletal system (American College of Rheumatology, 2004)
- It is estimated that one in 50 American’s have fibromyalgia equating to between 3-6 million people (American College of Rheumatology, 2004)
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Diagnosing fibromyalgia isn’t straightforward as such, as there are no tests with biomarkers to confirm a diagnosis.
The tender point/trigger point test is now outdated. In 2010 the American College of Rheumatology completely overhauled the fibromyalgia diagnostic criteria. In 2016 this was updated.
Many healthcare professionals who have not kept up to date with these newer diagnostic criteria continue to use the outdated trigger point/tender point test as the sole means for diagnosing fibromyalgia.
The (Outdated) Fibromyalgia Tender Point/Trigger Point Test
Once the diagnostic gold standard for identifying fibromyalgia, doctors assessed for sensitivity when specific tender points on the body were touched. Additionally, a favorable fibromyalgia diagnosis required widespread pain throughout the whole body.
Although other symptoms were frequently related to fibromyalgia, the trigger points and widespread pain were the sole criteria needed for getting a fibromyalgia diagnosis.
Under this first benchmark, you needed to undergo extreme pain and tenderness if physicians touched or pressed at least 11 of 18 specific points.
Fibromyalgia trigger points
- Back of the head
- Top of shoulders
- Upper chest
- Outer elbows
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‘Fibro Fog’ / (Brain Fog)
Fibromyalgia fog — also known as “fibro fog” or”brain fog” — is a term some people today use to describe the fuzzy feeling they get. Signs of fibro fog include:
- Memory lapses
- Difficulty concentrating
- Word loss
- Inability to complete coherent sentences
- Trouble staying awake
As per a 2015 study printed in Rheumatology International, a few people today find mental fogginess from fibromyalgia more upsetting than the pain.
Fibromyalgia Symptoms in Women & Men
Previously, it seemed that fibromyalgia symptoms were more severe in women than in men, and women had more widespread pain, IBS symptoms, and morning fatigue compared to men.
Unfortunately, many men feel that they just need to ‘suck it up’ and that support is only there for women, which can increase depression and feelings of isolation. Additionally, many men don’t want to talk about their pain or admit that they are struggling.
Interestingly, since the 2016 revisions into the diagnostic criteria of fibromyalgia were implemented, more men are being diagnosed with fibromyalgia, which might reduce the degree of differentiation between the pain amounts recorded for men and women.
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Over 200+ Co-Existing Conditions & Symptoms of Fibromyalgia
Fibromyalgia is an extremely complex condition, with over 200+ co-exisinting conditions and symptoms. Everyone is unique with their experience and this can range from managing daily life to being completely bed-bound.
However, the number one symptom for fibromyalgia is widespread chronic pain. Just a few of the other symptoms are:
- Sleep disturbances
- Brain fog (memory and concentration issues)
- Depression and/or anxiety
- Muscle and joint stiffness
- Sensitivities to light, sound, and/or touch
- Flare-Ups – times when symptoms become severe
We will look at the various different types of fibromyalgia pain and a few other symptoms below.
Fibromyalgia pain can vary from a mild achiness into an intense and almost unbearable discomfort. Its seriousness could dictate how well you cope day-to-day.
Anxiety is another hallmark fibromyalgia symptom. You’ll feel it in a variety of muscles and other soft tissues around your body as you tense up. Many people feel like their whole body is in a knot and in spasm.
As mentioned above, although a complex illness in nature, research points to fibromyalgia stemming from an abnormal nervous system response.
Your body overreacts to things that shouldn’t usually be painful. And you may feel the pain in more than one region of your body. However, available research still doesn’t pinpoint an exact cause for fibromyalgia.
Research continues to evolve in greater understanding fibromyalgia and its one specific origin and root cause. To date, fibromyalgia has a myriad of different studies all pointing to completely diferent causes.
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Chest pain, otherwise known as Costochondritis, is a very common co-existing fibromyalgia condition.
Costochondritis is based at the cartilage that connects your ribs to your breastbone. The pain can radiate to your arms and shoulders. If fibromyalgia pain is around your torso, it may feel frighteningly like the annoyance of a heart attack.
