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A beginner’s guide to fibromyalgia
Here’s what you need to know about diagnosing and treating this often misunderstood condition.
The unknown has a way of making even the most self-assured person uncomfortable. How big is space? What happens when we die? When will COVID-19 no longer be a threat?
Experiencing aches and pains without knowing why can be scary, too. Or at the very least, unnerving.
And that’s what makes fibromyalgia so unsettling. It’s a tricky condition to define and diagnose. Quite simply, it’s a long-lasting condition in which people have widespread pain and soreness for at least 3 months.
But the pain is subjective. One person may experience mild pins and needles, while someone else feels like they’re being pounded by a meat tenderizer. That’s why it can take such a long time to get a diagnosis — and treatment. (If your fibromyalgia treatment includes prescription medication, download our free app. You could find savings of up to 80%.)
“Many people experience fibromyalgia pain for years before being diagnosed,” says Ellen Voronov, MD. She’s a board-certified physiatrist at the Spine Center of Duly Health and Care in Elmhurst, Illinois. That’s a long time for the estimated 4 million Americans living with fibromyalgia to spend wading around in the unknown.
The best thing you can do: Learn more about the signs and symptoms of fibromyalgia. Here are some of the most important things to know.
What does fibromyalgia feel like?
At the most basic level, fibromyalgia causes pain all over the body. Yet where the pain is or what it feels like can differ from person to person, Dr. Voronov says. It’s very common in the neck and lower back, she adds. But any part of the body can be affected.
The pain could range from mild to debilitating, coming and going over time. And it can feel like burning, soreness, stiffness, aching or gnawing pain, according to Cedars-Sinai in Los Angeles. Fibromyalgia can also feel like arthritis, but without the damage to joints that can come with it.
As if all this weren’t bad enough, fibromyalgia is often partnered with a host of other symptoms. And they often mimic those of other conditions, making it even harder to diagnose.
According to the Mayo Clinic, other common symptoms are:
- Exhaustion. People with fibromyalgia often wake up feeling tired, even though they may sleep for a long time. Many people with fibromyalgia also have other sleep disorders, such as restless legs syndrome or sleep apnea.
- Cognitive problems. Known as “fibro fog,” it’s fuzzy thinking that makes it hard for people to focus or concentrate.
- Digestive problems. Symptoms may include stomach pain, bloating, constipation or irritable bowel syndrome.
An estimated 50% to 60% of people with fibromyalgia also have depression, says Deepak Ravindran, MD. He’s a pain medicine consultant and director of the Berkshire Pain Clinic in Reading, England.
What causes fibromyalgia?
Experts aren’t really sure. (Again with the unknown.)
With fibromyalgia, the body’s pain receptors are on high alert. Some people may be sensitive to pain to the point where “being touched or hugged can become painful,” says Jenny Andrus, MD. She’s an interventional pain management physician with the Orthopaedic & Spine Center in Newport News, Virginia.
According to the Office on Women’s Health, there’s evidence that the brains of people with fibromyalgia process pain differently than those without the condition. This may be due to lower levels of certain brain chemicals, such as serotonin, that cause you to be more sensitive to pain.
Some risk factors for fibromyalgia include:
- Trauma to the brain or spinal cord, such as from a car accident
- Emotional stress or trauma, such as post-traumatic stress disorder
- Having a mood disorder, such as anxiety or depression
- Certain illnesses, such as viral infections
Fibromyalgia tends to run in families, adds Dr. Andrus. And women are twice as likely to develop the condition as men, although it’s not known why.
How is fibromyalgia diagnosed?
There is no specific medical test for fibromyalgia. Instead, your doctor will first rule out other health problems that could be causing your symptoms. For example, the American College of Rheumatology says that the symptoms of hypothyroidism can sometimes mimic those of fibromyalgia, as can the symptoms of rheumatoid arthritis or lupus.
Your doctor may ask you to describe your pain, do a physical exam, and run x-rays and blood work. If you have no other conditions that could cause your specific pain, they’ll likely look to your symptoms to pinpoint a fibromyalgia diagnosis. Telltale signs include if you’ve had symptoms for at least 3 months, as well as other issues such as fatigue and memory problems.
How is fibromyalgia treated?
“Fibromyalgia does not have to be a lifelong problem,” Dr. Andrus says. It is possible to get relief from your symptoms with treatment.
The main goal of treatment is to find ways to tamp down the nervous system, says Dr. Ravindran. That can be done with medications, lifestyle changes or both.
Some overall healthy habits that your doctor may suggest:
- Make time for stress management. Mindfulness, deep breathing and meditation are some options. So is making time for hobbies and activities you truly enjoy. Cognitive behavioral therapy can also be helpful. (Here’s how to find a therapist online.)
- Keep a healthy sleep routine. That means getting 7 to 8 hours of sleep a night, going to bed and waking up at the same time every day, and limiting daytime napping.
- Staying physically active. Exercise can cause fibromyalgia pain to spike, but usually only at first, according to the Mayo Clinic. If you gradually build up to a regular exercise routine, it can decrease fibromyalgia symptoms. Walking, swimming and biking are good choices.
- Try complementary therapies. These may include acupuncture, yoga, tai chi or massage.
“The very best outcomes are in patients who exercise regularly and manage their stress,” says Dr. Andrus.
Medications that can help with fibromyalgia symptoms include:
- Over-the-counter pain relievers, such as acetaminophen (Tylenol®), ibuprofen (Advil® and Motrin®) or naproxen (Aleve®). People with fibromyalgia should avoid opiates because they can cause major side effects, lead to dependence and worsen pain over time.
- Antidepressants, such as duloxetine (Cymbalta®) and milnacipran (Savella®), for pain and fatigue.
- Anti-seizure medications, such as gabapentin (Neurontin®) and pregabalin (Lyrica®), for pain.
The more you know about fibromyalgia, the better equipped you’ll be to take action, ease your symptoms and live the life you want.
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