Fibromyalgia (fi·bro·my·al·gi·a) is a condition that causes pain all over the body (also referred to as widespread pain), sleep problems, fatigue, and often emotional and mental distress. People with fibromyalgia may be more sensitive to pain than people without fibromyalgia.
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and non-painful signals.
Symptoms often begin after an event, such as physical trauma, surgery, infection, or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.
Women are more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety, and depression.
While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation, and stress-reduction measures also may help.
The primary symptoms of fibromyalgia include:
- Widespread pain. The pain associated with fibromyalgia often is described as a constant dull ache that has lasted for at least three months. To be considered widespread, the pain must occur on both sides of your body and above and below your waist.
- Fatigue. People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain, and many patients with fibromyalgia have other sleep disorders, such as restless legs syndrome and sleep apnea.
- Cognitive difficulties. A symptom commonly referred to as “fibro fog” impairs the ability to focus, pay attention and concentrate on mental tasks.
Other signs and symptoms
Fibromyalgia often co-exists with other conditions, such as:
- Lack of energy.
- Trouble sleeping.
- Depression or anxiety.
- Migraine and other types of headaches.
- Muscle twitches or cramps.
- Numbness or tingling in the hands and feet.
- Itching, burning, and other skin problems
Irritable bowel syndrome
- Interstitial cystitis or painful bladder syndrome
- Temporomandibular joint disorders
- Postural tachycardia syndrome
Many researchers believe that repeated nerve stimulation causes the brain and spinal cord of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain.
In addition, the brain’s pain receptors seem to develop a sort of memory of the pain and become sensitized, meaning they can overreact to painful and non-painful signals.
There are likely many factors that lead to these changes, including:
- Genetics. Because fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing the disorder.
- Infections. Some illnesses appear to trigger or aggravate fibromyalgia. Possible triggers for the condition include an injury. A viral infection.
- Physical or emotional events. Fibromyalgia can sometimes be triggered by a physical event, such as a car accident. Prolonged psychological stress may also trigger the condition Fibromyalgia is often triggered by a stressful event, including physical stress or emotional (psychological) stress.
Fibromyalgia is typically not life-threatening but can affect day-to-day activities. Pain, fatigue, and lack of sleep that occur in fibromyalgia can impair the ability to function or concentrate. Patients may also feel frustrated due to their condition, and this can lead to anxiety or depression.
The 7 Types of Fibromyalgia Pain
Hyperalgesia is a condition in which you experience an enhanced sensitivity to pain. This is caused by specific nerve receptors in your body becoming more sensitive. Hyperalgesia can develop due to tissue or nerve injury as part of a surgery or procedure. It can also occur in people who are taking opioids.
Examples could include headaches, neck pain, leg pain, or back pain. Some people describe the pain as “diffuse” or spreading. Some may report all-over body pain and aches. The quality or experience of the pain is different from it used to be.
2. Widespread Muscle Pain.
Fibromyalgia is the second most common condition affecting your bones and muscles. Yet it’s often misdiagnosed and misunderstood. Its classic symptoms are widespread muscle and joint pain and fatigue.
The most common causes of muscle pain are tension, stress, overuse, and minor injuries. This type of pain is usually localized, affecting just a few muscles or a small part of your body.
Muscle pain – specifically systemic muscle pain – can be caused by an illness, infection, or a side effect of certain medications.
3. TMJ Pain.
TMJ (Temporomandibular joint) disorders may cause mild to debilitating symptoms, such as pain while chewing. Pain in the ear, face, jaw, and neck. Clicking, grating, or popping sounds in the jaw when you open or close your mouth.
Over-the-counter pain relievers such as ibuprofen and acetaminophen may help relieve TMJ pain. Muscle relaxers may be prescribed for severe pain. Doctors may also recommend: mouth guards to prevent teeth grinding and jaw clenching.
That said, the main causes of TMJ flare-ups are stress, which can lead to jaw clenching or bruxism (teeth grinding) while you’re asleep or awake; hormonal changes, such as those brought on by birth control or supplements; hard and chewy foods, which can strain the already stressed TMJ and includes foods such as apples, bagels, gummies, and nuts.
Allodynia is a type of neuropathic pain (nerve pain). People with allodynia are extremely sensitive to touch. Things that don’t usually cause pain can be very painful.
These may include cold temperatures, brushing hair, or wearing a cotton t-shirt. Allodynia can result from several conditions. The most common causes of allodynia include diabetes, shingles, fibromyalgia, and migraine headaches.
5. Neuropathic Pain.
Neuropathic pain can happen if your nervous system is damaged or not working correctly. You can feel pain from any of the various levels of the nervous system—the peripheral nerves, the spinal cord, and the brain. Together, the spinal cord and the brain are known as the central nervous system.
