Fibromyalgia

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KEY POINTS

• Fibromyalgia is a long-term condition that causes you to feel pain, stiffness, and tiredness.
• There is no known cure for fibromyalgia. Your treatment focuses on helping to decrease to reduce pain and other symptoms.
• You may need treatment with medicines, exercise, and therapy.

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What is fibromyalgia?

Fibromyalgia is a chronic (long-term) condition that causes you to feel pain, stiffness, and tiredness. The symptoms sometimes get better and at other times get worse, and can last for months to years. Although the illness can cause a lot of discomfort, it will not get worse over time. It is never fatal, and it will not cause damage to the joints, muscles, or internal organs. In many people, the condition does improve over time.

Fibromyalgia is usually diagnosed in middle age, although symptoms may start at an earlier age. It affects women more often than men. It is not common in children.

What is the cause?

The exact cause of fibromyalgia is not known. It has been linked to:

• Stress
• Anxiety or depression
• Physically or emotionally stressful or traumatic events, such as a car accident
• Infections or other illness
• Lack of restful sleep

It is also possible that some people with fibromyalgia are more sensitive to brain chemicals that send pain signals, or their bodies may make more of these chemicals than normal.

You are more likely to have fibromyalgia if you have a family member who has it.

What are the symptoms?

Pain that has lasted more than 3 months is the main symptom. You may have problems doing your normal daily activities because of the pain. The pain and stiffness may be different day to day or week to week. The pain may move from one part of the body to another. You may notice pain at specific places on the neck, shoulders, back, hips, arms, and legs, called tender points. These points hurt when pressure is put on them. Women may also have painful menstrual periods.

Other symptoms may include:

• Feeling tired all the time
• Headaches
• Problems with your digestive system, especially trouble swallowing, stomach pain, nausea, constipation, or diarrhea
• Trouble sleeping
• Depression or anxiety
• Problems with thinking and remembering things
• Flu-like symptoms
• Pain in the bladder or a need to urinate often or suddenly
• Jaw problems
• Restless legs

Symptoms may get worse when you do too much or when the weather is damp and cold.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Your provider will look for places that are tender. There is no specific test for fibromyalgia. You may have tests or scans to check for other possible causes of your symptoms, such as rheumatoid arthritis.

How is it treated?

There is no known cure for fibromyalgia. The goal of treatment is to reduce pain and other symptoms.

Exercise therapy and lifestyle changes can help lessen your symptoms. Exercise should start with slow and easy movement. You can increase the amount of exercise gradually to build muscle strength and energy.

Cognitive behavioral therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new ways to think and act.

Several kinds of medicine may help lessen your symptoms:

• Nonprescription medicine, such as ibuprofen, or naproxen may treat pain. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take this medicine for more than 10 days.
• Muscle relaxants may help relax muscles and lessen pain.
• Antidepressants may help you sleep better and may also help lessen pain.
• Antiseizure medicine may help lessen pain, decrease tiredness, and help you sleep

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• If your provider recommended or prescribed medicine, take it exactly as directed. Ask your provider how soon the medicine should start helping you feel better. Let your provider know if it has helped. If it hasn’t, you may need a different dose or a different medicine.
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress. Exercise according to your healthcare provider's instructions.
• Eat a healthy diet. Ask your provider about the benefits of talking to a dietitian to learn what you need in a healthy diet. Try to keep a healthy weight. If you are overweight, lose weight.
• Avoid doing too much at one time. Break up daily activities with periods of rest.
• Practice ways to treat pain and manage stress. For example, try relaxation exercises, water therapy, massage, acupuncture, or meditation. A therapist may be able to help with this.
• Warm or cold compresses may help to decrease pain:
  • Put moist heat on a sore area for up to 30 minutes to relieve pain. Moist heat includes heat patches or moist heating pads that you can buy at most drugstores, or a warm wet washcloth. To prevent burns to your skin, follow directions on the package and do not lie on any type of hot pad.
  • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the sore area every 3 to 4 hours for up to 20 minutes at a time.

Ask your provider:

• How and when you will get your test results
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

For more information contact:

• National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
  877-226-4267
  http://www.niams.nih.gov