Fibromyalgia

(FM; Fibromyalgia Syndrome; FMS)

Pronounced: FI-bro-my-OWL-jah

Definition

Fibromyalgia is a complex, chronic, and disabling disorder. It causes widespread pain. It also causes poor sleep and fatigue.

Fibromyalgia Trigger Points

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Causes  ^

The exact cause of fibromyalgia is unknown.It may be related to abnormal processing of pain.

The following are some of the conditions that are commonly associated with fibromyalgia:

Risk Factors  ^

Fibromyalgia is more common in women, and in people aged 20-60 years old. Physical or mental stress may also increase your chance of getting fibromyalgia.

Symptoms  ^

Symptoms and severity of fibromyalgia are different for everyone.

Fibromyalgia may cause:

  • Generalized pain and tenderness that can:
    • be moderate to severe
    • feel stabbing, shooting, achy, or throbbing
    • be widespread and chronic
    • be associated with muscle twitching
  • Fatigue
  • Weakness
  • Poor sleep
  • Reduced physical endurance
  • Problems with concentration, thought, or memory
  • Sensitivity to noises, light, or odors

Factors that may trigger or worsen symptoms include:

  • Physical injury
  • Weather changes, especially cold, damp weather
  • Stress or anxiety
  • Overexertion
  • Medical illness
  • Surgery

Diagnosis  ^

You will be asked about your symptoms and medical history. A physical exam will be done. Diagnosis is usually based on reported symptoms and tenderness in specific areas of the body during the physical exam.

Fibromyalgia is usually diagnosed when pain or tenderness is there at the same level for more than 3 months and:

  • present in more than 7 locations when the pain score is moderate (5-8 out of 12) or in 3-6 locations when the pain score is severe (9 out of 12)
  • there are problems with sleep, thinking clearly, or fatigue
  • there is no other reason for the symptoms

Treatment  ^

The goal of treatment is to relieve or control the symptoms. Talk with your doctor about the best treatment plan for you. Options include:

Therapy Programs

Lifestyle Changes

Your doctor may also recommend that you make lifestyle changes, such as:

  • Eat a healthy diet.
  • Learn to cope with physical and mental stress.
  • Maintain a regular sleep schedule.
  • Participate in a regular exercise program that includes aerobic activity, strength training, and flexibility exercises. Gentle exercises that may not strain painful areas include walking, biking, and swimming. Talk to your doctor to make sure it is safe for you to start exercising.

Medications

Your doctor may recommend the following to help manage symptoms:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Antidepressants
  • Anticonvulsants
  • Sedatives
  • Muscle relaxants
  • Opioids—if not relieved by other treatments

Prevention  ^

There are no current guidelines to prevent fibromyalgia.

RESOURCES:

American College of Rheumatology
http://www.rheumatology.org

The American Fibromyalgia Syndrome Association
http://www.afsafund.org

CANADIAN RESOURCES:

The Arthritis Society
http://www.arthritis.ca

Fibromyalgia Information and Local Support
http://fibromyalgia.ncf.ca

REFERENCES:

About fibromyalgia. National Fibromyalgia Association website. Available at: http://www.fmaware.org/about-fibromyalgia. Accessed May 6, 2016.

Buckhardt CS, Goldenberg D, Crofford L, et al. Guideline for the management of fibromyalgia syndrome pain in adults and children. Glenview (IL): American Pain Society (APS); 2005. as summarized in National Guideline Clearinghouse 2005;19:7298.

Carville SF, Arendt-Nielsen S, Bliddal H, et al. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis. 2008;67:536-541.

Fibromyalgia. American College of Rheumatology website. Available at: http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia. Updated May 2015. Accessed May 6, 2016.

Fibromyalgia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 15, 2016. Accessed May 6, 2016.

Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Fibromyalgia/default.asp. Updated July 2014. Accessed May 6, 2016.

Wierville L. Fibromyalgia: diagnosing and managing a complex syndrome. J Am Acad Nurse Pract. 2012;24(4):184-92.

2/17/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Russell IJ, Perkins AT, Michalek JE; Oxybate SXB-26 Fibromyalgia Syndrome Study Group. Sodium oxybate relieves pain and improves function in fibromyalgia syndrome: a randomized, double-blind, placebo-controlled, multicenter clinical trial. Arthritis Rheum. 2009;60:299-309.

4/14/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Munguía-Izquierdo D, Legaz-Arrese A. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2008;89:2250-2257.

4/22/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Sañudo B, Galiano D, Carrasco L, Blagojevic M, de Hoyo M, Saxton J. Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2010;91(12):1838-1843.

4/22/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Carson JW, Carson KM, Jones KD, Bennett RM, Wright CL, Mist SD. A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia. Pain. 2010;151(2):530-539.

Last reviewed May 2016 by Michael Woods, MD  Last Updated: 5/11/2013