Fibromyalgia chest pain may feel:
- like a burning sensation
- like a struggle to catch your breath
Of course, always seek medical attention if you are experiencing these symptoms to confirm a proper diagnosis.
Costochondritis, also known as chest wall pain, costosternal syndrome, or costosternal chondrodynia is an acute and often temporary inflammation of the costal cartilage, the structure that connects each rib to the sternum at the costosternal joint. The condition is a common cause of chest pain. Though costochondritis often resolves on its own, it can be a recurring condition that has little or no signs of onset.
Neck & Back Pain
The very same drugs you take to alleviate your additional fibromyalgia symptoms may also help with back pain. Stretching and strengthening exercises will help provide support to the muscles and other soft tissues of the spine.
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Is it Fibromyalgia, or Something Else?
Approximately 80% of all Americans have low back pain at one time in their lives. If your back and/or neck hurts, then it might not be clear whether it’s your fibromyalgia or another illness like arthritis or a pulled muscle.
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Many people with fibromyalgia experience leg pain and they may also experience Restless Leg Syndrome (RLS), which occurs at night.
Fibromyalgia leg pain can feel similar to the soreness of a pulled muscle or the stiffness of arthritis.
Fibromyalgia leg pain can be:
- crawling sensation
Sometimes people experience fatigue that manifests in the legs. A sense of feeling heavy, almost leaden-like legs can happen.
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Otherwise known as ‘fibro flares’, a flare-up is when the dial is turned up several notches in your symptoms from coping to struggling and severe.
For some people experiencing a flare-up can mean being laid out flat, bed-bound, whilst other people are able to cope with daily life, albeit with increased pain and fatigue. People can also experience depression and anxiety during a flare-up, as well as brain fog.
In severe cases people can struggle to shower or get to the toilet without assistance, and it can be extremely frightening.
Fibromyalgia Flare-Up Symptoms:
- Increased pain
- Increased fatigue and exhaustion
- Increased brain fog
- Increased depression and/or anxiety
You may also experience other symptoms flaring up such as IBS, allodynia (skin sensitivity), and sensitivity to light and noise.
Flare-ups can last a few days, but can also last weeks or even months, with remission times in between.
Fibromyalgia Flare-up Causes
For most people, when they track, they will find that there are causes (otherwise known as triggers) that have precipitated their flare-ups. These include:
- Changes in the weather
- Certain foods
Causes of Fibromyalgia
According to the latest research, the cause is apparently a multiple-hit theory that entails genetic disposition (hereditary characteristics) complemented by a cause, or a group of causes, such as:
- Illness and infections
- Stress and anxiety
In addition to the above, many people with fibromyalgia have vitamin and mineral deficiencies, which can actually be the root cause of many symptoms including pain, sleep disturbances, depression and much more.
People who self-manage with consistent adherence to supplements find that in many cases their symptoms improve.
Here are some of the supplements that people with fibromyalgia are deficient in and find relief with:
- Vitamin B12 – You may need regular B12 injections if you are highly deficient, otherwise a B12 supplement can help
- Magnesium – 80% of the population is magnesium deficient, and this can cause a list of symptoms similar to fibromyalgia such as pain, sleep disturbances and headaches
- Vitamin D – Can cause joint pain, heart problems, teeth problems, depression and anxiety
- Potassium – Muscle spasms and restless leg syndrome (RLS) are just a few of the symptoms associated with this deficiency
Illness & Infection
There have been links with a previous illness as a potential cause of fibromyalgia. These include:
Fibromyalgia frequently runs in families. You are at higher risk for developing it, if you have a family member with this condition.
Researchers think certain gene mutations may play a role and have identified a couple of genes that impact the transmission of chemical pain signals between nerve cells.
There are links with stress and hormonal changes that could contribute to fibromyalgia.
There have been several studies showing an association with the ‘fight or flight’ hormone cortisol and that fibromyalgia sufferers have lower levels than healthy test subjects.
