What Is Fibromyalgia?

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Fibromyalgia is a condition that comes with pain and tenderness anywhere in your body. You may also have fatigue and trouble getting the sleep you need. It’s often misdiagnosed and misunderstood.

There’s no cure. But a combination of medication, exercise, managing your stress, and healthy habits may ease your symptoms enough that you can live a normal, active life.

Doctors aren’t sure what causes it. But when you have fibromyalgia, you may be more sensitive to pain than other people are. Some studies suggest there may be changes in the way your brain and other parts of your nervous system send and receive pain signals.

It does run in families, so your genes may play a role. But scientists don’t know which genes are important. Like most complex conditions, other factors likely also play a role. For example, you’re more likely to have fibromyalgia if:

  • You’re a woman or were assigned female at birth (AFAB).
  • You’re middle aged or older.
  • You have a mental health or mood disorder, like anxiety or depression.
  • You were physically or emotionally abused or have PTSD.
  • You rarely exercise.
  • Other family members have it.

You may be more likely to get fibromyalgia if you also have another painful condition, such as:

  • Rheumatoid arthritis or osteoarthritis
  • Systemic lupus erythematosus (also known as lupus)
  • Ankylosing spondylitis
  • Back pain that doesn’t go away
  • Irritable bowel syndrome (IBS)

 

Simply put, you ache all over. Common signs of fibromyalgia include:

  • Muscle pain, burning, twitching, or tightness
  • Pain in your arms, legs, head, chest, belly, back, and butt
  • Feeling like you’re body is aching, burning, or throbbing
  • Low pain threshold or tender points when you’re touched
  • Draining fatigue or overwhelming tiredness
  • Trouble concentrating and remembering, called “fibro fog”
  • Insomnia or not sleeping well
  • Feeling nervous, worried, or depressed

Fibromyalgia can feel similar to osteoarthritis, bursitis, and tendinitis. But rather than hurting in a specific area, the pain and stiffness could be throughout your body.

Other symptoms can include:

  • Belly pain, bloating, queasiness, constipation, and diarrhea (irritable bowel syndrome)
  • Frequent headaches, including migraines
  • Dry mouth, nose, and eyes
  • Sensitivity to cold, heat, light, or sound
  • Peeing more often
  • Numbness, tingling, or crawling sensations in your arms and legs
  • Stiff muscles or joints
  • Pain in your bladder
  • Pain in your pelvis
  • Trouble moving your jaw or clicking and popping when you open and close your mouth
  • Pain in your face or jaw muscles in or near your ears
  • Sleep apnea
  • Restless leg syndrome
  • Eye irritation
  • Blurred vision

Since it isn’t clear what causes fibromyalgia, the triggers are mysterious, too. Your experience might be different from someone else. But anything that causes you stress may make it more likely your fibromyalgia will feel worse. Sometimes people call this a fibromyalgia flare-up. Your triggers may include:

  • Emotional stress
  • Major life changes that alter your routine
  • Changes in what you’re eating
  • Poor nutrition
  • Changes in your hormones
  • No sleeping enough or sleeping at different times
  • Changes in the weather or season
  • Other illnesses or infections
  • Starting new medicines for another condition
  • Changing your fibromyalgia treatment regimen

Pay attention to how you feel and make note of any changes that go along with worsening symptoms. This may help you figure out your triggers and how to avoid them.

Your doctor will examine you and ask you about your past medical issues and about other close family members.

There’s no test that can tell you that you have fibromyalgia. Instead, because the symptoms are so similar to other conditions, your doctor will want to rule out illnesses such as:

  • Arthritis
  • Lupus
  • Akylosing spondylitis
  • Polymyalgia rheumatica
  • Sjogren’s syndrome
  • Underactive thyroid or hypothyroidism
  • Endocrine disorders
  • Connective tissue problems
  • Neurologic conditions
  • Muscle inflammation or disease

You may get blood tests to check hormone levels and signs of inflammation, as well as X-rays, as your doctor looks for a cause. If your doctor can’t find another reason for how you feel, they’ll use a two-part scoring system to measure how widespread your pain has been and how much your symptoms affect your daily life. They’ll also consider your other symptoms, including:

  • Moderate or severe sleep problems
  • Fatigue
  • Trouble thinking clearly
  • Other issues, such as headache or gut problems

Using all the information and your test results, together you’ll come up with a plan to manage the condition.

