Fibromyalgia is a chronic disorder characterized by pain in the tendons, ligaments, and tendons. The main symptom of fibromyalgia is tender points along certain areas of the body. There is no known cause of fibromyalgia, and many people suffer for years before a diagnosis is made.

How common is fibromyalgia?

According to the Centers for Disease Control and Prevention, fibromyalgia affects around 2% of the adult population in the United States. The prevalence is much higher for women than men, with a female to male ratio of 7:1.

What are the signs and symptoms of fibromyalgia?

Patients with fibromyalgia have varying symptoms. These include:

  • Widespread pain
  • Multiple body tender points
  • Paresthesia (tingling)
  • Irritable bowel syndrome
  • Depression
  • Fatigue or trouble sleeping
  • Skin sensitivity
  • Headaches
  • Pain after exertion
  • Dizziness
  • Restless leg syndrome (RLS)
  • Memory lapses or difficulty concentrating

What causes fibromyalgia?

Experts are unsure of the cause of fibromyalgia, but they do have some theories. One theory involves changes in brain chemicals (called neurotransmitters) is thought to affect the patient’s perception of pain. Another theory involves dysregulation of the autonomic nervous system. This system releases certain hormones that affect how a person perceives pain. Genetics also play a role in the condition, as fibromyalgia tends to run in families.

How is fibromyalgia diagnosed?

The doctor will conduct a detailed physical examination to assess “tender points” along the body. X-rays and imaging scans are used to rule out serious conditions. A new blood test for fibromyalgia is under investigation, but few doctors use this for diagnosing the condition. The diagnosis of fibromyalgia is made based on the patient’s symptoms and certain diagnostic criteria.

What medications are used to treat fibromyalgia?

The aim of treatment is to help the patient function at the highest possible level on a daily basis. The main goal is to relieve all the symptoms and improve quality of life. Medications used to treat fibromyalgia include:

  • Muscle relaxants – Flexiril and Baclofen are used to treat muscle spasms.
  • Pregabalin (Lyrica) – This drug is the first medicine approved by the FDA for fibromyalgia.
  • Tricyclic antidepressants – Elavil and Trazadone are used to help with pain and sleep.
  • Analgesics – These include nonsteroidal anti-inflammatory drugs (NSAIDs), as well as opioids and acetaminophen.
  • Topical agents – Muscle pain sometimes responds to topical analgesics, such as capsaicin, menthol, and Aspercreme.
  • Supplements – These include omega-3 fatty acids, vitamin C, L-carnitine, alpha-lipoic acid, probiotics, S-adenosylmethionine, and magnesium.

What other treatment options are there?

Several therapies have been proven effective for fibromyalgia. These include:

  • Acupuncture – Many patients with fibromyalgia report positive results with acupuncture. This involves placing small needles along body regions (called meridians) to restore energy, promote healing, and ease pain.
  • Chiropractic therapy – Fibromyalgia often causes neck and back pain. In a recent study, 77% of women with fibromyalgia reported a reduction of pain with this therapy. In addition, 63% enjoyed improved sleep, and 75% reported improvement of fatigue.
  • Transcutaneous Electrical Nerve Stimulator (TENS) – This device is worn outside the body. Small electrodes are attached to various body regions and wires run to a small unit. The device produces pleasant sensations to interfere with pain signals.
  • Trigger point injections – The doctor can injected tender points and trigger points with an anesthetic, a steroid agent, or both. This therapy is done in the doctor’s office.
  • Botox injections – Some patients with fibromyalgia respond to Botox injections. This is used to relieve muscle tension and pain.

Resources

Abeles M, Solitar B, Pillinger M, Abeles A. Update on Fibromyalgia Therapy. The American Journal of Medicine. 2008;121(7).

Bartecchi CE. Fibromyalgia and complementary and alternative medicine. Mayo Clin Proc. 2005;80(6):826; author reply 826-7.

Kengen Traska T, Rutledge DN, Mouttapa M, Weiss J, Aquino J. Strategies used for managing symptoms by women with fibromyalgia. J Clin Nurs. 2012; 21(5-6)626-35.

Langhorst J, Klose P, Musial F, Irnich D, Häuser W. Efficacy of acupuncture in fibromyalgia syndrome–a systematic review with a meta-analysis of controlled clinical trials. Rheumatology (Oxford).2010;49(4):778-88.

McBeth J, Jones K. Epidemiology of chronic musculoskeletal pain. Best Pract Res ClinRheumatol. 2007;21(3):403-25.

Staud R. Treatment of fibromyalgia and its symptoms. Expert Opin Pharmacother. 2007;8(11):1629-42.

Targino RA, Imamura M, Kaziyama HH, Souza LP, Hsing WT, Furlan AD, Imamura ST, Azevedo Neto RS. A randomized controlled trial of acupuncture added to usual treatment for fibromyalgia. J Rehabil Med. 2008;40(7):582-8.