Fibromyalgia

Definition

Fibromyalgia is a common syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues.

Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, and anxiety.

Alternative Names

Fibromyositis; Fibrositis

Causes

The cause is unknown. Possible causes or triggers of fibromyalgia include:

Fibromyalgia is most common among women aged 20 to 50.

The following conditions may be seen with fibromyalgia or mimic its symptoms:

Symptoms

Pain is the main symptom of fibromyalgia. It may be mild to severe.

People with fibromyalgia tend to wake up with body aches and stiffness. For some patients, pain improves during the day and gets worse at night. Some patients have pain all day long.

Pain may get worse with activity, cold or damp weather, anxiety, and stress.

Fatigue, depressed mood, and sleep problems are seen in almost all patients with fibromyalgia. Many say that they can't get to sleep or stay asleep, and they feel tired when they wake up.

Other symptoms of fibromyalgia may include:

Exams and Tests

To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 areas, including

Blood and urine tests are usually normal. However, tests may be done to rule out other conditions that may have similar symptoms.

Treatment

The goal of treatment is to help relieve pain and other symptoms, and to help a person cope with the symptoms.

The first type of treatment may involve:

If these treatments do not work, your doctor may prescribe an antidepressant or muscle relaxant. The goal of medication is to improve sleep and pain tolerance. Medicine should be used along with exercise and behavior therapy. Duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella) are medications that are approved specifically for treating fibromyalgia.

However, many other drugs are also used to treat the condition, including:

Cognitive-behavioral therapy is an important part of treatment. This therapy helps you learn how to:

Support groups may also be helpful.

Other recommendations include:

Severe cases of fibromyalgia may require a referral to a pain clinic.

Outlook (Prognosis)

Fibromyalgia is a long-term disorder. Sometimes, the symptoms improve. Other times, the pain may get worse and continue for months or years.

When to Contact a Medical Professional

Call your health-care provider if you have symptoms of fibromyalgia.

Prevention

There is no known prevention.

References

Abeles M, Solitar BM, Pillinger MH, Abeles AM. Update on fibromyalgia therapy. Am J Med. 2008;121:555-561.

Häuser W, Bernardy K, Üceyler N, Sommer C. Treatment of fibromyalgia syndrome with antidepressants. JAMA. 2009;301:198-209.

Wolfe F, Rasker JJ. Fibromyalgia. In: Firestein GS, Budd RC, Harris ED Jr., et al., eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 38.

Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62(5):600-610.