Fibromyalgia

Fibromyalgia is a disorder that causes tiredness and widespread pain, aches, and stiffness in muscles and joints throughout the body. Experts haven't yet found a cause or physical reasons for fibromyalgia, and blood tests, x-rays, and other tests usually are normal. This has made fibromyalgia a controversial disease.

It is possible that there is more than one cause for fibromyalgia. Possibilities include:

• a problem in a non-dream part of the sleep cycle
• a low level of serotonin, a brain chemical that regulates sleep and pain perception
• a low level of somatomedin C, a chemical related to muscle strength and muscle repair
• a low threshold at which a person experiences pain
• blood-flow abnormalities in the muscles
• viral or other infections

Fibromyalgia affects an estimated 3 million to 6 million Americans. It is more common among women than men. Many people with fibromyalgia also have mental health issues such as depression, anxiety or eating disorders.

Fibromyalgia tends to be a chronic (long-lasting) condition.

Symptoms of fibromyalgia

Pain and fatigue are the most common symptoms of fibromyalgia.

Pain. Pain and stiffness, can occur in muscles and joints almost anywhere in the body, including the trunk, neck, shoulders, back and hips. It is often felt between the shoulder blades and at the bottom of the neck. Pain may be either a general soreness or a gnawing ache, and stiffness is often worst in the morning. People with fibromyalgia also have tender points, which are specific spots on the body that are painful to touch.

Fatigue. Most people with fibromyalgia feel abnormally tired, and often wake up tired even though they may have slept well.

Other symptoms. Some people report symptoms of irritable bowel syndrome, depression, anxiety, and headache.

Treatment

Since the cause of fibromyalgia isn't known, treating it aims to improve the symptoms.

Pain relief. The starting point for pain relief is usually an over-the-counter pain reliever such as acetaminophen (Tylenol and other brand names); aspirin or other nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil and others) or naproxen (Aleve). Muscle relaxants such as cyclobenzaprine (Flexeril) and antidepressants such as amitriptyline (Elavil) or fluoxetine (Prozac) ease pain for some people.

Other medications. Medications often don't work well for treating fibromyalgia, and non-medication treatments (see below) may be more helpful. That said, the FDA has approved three medications specifically to treat fibromyalgia: pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). Other medicines, such as gabapentin (Neurontin), tramadol (Ultram), and tizanidine (Zanaflex), may also be beneficial.

Non-medication treatments. Several lifestyle or alternative therapies can help ease pain and fatigue in people with fibromyalgia.

• aerobic exercise. Activities such as low-impact stepping, cycling, or swimming, several times a week is an essential part of treatment.
• sleep hygiene. Strategies such as keeping the bedroom dark and cool, not watching television or working on a computer close to bedtime, exercising early in the day, getting bright light early in the day, not drinking caffeinated beverages, and not drinking fluids late in the evening, may help improve sleep and ease fatigue.
• alternative therapies. Some people with fibromyalgia find relief from acupuncture, massage therapy, biofeedback, tai chi, hypnosis, and stress management.

Every person with fibromyalgia is different, so it's important to work out a treatment plan that fits your symptoms, your preferences, and your lifestyle.

Community-based treatment programs show that symptoms fade away in about 25% of people with fibromyalgia and significantly improve in about 50%.