This month’s topic is fibromyalgia.
Fibromyalgia is a chronic condition that causes widespread pain, tenderness, fatigue, and other symptoms such as sleep disturbances and cognitive difficulties. It is not an autoimmune disease, but it can co-exist with conditions like rheumatoid arthritis and lupus. Anyone can develop fibromyalgia, although it is more common in women and people over the age of 40.
People with fibromyalgia often experience symptoms that come and go in periods called flare-ups. These fluctuations—feeling well one day and overwhelmed by symptoms the next—can make everyday life exhausting and challenging.
Experts do not yet know what causes fibromyalgia, but studies suggest that certain health conditions, stress, and life changes may trigger it. You may be more likely to develop fibromyalgia if a biological parent has had it. Often, new pain in the body—especially in the muscles—is the first sign. It is important to trust your instincts and listen to your body. If you are experiencing new pain, fatigue, or other symptoms—even if they come and go—visit a healthcare provider.
Fibromyalgia is a real medical condition, recognized by the ICD-9 code 729.1. It is not “in your mind”—it is how you feel, and those feelings are valid.
The list of symptoms associated with fibromyalgia is long. These include chronic pain throughout the body or in multiple areas such as the face, jaw, arms, legs, head, chest, abdomen, back, and buttocks. Pain is often described as aching, burning, or throbbing. Fatigue and an overwhelming sense of tiredness are common, along with trouble sleeping.
Other symptoms may include:
Headaches or migraines
Dry eye syndrome
Hearing loss
Digestive problems such as IBS (diarrhea, constipation, or mixed), and reflux/GERD
Dyspnea (shortness of breath)
Dysphagia (difficulty swallowing)
Heart palpitations or altered heart rate variability (HRV)
Raynaud’s phenomenon (fingers or toes becoming numb and cold, especially in response to stress or cold temperatures)
Orthostatic hypotension (a sudden drop in blood pressure when standing)
Bladder control issues, including urgency and frequency consistent with painful bladder syndrome
Cognitive and emotional symptoms such as memory problems (“fibro fog”), anxiety, and depression
Fibromyalgia is often triggered by events that cause physical or emotional stress. Possible triggers include serious injuries, such as those sustained in a car accident, or infections like Epstein-Barr virus or Lyme disease.
Flare-ups can also be triggered by changes in daily life. While triggers vary from person to person, common ones include:
- Changes in routine
- Dietary changes or inadequate nutrition
- Hormonal shifts
- Lack of sleep or changes in sleep patterns
- Weather or temperature changes
- Illness
- Starting new medications or treatments
- Changes in an existing treatment routine
There is no single test to diagnose fibromyalgia. Healthcare providers rely on a physical exam and a discussion of your medical history, including family history. They will ask about your symptoms and when they began. Diagnosis is usually part of a differential diagnosis process—meaning other conditions are ruled out first. Blood tests may also be included as part of this evaluation.
Because the cause of fibromyalgia is unknown, it cannot be prevented. However, maintaining overall health may help reduce the severity of symptoms. There is no one-size-fits-all treatment. Your healthcare provider will work with you to find a combination of treatments that help manage your symptoms.
It is important to communicate openly with your provider. Let them know which symptoms you are experiencing and how they change over time—whether improving or worsening. Keeping a diary can be helpful to track what triggers symptoms and what brings relief.
Treatment approaches may include:
- Medications to manage symptoms
- Exercise such as stretching, strength training, and relaxation techniques
- Developing a healthy sleep program
- Stress management strategies
Even though experts do not fully understand what causes fibromyalgia, it is real—and so are your symptoms. Living with a chronic condition can be difficult. Some days may make you feel like “it’s all in your head” but it is not. If you are struggling, talk to your healthcare provider or a mental health professional for support in managing stress and emotional challenges.
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