Barnsley Fibromyalgia Support group
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Coping with Fibromyalgia

What is fibromyalgia ?

 

 

Below is a small sample of the definitions of fibromyalgia on the internet.

 

 

  • A chronic, widespread pain in muscles and soft tissues surrounding the joints throughout the body.
    www.ric.org/conditions/arthritis/whatis/index.aspx

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  • A chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple tender points that occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips; also may cause sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and ...
    ukhealthcare.uky.edu/patient/glossary/glossary-f.htm

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  • A debilitating chronic syndrome characterized by diffuse and or specific muscle, joint, or bone pain, fatigue, and a wide range of other symptoms
    www.dhss.mo.gov/PainManagement/Glossary.html

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    What is fibromyalgia

     

     

    Fibromyalgia is a chronic (long-term) condition that causes pain all over the body. However, the condition does not just affect the muscles, ligaments and tendons, but is felt all over the body. This results in widespread pain, fatigue and extreme sensitivity to pain.

    Who is affected by fibromyalgia? 

    Anyone can develop fibromyalgia, although the condition affects more women than men. In most cases, it occurs between 35-60 years of age, but can develop in people of any age, including children and the elderly. It is thought that between 2 and 4.5% of people in the UK have the condition.

    Symptoms of fibromyalgia 

    There are many symptoms of fibromylagia and they tend to vary from person to person & they can also come and go although it is unlikely that they will ever disappear altogether. The main symptoms of fibromyalgia are outlined below.

     

    Pain

     

    If you have fibromyalgia, one of your main symptoms is likely to be widespread pain, which you may feel from 'head to toe'. It can feel like an ache, a burning sensation, or a sharp stabbing pain. The pain can be worse in the areas of your body that you use the most, such as your back, neck, shoulders and feet.

     

    Extreme sensitivity

     

    Fibromyalgia can cause you to become extremely sensitive to pain all over your body, and you may find that even the slightest touch is very painful. If you hurt yourself - for example, if you stub your toe - you may find that the pain continues for much longer than it normally would.

     

    Also you may find that you are very sensitive to other things as well, such as smoke, certain foods and bright lights. Being exposed to something you are sensitive to can cause your other fibromyalgia symptoms to flare up.

     

    Fatigue and trouble sleeping

     

    Fatigue as a result of fibromyalgia can range from a mild, tired feeling to  exhaustion. Sometimes, severe fatigue may come on very suddenly and can drain you of all your energy.

     

    Fibromyalgia can also affect your sleep, and you may find that you often wake up tired even when you have had plenty of sleep. Due to fibro sometimes prevent you from sleeping deeply enough to refresh you properly. The muscles in your legs may also spasm at night which can also interfere with a restful night's sleep.

     

    Stiffness

     

    If you have fibromyalgia, as well as causing you pain, you may find that your muscles, tendons and ligaments become stiff and prone to spasm & may be most severe when you have been in the same position for a long period of time.

     

    Cognitive problems ('fibro-fog')

     

    If you have fibromyalgia, you may have trouble remembering and learning new things, problems with attention and concentration, and slowed or confused speech.

     

    Headaches

     

    If you have pain and stiffness in your neck and shoulders from fibromyalgia, you may also have frequent headaches varying from being quite mild to very severe migraines.

     

    Irritable bowel syndrome (IBS)

     

    You may also develop irritable bowel syndrome (IBS) which is a common digestive condition that causes pain and bloating in your gut along with constipation and diarrhoea.

     

    Other symptoms

     

    Other symptoms of fibromyalgia can include:

     

    • facial pain, often as a result of neck, shoulder, or jaw muscle stiffness
    • tingling, numbness, prickling, or burning sensations in your hands and feet (paresthesia)
    • dry eyes, skin, or mouth
    • unusually painful periods (in women)
    • anxiety
    • depression

    Your symptoms may sometimes get better, or worse, depending on factors such as changes in the weather, stress levels, and how physically active you are.

    If you have fibromyalgia, it is unlikely that your condition will ever resolve permanently, although there may be long periods of time when your symptoms disappear completely. Most people have to learn to live with the condition long-term. However, fibromyalgia is not life-threatening and does not reduce life expectancy.

