Fibromyalgia

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Published: September 4, 2017
Last reviewed: October 12, 2017

What is fibromyalgia?

Fibromyalgia is a state of chronic widespread pain and tenderness in the absence of tissue damage [1,10]. The word fibromyalgia literally means pain in the fibrous connective tissue (tendons and ligaments) and muscles [3].

Current evidence suggests that fibromyalgia develops due to inability to cope with psychological or physical stress [4,5,6].

Perfectionists who have unrealistic ideas have a problem with reaching their goals, so they can develop strong emotions of sadness, anger, fear and helplessness [7]. These emotions, when sustained, can trigger chemical changes in the central nervous system (the brain and spinal cord) that lead to increased sensitivity to pain [8,9].

Similarly, unsuccessful coping with physical stress, trauma or infection may trigger the onset of fibromyalgia [4,7].

Fibromyalgia is also called fibromyalgia syndrome [8]. A syndrome means a cluster of symptoms, so fibromyalgia should be viewed as such and not as a disease [16].

Fibromyalgia most commonly occurs in young and middle-aged women, but also in men and children, especially adolescents [3,9].

Fibromyalgia is NOT [10]:

  • Dangerous or fatal
  • Contagious
  • Malingering
  • “All in your head”

The old and technically incorrect names for fibromyalgia are fibrositis, fibromyositis and muscular rheumatism [11].

Symptoms and Signs

Typical symptoms of fibromyalgia include [12,13]:

  • Widespread pain and tenderness
  • Tingling and numbness
  • Fatigue
  • Depression and anxiety
  • “Fibro fog” (poor memory and concentration)
  • Disturbed sleep and morning stiffness

A typical sign of fibromyalgia are symmetrical tender points in most body regions [15].

Causes

Fibromyalgia can be triggered by unsuccessful coping with [4,10,13]:

  • Emotional trauma, sexual abuse, neglect or alcoholism in the family
  • Excessive physical work
  • Physical trauma, such as whiplash injury or surgery
  • Childbirth

Diagnosis

A doctor can make a diagnosis of fibromyalgia from:

  • The history of widespread pain and fatigue
  • Presence of tender points
  • Exclusion of other conditions

Investigations, such as laboratory tests and imaging (X-ray, CT, MRI), are not useful in diagnosing fibromyalgia but can help to detect other health disorders [9,15].

Treatment

The approach to the treatment of fibromyalgia should be holistic, that is involving the whole person [2,5]:

  • Become aware of the emotions of peace and joy and adjust work and relationships accordingly.
  • Set clear goals and stick with them.
  • Stay physically active (walking, cycling).
  • Share your problems with a person you trust.

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