Fibromyalgia is a common syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues.
Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, and anxiety.
Causes, incidence, and risk factors
The cause is unknown. Possible causes or triggers of fibromyalgia include:
- Physical or emotional trauma
- Abnormal pain response - areas in the brain that are responsible for pain may react differently in fibromyalgia patients
- Sleep disturbances
- Infection, such as a virus, although none has been identified
Fibromyalgia is most common among women aged 20 to 50.
The following conditions may be seen with fibromyalgia or mimic its symptoms:
- Chronic neck or back pain
- Chronic fatigue syndrome
- Hypothyroidism (underactive thyroid)
- Lyme disease
- Sleep disorders
Pain is the main symptom of fibromyalgia. It may be mild to severe.
- Painful areas are called tender points. Tender points are found in the soft tissue on the back of the neck, shoulders, chest, lower back, hips, shins, elbows, and knees. The pain then spreads out from these areas.
- The pain may feel like a deep ache, or a shooting, burning pain.
- The joints are not affected, although the pain may feel like it is coming from the joints.
People with fibromyalgia tend to wake up with body aches and stiffness. For some patients, pain improves during the day and gets worse at night. Some patients have pain all day long.
Pain may get worse with activity, cold or damp weather, anxiety, and stress.
Fatigue, depressed mood, and sleep problems are seen in almost all patients with fibromyalgia. Many say that they can't get to sleep or stay asleep, and they feel tired when they wake up.
Other symptoms of fibromyalgia may include:
- Irritable bowel syndrome (IBS)
- Memory and concentration problems
- Numbness and tingling in hands and feet
- Reduced ability to exercise
- Tension or migraine headaches
Signs and tests
To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 areas, including
- Arms (elbows)
- Lower back
- Rib cage
Blood and urine tests are usually normal. However, tests may be done to rule out other conditions that may have similar symptoms.
The goal of treatment is to help relieve pain and other symptoms, and to help a person cope with the symptoms.
The first type of treatment may involve:
- Physical therapy
- Exercise and fitness program
- Stress-relief methods, including light massage and relaxation techniques
If these treatments do not work, your doctor may prescribe an antidepressant or muscle relaxant. The goal of medication is to improve sleep and pain tolerance. Medicine should be used along with exercise and behavior therapy. Duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella) are medications that are approved specifically for treating fibromyalgia.
However, many other drugs are also used to treat the condition, including:
- Anti-seizure drugs
- Other antidepressants
- Muscle relaxants
- Pain relievers
- Sleeping aids
Cognitive-behavioral therapy is an important part of treatment. This therapy helps you learn how to:
- Deal with negative thoughts
- Keep a diary of pain and symptoms
- Recognize what makes your symptoms worse
- Seek out enjoyable activities
- Set limits
Support groups may also be helpful.
Other recommendations include:
- Eat a well-balanced diet
- Avoid caffeine
- Practice good sleep routines to improve quality of sleep
- Acupressure and acunpuncture
Severe cases of fibromyalgia may require a referral to a pain clinic.
Fibromyalgia is a long-term disorder. Sometimes, the symptoms improve. Other times, the pain may get worse and continue for months or years.
Calling your health care provider
Call your health-care provider if you have symptoms of fibromyalgia.
There is no known prevention.
Abeles M, Solitar BM, Pillinger MH, Abeles AM. Update on fibromyalgia therapy. Am J Med. 2008;121:555-561.
Häuser W, Bernardy K, Üceyler N, Sommer C. Treatment of fibromyalgia syndrome with antidepressants. JAMA. 2009;301:198-209.
Wolfe F, Rasker JJ. Fibromyalgia. In: Firestein GS, Budd RC, Harris ED Jr., et al., eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 38.
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62(5):600-610.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. ©1997-2014 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Chemo Bath Can Extend Life For Some Patients With Abdominal Cancer
Can Asthma Affect Your Fertility?
5 Heart-Healthy Ways to Enjoy Kale
6 Ways to Get Relief From Monster Headaches
Beauty Care Products: What Do the Buzzwords Mean?
Sign Up for Free Newsletters
Ask Your Doctor the RIGHT Questions!
the most from your doctor visit.
Emailed right to you!
The Ask Your Doctor email series
may contain sponsored content.
18+, US residents only please.
Explore Original Articles About...
Get the MOST from QualityHealth
- Top Searches
- 1. Arthritis Management: Nature Heals
- 2. 5 Digestive To-Dos
- 3. Men: Should You Shave It or Leave It?
- 4. Today's Top Fitness Trends
- 5. Sugar and Osteoarthritis : The Link
- 6. Can't Afford Your Hospital Bills?
- 7. Stay Energized All Day Long
- 8. Phobias: Who Has Them and Why?
- 9. What If Your EpiPen Fails?
- 10. 5 Costly Medical Billing Mistakes
- 1. Hotter Temperatures Linked To Kidney Stones
- 2. Summer Bug Bites: What to Look For
- 3. Skin Health Advice with Dr. Kenneth Beer
- 4. Summer Safety Tips That Every Parent Needs To Know
- 5. Sugar and Your Immunity System
- 6. Do Weight Loss Supplements Work?
- 7. 5 Super Foods for Spring
- 8. The Hazards of Reusable Bags
- 9. How to Avoid Ingrown Hairs
- 10. Health Tip: Constantly Change Shoes
- 1. 4 Common Treatments for Epilepsy
- 2. What Does a Urogynecologist Do?
- 3. GERD Without Heartburn? It's Possible
- 4. Graston Technique: Can It Work on You?
- 5. Music Therapy Can Help Autism
- 6. 8 Ways to Fight MS-Related Fatigue
- 7. Can You Still Bleed After Menopause?
- 8. Be Your Own Health Care Advocate
- 9. Why Is Syphillis on the Rise?
- 10. Ideal Weight vs. Happy Weight
The material on the QualityHealth Web site is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a physician or other qualified health provider. See additional information.