Healthcare providers do not fully understand the causes of the chronic widespread character of fibromyalgia pain. As mentioned above, some studies show that the brain and chemical imbalances reduce the pain threshold. Sensations that weren’t painful before become quite painful over time. Another notion is that the nerves overreact to pain signals.
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You may be interested in the Mayo Clinic Guide to Fibromyalgia: Strategies to Take Back Your Life.
Practical strategies that can help you manage fibromyalgia successfully and return to a fulfilling and enjoyable life.
Fibromyalgia & Auto-Immune Conditions
Fibromyalgia symptoms seem very similar to those of autoimmune diseases. These symptoms have contributed to the theory that fibromyalgia may be an autoimmune condition. However, this claim has been hard to prove, in part since fibromyalgia does not cause inflammation, and to-date replicating autoantibodies haven’t been found.
Much like it would ordinarily attack germs or viruses, the immune system instead attacks the joints along with other healthy tissues.
How Auto-Immunity Works
Fibromyalgia Risk Factors
In addition to the stress, injury, genetics, brain chemical imbalances, hormones, and previous illnesses – if that wasn’t enough – there are other factors that increase your risk of developing fibromyalgia:
- Gender – Women have a 90% higher chance of a fibromyalgia diagnosis, however, this could be because women are more likely to go to their doctors regarding an illness
- Genetics – There is a much higher chance of developing fibromyalgia if other close family members have it.
- Age – Children can develop fibromyalgia, however, you’re most likely to be diagnosed at middle age.
- Disease – If you already have a rheumatic condition such as osteoarthritis, lupus or RA, you’re more likely to also have fibromyalgia.
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No laboratory test or imaging scanning may detect fibromyalgia, however, your healthcare provider can use these tests to help rule out other potential causes of your chronic pain.
Your healthcare provider can diagnose you with fibromyalgia if you have had widespread pain for 3 months or more. “Widespread” means the pain is on each side of the body, and you experience it all over your body.
Following a thorough evaluation, your physician needs to conclude that no additional condition is causing your pain.
At this time, there isn’t a cure for fibromyalgia. However, there are a variety of options available to help treat the symptoms with the view of improving quality of life.
Generally, a multi-faceted approach regarding medications, supplements, diet, exercise/movement, and behavioural therapies are mainstream and accepted fibromyalgia treatments.
You might want to seek out treatment options available to you and guidance from your healthcare provider. This may involve seeing a therapist, pain clinic and/or joining a support group. In a support group, you are able to get advice from others who have fibromyalgia and they can help you through your journey.
If you’re looking for a support group, please check out our Resources page.
Fibromyalgia Treatment Options
Although everyone is unique, many people with fibromyalgia try a variety of these options to find what gives them the best relief:
- Medications: can relieve pain and allow you to sleep better.
- Physical and occupational therapy: can enhance your stamina and decrease strain on your body.
- Mindfulness and meditation: can help you to relax and treat pain and other symptoms holistically
- Functional health: naturopaths and holistic health practitioners can carry out tests and provide tailored, natural treatment options
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Gabapentin (Neurontin) was created to treat epilepsy, but it might also help reduce symptoms in people with fibromyalgia. If your healthcare professional has suggested Gabapentin (or you’re already taking it), this article Gabapentin: The Good, The Bad and the Ugly is worth a read.
Pregabalin (Lyrica), yet another anti-seizure drug that was the first medication FDA-approved for fibromyalgia may also be prescribed. It blocks nerve cells from sending out pain signals.
These medications may improve sleep quality and operate on rebalancing neurotransmitters, however many people using these medications have experienced moderate to severe side-effects including:
- Depression and anxiety
- Suicidal thoughts
- Significant weight gain
- Severe withdrawal
Muscle relaxants, which were once used, are no longer recommended.
Over-the-counter pain relievers such as ibuprofen (Advil) or acetaminophen (Tylenol) can assist with moderate pain.
The objective of fibromyalgia treatment would be to manage pain and enhance quality of life. This can be accomplished via a two-pronged method of treatment including cognitive behavioural therapy (CBT), gentle exercise, diet, and medication.
