Fibromyalgia Explained: Causes, Symptoms, And Treatments

Pain is an unpleasant but fairly common sensation in daily life. An ache in your back from sitting too long or the sharp sting of a paper cut causes pain. Eventually, the feeling fades away and you're back to normal. 

Sometimes, pain is even a good thing. For example, if you pull a muscle and need to take it easy at the gym, pain can be your guide to let you know that something is wrong.

The perception of pain, however, can be skewed. In people with fibromyalgia, there's an extreme sense of pain compared to people without it. According to the Centers for Disease Control and Prevention (CDC), fibromyalgia can cause pain all over the body. While an injury or illness can cause pain in the body by damaging something or causing inflammation, fibromyalgia is a disorder that affects the way you feel pain. Roughly 2% of the U.S. population suffers from this problem, and there's no known cause or cure.

Who can get fibromyalgia?

Scientists aren't sure what causes fibromyalgia, says the National Institute of Arthritis and Musculoskeletal and Skin Diseases. However, some people have observed that it tends to run in families, so there may be a genetic component. More research needs to be done in that area to prove if there's a connection. Until then, there are certain demographics that tend to be more at risk for developing the pain disorder.

Gender seems to be one area where there's a distinction, as women are at higher risk for developing fibromyalgia. Meanwhile, racial and ethnic backgrounds don't seem to be an important factor. Age is less clear, since people of all ages can get it, even children. However, middle-aged folks tend to be the most at-risk population. 

There are also some previous medical conditions that seem to increase your risk for developing fibromyalgia. Rheumatoid arthritis, osteoarthritis, and lower back pain can all make you more likely to develop fibromyalgia.

What causes fibromyalgia?

Experts aren't entirely certain what causes fibromyalgia, says the U.K.'s National Health Service, but there are a few possible explanations. 

A change of chemicals in the nervous system, for instance, could alter the way you perceive pain. If the signals your brain sends between your spinal cord and your body get mixed up, it can lead to abnormal pain processing, which is one of the main symptoms of fibromyalgia. Some of the chemicals that can become imbalanced include serotonin, dopamine, and noradrenaline. Changes in another hormone, cortisol, could also cause fibromyalgia. Sleep loss is a symptom of fibromyalgia, but it could also be a cause. It might not cause the pain that you feel from fibromyalgia, but it could lead to some of the other symptoms. Plus, lack of sleep can make someone with fibromyalgia feel even more pain.

Genetics are another possible explanation for the development of fibromyalgia. If you have a genetic problem that makes you more likely to develop fibromyalgia, a triggering event could set it off. 

How do I know if I have fibromyalgia?

If you have been feeling excessive pain in multiple places in your body, feel fatigued, or have any of the possible fibromyalgia symptoms, your doctor can help diagnose you properly. 

Some doctors will test out different areas of your body and require you to have a certain number of tender points to diagnose you as having fibromyalgia, says the American College of Rheumatology. Making a diagnosis is tricky because your doctor can't simply draw blood or take an x-ray to check for it.

Part of the problem with diagnosing fibromyalgia is that there are so many different symptoms. Your doctor will have to go through everything you're feeling and try to figure out whether it's attributable to fibromyalgia or not. Your doctor will ask you to describe your pain, where it is, and how long it has lasted. Part of the criteria is that your symptoms have to be consistent for at least three months.

Symptoms of fibromyalgia

The full list of symptoms related to fibromyalgia are listed in an article from MedlinePlus. In addition to feeling pain all over your body, you might feel stiff. Sleep can be difficult, and fatigue is common. Your brain is also affected by "fibro fog," which causes problems thinking. Your mental health could also suffer, since depression and anxiety are known symptoms of fibromyalgia. 

Irritable bowel syndrome can occur with fibromyalgia, which can be very uncomfortable. Irritable bowel syndrome is a problem with the large intestine. It results in pain in the abdomen, along with cramping and bloating. While it doesn't cause damage to the large intestines, irritable bowel syndrome can be difficult to live with. Some other symptoms of fibromyalgia include pain in the face or jaw, known as temporomandibular joint syndrome or TMJ, and numbness or tingling in the hands and feet. The wide range of fibromyalgia symptoms makes the condition difficult to live with.

