About fibromyalgia

What is fibromyalgia?

Fibromyalgia is a chronic condition of widespread pain and profound fatigue. The pain tends to be felt as diffuse aching or burning, often described as head to toe. It may be worse at some times than at others. It may also change location, usually becoming more severe in parts of the body that are used most.

The fatigue ranges from feeling tired, to the exhaustion of a flu-like illness. It may come and go and people can suddenly feel drained of all energy – as if someone just “pulled the plug”. Fibromyalgia Syndrome (fibromyalgia for short) is a common illness. In fact, it is as common as rheumatoid arthritis and can even be more painful. People with mild to moderate cases of fibromyalgia are usually able to live a normal life, given the appropriate treatment.

If symptoms are severe, however, people may not be able to hold down a paying job or enjoy much of a social life. The name fibromyalgia is made up from “fibro” for fibrous tissues such as tendons and ligaments; “my” indicating muscles; and “algia” meaning pain.

A Collection of Symptoms
Fibromyalgia is known as a syndrome because it is a collection of symptoms rather than a specific disease process that is well understood. Besides pain and fatigue fibromyalgia symptoms often include:

• Non refreshing sleep
• waking up tired and stiff
• headaches ranging from ordinary types to migraine
• irritable bowel
• frequent diarrhoea or constipation, sometimes accompanied by gas in the abdomen or nausea
• cognitive disturbances including lack of concentration and word mix up
• clumsiness and dizziness
• sensitivity to changes in the weather and to noise, bright lights, smoke and other environmental factors
• allergies

Diagnosis
Fibromyalgia is not new, but for most of the last century it was difficult to diagnose. Part of the problem has been that the condition could not be identified in the standard laboratory tests or x-rays. Moreover, many of its signs and symptoms are found in other conditions as well – especially in chronic fatigue syndrome (CFS).

Two Canadian doctors developed a way of diagnosing fibromyalgia in the 1970s and in 1990 an international committee published requirements for diagnosis that are now widely accepted.

Once other medical conditions have been ruled out through tests and the patient’s history, diagnosis depends on two main symptoms:

1. widespread pain for more than three months together with
2. pain in at least 11 out of 18 tender point sites when they are pressed.

“Widespread pain” means pain above and below the waist and on both sides of the body. The “tender points”, or spots of extreme tenderness, are rarely noticed by the patient until they are pressed.

What Causes Fibromyalgia?
Fibromyalgia often develops after some sort of trauma that seems to act as a trigger, such as a fall or car accident, a viral infection, childbirth, an operation or an emotional event. Sometimes the condition begins without any obvious trigger.

The actual cause of fibromyalgia has not yet been found. Over the past several years, however, research has produced some insights into this puzzling condition. For instance, it has been known that most people with fibromyalgia are deprived of deep restorative sleep.

Current studies may find out how to improve the quality of sleep. Research has identified a deficiency in Serotonin in the central nervous system and a resulting imbalance of Substance P a spinal fluid that transmits pain signals.

The effect is disordered sensory processing. The brain registers pain when others might experience a slight ache or stiffness. It is hoped that more research will discover the cause and result in more effective treatment.

Current Treatment
At the present time treatment for fibromyalgia aims at reducing pain and improving sleep. In other words, some of the symptoms are being treated, rather than the condition itself. Medications most often prescribed for fibromyalgia are tricyclic drugs also used to treat depression although doses for fibromyalgia are much lower than for depression.

In some cases these drugs will help both sleep and pain. Over-the-counter medications may help relieve the pain of fibromyalgia but severe pain may require the expertise of a pain clinic. It is best to discuss any form of pain relief with your specialist or GP. It is most important to note that medications work for some people and not others.

Support from family, friends and other people who have fibromyalgia is extremely valuable to those who have fibromyalgia. Professional counselling may help some people to cope with this illness and to take an active part in their own treatment. Learning to manage the condition seems, so far, to be the most successful way of dealing with fibromyalgia. A combination of heat, rest, exercise and reducing stress can enable some people with fibromyalgia to maintain a productive life.

Managing Fibromyalgia
The best way to cope with fibromyalgia is to use a number of techniques that ease the symptoms as much as possible. Relaxation is one technique that works really well for almost everybody with fibromyalgia. It reduces tension in the mind and body right away.

The results are calming for all the symptoms, especially for the pain. Relaxation can be learned from books, tapes, videos or special courses. Heat is important. A hot water bottle and hot baths or showers will help reduce pain and banish morning stiffness. Soaking hands and feet in hot water for a few minutes can ease their aching. Exercise is the most common prescription for fibromyalgia.

Although no particular diet has been shown to help fibromyalgia, a healthy, balanced diet is important to provide protein, vitamins and minerals. It is best to avoid or at least cut down on coffee, tea and alcohol. Some sufferers have a tendency to gain weight and this can be distressing in itself. If you follow a healthy diet this should in turn help with your weight control.

People with fibromyalgia can have good days and bad days. On a good day it is important to pace yourself; overdoing it may simply make matters worse. Rest is also important. Listen to your body when it tells you to slow down.

Facts about fibromyalgia

An Extract for the Support Group Pack v 1.1 (minor updates)

Fibromyalgia Facts

General Introduction

Fibromyalgia (FM for short) is not a life threatening illness but is often life changing. It does not necessarily affect everyone in the same way but it is a condition that is often invisible to others, however, research supports that FM is a distinct clinical condition.

FM is recognised by the Department of Health and is listed on the NHS Direct website. The more you know about the illness, the easier it is to cope with.