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No to Opioids & Narcotics
Narcotics, such as tramadol (Ultram), which is an opioid, were formerly prescribed for pain relief, however, this medication, along with all opioids are now being discouraged due to addiction, fatalities and evidence that they are ineffective for the treatment of long-term pain.
Too Many Meds?
Many people find that along with a fibromyalgia diagnosis comes a raft of pharmaceutical prescriptions. It isn’t uncommon that people are on 10+ prescriptions a day.
What is important to understand is what medications are of benefit, and which ones may be causing side-effects – which, in many cases healthcare professionals will chalk up to ‘another fibro symptom’.
Educating yourself, researching and knowing your body is critical. Be an empowered fibromyalgia warrior!
Natural Treatments for Fibromyalgia
There’s a wide range of natural treatment options for fibromyalgia available. These include:
- 5-hydroxytryptophan (5-HTP) – for sleep and mood. Note: it is important that you are not on any anti-depressants when using 5-HTP
- yoga – you may want to avoid if you have hypermobility
- tai chi
- physical therapy
- massage therapy
- a diet that inhibits trigger foods which may increase pain, fatigue and other fibromyalgia symptoms
Group therapy can also come with negative elements, and like many social media groups, there can be a significant amount of negativity.
Cognitive behavioral therapy (CBT) is another option that could help you manage stressful circumstances. Individual treatment is also available if you would rather one-on-one help. Therapy can potentially lower the stress that causes fibromyalgia symptoms and melancholy. CBT is encouraged by many healthcare professionals.
However, in a Cochrane review of 23 different studies with 2031 people, in conclusion, the positive results were very small and incremental.
Fibromyalgia and Diet
Some people with fibromyalgia who follow a specific diet by avoiding certain foods have found improvement in their pain, fatigue, IBS and ‘fibro fog’. However, research hasn’t proven that one specific diet improves fibromyalgia symptoms.
Keeping a food diary and tracking pain and other fibromyalgia symptoms will help you to determine what foods are triggers. Eating clean should be considered – eating healthy, unprocessed foods that are high in nutrients, such as salads, fresh veg, nuts and some fruits such as berries.
Many people who have fibromyalgia have found improvements by following these beneficial diets:
- keto and low carb
- clean eating (no processed foods)
- no sugar
- no dairy
- no grains or cereals (including flour – so no bread)
- no gluten
- no nightshades (peppers, white potatoes, tomatoes, chilies, eggplant/aubergine)
So, altering your diet is not going to be an easy task! That’s why a book that has a good approach and advises on the foods to eat and avoid, as well as recipes, can be very beneficial.
Pain Relief Medication for Fibromyalgia
Painkillers, otherwise known as analgeiscs are medications used to achieve relief from pain – analgesia.
Analgesics work in a variety of ways on the peripheral and central nervous system.
Some pain medications can help reduce pain and discomfort and may be beneficial if the pain from fibromyalgia is affecting your daily quality of life. They can also cause a variety of side-effects, that may not present immediately, including liver damage.
CBD Oil – The Age-Old Wonder Drug
Many people with fibromyalgia and other chronic pain conditions have experienced an improvement in relieving a variety of symptoms by using good quality CBD products. CBD (cannabidiol).
It is important to understand that CBD doesn’t have the mind-altering chemical THC in it, and it is perfectly legal in many countries.
Always look for a high-quality brand, preferably organic and avoid buying from third-party sellers such as Amazon and eBay, where quality can be affected.
CBD oil can help with:
Living with Fibromyalgia
Firstly, it is important to know that fibromyalgia is a real, accepted health condition. If your healthcare professional informs you that what you are going through is ‘all in your head’, it’s time to look for a new one that is supportive and can help you get the best treatment.
Although nobody will ever fully understand what you’re going through, generally people are more than willing to help. Ask for help and support from:
- Friends and family
- Healthcare professionals
With a combination of different therapies, treatments, exercise, supplements and food choices, although there is no cure for fibromyalgia, many people do find that once they achieve the right balance, they are able to manage and cope better with the condition.