fibromyalgia

Fibromyalgia is chronic (long-lasting) condition that causes pain all over the body, fatigue, and other symptoms. There is no cure, but treatments can help with the symptoms.

The exact cause of fibromyalgia is unknown. Studies of the brains of people with fibromyalgia found that they seem to process pain differently than people who don't have it. They may feel pain when others do not, and they may also have a more severe reaction to pain.

Fibromyalgia can run in families, so genetics may also play a role. Other factors may also be involved, such as having certain diseases that cause pain.

Anyone can get fibromyalgia, but it is more common in:

• Women; they are twice as likely to have fibromyalgia
• Middle-aged people; your chance of having it increases as you get older
• People with certain diseases, such as lupus, rheumatoid arthritis, osteoarthritis or ankylosing spondylitis
• People who have a family member with fibromyalgia

The main symptoms of fibromyalgia are:

• Chronic (long-lasting) pain and stiffness all over the body. People often describe it as aching, burning, or throbbing.
• Fatigue and tiredness.
• Trouble sleeping.

Other symptoms may include:

• Problems with thinking, memory, and concentration (sometimes called "fibro fog")
• Muscle and joint stiffness
• Numbness or tingling in the arms and legs
• Sensitivity to light, noise, odors, and temperature

People who have fibromyalgia are also more likely to have certain diseases, including:

• Anxiety
• Depression
• Headaches, including migraines
• Irritable bowel syndrome
• Pain in the face or jaw, including disorders of the jaw know as temporomandibular joint syndrome (TMJ)

Fibromyalgia can be hard to diagnose. It sometimes takes visits to several different health care providers to get a diagnosis. One problem is that there isn't a specific test for it. And the main symptoms, pain and fatigue, are common in many other conditions. Providers have to rule out other causes of the symptoms before making a diagnosis of fibromyalgia. This is called making a differential diagnosis.

To find out if you have fibromyalgia, your provider:

• Will take your medical history, including asking detailed questions about your symptoms
• Will do a physical exam
• May order x-rays and blood tests to rule out other conditions

Not all providers are familiar with fibromyalgia and its treatment. You should see a provider or team of providers who specialize in the treatment of fibromyalgia.

There is no cure for fibromyalgia, so treatment focuses on relieving the symptoms. Providers usually use a combination of treatments, including medicines, lifestyle changes, talk therapy, and complementary therapies:

• Medicines
• Certain antidepressants and anti-seizure medicines, which may help with pain or sleep problems.
• Pain relievers.
• Lifestyle changes
• Getting enough sleep.
• Getting regular physical activity. If you have not already been active, start slowly and gradually increase how much activity you get. You may want to see a physical therapist, who can help you create a plan that is right for you.
• Learning how to manage stress.
• Learning to pace yourself. If you do too much, it can make your symptoms worse. So you need to learn to balance being active with your need for rest.
• Talk therapy, such as cognitive behavioral therapy (CBT), can help you learn strategies to deal with pain, stress, and negative thoughts. If you also have depression along with your fibromyalgia, talk therapy can help with that too.
• Complementary therapies have helped some people with the symptoms of fibromyalgia. But researchers need to do more studies to show which ones are effective. You could consider trying them, but you should check with your provider first. These therapies include:
• Mindfulness meditation.
• Biofeedback, which uses electronic devices to measure body functions such as breathing and heart rate. This teaches you to be more aware of your body functions so you can learn to control them.
• Movement therapies such as yoga and tai chi.
• Massage therapy.
• Acupuncture.

Pain is a signal from your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Pain may be sharp or dull. You may feel pain in one area of your body or all over. Each person feels pain differently, even if the reason for the pain is the same.

Pain might be acute or chronic. The type of pain is based on how long and how often you have pain. Acute pain starts suddenly and goes away when the cause is treated or healed. This pain lets you know that you may be injured or have a problem you need to take care of. Chronic pain lasts longer than three months or the time in which you should have healed.

If you have chronic pain, it can occur most days or every day and may last for weeks, months, or even years. It can affect all aspects of daily life, including your mood and relationships. Treatment may not get rid of chronic pain, but it can help with your symptoms.