Your treatment will work best if it involves multiple approaches and doctors with varying expertise. In addition to your doctors, you may benefit from seeing a physical therapist and a mental health professional.

Fibromyalgia medication

Depending on your symptoms, your doctor may prescribe pain relievers, antidepressants, muscle relaxers, anti-seizure medicines, and drugs that help you sleep.

The three drugs approved specifically for fibro pain are:

  • Duloxetine (Cymbalta)
  • Milnacipran (Savella)
  • Pregabalin (Lyrica)

Your doctor may prescribe other medicines “off-label.” That means that they may help but haven’t been approved specifically for fibromyalgia. Over-the-counter pain relievers such as acetaminophen may help, too. Over-the-counter anti-inflammatories usually don’t help since fibromyalgia doesn’t involve inflammation.

Stronger pain medicines, like opioids, tend not to work well in the long run. In fact, there’s some evidence opioids can make it worse. You also could have serious side effects and may become dependent on them.

Some people with fibromyalgia think that cannabis or products with cannabidiol (CBD) in them can help. But there’s not enough data to know if they really do.

Fibromyalgia self-care

Regular moderate exercise is key to controlling fibro. You’ll want to do low-impact activities that build your endurance, stretch and strengthen your muscles, and improve your ability to move easily — like yoga, tai chi, Pilates, and even walking. Exercise also releases endorphins, which fight pain, stress, and feeling down. Exercise also can help you sleep better.

You can try complementary therapies, including massage, acupuncture, and chiropractic manipulation, to ease aches and stress, too.

A counselor, therapist, or support group may help you deal with difficult emotions and how to explain to others what’s going on with you.

In general, it may help you to remember that:

  • Fibromyalgia is a health condition, and your pain is real.
  • While your disorder isn’t life-threatening, it’s still life-altering and difficult.
  • Treatments and other steps you take can help you with your pain, sleep, and mood.
  • Learning about fibromyalgia and accepting that it isn’t well understood may help you to cope.

Fibromyalgia diet

There’s no recommended fibromyalgia diet. But it’s possible that your diet or nutrition could play some role. Many people with this condition use nutritional supplements. But remember that supplements aren’t regulated the way that medicines are. It’s possible you could have vitamin or mineral deficiencies for:

  • Vitamin D
  • Vitamin C
  • Vitamin E
  • Magnesium or other minerals

If you are worried you’re deficient for some nutrients you need, see a doctor who can check your levels and help you decide if taking vitamins or other supplements may be worth trying. There’s also some evidence that microbes in your gut may have some role. Ask your doctor about probiotics and whether they’d be OK to try.

Some studies have looked at how dietary changes affect fibromyalgia. For example, one suggests that extra-virgin olive oil may help. Another study looked at adding an ancient grain called Khorasan wheat in place of other grains and saw some improvement. You could try avoiding MSG or gluten, too, to see if it helps.

One 4-week study found that a low-FODMAP diet helped. The low-FODMAP diet is sometimes used for IBS and many people with fibromyalgia have IBS or gut symptoms. FODMAP stands for fermentable oligo-di-mono-saccharides and polyols. These are short-chain carbs that your body doesn’t absorb well, including:

  • Lactose
  • Free fructose
  • Polyols
  • Fructans
  • Galacto-oligosaccharides

Other diets you could try or ask your doctor about trying include:

  • Low-calorie diet
  • Vegetarian diet
  • Mediterranean diet

Keep in mind, though, that most studies of diet and fibromyalgia are small. They also don’t rule out other explanations or make sure that people really stick to the diet that’s being tested. It isn’t known whether staying on any special diet long-term will help since most studies only last a few weeks. It’s possible that making healthy changes to your diet could help you feel better. But there’s not enough information to say for sure how much diet or nutrition can help you with your fibromyalgia pain and other symptoms.

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