Fibromyalgia

Definition

Fibromyalgia is a common syndrome in which a person has long-term pain that is spread throughout the body. The pain is most often linked to fatigue, sleep problems, headaches, depression, and anxiety.

People with fibromyalgia may also have tenderness in the joints, muscles, tendons, and other soft tissues.

Alternative Names

Fibromyositis; FM; Fibrositis

Causes

The cause is unknown. Researchers think that fibromyalgia is due to a problem with how the central nervous system processes pain. Possible causes or triggers of fibromyalgia include:

Fibromyalgia is most common among women between ages 20 to 50.

The following conditions may be seen with fibromyalgia or have similar 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 people, pain improves during the day and gets worse at night. Some people have pain all day long.

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

Fatigue, depressed mood, and sleep problems occur in almost all people with fibromyalgia. Many people say that they cannot 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 with one or more of the following:

It is no longer necessary to find tender points during the exam to make a diagnosis.

Results from the physical exam, blood and urine tests, and imaging tests are normal. However, these tests may be done to rule out other conditions with similar symptoms. Studies of breathing during sleeping may be done to find out if you have a condition called sleep apnea.

Fibromyalgia may also occur in people who have other forms of arthritis, such as:

Treatment

The goals of treatment are to help relieve pain and other symptoms, and to help the person cope with the symptoms.

The first type of treatment may involve:

If these treatments do not work, your health care provider may also prescribe an antidepressant or muscle relaxant.

Other drugs are also used to treat the condition, such as:

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

Support groups may also be helpful.

Things you can do to help take care of yourself include:

Your provider may refer you to a pain clinic if your condition is severe.

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 provider if you have symptoms of fibromyalgia.

Prevention

There is no known prevention.

References

Bennett RM. Fibromyalgia, chronic fatigue syndrome, and myofascial pain. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 274.

Mbuyi N. Fibromyalgia. In: Ferri FF, ed. Ferri's Clinical Advisor 2018. Philadelphia, PA: Elsevier; 2017:491-492.

Selfridge NJ. Fibromyalgia. In: Rakel D, ed. Integrative Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 47.

Won C, Kirsch D. Fibromyalgia and chronic fatigue syndromes. In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 131.