     

    Causes of fibromyalgia 

    The exact cause of fibromyalgia is unknown, and research is ongoing which has identified a number of possible causes of the condition, outlined below.

     

    Problems with pain messages

     

    One of the most likely causes is a problem with the way that pain messages are carried and received in your body. It is thought that, the central nervous system (which transmits messages to and from your brain) cannot process pain messages properly. It is also thought that the brain becomes more sensitive to any pain messages that it receives. This may be why fibromyalgia results in constant feelings of pain and extreme sensitivity to pain.

    Research has also found that people with fibromyalgia have higher levels of pain transmitting chemicals in their spinal cords compared with those who do not.

     

    Low levels of hormones

     

    People with fibromyalgia have been found to have lower than normal levels of the hormones serotonin, noradrenaline (also known as norepinephrine) and dopamine.Each play an important part in controlling many of the processes in the body. For example, serotonin helps to regulate your moods, your appetite, and the way that you sleep. Noradrenaline contributes to attention and your responses, and dopamine helps to control your mood and behaviour, and the way that you learn.

     

    External factors and genetic predisposition

     

    In many cases, fibromyalgia develops after an external factor, such as an illness, injury, or operation and may act like a trigger causing fibromyalgia to occur.

    There also seems to be a genetic link to fibromyalgia, with some people being more likely than others to develop the condition due to their genes. If this is the case, a genetic predisposition (tendency) could help explain why some people develop fibromyalgia after some sort of trigger.

     

    Other conditions

     

    There are several other conditions that can lead to fibromyalgia known as secondary fibromyalgia. Some conditions that can cause fibromyalgia are outlined below.

     

    • Joint hypermobility - a condition where your joints are extremely flexible, and can lead to pain, stiffness, and a risk of joint dislocation.
    • Lupus - a condition where your immune system attacks your body's connective tissues, such as ligaments and tendons, by mistake.
    • Rheumatoid arthritis - joint pain and stiffness which occurs as a result of your immune system attacking the lining of your joints by mistake.

     

    Diagnosing fibromyalgia 

    If you think that you may have fibromyalgia, you should see your GP. They will ask you about your symptoms, before carrying out a physical examination.

    However, diagnosis can be difficult as there is no specific test that can be done, and the symptoms of fibromyalgia can be varied and very similar to those of several other conditions.

     

    Ruling out other conditions

     

    If your GP thinks that you may have fibromyalgia, they will first have to rule out any other conditions that could be causing your symptoms.These include chronic fatigue syndrome, rheumatoid arthritis, and multiple sclerosis (MS).

    You may have blood tests, X-rays, plus other scans in order to rule out conditions that have symptoms which are similar to fibromyalgia.

    If you are found to have another condition, such as those listed above, it does not necessarily mean that you do not also have fibromyalgia. As fibromyalgia is a complex condition, when making a diagnosis, your GP will need to take any other symptoms and possible factors into account.

      

    Diagnosing fibromyalgia

     

    Although there is no specific test that can be used to diagnose fibromyalgia, there are two criteria that can be used to confirm it.They are:

     

    • that you have had widespread pain for more than three months on both the left and right sides of your body, above and below your waist
    • that you have pain in at least 11 of the 18 'tender point' sites when they are pressed

     

    Tender points

     

    The tender points are areas on your body where your pain is likely to be at its worst and where everyone is most sensitive to pain, so if you have fibromyalgia, these areas will be very painful. Sites include the back of your neck, above each of your shoulder blades, and the inside of your elbows.

    Treating fibromyalgia 

    There is no cure for fibromyalgia, but treatment aims to ease symptoms as much as possible and to improve your quality of life.

    As symptoms tend to vary widely from person to person, you may be treated  by several different healthcare professionals. For example, your GP, a rheumatologist or a neurologist. It can be treated in several different ways, and it is likely that you will need more than one kind of treatment to ease your condition. However, all types of treatment may not be effective for everyone with fibromylagia.

    In most cases, it is treated using a combination of medicines, complementary therapies and lifestyle changes. You may also find that joining a fibromyalgia support group can be a tremendous source of comfort and support.

     

    Medicines for fibromyalgia

     

    You may need to take several different types of medicines including painkillers, antidepressants, and those to help you sleep.

