Fibromyalgia is a common health condition that causes widespread body pain and sensitivity to touch. Women are most often affected but men and children can also have Fibromyalgia. The reasons why people get Fibromyalgia are unclear with a number of theories proposed including genetic susceptibility and environmental triggers that may interact with genes such as physical or emotional stress or an illness. In Fibromyalgia, it is like the pain “volume button” is turned up. The way in which the nervous system processes normal sensations (such as touch and movement) in people with Fibromyalgia also appears to be changed. This means that normal non-painful sensations like touch and movement can be interpreted as painful and pain sensations are amplified, hurting even more than usual (increased pain sensitivity).
What are the symptoms of Fibromyalgia?
A variety of other symptoms can occur when you have Fibromyalgia such as:
- Sleep disturbances
- Generalized muscle and joint stiffness in the mornings
- Jaw pain and clicking
- Numbness and tingling of the hands and feet
- Restless legs syndrome
- Sensitivity to hot and cold temperatures
- Sensitivity to loud noises or bright lights
- Cognitive (thinking) and memory difficulties
- Low mood (depression) or anxiety.
How do you diagnose Fibromyalgia?
Your doctor can help make a diagnosis and may refer you to a specialist, usually a rheumatologist. The most widely used clinical criteria for diagnosing Fibromyalgia come from the American College of Rheumatology (2010). These include:
- Pain and symptoms over the past week, based on the total number of painful areas out of 18 parts of the body, plus the level of severity of fatigue, waking unrefreshed and cognitive (memory or thought) problems. Plus the number of other general physical symptoms
- Symptoms lasting at least three months at a similar pain intensity level
- No other health condition that would explain the pain and symptoms you are experiencing.
What treatments are available for Fibromyalgia?
Like many other pain conditions, currently there is no cure for Fibromyalgia, but there are many things that, taken together, can help! These treatments include:
- Improving your sleep routine
- Having a balanced diet
- Meditation strategies
- Pacing your activity
- Goal setting
- Controlling your mood and your physical and emotional “load” or stress.
The list of treatments above may be helpful to address various parts of your “pie”. Rather than tackling all pieces of the pie in one go, try setting your focus on 1 or 2 small achievable goals. For example, improving your sleep routine is a great start to better managing your pain. Developing a regular sleep time and routine will help to reduce your pain. Using a low dose anti-depressant may help you to regulate your sleep: discuss this with your doctor. Improved sleep means less pain and allows you to undertake more carefully paced activity and exercise. So, rather than using a single approach (like medications), you have coupled up a few simple strategies (sleep, medications and paced activity). This multimodal approach can make a big difference to your pain over the days and weeks.
What is the role of medications in managing Fibromyalgia?
Like many other pain disorders, medications can play a role in the management of Fibromyalgia, but are not recommended as a standalone treatment. The use of medications is designed to help keep you moving and stay engaged in the things you love to do.
Side effects from medications can vary and you should ask your doctor about the risks and benefits of your medicines.
The medications recommended for use in Fibromyalgia are designed to reduce or calm down nerve activity, reducing pain hypersensitivity. These medications may include:
- Anti-depressants (Amitriptyline, Nortriptyline, Trimipramine)
- Serotonin Noradrenaline Reuptake Inhibitors (SNRIs) such as Duloxetine (Cymbalta) and Venlafaxine (Effexor)
- Anti-epilepsy drugs (Gabapentin and Pregabalin).
Below are a few tips to help you manage Fibromyalgia
- Set yourself little tasks you can achieve TODAY
- Pace your activities: this means doing small bits often or taking the middle road, rather than overdoing or under doing. This also helps to conserve energy
- Exercise a little everyday. Doing exercise you like, means that you are more likely to do it, even if this is only a short walk
- Exercise is good for your general well being, your mood, heart and lungs, joints and muscles, your balance and your bone health
- Gentle stretching and relaxation are often useful options. Try changing positions frequently rather than staying in the one position for extended periods
- A regular sleep routine is very important – dark room, same time, quiet music may help
- Planning your work and social activities ahead helps you think about ways you can better manage challenging situations or pain flares. Possibly only going for part of the function rather than all will help manage your energy levels and pain levels
- Asking your family or friends to help where possible, can help both you and help them to understand.
Want more information?
For more information about Fibromyalgia, visit Arthritis Australia, Arthritis Victoria or the Fibromyalgia Support Network of WA and Cochrane Summaries. Alternatively, if you want to talk to someone about Fibromyalgia, please seek further assistance.