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Fibromyalgia: Everything you need to know

Fibromyalgia is a condition that causes pain in muscles and soft tissues all over the body. It is an ongoing (chronic) condition. It can affect your neck, shoulders, back, chest, hips, buttocks, arms and legs. The pain may be worse in the morning and evening. Sometimes, the pain may last all day long. The pain may get worse with activity, cold or damp weather, anxiety and stress. The condition affects about 2 percent to 4 percent of people in the U.S. It is most common in middle-aged women.

What causes fibromyalgia?     

The cause is unknown. Researchers think there may be a link with sleep problems and stress. It also might be linked to immune, endocrine or biochemical problems.

What are the symptoms of fibromyalgia?     

Each person’s symptoms may vary. But chronic pain is the most common symptom. The pain most often affects the muscles and the points where muscles attach to bones. These are the ligaments and tendons.

Pain may begin in one part of your body, such as your neck and shoulders. Over time your whole body may be affected. The pain ranges from mild to severe. It may feel like burning, soreness, stiffness, aching, or gnawing pain. You may have sore spots in certain parts of your muscles. It may feel like arthritis, but it’s not a condition that gets worse. And it doesn’t damage muscles or bones.

Other common symptoms of fibromyalgia include: 

  • Medium to severe fatigue
  • Less exercise endurance
  • Sleep problems at night
  • Depressed mood
  • Anxiety
  • Headaches
  • Irritable bowel symptoms, such as abdominal pain and bloating, diarrhea and constipation
  • Restless legs
  • Painful menstrual periods
  • Trouble thinking clearly (called “fibro fog”)

These symptoms can seem like other health conditions. Make sure to see your health care provider for a diagnosis.

How is fibromyalgia diagnosed?     

There are no tests that can confirm a diagnosis of fibromyalgia. Instead, diagnosis is based on your symptoms and a physical exam. Your health care provider may diagnose you with fibromyalgia if you have:

  • Widespread pain for more than three months
  • 18 sore points on your body during that time
  • At least 11 sore points during the physical exam

 How is fibromyalgia treated?     

Your health care provider will figure out the best treatment for you based on:   

  • Your age, overall health and medical history
  • How sick you are
  • How well you handle certain medicines, treatments or therapies
  • Your opinion or preference

There is no cure for fibromyalgia, but symptoms can be managed. Mild cases may get better with stress reduction or lifestyle changes. More severe cases may need to be treated with a team. This may include your primary health care provider, a specialist called a rheumatologist, a physical therapist, and a pain management clinic. Treatment may include:

  • Anti-inflammatory medicines, to ease pain and help you sleep
  • Other pain medicines
  • Medicines approved for treating fibromyalgia (duloxetine, pregabalin, and milnacipran)
  • Medicines to ease depression (antidepressants)
  • Exercise and physical therapy, to stretch muscles and improve cardiovascular fitness
  • Relaxation methods
  • Heat treatments
  • Cold treatments once in a while
  • Massage

Talk with your health care providers about the risks, benefits, and possible side effects of all medicines.

Living with fibromyalgia

Fibromyalgia is a chronic condition. But you can manage it by working with your health care provider. In addition to medicines, lifestyle changes can help symptoms. These include getting enough sleep and exercise.

When should I call my doctor?  

If your symptoms get worse or you have new symptoms, tell your health care provider.

Key points about fibromyalgia

  • Fibromyalgia is a chronic condition that causes pain in muscles and soft tissues all over the body.
  • Researchers think it may be linked to sleep problems, stress or immune, endocrine, or biochemical problems.
  • Symptoms may also include lack of energy (fatigue), sleep problems, depression, headaches and other problems.
  • There is no cure, but symptoms can be managed.
  • Treatment can include medicine, exercise, relaxation, heat or cold, and massage.

Next steps 

Tips to help you get the most from a visit to your health care provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis and any new medicines, treatments or tests. Also, write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed and how it will help you. Also, know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time and purpose for that visit.
  • Know how you can contact your provider if you have questions.

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