Fibromyalgia

This is a long term, common condition which causes pain in the tendons, ligaments and muscles of the body. It does not lead to any long term damage to the joints or bones unlike many other forms of arthritis. But it can have a noticeable impact upon your life.

Many people learn to live with fibromyalgia.

It usually affects the hands and the hips but often affects other parts of the body which you use regularly. These include the arms, legs, back and neck.

At present there is no cure for fibromylagia but the symptoms can be controlled via medication, exercise and self-help options such as physical massage and healthy eating.

Fibromyalgia is structured as follows in this section:

• Who is most likely to develop fibromyalgia?
• How does fibromylagia occur?
• Causes of fibromyalgia
• Symptoms of fibromyalgia
• Diagnosis of fibromyalgia
• Tests for fibromyalgia
• Treatment for fibromyalgia
• Managing fibromylagia

Who is most likely to develop fibromyalgia?

There are nearly 2 million adults in the UK with fibromyalgia. It occurs in both sexes but like many other forms of arthritis affects more women than men.

People aged between 30 and 60 are most affected but it has occurred in children and the elderly.

It is a difficult condition to diagnose because the symptoms are similar to many other types of arthritis.

This condition can persist for many years and in some cases, affect your quality of life.

How does fibromyalgia occur?

This condition develops as a pain and chronic fatigue disease which mainly affects connective tissues in the body. It does not affect the joints which is a common feature of osteoarthritis and rheumatoid arthritis.

It may be caused by an undiagnosed disposition to this condition.

Causes of fibromyalgia

That is a difficult question to answer. Experts are unsure about the precise cause of fibromyalgia but they do have several possibilities which include:

• Accident or traumatic event
• Chemical changes in the nervous system, e.g. confused pain messages.
• Sleep problems, e.g. insomnia
• Low hormone levels
• Genetics
• Viral infection, e.g. HIV

Accident

Physical trauma to the body, e.g. car accident or emotional trauma, e.g. bereavement can trigger an attack of fibromyalgia. This either increases the risk of fibromyalgia or causes the symptoms to appear.

Chemical change in the nervous system

One example of this is the way pain messages are transmitted and detected in your body. Your nervous system is responsible for sending information to different areas of your body via specialised cells.

But this process goes haywire in people with fibromyalgia which is why they experience constant pain and extreme sensitivity.

Sleep problems

People who find it difficult to sleep or experience deep sleep may be at risk of developing fibromyalgia. But, this is seen as a symptom rather than a cause.

The pain and discomfort caused by this condition often disturbs your sleep thereby preventing the body from rejuvenating itself and leading to chronic tiredness the following day. This lack of sleep can worsen the symptoms of fibromyalgia.

Low hormone levels

If you have low levels of hormones such as serotonin, dopamine and noradrenaline then you may be at risk of fibromyalgia. People with fibromyalgia have low levels of these hormones which are related to the processes they control.

Noradrenaline regulates your response to a stressful situation: serotonin controls your moods, sleep and appetite: dopamine is responsible for your behaviour.

Genetics

There are people who are genetically predisposed to fibromyalgia due to the fact that someone in their family already has this disease.

If one of your parents has fibromyalgia then you may have inherited the gene for this condition which also increases your risk.

Viral infection

A viral infection such as HIV or Hepatitis B may trigger this condition.

Symptoms of fibromyalgia

There are three distinct signs of fibromyalgia which are:

• Pain
• Fatigue
• Sleep problems

These are the symptoms that most sufferers associate with fibromyalgia.

Other symptoms include:

• Heightened sensitivity to pain
• Headaches
• Poor circulation
• Depression
• Poor concentration
• Poor memory
• Frequent or urgent need to urinate
• Abdominal pain
• Constipation
• Diarrhoea
• Anxiety
• Painful periods
• Tinnitus (noises in the ears)
• Restless legs
• Feeling irritable

Pain is the symptom which bothers many sufferers although most cite chronic fatigue as the worst symptom of this condition.

This pain is described as a burning sensation or aching which moves around different areas of the body. It can be severe in a few areas or spread throughout the whole of the body.

These symptoms can be mistaken for those associated with ME or ‘myalgic encephalomyelitis, also known as ‘chronic fatigue syndrome’.They may be part of the same condition.

Diagnosis of fibromyalgia

There is no single test for diagnosing fibromyalgia. This means that your GP will use a set of criteria, specially designed for this condition to rule out any similar conditions, e.g. ME.

Although this is a common condition the symptoms are often seen in other similar diseases which make it difficult to obtain an exact diagnosis.

But we would say that if you are experiencing any of the symptoms mentioned in the previous section then see your GP. He/she will examine the areas of the body most affected by fibromyalgia which will take the form of pressing on these areas, e.g. the back of your neck and above your shoulder blades.

This will only be a light touch but if you have fibromyalgia then it will feel rather painful. This is due to the acute sensitivity of these affected areas caused by this disease.

He/she will ask you a series of questions about your symptoms. This will also include questions about your medical history and if there is a history of fibromyalgia in your family.

Tests for fibromyalgia

These will include tests which are used to diagnose different types of arthritis such as rheumatoid arthritis and osteoarthritis. These tests include a blood test, X-rays and ultrasound/MRI scan if necessary.

You may be referred to a rheumatology specialist for further tests.

The idea behind these is to rule out diseases which cause similar symptoms to these. These include lupus, rheumatoid arthritis, ME and multiple sclerosis.

Treatment for fibromyalgia

There is no cure for fibromyalgia but it can be controlled. There are treatments available which if combined with a few lifestyle changes can help you to manage your condition.

Your GP will devise a treatment plan for you which may include the involvement of other healthcare professionals, e.g. rheumatologist.

Your treatment will include a combination of drugs such as anti-depressants, painkillers, e.g. paracetamol and anti-convulsants (prevents seizures). Other drugs include muscle relaxants, anti-psychotics and sleeping tablets.

Other options include physiotherapy, counselling, exercise e.g. hydrotherapy and cognitive behavioural therapy. Another option is acupuncture and complimentary remedies such as herbal medicines but you must consult with your GP first before using these.

Some of these remedies react badly with medication or are ineffective.

In regard to your lifestyle, try to eat a healthy, well balanced diet and take some form of exercise such as swimming. Avoid caffeine last thing at night as this will prevent you from sleeping. Wear a soft collar during the day to ease any pain in your neck.

Find out more about these options in our treatment for arthritis section.

Managing fibromyalgia

Being diagnosed with fibromyalgia is upsetting and difficult for both you and your family. It means making a few changes to your normal routine to ease the symptoms and enable you to live a normal life.

This includes exercise and/or physiotherapy. Relaxation techniques such as meditation can help as they will help to reduce the stress caused by your condition. Some people find counselling helpful.

What you will find is that you have good days and bad days. This means pacing yourself and not overdoing things. Take time out when you need to.

Find out more in our living with arthritis section.