Possible feelings after Diagnosis:

• Relieved that you have been given a positive diagnosis that something “real” is wrong with you.
• In “no man’s land” because you do not really know what your next step should be, or indeed where to go to get information and help.

What does the Word Fibromyalgia Mean?

Fibromyalgia is possibly a word that you have never heard of before. What does it mean?

• Fibro = Fibrous Tissues (tendons & ligaments)
• My = Muscle
• Algia = Pain

What is Fibromyalgia?

Fibromyalgia is a condition of:

• Chronic widespread pain/chronic pain amplification
• Fatigue
• Brain Fog (cognitive issues)
• Non refreshing sleep

The muscle pain fluctuates and is often aggravated by:

• various physical factors
• environmental factors
• emotional factors.

In addition to widespread pain and fatigue, fibromyalgia can be associated with:

• irritable bowel syndrome
• fluctuating stiffness
• numbness
• a feeling of weakness
• cold intolerance
• poor sleep
• headaches
• chest pain
• cognitive difficulties
• sensitivity to light, smells, temperature and sound
• dizziness (balance problems)
• anxiety/panic attacks

It can be called a “Head to Toe” condition.

Fibromyalgia is NOT:

• Fibromyalgia can cause symptoms that resemble arthritis or neurological disorders, but it is different from these disorders.
• Unlike arthritis, it does not cause the joints to swell or become deformed, even though it may cause pain in the tissues or a feeling of swelling around a joint.
• It does not cause paralysis or progressive neurological problems
• It is not crippling
• It is not a ruptured disc
• It is not a pinched nerve, even though the symptoms may resemble those caused by a pinched nerve
• It is not a tumour
• It is not life threatening—despite what the pain may be telling you
• It is not all in your head
• It is not a mental health problem
• It is not a “new” disease or some recent “medical” fad

However:

People with fibromyalgia may look okay on the outside, but are definitely hurting on the inside.

What are the Characteristics of Fibromyalgia?

• Seen in about 2 - 5% of the population, affects men, women, and children of all ages, races and economic levels..
• Onset of symptoms can be at any age, but mainly from 20-60 years of age.
• Mild to incapacitating, no two people are the same
• Variable chronic symptoms
• Pain changes location
• Affects women more than men in the ratio: 7 to 1

How common is Fibromyalgia?

Fibromyalgia is a common illness. In fact, it is as common as rheumatoid arthritis and can be more painful. People with mild to moderate cases of fibromyalgia are usually able to live a near normal life, given the appropriate treatment.

If a person’s symptoms are more severe they may find that they

• have to greatly modify their typical day,
• or find themselves not being able to hold on to a job
• or enjoy much of a social life

What Causes Fibromyalgia?

Some possible triggers of FM are:

• some sort of trauma such as a fall or car accident
• a viral infection
• hormonal problems
• an operation
• muscle physiology problems—decreased oxygen supply to muscles may account for some of the pain mechanism
• or it begins without any obvious trigger

It is a complicated condition:

• which often has more than one factor involved
• may even stem from a genetic predisposition
• triggers may be recognised, but the exact mechanism of how fibromyalgia develops from any trigger is not fully known
• it is an “end point” condition with multiple paths leading to it

Latest research has identified:

• a deficiency in Serotonin in the central nervous system and
• a resulting imbalance of Substance P (a transmitter substance that sends pain messages to the brain)

The effect of this is:

• disordered Sensory Processing (the brain registers pain, which is amplified, when others might experience a slight ache or stiffness)
• Research now strongly indicates that a central nervous system dysfunction is primarily responsible for the increased pain sensitivity of FM

With these advances come the hope that a cause may be found and hence a cure, or at least more effective treatment.

Will the Pain Worsen?

People with fibromyalgia have physical abnormalities that result in pain amplification, causing pain to be perceived even when they are exposed to sensations that would not normally cause pain i.e. wearing certain items of clothing, a touch on the arm or even a bright light can cause extreme pain & fatigue.

• The pain usually consists of generalised aching, it can be described as stabbing, burning or even cramping – a sense of “I hurt all over”
• certain parts of the body may be particularly painful
• the pain may move around and be accompanied by muscle spasm
• the pain can fluctuate from day to day, even hour to hour
• everyone with fibromyalgia will experience worsening of their pain from time to time; that is part of the illness
• usually the worsening is temporary, and is known as a flare-up, we can’t stop this from happening, some people have frequent flare-ups others don’t
• usually we can identify the cause of the increased pain, if not, we call the flare-up spontaneous
• sometimes flare-ups happen even when we have taken care to handle everything we do correctly. We simply have to deal with them as they occur and try to accept that these intrusions are part of the condition

When you don’t feel well how do you know if it is because of Fibromyalgia or something else?

The impact of fibromyalgia differs in type and severity from person to person. FM does not preclude the possibilities of you suffering from other medical conditions. You should never assume that everything that you are experiencing or feeling is because of fibromyalgia.

Because FM is associated with:

• widespread pain in all parts of the body including the chest and abdomen
• as well as severe fatigue

it is often difficult to know whether symptoms are related to FM or caused by another medical condition.

Acute pains, shortness of breath, and high fevers are your body’s warning signs which you should not ignore.

If you are experiencing any new symptoms:

“The GOLDEN RULE” must be to check them out with your own MEDICAL PROFESSIONALS.

Similarly if you feel that:

• the treatments
• medications

that you are receiving are not helping you manage your condition you will need to discuss this with your own medical professionals

What should I do if I think I have fibromyalgia?

More about fibromyalgia

The history of fibromyalgia