Sometimes, acute pain can become chronic pain. The original cause may have been an injury or infection, or you may have an ongoing cause of pain, such as arthritis or cancer. In some cases, there is no clear cause. Environmental factors and psychological factors such as mood and stress can make chronic pain worse.

Since people feel pain in different ways, two people could have the same issue, but each may have different symptoms. Chronic pain can occur anywhere in your body and may cause other symptoms such as fatigue, mood changes, or difficulty sleeping. If you have depression or stress, it may make chronic pain worse.

Many older adults have chronic pain. Women also report having more chronic pain than men, and they are at a greater risk for many pain conditions. Some people have two or more chronic pain conditions. You may be more likely to have chronic pain if you have certain medical conditions such as:

• Headaches or migraines
• Cancer
• Fibromyalgia
• Arthritis
• Nerve damage
• Back problems

Chronic pain lasts three months or longer or when pain continues after your body has healed. If the cause of your pain is unknown, your health care provider may:

• Ask you about your medical history
• Ask you to describe the pain and how it affects your life
• Do a physical exam
• Order blood tests or other medical tests

Chronic pain is not always curable, but treatments can help. Treatments may include medicines, including pain relievers. There are also non-drug treatments, such as acupuncture, physical therapy, and sometimes surgery.

Depending on the cause of your pain and your symptoms, your provider may also recommend lifestyle changes which may include suggestions for:

• Improving mental health
• Managing stress
• Getting to and staying at a healthy weight
• Adding low-impact exercise

Fatigue is a feeling of weariness, tiredness, or lack of energy. It can interfere with your usual daily activities. Fatigue can be a normal response to physical activity, emotional stress, boredom, or lack of sleep. But sometimes it can be a sign of a mental or physical condition. If you have been feeling tired for weeks, contact your health care provider. They can help you find out what's causing your fatigue and recommend ways to relieve it.

Fatigue itself is not a disease; it's a symptom. It can have many different causes, including pregnancy and various medical problems, treatments, and lifestyle habits such as:

• Medical problems:
  • Chronic (long-lasting) diseases such as diabetes, COPD (chronic obstructive pulmonary disease), and heart, liver, kidney and thyroid diseases
  • Untreated pain and diseases like fibromyalgia
  • Anemia
  • Infections
  • Parkinson's disease
  • Sleep apnea and other sleep disorders
  • Recent stroke
  • Mental disorders such as depression and anxiety
• Treatments:
  • Cancer treatments such as chemotherapy, radiation, and bone marrow transplants
  • Recovering from major surgery
  • Taking certain medicines, such as antidepressants, antihistamines, and medicines for nausea and pain
• Lifestyle habits:
  • Not getting enough sleep
  • Staying up too late
  • Drinking too much alcohol
  • Substance use
  • Having too much caffeine (which can keep you from getting a good night's sleep)
  • Getting too little or too much exercise

Overwhelming fatigue is part of a disorder called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The fatigue caused by this disorder is different from a tired feeling that goes away after you rest. Instead, the fatigue in ME/CFS lasts a long time, does not get better with rest, and limits your ability to do ordinary daily activities.

If you've had fatigue that does not get better after several weeks, call your provider. They will ask questions about your sleep, daily activities, appetite, and exercise. They will likely do a physical exam and order lab tests. Once they decide on a diagnosis, they can tell you what treatments might help.

You can also make some lifestyle changes to feel less tired:

• Get regular physical activity
• Improve your sleep habits
• Stop smoking (if you smoke), since smoking is linked to many diseases that can cause fatigue
• Manage stress
• Eat a healthy diet and avoid alcohol

It also may be helpful for you to keep a fatigue diary. This can help you find patterns throughout the day, such as when you feel more tired and when you have more energy. It can also help you plan for activities that may give you more energy.

NIH: National Institute on Aging

Your muscles help you move and help your body work. Different types of muscles have different jobs. There are many problems that can affect muscles. Muscle disorders can cause weakness, pain or even paralysis.

Causes of muscle disorders include:

• Injury or overuse, such as sprains or strains, cramps or tendinitis
• A genetic disorder, such as muscular dystrophy
• Some cancers
• Inflammation, such as myositis
• Diseases of nerves that affect muscles
• Infections
• Certain medicines

Sometimes the cause of muscle disorders is unknown.