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Fibromyalgia: Symptoms and diagnosis

What is fibromyalgia?

Fibromyalgia is a condition characterized primarily by chronic widespread pain (CWP) in the muscles, ligaments and tendons, and a heightened sensitivity to touch resulting in pain that can last for months. The condition itself is not rheumatic, meaning it does not affect the joints; however, fibromyalgia often co-occurs with different types of arthritis such as osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis.

Main symptoms of fibromyalgia

The hallmark symptoms of fibromyalgia are pain and sensitivity. Other common signs and symptoms of fibromyalgia can include:

  • Pain and stiffness all over the body
  • Fatigue and tiredness
  • Depression and anxiety
  • Sleep problems
  • Problems with thinking, memory, and concentration
  • Headaches, including migraines
  • Tingling or numbness in hands and feet
  • Pain in the face or jaw, including disorders of the jaw known as temporomandibular joint syndrome (also known as TMJ)
  • Digestive problems, such as abdominal pain, bloating, constipation, and even irritable bowel syndrome (also known as IBS)

Who gets fibromyalgia

Fibromyalgia affects between 2 to 4% in the general population and is more common in women than in men.The cause of fibromyalgia remains unknown, but several theories exist. One is called "central sensitization". It is believed that people with fibromyalgia have an increased sensitivity to pain signals in the brain. Another theory is the presence of higher-than-normal levels of a nerve chemical, called "substance P", in the spinal fluid of people experiencing symptoms of fibromyalgia. This chemical causes increased pain signals to and from the brain. In other words, for someone diagnosed with fibromyalgia, the "volume control" for pain is turned up too high in the brain.

Other theories about the cause of fibromyalgia include:

  • Poor functioning of the nervous system, which regulate senses (e.g., touch)
  • Suboptimal control of the systems that fight infection and regulate hormones
  • Chronic sleep disorders
  • Emotional stress or trauma

Getting a diagnosis of fibromyalgia

The diagnosis of fibromyalgia is difficult to arrive at because there is no specific diagnostic laboratory tests, like a blood test or an x-ray. A physician makes a diagnosis of fibromyalgia based on the patient's history and physical examination. The American College of Rheumatology has created guidelines to help with assessment and diagnosis of fibromyalgia. According to the guidelines, diagnosis requires a patient to:

  • Have experienced widespread aching pain for at least three months
  • Have experienced fatigue, waking up feeling unrefreshed, cognitive (memory or thought) problems
  • Have no other health problem that would explain the pain and other symptoms
  • Have a minimum of 11 locations on your body that are abnormally tender under relatively mild, firm pressure

Treatment of fibromyalgia

While there is no known cure for fibromyalgia, treatments exist that can help to manage the symptoms of the disease. In general, treatment for fibromyalgia includes both medication (for symptom management) and self-care.

Learn more about treatment options here.