Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals.

Symptoms often begin after an event, such as physical trauma, surgery, infection or significant psychological stress.

Women are more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.

While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.

Symptoms of fibromyalgia can be confused with those of arthritis, or joint inflammation. However, unlike arthritis, it has not been found to cause joint or muscle inflammation and damage. It is seen as a rheumatic condition, in other words, one that causes soft tissue pain or myofascial pain.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), around 5 millionTrusted Source adults aged 18 years or over in the United States experience fibromyalgia, and 80 to 90 percent of fibromyalgia patients are women.

Fast facts on fibromyalgia:

Fibromyalgia causes widespread pain, fatigue, and other types of discomfort.

Symptoms resemble those of arthritis, but fibromyalgia affects the soft tissue, not the joints.

The cause is unknown, but risk factors include traumatic injury, rheumatoid arthritis and other autoimmune disorders, such as lupus, and genetic factors.

There is no cure, but medications, exercise, acupuncture, and behavioral therapy can help relieve symptoms and improve sleep quality.

Exercise

A combination of aerobic exercise and resistance training, or strength training, has been linked to a reduction in painTrusted Source, tenderness, stiffness, and sleep disturbance, in some patients.

If exercise is helping with symptoms, it is important to maintain consistency in order to see progress. Working out with a partner or personal trainer may help to keep the exercise program active.

Some patients have experienced improvements in their quality of life after starting acupuncture therapy for fibromyalgia. The number of sessions required will depend on the symptoms and their severity.

One study found that 1 in 5 people with fibromyalgia use acupuncture within 2 yearsTrusted Source of diagnosis. The researchers concluded that it may improve pain and stiffness. However, they call for more studies.

Behavior modification therapy

Behavior modification therapy is a form of cognitive behavioral therapy (CBT) that aims to reduce negative, stress- or pain-increasing behaviors and improve positive, mindful behaviors. It includes learning new coping skills and relaxation exercises.

Causes

The exact cause of fibromyalgia is unclear. However, current thinking in the field of Rheumatology suggests that fibromyalgia is a problem with central pain processing in the brain, where there may be an increased sensitivity or perception of pain to a given trigger.

There is a range of likely risk factors, including: a stressful, traumatic physical or emotional event, such as a car accident, repetitive injuries, rheumatoid arthritis or other autoimmune diseases, such as lupus, central nervous system (CNS) problems.

Fibromyalgia may also be hereditary. Females who have a close relative with fibromyalgia have a higher risk of experiencing it themselves.

People with rheumatoid arthritis, lupus, or spinal arthritis, known ankylosing spondylitis, have a higher riskTrusted Source of developing fibromyalgia, as do patients with some other rheumatic diseases.

Many researchers believe that repeated nerve stimulation causes the brain and spinal cord of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain.

In addition, the brain’s pain receptors seem to develop a sort of memory of the pain and become sensitized, meaning they can overreact to painful and nonpainful signals.

There are likely many factors that lead to these changes, including:

Genetics. Because fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing the disorder.

Infections. Some illnesses appear to trigger or aggravate fibromyalgia.

Physical or emotional events. Fibromyalgia can sometimes be triggered by a physical event, such as a car accident. Prolonged psychological stress may also trigger the condition.

Diagnosis

It can take some time to confirm a diagnosis of fibromyalgia because the symptoms resemble those of other conditions, such as hypothyroidism. These conditions must first be ruled out before diagnosing fibromyalgia.

Pain and symptoms over the previous week, out of 19 identified body parts, plus levels of fatigue, unsatisfactory sleep, or cognitive problems, symptoms that have been ongoing for at least 3 months, no presence of another health problem that would explain the symptoms.

Previously, ‘tender points’ were used to diagnose the condition. However, these are no longer recommended to aid the diagnosis of fibromyalgia.

Symptoms

The primary symptoms of fibromyalgia include Widespread pain and Fatigue.

Widespread pain

The pain associated with fibromyalgia often is described as a constant dull ache that has lasted for at least three months. To be considered widespread, the pain must occur on both sides of your body and above and below your waist.

Fatigue

People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain, and many patients with fibromyalgia have other sleep disorders, such as restless legs syndrome and sleep apnea.

Cognitive difficulties. A symptom commonly referred to as “fibro fog” impairs the ability to focus, pay attention and concentrate on mental tasks.

Fibromyalgia often co-exists with other conditions, such as:

Irritable bowel syndrome, Chronic fatigue syndrome, Migraine and other types of headaches, Interstitial cystitis or painful bladder syndrome,Temporomandibular joint disorders, Anxiety, Depression

Risk factors

Your sex. Fibromyalgia is diagnosed more often in women than in men.

Family history. You may be more likely to develop fibromyalgia if a parent or sibling also has the condition.

Other disorders. If you have osteoarthritis, rheumatoid arthritis or lupus, you may be more likely to develop fibromyalgia.

Complications

The pain, fatigue, and poor sleep quality associated with fibromyalgia can interfere with your ability to function at home or on the job. The frustration of dealing with an often-misunderstood condition also can result in depression and health-related anxiety.

Treatment

Around 20 percent of people with fibromyalgia try acupuncture within the first 2 years. It may work, but more research is needed.

Medical attention is needed because fibromyalgia can be difficult to manage. As it is a syndrome, each patient will experience a different set of symptoms, and an individual treatment plan will be necessary.

Treatment may include some or all of the following: an active exercise program, acupuncture, psychotherapy, behavior modification therapy, chiropractic care, massage, physical therapy, low-dose anti-depressants, although these are not a first-line treatment.

People with fibromyalgia need to work with their doctor to come up with a treatment plan that provides the best results.

Drugs

Drugs may be recommended to treat certain symptoms.

These may include over-the-counter (OTC) pain relievers. However, the European League Against Rheumatism (EULAR) issued a recommendation against using non-steroidal anti-inflammatory drugs (NSAIDs) to treat fibromyalgia in their updated 2016 guidelines.

Antidepressants, such as duloxetine, or Cymbalta, and milnacipran, or Savella, may help reduce pain. Anti-seizure drugs, such as gabapentin also known as Neurontin, and pregabalin, or Lyrica, may be prescribed.

However, a review has suggested that patients often stop using these drugs because they are not effective in relieving pain or because of their adverse effects.

Patients should tell the doctor about any other medications they are taking to avoid side-effects and interactions with other drugs.