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This article waslast modified on October 5, 2020.
What is fibromyalgia?

Fibromyalgia (also referred to as fibro or FM) is a syndrome associated with chronic, widespread pain, sensitivity to touch, fatigue, and memory problems. People with fibromyalgia experience aching muscles, sleep poorly, and are often stiff when they wake up or when they move after sitting for long periods of time. The intensity and location of the pain and the degree of fatigue may vary from day to day and may become worse with excessive exercise or stress.

Fibromyalgia is thought to affect more than 5 million Americans over the age of 18. Between 75% and 90% of the people affected by fibromyalgia are women, but men and children can also be affected. People with certain health conditions that affect muscles, bones, and joints (rheumatic diseases) like arthritis and lupus may also have a higher risk of fibromyalgia.

The pain, fatigue, and numerous other symptoms that are associated with fibromyalgia can affect your quality of life and interfere with your ability to function at work or home. The condition can often make you feel in poor health, but it does not cause inflammation or visible damage to muscles, joints or organs. The pain and other symptoms come and go at random, causing uncertainty and frustration. While some depression is associated with fibromyalgia, it does not cause the condition and is about as common in fibromyalgia as in any other chronic illness.

Healthcare practitioners familiar with fibromyalgia can make a diagnosis using the criteria established by the American College of Rheumatology (ACR). (See the Tests section for more on this.) New research into understanding fibromyalgia centers mostly on how pain is processed in the brain and spinal cord rather than the pain receptors in the rest of the body. This research may lead to new means of diagnosing the disorder in the future.

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About Fibromyalgia
  • Causes

    No single cause of fibromyalgia has been identified, but it is thought that there are both genetic and environmental components.

    • Some factors may trigger the condition in people who are predisposed to it.
    • Some families have a higher incidence of the disorder.

    Some cases appear to start with a physical trauma, an infection, emotional stress, or a severe illness, while other cases arise without a discernible "event." Fibromyalgia is not caused by inflammation, and is not an autoimmune, muscle or joint disorder.

    Scientists believe fibromyalgia is a condition affecting the nervous system (neurological). Some studies show that the brains of people with fibromyalgia do not process pain the same way as people who do not have the condition. There is an abnormal increase in the chemicals in the brain that signal pain. It is thought repeated nerve stimulation from the increase in these chemicals causes the brain to change and become more sensitive to pain signals.

  • Signs and Symptoms

    Fibromyalgia symptoms typically intensify, or flare, periodically. These flares can be unpredictable. You may have an invigorating walk one day and then an excruciatingly painful walk the next. Symptoms may also ease considerably or even disappear for days, months, or longer, only to re-appear again later.

    There are many variable signs and symptoms associated with fibromyalgia, but the condition almost always starts with:

    • Chronic widespread pain (pain that affects your whole body)
    • Pain in specific areas called "tender points"
    • Extreme tiredness (fatigue) that doesn't get better with rest or sleeping
    • Trouble sleeping
    • Difficulty concentrating, memory lapses

    Other common symptoms include:

    • Body stiffness, especially in the morning and with prolonged sitting
    • Depression and anxiety (may coexist)
    • Headaches, including migraines
    • Painful menstrual periods
    • Numbness and tingling in hands and feet
    • Irritable bowel syndrome (IBS), which can cause pain, diarrhea and/or constipation
    • Mood problems
    • Muscle fatigue with twitching or cramping
    • Restless legs syndrome
    • Inability to tolerate heat or cold
    • Sensitivity to loud noises or bright lights

    Fibromyalgia can co-exist with many other chronic illnesses such as chronic fatigue syndrome, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, Sjögren syndrome, thyroid disease, multiple sclerosis, and lupus. The symptoms of these conditions may overlap with symptoms of fibromyalgia, making diagnosis more of a challenge.

  • Tests

    Fibromyalgia is usually diagnosed by documenting your medical history, ruling out disorders and diseases that may be mimicking or worsening fibromyalgia, and by using the clinical fibromyalgia diagnostic criteria from the American College of Rheumatology (ACR).

    The ACR criteria evaluate pain location and severity. They also take into account your symptoms — how you feel. To help make a diagnosis your healthcare practitioner may:

    1. Ask whether you've had pain and symptoms in specific areas over the past week, and the level of severity of these symptoms:
      • Fatigue
      • Waking unrefreshed
      • Cognitive (memory or thought) problems

        Your healthcare practitioner may also ask about other general physical symptoms. 

    2. Ask if you've had widespread pain for at least 3 months

    3. Determine whether you have another condition that would explain the pain

    Laboratory Tests
    Currently there is no widely accepted test to diagnose fibromyalgia. However, laboratory tests can be useful to help diagnose conditions with symptoms similar to fibromyalgia, such as rheumatoid arthritis, Sjögren syndrome, thyroid disease, and lupus. It is not usually cost effective or necessary to do extensive screening. General tests that may be ordered while diagnosing fibromyalgia include:

    • CMP (comprehensive metabolic panel) – to examine electrolytes, proteins, liver and kidney function, calcium, and glucose
    • CBC (complete blood count) – to look for anemia, a possible cause of weakness and fatigue
    • TSH (thyroid stimulating hormone) and/or other thyroid testing since hypothyroidism can cause symptoms similar to fibromyalgia
    • ANA (anti-nuclear antibody) – to diagnose autoimmune disorders, such as lupus or Sjogren syndrome
    • CK (creatine kinase) – to rule out other conditions that can cause muscle weakness or pain
    • CRP (C-reactive protein) – to detect inflammation
    • Cyclic citrullinated peptide antibody – an antibody present in most people with rheumatoid arthritis
    • Rheumatoid factor – high levels often associated with rheumatoid arthritis

    Meanwhile, researchers continue to look for new testing that may be more specific for fibromyalgia, including identifying biomarkers unique to people with fibromyalgia.

    Non-Laboratory Tests
    Electromyography (EMG) may be performed to assess the health of muscles and the nerves that control them. For more on this procedure, read the Electromyography article on the Mayo Clinic website.

    Occasionally, an imaging scan such as an MRI (magnetic resonance imaging) may be ordered to help rule out the possibility of multiple sclerosis or other diseases that may cause symptoms similar to fibromyalgia.

  • Treatment

    Currently, there is no cure for fibromyalgia. Few people achieve complete remission of their symptoms, but you can learn to manage your condition. Fibromyalgia is not inherently crippling, and it does not decrease your lifespan. You may need to be treated by a team of professionals that includes a general practitioner and a physical therapist.

    Treatment will likely include a combination of lifestyle changes and medications for symptom relief.

    • If you can tolerate it, a gentle exercise program is strongly recommended. Regular aerobic exercise and stretching can help maintain muscle conditioning, improve sleep, and decrease pain and stiffness. Caution should be used, especially when starting to exercise, as overexertion can cause painful flare-ups.
    • Stress reduction, such as meditation, yoga and massage, as well as limiting caffeine and alcohol also may help to reduce symptoms.
    • Getting enough sleep, a healthy diet, and managing stress may also improve your condition.
    • The U.S. Food and Drug Administration (FDA) has approved a few drugs for the treatment of fibromyalgia. Medications may be able to relieve some symptoms, decreasing pain and increasing quality of sleep.

    Support groups and counseling may help you deal with the physical, psychological, financial, and social frustrations that your condition can cause.

    For more information on treatment, see the links in the Related Content section.

View Sources

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