When it comes to chronic, long-term medical conditions affecting your bones and muscles, fibromyalgia is the second most commonly occurring. It affects some 5 million people in the U.S. alone.
However, it’s also a condition that often goes misdiagnosed or undiagnosed due to it being so difficult to identify at the onset of the condition. Estimates actually show that fibromyalgia takes an average of five years to be officially diagnosed. The precise reasoning behind why you develop fibromyalgia is even more elusive and mysterious.
Beyond certain factors that may predispose you, medical science can’t provide answers to why you develop fibromyalgia. To help you understand fibromyalgia, let’s look at what we do know about it.
What Is Fibromyalgia?
Fibromyalgia is a widespread, chronic, and painful musculoskeletal condition that’s characterized by you experiencing an exaggerated response to pain and fatigue.
You’ll find it falls under the umbrella medical label of a “chronic pain condition,” and it may coexist with other long-term diagnostic labels like chronic fatigue syndrome.
How Is Fibromyalgia Diagnosed?
It’s important for you to understand that there’s not a diagnostic lab test yet available to identify fibromyalgia. Diagnosis is based purely on the symptoms you exhibit and your doctor ruling out other possible causes for said symptoms.
For you to receive a diagnosis of fibromyalgia, your doctor will use a two-point criteria standard:
- The pain must be present for at least three months and be present in both the left and right sides and upper and lower hemispheres of your body.
- Of the 18 possible tender points on your body, you must have pain upon pressure for at least 11 of them.
When you have fibromyalgia, you may also experience the amount of sleep, mood, memory, and depression symptoms. These disturbances are generally considered to be offshoots, or results, of the classic symptoms of widespread pain and fatigue, not a primary symptom of fibromyalgia itself.
In other words, you may experience insomnia as the result of routinely being in too much pain and discomfort to sleep -or- a lack of physical ability to have an active social life because of fatigue and pain may cause you to suffer from depression.
That said, in some people, symptoms like insomnia and depression may be present before fibromyalgia and can even factor in its development. More on that in a minute.
What’s the Prognosis for Fibromyalgia?
While the symptoms can be difficult to live with, the good news is that fibromyalgia isn’t a progressive condition that worsens over time It's not a deteriorating disease process, meaning it doesn’t do damage to your muscles, bones, and joints.
So, while chronic, it’s not fatal and can even improve with lifestyle changes.
What Causes Fibromyalgia?
Your brain is the first responder when it comes to pain and injury. Your nervous system senses pain and uses nerves to send signals from the point of pain, through your spinal column, and onward to your brain. This is like a built-in warning system that something is going wrong with or to your body and you need to seek relief from it.
When relief is sought, the pain then ceases. That’s a normal case scenario. When you have fibromyalgia, however, there’s a glitch in the above systemic approach to pain. You hurt throughout your body for no specific reason and without any specific ‘cause’ to seek relief from.
Medical science is still trying to determine what exactly causes this glitch. For now, they only have theories. One of the most commonly accepted theories is that you may have more than normal pain signal cells and/or less than normal cells to slow pain signals down. The result is like a radio turned full blast all the time, meaning even a minor bump can feel like a baseball bat hitting you and experiencing long-lasting pain when you shouldn’t be hurting at all.
While the bottom line is that doctors just don’t know why some people get fibromyalgia and others don’t, they have identified some potential causative factors that leave you more apt to experience fibromyalgia in your life:
- The presence of other musculoskeletal diseases, such as rheumatoid arthritis and lupus.
- Genetics. It’s believed that fibromyalgia runs in families due to genetic disposition and passage of genes that make you more prone to depression, anxiety, and pain sensitivity. This is where those symptoms become part of fibromyalgia’s process verses a result of the process.
- Experiencing emotional or physical abuse, especially during childhood. This is thought to change the neural pathways in the brain to alter how pain and stress is handled.
- Experiencing PTSD, or post-traumatic stress disorder, especially as a child. Like abuse, this mental health condition is thought to alter how the brain handles stressors and pains.
- Being a female is a risk factor simply due to the fact that 80-90 percent of suffers are women. The other 10-20 percents are males and children. The best scientific guess for why so many women are fibromyalgia suffers is within the difference in how men and women physically experience and respond to pain and in how society expects them to experience and respond to pain.
- Having an inactive lifestyle. Most people suffering from fibromyalgia have a history of not routinely exercising long before pain and fatigue limited their activity levels.
How Is Fibromyalgia Treated?
You may face a great impact on your daily life, career, relationships, and social life as the pain, fatigue, sleeplessness, mental “fibro-fog,” and other symptoms overtake your existence. You may not be able to work as you once did. You may not be able to do all the social and physical activities you once did.
Statistics show you’re twice as likely to be hospitalized than those without fibromyalgia. You’re three times as likely to suffer depression as those without fibromyalgia. All of the above combine to create a frustrating and lonely existence for fibromyalgia sufferers.
You may not be understood by even those closest to you. After all, pain can’t be seen, and with fibromyalgia, there’s not even a visual injury to spur empathy from those around you. It often creates an environment where non-sufferers seem to think the symptoms you experience are somehow within your control to just turn ‘off.’ They aren’t.
However, with treatment, you can learn to manage your symptoms and regain some control over your life. Your treatment of fibromyalgia will include a multi-faceted approach to managing the pain and fatigue and any offshoot symptoms. Pain management may include one of three FDA-approved prescription medications: Lyrica, Savella, or Cymbalta. Non-narcotic pain relievers may also be added to help manage pain.
Therapies and therapeutic reliefs are also commonly prescribed for pain management, and may include any of the following:
- Physical therapy
- Massage therapy
- Water therapy
- Aerobics
- Acupuncture
- Yoga
- Relaxation and breathing techniques
- Biofeedback
- Aromatherapy
- Cognitive therapy
- Chiropractor services
- Psychiatric services
- Ergonomics at work and home
- Wearing non-restrictive clothing and supportive shoes
Fatigue management is aimed at sleep management. These are techniques used to ensure you get an adequate amount and quality of sleep routinely.
Some interventions may include any of the following:
- Diet and exercise program
- Restorative sleep habits
- Avoiding naps
- Only use your bed for sleep
- Relaxation techniques before bedtime
- Psychological support
- Sleep aids