The examples include post-herpetic (or post-shingles) neuralgia, reflex sympathetic dystrophy/causalgia (nerve trauma), components of cancer pain, phantom limb pain, entrapment neuropathy (e.g., carpal tunnel syndrome), and peripheral neuropathy (widespread nerve damage).
Headaches. If fibromyalgia has caused you to experience pain and stiffness in your neck and shoulders, you may also have frequent headaches. These can vary from being mild headaches to severe migraines, and could also involve other symptoms, such as feeling sick.
However, these are some common fibromyalgia headache symptoms, including pulsing, sharp, or aching pain. Pain on one side of the face only, extending into the eye. Head pain radiates into the neck and shoulder muscles.
In more than half of all fibromyalgia sufferers, one of the accompanying symptoms is headaches. These may range from tension headaches to migraines. Almost 36 percent of fibromyalgia patients also experience intensely painful migraine headaches.
Yet, in more than 80% of cases, acute pain goes away in about two weeks.
7. Abdominal and Pelvic Pain
Nearly half of people with fibromyalgia are also diagnosed with irritable bowel syndrome (IBS). This is a digestive disorder that causes cramping, belly pain, constipation, diarrhea, and nausea. Besides abdominal pain, women with fibromyalgia may have pelvic pain due to bladder pain.
What kind of medical test is done for fibromyalgia?
There is no widely accepted medical test to diagnose fibromyalgia. Instead, diagnostic tests are performed to see if another condition could be causing the symptoms. Blood tests are usually ordered to rule out conditions with similar symptoms.
Is fibromyalgia Real or mental?
Fibromyalgia is a condition that causes widespread pain all over the body and tender points that are sensitive to the touch. It is not considered a mental illness, but many people with fibromyalgia also experience depression and/or anxiety
What Are Fibromyalgia Tender Points?
“One of the things that’s true in people that have fibromyalgia is that they have a reduced threshold to pain,” says Frederick Wolfe, MD, a rheumatologist and fibromyalgia expert in Wichita, Kansas, who helped create the original and updated fibromyalgia diagnostic criteria from the American College of Rheumatology.
Someone without fibromyalgia could be gently bumped into and barely notice it. But because someone with fibromyalgia is more sensitive to pain, that same degree of touch could hurt a lot more.
Although fibromyalgia is a condition known for causing widespread pain, doctors used to identify specific areas of the body — called tender points — that felt more sensitive to touch to fibromyalgia patients than to someone who doesn’t have this disorder.
Tender points are specific areas of pain that are near your joints but are not the joints themselves. They hurt when you press on them. Even pressure from a finger — like a poke — can make someone winces or flinch.
History of Tender Points
“The term ‘tender points’ came about in 1977 when two Canadian physicians, Hugh Smythe and Harvey Moldofsky, proposed criteria for fibromyalgia based on the identification of these tender spots,” says Dr. Wolfe. “It seemed reasonable and found its way to be the prime diagnostic component of the 1990 fibromyalgia criteria from ACR.”
These tender points aren’t located randomly. They are in specific certain areas of the body and are small — about the size of a penny. They help to differentiate between otherwise healthy people and people with fibromyalgia, says Dr. Wolfe.
When doctors would diagnose fibromyalgia years ago, they would count tender points that caused pain in the patient. If 11
out of 18 tender points tested positive for sensitivity, this would help them make a diagnosis of fibromyalgia.
Where Are Fibromyalgia Tender Points?
Fibromyalgia tender points tend to be symmetrical in the body. They are located both above and below the waist around the neck, chest, shoulders, hips, and knees. The tender point should cause pain in that exact area when the doctor presses on it with enough force to turn their fingernail white. It should be painful in the exact spot that is being pressed.
The 18 tender points for fibromyalgia include:
- Lower neck in front
- Edge of upper breast
- Arm near the elbow
- The base of the skull in the back of the head
- Hip bone
- Upper outer buttock
- Back of the neck
- Back of the shoulders
What Causes Tender Points?
Although experts don’t know exactly what is causing these sensitivities in specific areas, it has to do with muscle spasms, says John Dombrowski, MD, anesthesiologist and pain management at The Washington Pain Center, Washington, D.C.
“When muscles get spasms [involuntary contractions], they tend to have a lack of oxygen and blood. That lack of oxygen and buildup of acid and carbon dioxide causes more pain in the muscles, which causes greater spasms, and it’s a vicious cycle.”
Why do muscles have spasms in the first place?
“We still don’t know the reason for these spasms and increased sensitivities,” he says. “But what’s causing the pain is a cyclical event.”