Other problems related to fibromyalgia

There are known symptoms that come with fibromyalgia, but there are also possible problems that can happen alongside the pain disorder. 

The Arthritis Foundation discusses some of these, such as restless leg syndrome. You can have restless leg syndrome on its own, but people with fibromyalgia can develop it as part of their disorder. It can make falling asleep very difficult. Women might suffer from something called endometriosis, which can make the menstrual cycle very painful. Meanwhile, headaches, pelvic pain, and an overactive bladder are all common health effects of fibromyalgia.

Additionally, being in constant pain can take a toll on your mental health. One condition that can develop alongside fibromyalgia is somatization syndrome, which is anxiety that develops around a physical symptom (for example, if you feel anxiety about the pain or fatigue that comes along with fibromyalgia). Depression is another example of a problem that is likely to come with the disease. 

Is fibromyalgia the same as chronic pain?

Injuries hurt, but most of them heal. Modern medicine can fix broken bones, replace some joints, and repair tendons. 

Some injuries and pains stick around for a while. For example, chronic lower back pain is pain that lasts over 12 weeks, according to the National Institute of Neurological Disorders and Stroke. In fact, roughly 20% of people who experience back pain still have it a year later. Pain can even continue after surgery and rehabilitation.

Chronic pain, however, is a problem. It's one of the most expensive medical problems in the United States (per Johns Hopkins Medicine). There are a few causes of chronic pain, such as back pain, arthritis, and cancer. Fibromyalgia may sound like just another version of chronic pain, but it's not quite the same thing. As Harvard Health explains, fibromyalgia is a type of chronic pain disorder, but medical professionals aren't sure exactly what causes it. There are also some unique symptoms (like fatigue, sleep problems, and memory problems) that distinguish it from chronic pain.

What are some triggers of fibromyalgia?

People with fibromyalgia often experience symptoms, but they're not constant. The feelings of pain ebb and flow, and can be worse depending on other factors. 

A bad episode of symptoms is known as a flare-up, explains an article from the Cleveland Clinic. If you have fibromyalgia, you should try to avoid activating some of the triggers that they mention in order to avoid flare-ups. One trigger is a change in daily routine — for example, if you suddenly change your sleeping pattern. One more thing to avoid is making major, drastic changes to your diet (like going from an omnivorous diet to a vegan diet). 

While they're hard to control, fluctuations in hormones can also trigger a flare-up. Even changes in the weather or outdoor temperature can cause your symptoms to spike. Another potential trigger is stress in any form. Whether it's related to work, relationships, or health problems, stress can make your symptoms worse.

Are there other ways to manage fibromyalgia?

Medication can help control your symptoms, but there are other ways you can alleviate pain and fight fatigue on your own. 

Cognitive behavioral therapy is one strategy you can use to help relieve fibromyalgia, according to the Cleveland Clinic. Cognitive behavioral therapy is a form of talk therapy that can helps you understand how your thoughts affect your actions. It'll help you gain a new perspective on the chronic pain you feel from fibromyalgia (per the Cleveland Clinic).

Stress management techniques also work well to diminish the symptoms of fibromyalgia. Since stress is one of the causes of flare-ups, reducing the amount of stress you feel throughout the day can help you manage spikes in your symptoms. Some stress management techniques you can use (via the Cleveland Clinic) include exercise and yoga, taking time to reflect at the end of the day, and speaking to a therapist. Strength training and other forms of exercise are recommended, even though you might not feel up to it because of the pain and fatigue you are experiencing. 

Are there medicines you can take for fibromyalgia?

Even though scientists aren't sure what causes fibromyalgia or how to cure it, there are ways to make it more manageable. 

Certain medications can help you keep your symptoms at bay. Over-the-counter pain relievers are recommended, according to MedlinePlus. These are medications you can pick up at the pharmacy without a prescription, such as Advil, Aleve and Motrin. Your doctor can help you figure out which one is the best for you. A doctor may also prescribe specific types of pain pills.

Antidepressants are another type of drug that can be used to treat both the pain associated with fibromyalgia and some of the underlying mental side effects. They can also help with sleep problems. Pregabalin is one of those medications, says the Johns Hopkins Lupus Center. It helps by reducing pain, helping with sleep, and reducing fatigue. There are other medications that are effective, but come with limited side effects.

