Fibromyalgia is a chronic pain syndrome affecting more than 500,000 Canadians, or approximately two per cent of the population, yet it has only been accepted as a valid medical condition for about a decade.
That’s because it’s so difficult to diagnose. Symptoms vary from person to person and can change from day to day. There is no test to confirm if you have fibromyalgia. Doctors have to rule out other conditions to make a diagnosis but there are now Canadian guidelines to identify and manage the condition.
Women are estimated to be four to nine times more likely to develop the disease than men (80%-90% of people with fibromyalgia are women) and initial symptoms appear between ages 20 and 50. However, it can also affect men, teens and children.
Fibromyalgia symptoms include widespread body pain, fatigue, poor sleep and mood problems.
The cause is unknown but researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process pain signals. As a result, they react more strongly to touch and pressure, with a heightened sensitivity to pain. It is a real physiological and neurochemical problem.
The condition doesn’t harm organs and is almost never life-threatening but it can significantly impact quality of life. There’s no cure, but a variety of treatments can help to manage symptoms and pain.
Symptoms of fibromyalgia include:
- Widespread pain – often described as a constant dull ache lasting for at least 3 months. Widespread pain occurs on both sides of the body and above and below the waist. Areas commonly affected include the neck, back, chest, arms and legs.
- Fatigue – even after sleeping for long periods of time, people with fibromyalgia often wake up tired. Their sleep is often disrupted by pain, and many have other sleep disorders such as restless leg syndrome and sleep apnea.
- Cognitive difficulties – a symptom commonly referred to as “fibro fog” impairs the ability to focus, pay attention and concentrate on mental tasks.
It is also possible to experience:
- vision problems
- pelvic and urinary problems
- weight gain
- cold or flu-like symptoms
- skin problems
- chest symptoms
- depression and anxiety
- breathing problems
Symptoms of fibromyalgia sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.
Symptoms may resemble those of arthritis, but fibromyalgia affects the soft tissue, not the joints.
Fibromyalgia often co-exists with other painful conditions, such as:
- irritable bowel syndrome
- migraines and other types of headaches
- interstitial cystitis or painful bladder syndrome
- temporomandibular joint disorders/jaw pain
- Genetics – fibromyalgia tends to run in families so there may be genetic mutations that make you more susceptible to developing the disorder.
- Infections – some illnesses appear to trigger or aggravate fibromyalgia.
- Physical or emotional trauma –fibromyalgia is sometimes triggered by a physical trauma, such as a car accident, or by psychological stress.
- Other disorders – if you have osteoarthritis, rheumatoid arthritis or lupus, you may be more likely to develop fibromyalgia.
There is no cure for fibromyalgia, but lifestyle changes, medications, exercise, acupuncture and behavioural therapy can help relieve symptoms and improve quality of sleep. It’s important to have a variety of strategies to deal with the symptoms. Not all therapies will help everyone.
Maintaining a balanced diet and healthy weight is important for your overall health and can improve your quality of life. Studies have shown that people with both fibromyalgia and obesity showed an improvement in quality of life and pain symptoms once they lost weight.
More research is needed on the effects of diet on fibromyalgia, but reducing sugar and gluten has been shown to help.
There is little evidence to support a direct relationship between eating seeds and nuts and an improvement in fibromyalgia symptoms but they contain powerful micronutrients and minerals important for cell function, and this may support people with the condition.
An important first step to relieve symptoms of fibromyalgia is to remain physically active. Regular exercise at a comfortable level has been shown to help decrease pain, fatigue and sleep difficulties and improve mood.
While pain and fatigue may make exercise and daily activities difficult, research has shown that low-impact aerobic exercise improves pain, function and overall quality of life. Appropriate exercises include walking, swimming, biking and water aerobics. A good goal is to work up to at least 30 minutes of aerobic exercise three times a week.
Strength or resistance training such as lifting weights, using resistance machines or elastic resistance bands may also be helpful but hasn’t been as extensively researched. It does appear to reduce pain and improve quality of life and muscle strength.
Mind-body practices such as yoga and tai chi that combine meditation, slow movements, deep breathing and relaxation may help improve symptoms and overall well-being.
For most people, medications do little to improve their symptoms, and the benefits are often outweighed by the side effects.
Health Canada has only approved two medications for the treatment of fibromyalgia: Cymbalta (duloxetine), an antidepressant that, for some people, delivers an energy boost; and Lyrica (pregabalin), an antiseizure medication that can be prescribed for pain relief. All other pharmacological treatments, including mild muscle relaxants (aspirin, Tylenol, Advil, etc.) and opioid pain relievers, can be used in moderate doses to manage pain but are considered “off label” – the prescribing of approved medications for other than their intended indications.
Alternative therapies may also provide relief to fibromyalgia sufferers. These include:
- mental imaging
While there is no single treatment for fibromyalgia that works for everyone, over time, most people with the condition will discover what gives them the best relief. Eliminating all symptoms is rarely possible so the aim of a treatment plan, with the help of a healthcare team, should be to improve symptoms as much as possible so people with fibromyalgia can lead an active and enjoyable life.
Medical News Today
Canadian Women’s Health Network
Canadian Rheumatology Association
Canadian Guidelines for the Diagnosis and Management of Fibromyalgia