Fibromyalgia: Coping with Chronic Pain

Fibromyalgia may never go away completely, but treatment and good self-care can reduce the symptoms.

Fibromyalgia is a chronic illness that may cause aches, pains and extreme fatigue. The symptoms are similar to those caused by arthritis, but unlike arthritis, it doesn't cause damage to the joints and muscles.

Anyone can get fibromyalgia, but those most commonly affected are:

  • Women in their 20s and 30s
  • People who have a disease that affects the joints, such as rheumatoid arthritis, lupus or ankylosing spondylitis

Fibromyalgia tends to get worse at times and better at others. It may never go away completely, but you can feel better with treatment.

What causes it?
Doctors aren't sure what causes fibromyalgia, but they think it's related to a problem with how the body processes pain signals. Studies have found that people with fibromyalgia may have abnormal levels of a chemical called substance P in their spinal fluid. Substance P helps carry pain signals to and from the brain. Having too much of it may cause the body to overreact to pain signals.

Fibromyalgia is often brought on by an injury, an infection or stress. It seems to run in families, so the tendency to get it may be at least partly inherited (genetic).

What are the symptoms?
The most common symptoms of fibromyalgia are:

  • Tenderness. One of the key features of fibromyalgia is the presence of specific "tender points" on the neck, shoulders, arms, legs, back and hips. Even light pressure on these points may be painful.
  • Pain. The pain is widespread and affects different parts of your body at different times. Your muscles and joints may throb, ache or burn. You may feel stiff when you wake up in the morning.
  • Fatigue. You may feel so exhausted that you have trouble getting through the day.
  • Sleep problems. You may have trouble getting enough deep, restorative sleep.

Fibromyalgia may cause other symptoms, too. These include irritable bowel syndrome, headaches, restless legs syndrome, trouble thinking or remembering (sometimes called "fibro fog"), anxiety and depression.

How is it diagnosed?
People sometimes live with the pain and fatigue for some time before they are diagnosed with fibromyalgia. Its symptoms are similar to those of many other conditions and it often occurs along with other diseases. Doctors usually have to rule out these diseases before fibromyalgia can be pinpointed. Doctors rely on a physical exam and a history of symptoms to diagnose it. You may be diagnosed with fibromyalgia if you have:

  • Widespread pain for at least three months and
  • Pain or tenderness at 11 out of 18 specific "tender points"

There are no blood tests or x-rays that can diagnose fibromyalgia, but a doctor might do these tests to help rule out another problem that causes similar symptoms.

How is it treated?
Fibromyalgia is a frustrating condition that can be hard to diagnose and treat. Many people benefit from a combination of medical treatment and self-care strategies.

Medicines may help with your symptoms. Medicines that doctors often prescribe include:

  • Pain relievers. Over-the-counter pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) help some people. Others need stronger prescription medicines, such as tramadol (Ultram).
  • Antidepressants, such as amitriptyline (Elavil, Endep), fluoxetine (Prozac) and venlafaxine (Effexor). These medicines may help with any sleep problems as well as pain and fatigue.
  • Medicine for nerve pain called pregabalin (Lyrica) or gabapentin (Neurontin).
  • Medicines for specific symptoms, such as muscle relaxants and headache remedies.

Your doctor may also suggest other treatments, such as therapeutic massage, physical therapy and counseling. A type of counseling called cognitive-behavioral therapy may help you learn ways to cope with your illness.

Good self-care is vital in managing fibromyalgia. To do your best:

  • Get daily exercise. It may be hard to think of exercising when you have no energy and you hurt all over. But exercise is probably the best thing you can do for yourself. Start slowly and do more as you feel able. Try a 15-minute walk, swim or bike ride, then do some stretching. Over time, exercise can reduce pain and stiffness. Always check with your doctor before you increase your activity.
  • Practice good sleep habits. Go to bed and get up at the same time everyday. Make sure your bedroom is quiet, dark and at a comfortable temperature. Avoid caffeine and alcohol before bedtime. Try not to nap during the day.
  • Find ways to reduce stress. Look for ways to simplify your schedule. Make some time each day to relax. Try meditation or deep breathing.
Learn more about fibromyalgia. Organizations such as the National Fibromyalgia Association have lots of information. Sharing what you learn with family, friends and coworkers can help them understand more about your illness.