What are the best workouts for fibromyalgia?

You can help manage your symptoms by exercising regularly, but what does that mean? 

There are many forms of exercise, and you might not be excited to jump into a general workout routine without knowing whether or not it will work first. An article from the American Academy of Family Physicians shows that aerobic exercise can help reduce your symptoms. The authors explain that there's high-quality evidence showing that 20 to 30 minutes of aerobic exercise performed two to three days per week can reduce pain and fatigue.

Aerobic exercise, according to a study published in the World Journal of Cardiology, is any type of exercise that uses large muscle groups, is performed continuously, and is rhythmic. Some examples they give include long-distance running, hiking, dancing, and swimming. You can pick the activity that you enjoy most or do a combination of them. You can also work out for more than 20 to 30 minutes — that's the recommended minimum to get the benefits from exercise.

Acupuncture for fibromyalgia

There are some alternative ways to lessen your symptoms from fibromyalgia. One way is with acupuncture, which you don't need a recommendation from your doctor to pursue. 

The Hospital for Special Surgery explains that treatment is different from person to person, so if medications and other lifestyle changes don't work for you, this might. Originally developed as part of an ancient system of medicine used in China, acupuncture is a practice where small needles are placed into different areas of the body. Many patients undergo this procedure mainly to relieve pain. It's also used to treat chronic conditions such as musculoskeletal disorders. 

The pain relief benefits of acupuncture can help with fibromyalgia. One theory as to why it works is that the needles cause the body to produce endorphins, which reduce pain. Another theory is that they improve circulation. Interestingly, it's effective enough at reducing pain that acupuncture is sometimes used to treat the painful side effects of surgery.

Coping with fibromyalgia

There's no cure for fibromyalgia, so instead of thinking about how to treat it, you'll have to work with your doctor to learn how to live with it. 

The first thing the University of Washington's Orthopaedics and Sports Medicine acknowledges is that many people get frustrated before they even receive their diagnosis. Since the symptoms of fibromyalgia can be so general, it's hard to quickly pin down the reason why people are in pain.

On the positive side, symptoms from fibromyalgia tend to stay the same over the course of your life. It's also not life-threatening, so you don't have to worry about your condition worsening over time. Once you have a proper diagnosis, you might already feel some relief. Experts recommend a regular stress-relieving practice and seeking help from a mental health professional if you feel depressed or anxious. You should also avoid caffeine and alcohol.

Anxiety and depression from fibromyalgia

Symptoms of fibromyalgia can be constant, which can cause a lot of mental hardship. Eventually, that takes a toll on mental health. 

Roughly 20% of people who have fibromyalgia also suffer from anxiety and depression, says the Anxiety & Depression Association of America. This high number suggests that fibromyalgia increases a person's risk for anxiety and depression. It is recommended to see a separate doctor for anxiety if that becomes a problem.

There are other mental health challenges to be aware of when it comes to dealing with fibromyalgia. For starters, it can take a toll on your social life by limiting the amount of things you can do. It also affects your body image, according to a study published in Psychological Research and Behavior Management. For example, it can lower your self-esteem and create body image issues. Part of the reason could be a lack of social support, the researchers suggest. If your mental state worsens, it can exacerbate your symptoms.

If you or someone you know is struggling with mental health, please contact the Crisis Text Line by texting HOME to 741741, call the National Alliance on Mental Illness helpline at 1-800-950-NAMI (6264), or visit the National Institute of Mental Health website.

Prognosis for fibromyalgia

According to Penn Medicine, fibromyalgia can get worse over time. In some cases, however, the symptoms may actually improve. Either way, it's something that will stay with you for a while. 

On the bright side, it's not life-threatening. A study published in Frontiers in Medicine showed that 26 years after onset, 11% of people in the study were cured of fibromyalgia. Meanwhile, 23% had been in remission for a year. They also point out that there are few cases of people over 70 with fibromyalgia, meaning it could go away as you age.

However, there are some complications that can arise from fibromyalgia. For instance, the CDC points out that you're twice as likely to be hospitalized if you suffer from fibromyalgia compared to someone who doesn't. You may also experience a lower quality of life. There are other types of rheumatic conditions that you might develop, including different forms of arthritis. If you have fibromyalgia, it can help to be on the lookout for these complications.