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Fibromyalgia explained

Fibromyalgia is a mysterious long-term condition that involves widespread chronic pain without a known cause; it’s more of a frustrating label than a diagnosis. Some people will eventually discover a specific reason, but in many cases; the condition appears to be triggered by a physically stressful event, such as an injury, infection or having a baby. Or an emotional upset such as bereavement or the breakdown of a relationship.

Also called fibromyalgia syndrome (FMS), it affects 2 – 4% of the population. It can occur at any age, in both sexes, but most commonly in women typically developing between the ages of 30 – 50.


Risk factors include people with:

  • Another painful condition such as lupus, rheumatoid arthritis, or ankylosing spondylitis. 
  • A family member with the condition.
  • Anxiety, depression or another mood disorder.
  • Sedentary lifestyles, and rarely exercising.
  • A previous history of abuse (physical or emotional) or living with PTSD.


Fibromyalgia can feel similar to other joint-related problems such as osteoarthritis and tendinitis, but rather than being in a specific area, the symptoms are more widespread throughout the body. They also tend to come and go for no apparent reason and move around the body, symptoms can include:

  • Muscle pain or tight tender spots 
  • Debilitating fatigue
  • Burning sensation or muscle, twitching
  • Numbness or tingling in arms and hands, legs and feet, also the face
  • Difficulty concentrating aka “fibro fog.”
  • Insomnia or poor quality un-refreshing sleep
  • Feeling nervous, worried, or depressed
  • Sensitivity to cold, heat, light, or sound
  • Headaches or head pain
  • Digestive symptoms: abdominal pain, nausea bloating, and IBS (irritable bowel syndrome) including constipation, and diarrhoea. 
  • Dry mouth and eyes
  • Urinary frequency

Headaches are the most common symptom reported by people suspected of Fibromyalgia

Background and history 

Fibromyalgia is not a new condition; it’s existed for centuries and was once considered a mental disorder until the tender points associated with the condition were discovered in the early 1820s. It was then reclassified as fibrositis because it was believed at the time that the pain was caused by inflammation at the tender sites.

In 1976 it was renamed Fibromyalgia; derived from the Latin word “fibro” (fibrosis tissue), and the Greek terms for “myo” (muscle) and “algia” (pain). In 1981Dr. Muhammad Yunus known as “The Father of Fibromyalgia” published his first paper. The International Diagnostic Criteria for Fibromyalgia was clarified in 2019 to include:

  • A 3 months history of pain 
  • With severe pain in 3 to 6 different areas of the body, or milder pain in 7 or more different areas. Note: this is assessed by applying gentle pressure to specific “tender points”, where any pain is likely to be at its worst. 
  • Moderate sleep disturbance
  • Fatigue
  • No other reason for the symptoms has been determined.

Tender points associated with Fibromyalgia.

Fibromyalgia what causes it?

It is often misdiagnosed health care professionals and misunderstood by the general public. Research suggests Fibromyalgia is not an autoimmune or inflammation illness, but one where the brain has a problem interpreting pain signals from the nervous system, but the condition is not fully understood or recognised by all medical practitioners.


Background and history 

Fibromyalgia is not a new condition; it’s existed for centuries. Once considered a mental disorder, until the tender points associated with the condition were discovered in the early 1820s when it was reclassified fibrositis because it was believed at the time that the pain was caused by inflammation at the tender sites. Dr. Muhammad Yunus is known as “The Father of Fibromyalgia” he published his first paper in 1981. 

In 1976 it was renamed Fibromyalgia derived from the Latin word “fibro” (fibrosis tissue), and the Greek terms for “myo” (muscle) and “algia” (pain). Updated again in 2019 The International Diagnostic Criteria for Fibromyalgia was clarified to include:

  • A 3 months history of 3 months 
  • With severe pain in 3 to 6 different areas of the body, or milder pain in 7 or more different areas. Assessed by applying gentle pressure to specific “tender points”, where any pain is likely to be at its worst. 
  • Moderate sleep disturbance
  • Fatigue
  • No other reason for the symptoms has been determined.


Getting a diagnosis

There is no test for Fibromyalgia, so diagnosis is made following a careful medical history and physical examination, and by elimination. Blood tests are usually needed to rule out other conditions, check hormone levels and look for signs of inflammation.


Other considerations

  • Myofascial pain syndrome 
  • Autoimmune conditions such as multiple sclerosis, lupus, and ankylosing spondylitis, especially in the early stages 
  • Hypothyroidism 
  • Vitamin D or B12 deficiencies
  • Coeliac disease
  • Myelopathy resulting of spinal cord compression
  • Mood disorders including depression and anxiety disorders
  • Lyme disease 
  • Myalgic encephalomyelitis (also called, inaccurately chronic fatigue syndrome) 


Treatment

There is no known cure for Fibromyalgia, but medication can reduce symptoms in some people. Treatment plans usually involve a combination of medication such as pain killers, antidepressants and graded exercise. Plus support or talking therapies to manage stress and mood therapies.


Lifestyle, mind, and movement 

Lifestyle changes may ease symptoms and enable people to live more active meaningful lives. Stress reduction is fundamental to any fibromyalgia treatment plan, relaxation techniques and mind-body therapies can be effective options because they help the release of “feel-good” chemicals: serotonin, dopamine, and endorphins.

Meditation, mindfulness, guided imagery, and deep breathing are useful options too, and while ‘pacing’ is key to managing symptoms; not overdoing it by balancing periods of activity with periods of rest. Adding in a movement practice such as restorative pilates or yoga, Tai Chi or Qi Gong, is an excellent way to build resilience. The controlled movements of these methods, help release tension but shouldn’t cause fatigue.


Summary 

Fibromyalgia is a long-term condition that in a few cases, results in disability. People affected respond best with multifactorial healthcare approaches. Treatment is most effective when an integrative approach is used, one that includes patient education, exercise, and medications. 


Support 

Fibromyalgia Action UK is a charity that offers information and support groups. Some people find this a useful network where they can talk to others living with the condition.

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