What Is the Treatment for Tender Points?
Treating tender points involves treating your fibromyalgia condition as a whole and may involve several prescriptions and recommendations for lifestyle modifications.
Physicians may recommend the following types of medication to help with fibromyalgia symptoms and tender point pain:
- Anti-seizure medications
- Non-steroidal anti-inflammatory drugs
- Injections of steroids or other medications
Within these classes, some medications are approved specifically for fibromyalgia: duloxetine (Cymbalta®), milnacipran (Savella™), and pregabalin (Lyrica®).
“If there’s one specific muscle group that is more painful than another, then that’s where an injection would play a role,” says Dr. Dombrowski. He says he might use a local anesthetic and a small amount of cortisone to the affected area.
“If the muscle continues to be in spasm and doesn’t respond to exercise and stretching, you could actually use Botox to keep the muscle paralyzed.” A pain management specialist may recommend a trigger-point injection or myofascial injection with a local anesthetic and steroids, says Dr. Dombrowski.
As well, lifestyle modifications are critically important in managing fibromyalgia symptoms, especially exercise. Exercise can help address many issues related to fibromyalgia, including anxiety and depression, pain, and fatigue.
“Getting regular aerobic exercise and doing muscle strengthening can help,” suggests Dr. Wolfe. “Controlling stressors is a very important thing. Because we know that stress is an important determinant in some people with fibromyalgia.”
Alternative therapies to manage fibromyalgia pain include acupuncture, massage, acupressure, physical therapy, yoga, and cognitive behavioral therapy.
Fibromyalgia sufferers should eat a diet that’s high in lean protein and fiber, and lower in carbohydrates. Foods that help fibromyalgia include fruits with a low glycemic index, vegetables, and whole grains. A well-balanced diet can improve energy levels, and staying physically active can lead to better overall health.
Foods to eat
The following guidelines can help a person make anti-inflammatory diet choices.
Eat eight to nine servings of fruits and vegetables per day: Eating a variety of colorful fruits and vegetables can ensure the greatest range of nutrients. Foods that are particularly rich in nutrients include broccoli and berries.
Choose healthful oils: Olive oil is a good choice.
- egg yolks
- low-fat yogurt fortified with vitamin D
- orange juice fortified with vitamin D
- swordfish and salmon
- tuna, canned in water
- whole-grain cereals fortified with vitamin D
- Foods containing vitamin D may not reduce symptoms in everyone with fibromyalgia, but they have overall benefits, such as building healthier bones.
Some researchers have looked at whether the following may help manage the symptoms of fibromyalgia:
There is not yet enough evidence to confirm that these will help with fibromyalgia, however.
It is important to talk to a doctor before starting to take any supplements, even the “natural” ones. Some supplements can have adverse effects, while others can interact with medications the person may be taking.
For example, some people with fibromyalgia use antidepressants, such as sertraline (Zoloft) or fluoxetine (Prozac). St. John’s wort can interact with these types of drugs.
What are the worst foods for fibromyalgia?
Fibromyalgia: Seven foods to avoid continued…
- Food additives including MSG (monosodium glutamate) and nitrates. …
- Sugar, fructose, and simple carbohydrates. ...
- Caffeine — including coffee, tea, colas, and chocolate. ...
- Yeast and gluten. …
- Dairy. …
- Nightshade Plants: Tomatoes, chili and bell peppers, potatoes, and eggplant.
Other ingredients that may trigger inflammation include:
- saturated fats and trans fats
- refined starches
- foods with added sugar
It may help to keep a food journal and record any symptoms that occur after eating particular food items. If any patterns emerge, it may be worth considering avoiding those foods for a while to see how this affects symptoms.
It is important to remember that avoiding any or all of these foods is unlikely to eliminate all fibromyalgia symptoms.
Also, when cutting out foods, people should ensure that they are getting the nutrients that those items provide from other foods or supplements.
Other stress-relieving activities that may help relieve fibromyalgia symptoms include:
- massage therapy
- relaxation training
- magnetic therapies
- counseling or therapy
Most of these are safe to try, even if scientific evidence to support them is currently lacking. For treatments such as homeopathy and acupuncture, people should check that the provider they choose has approved qualifications.
Please let us know in the comments below:
1. Are you familiar with fibromyalgia before you read this topic?
2. Do you know of anyone who suffers from it? If so, what kind?
3. What measures do they use to lessen the underlying pain? Did it help them at all? If not, why not?
Information on this site is not intended to diagnose, treat, cure, or prevent any disease. We encourage you to do your own research. Seek the advice of a medical professional before making any changes to your lifestyle or diet.
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