Fibromyalgia: Widespread Pain, Fatigue, Poor Sleep and When to Be Seen

What it involves

MedlinePlus describes fibromyalgia as a chronic, long-lasting condition that causes pain all over the body, fatigue, and other symptoms. It says there is no cure, but treatments can help with the symptoms.

Who this is for

• Patients with aching, burning, or throbbing pain in many areas that has lasted for months
• Patients who are tired all the time and sleep poorly
• Patients who have had many tests with no clear answer
• Patients with trouble concentrating or remembering, often called fibro fog

What to expect

• Detailed questions about where the pain is, how long it has lasted, sleep, mood, and energy
• A physical exam and, if needed, x-rays or blood tests to rule out other conditions
• A discussion of how pain and fatigue affect daily life
• A plan that may combine activity, sleep, stress management, medicine, or a referral to a specialist

The main symptoms

MedlinePlus lists chronic pain and stiffness all over the body, which people often describe as aching, burning, or throbbing, along with fatigue and tiredness and trouble sleeping. Other symptoms may include problems with thinking, memory, and concentration, muscle and joint stiffness, numbness or tingling in the arms and legs, and sensitivity to light, noise, odors, and temperature. The fatigue guide covers other reasons for being tired all the time.

What is thought to cause it

MedlinePlus says the exact cause is unknown. Studies of the brain suggest people with fibromyalgia process pain differently, so they may feel pain when others do not and react more strongly to it. It can run in families, and certain pain-causing diseases may be involved. Women are twice as likely to have it, and the chance rises in middle age and with conditions such as lupus, rheumatoid arthritis, and osteoarthritis, the latter described in the osteoarthritis guide.

Why diagnosis can take time

MedlinePlus says fibromyalgia can be hard to diagnose and sometimes takes visits to several providers. There is no specific test, and the main symptoms of pain and fatigue are common in many other conditions. A provider has to rule out other causes first, which is called a differential diagnosis. That includes a medical history, a physical exam, and sometimes x-rays and blood tests such as the thyroid blood tests or vitamin D and B12 tests.

Conditions that travel with it

MedlinePlus says people with fibromyalgia are more likely to have anxiety, depression, headaches including migraines, irritable bowel syndrome, and pain in the face or jaw, including TMJ disorders. If any of these sound familiar, the anxiety guide, depression guide, headache guide, and IBS guide explain each in turn.

Treatment is a combination

MedlinePlus says treatment focuses on relieving symptoms and usually combines medicines, lifestyle changes, talk therapy, and complementary therapies. Certain antidepressants and anti-seizure medicines may help with pain or sleep. Lifestyle steps include enough sleep, regular physical activity started slowly and increased gradually, stress management, and pacing yourself. Cognitive behavioral therapy can help with coping, and mindfulness, yoga, tai chi, massage, and acupuncture have helped some people but need more study.

Seeing the right provider

MedlinePlus notes that not all providers are familiar with fibromyalgia, and advises seeing a provider or team that specializes in treating it. A primary care provider is a sensible first stop to rule out other causes, manage sleep and mood, and refer you onward. Sleep is often the piece that makes the biggest difference, and the insomnia guide explains common causes of poor sleep.

Sources

• MedlinePlus — Fibromyalgia
• MedlinePlus — Chronic Pain