    Painkillers

    If you have fibromyalgia, you can treat your pain using simple painkillers, such as paracetamol. If  it is not effective your GP, may prescribe a stronger painkiller, such as codeine.

    You may also be prescribed a painkiller called tramadol, or one called nefopam. Both of these have been found to be effective in treating pain that is caused by fibromyalgia.

    In some cases, in addition to your main painkiller, you may also be prescribed a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen. As well as easing pain, NSAIDs help to reduce inflammation. However, as fibromyalgia does not cause inflammation, they are not effective in treating the condition when taken on their own.

    Antidepressants

    Antidepressant medicines for fibromyalgia are not prescribed specifically to treat depression. They are used to boost the levels of certain neurotransmitters, such as serotonin, noradrenaline (also known as norepinephrine), and dopamine. Neurotransmitters are chemicals that carry messages to and from the brain and by raising their levels may help to treat  the pain.

     

    There are many different types of antidepressant medicines that you may be prescribed. The choice of medicine will depend on the severity of your symptoms, plus any side effects that the medicines may cause.

    Antidepressants used to treat fibromyalgia include those described below.

    • Tricyclic antidepressants - such as amitriptyline, nortriptyline, and dosulepin. These are usually the first choice of antidepressant and raise levels of serotonin and noradrenaline  (norepinephrine) in order to ease pain and help you sleep.
    • Serotonin-norephinephrine reuptake inhibitors - such as venlafaxine and duloxetine which raise levels of serotonin and noradrenaline (norepinephrine). Venlafaxine also raises levels of dopamine, as well as serotonin and noradrenaline.
    • Selective serotonin reuptake inhibitors (SSRIs) - such as citalopram, fluoxetine, and paroxetine which can be used to  raise serotonin levels.

    There are also two other types of medicine that affect the levels of neurotransmitters which are sometimes used to treat fibromyalgia - a dopamine agonist called pramipexole, and a serotonin 5-HT3 receptor antagonist called tropisetron.

    Muscle relaxants and medicines to help you sleep

    If you have stiffness, or spasms, in your muscles as a result of fibromyalgia, your GP, or health professional, may prescribe a muscle relaxant to help ease your symptoms.They are often used for fibromyalgia include medicines called tizanidine and carisoprodol. Tricyclic antidepressants (see above) can also help to relax your muscles.

    Muscle stiffness and spasms can also affect your ability to sleep, but even if you sleep all night, you may find that you still wake up feeling tired. This is because fibromyalgia can prevent you from sleeping deeply enough to fully refresh you.Using one of the muscle relaxant medicines mentioned above may help you to sleep more deeply at night because they have a sedative (sleep-inducing) effect.

    There are also stronger medicines, such as zopiclone and zolpidem, which can help you sleep. However, you may only be able to use one of these medicines for a short period of time because long-term use can end up disrupting your sleeping patterns even further.

    Pregabalin

    Pregabalin is an anti-seizure medicine that has been found to be effective in treating several fibromyalgia symptoms, including pain and sleeping problems. You may be able to take pregabalin as a brand called Lyrica.

    However it can cause a number of side effects, such as dizziness, blurred vision, and weight gain, so it may not be suitable for everyone.

    Complementary therapies for fibromyalgia

    There are a number of complementary therapies which may help to ease your symptoms of fibromyalgia. However, it is important to remember that there is little medical evidence to back up the effectiveness of these therapies, and that they may not work for everyone.

    Warm water therapy, such as swimming, gentle exercises in a warm pool, or simply having a warm bath, is a popular complementary therapy for people with fibromyalgia. 

    Some people also find that complementary therapies help to ease their pain, or fatigue, and help them to relax and manage their condition more effectively. Examples of complementary treatments that may help to ease symptoms of fibromyalgia include acupuncture. aromatherapy massage, and osteopathy.

    There are also complementary therapies for fibromyalgia that focus on the mental and emotional aspects of the condition. Relaxation therapy, anxiety management techniques, counselling, cognitive behavioural therapy (CBT), or other ‘talking treatments’, can sometimes help some people to cope better with pain, fatigue, or other symptoms.

    If you decide to use a form of complementary therapy, always ensure that your therapist is a fully qualified and accredited member of the appropriate organisation - for example, the British Acupuncture Council (BAC).