Fibromyalgia: Symptoms, Diagnosis & Treatment

Older woman at home holding her neck in pain — Photo Courtesy: Adobe Images

Fibromyalgia is a chronic condition that causes widespread pain throughout the musculoskeletal system, including the muscles and joints. It isn't easy to identify, as diagnosis often requires eliminating similar conditions. On average, it takes patients five years to receive a fibromyalgia diagnosis from the time they first develop symptoms.

The high pain sensitivity in those with fibromyalgia can make injuries and stressors have a lasting effect, and other symptoms accompanying this condition can add to its impact. However, with treatment, management of triggers, and self-care, it is possible to surpass the barriers of fibromyalgia to live a full, dynamic life. What are the symptoms of fibromyalgia? What causes this condition? And how can treatment help empower those with fibro?

Symptoms of Fibromyalgia

While widespread pain is the hallmark of fibromyalgia, a range of symptoms can accompany this condition. These may develop suddenly or over time, with triggering events (trauma, chronic stress, and physical injury) often sparking the initial flare-up. Common symptoms of fibromyalgia include:

Joint and muscular pain
Fatigue or lethargy
Insomnia
Cognitive processing issues (known as "fibro fog")
Headaches/migraines
Depression, anxiety, and mood swings
Skin tenderness
Jaw/facial pain
Tingling in the limbs
Digestive troubles

Each individual with fibromyalgia may experience a different combination and severity of symptoms, contributing to the difficulty of diagnosis. Many may go through periods where they do not experience pain or other symptoms, known as remission, and flare-ups, where symptoms return.

What Causes Fibromyalgia

Researchers are still studying the causes of fibromyalgia. Medical scientists widely pose that the oversensitivity to pain observed in fibro patients may stem from changes to the nerve stimulation in the brain/spinal cord or genetic mutations that affect the neural pathways. Those with fibromyalgia experience heightened pain signals, even without external trauma.

While the cause is uncertain, risk factors have been observed, including:

Gender: Women are more likely to be diagnosed than men.
Age: Those 40+ are more likely to be diagnosed.
Chronic illnesses: IBS, arthritis, osteoarthritis, and mental illnesses can all contribute to the onset of fibro.
Trauma or stress: Psychological or physical trauma may activate fibromyalgia.
Severe infections: Infections with severe symptoms can contribute to fibro.
Obesity: Being overweight may increase your risk of fibro-related joint and muscular stress.
Genetics: Fibromyalgia can be passed through families.

How Is Fibromyalgia Diagnosed?

Diagnosing fibromyalgia does not come down to a singular test. Often, it takes time to eliminate other potential conditions before receiving a diagnosis of fibromyalgia. This elimination, known as differential diagnosis, narrows the pool of disorders with similar symptoms. Blood testing, physical examinations, and x-ray imaging may all help rule out other conditions to arrive at a fibromyalgia diagnosis.

While general physicians may diagnose fibro, patients undergoing testing may be referred to a rheumatologist, a doctor specializing in treating joint and musculoskeletal issues. One of the primary resources for diagnosis is the American College of Rheumatology's Preliminary Diagnostic Criteria chart. This tool asks patients to assess pain across 19 areas of their body and identify the severity of fatigue, cognitive issues, sleep troubles, and other somatic symptoms linked to fibro. The test will result in a widespread pain index (WPI) score, which a healthcare provider can assess for fibromyalgia.

Treatment for Fibromyalgia

Although fibromyalgia is a chronic condition and cannot be cured, it can be managed with treatment. Each patient's treatment plan should focus on their specific symptoms and triggers, as practices that relieve pain in some may agitate symptoms in others.

One of the primary methods of managing fibromyalgia is low-impact exercise that strengthens the muscles and joints. This may include yoga, qigong, swimming, and other aerobic exercises. Physical activity can help decrease flare-ups, lessen overall pain, and relieve other symptoms. However, exercise can also exacerbate pain during a flare-up, so it's important to recognize when to prioritize rest over movement. If you are worried about harming yourself, consider physical therapy or look for exercise groups focused on gentle exercise.

Another option for treatment is prescription medications. Two medications often used for fibromyalgia management are Cymbalta and Savella, which work to decrease overall pain. Another approved medication is Lyrica, a nerve blocker that lessens pain sensitivity. Antidepressants and anti-seizure medications may help treat emotional distress and improve sleep. While these can all be a great pairing with other treatments, introducing new medications may initially activate your symptoms, which is important to monitor.

Self-care and avoidance of triggers is another way to decrease flare-ups. Emotional or physical stress, poor nutrition, hormone shifts, illness, and inadequate sleep often worsen fibromyalgia symptoms. Knowing your common triggers and minimizing your exposure can help prevent the frequency of flare-ups. Of course, things like stress are not always avoidable. Talk therapy, meditation, rest, and psychotropic medications can all help to lower anxiety.

If you have recently been diagnosed with fibromyalgia, finding a treatment routine that works for you may take time. Be patient with yourself, practice self-care, and lean on your support system when needed. With time and consistency, you can manage your fibromyalgia symptoms and live beyond the limits of your diagnosis.