Fibromyalgia – The Facts As We Know Them

Although fibromyalgia has long been known to exist, it has only recently begun to be fully accepted and recognised as the chronic debilitating condition that it can be. The NHS and the Department of Work and Pensions both now list fibromyalgia as ‘real’ (as though it ever wasn’t!), and although there may still be the odd GP who is not fully on board with this, a gentle nudge towards the NHS Direct website should correct this.

So what is fibromyalgia?
The exact cause of fibromyalgia is still unknown, but it’s thought to be related to abnormal levels of certain chemicals in the brain and changes in the way the central nervous system (brain, spinal cord and nerves) processes pain messages carried around the body. It may be connected to other conditions, including various arthritis’s and may be genetic, but even this is unsure.

What is known is that it is often triggered after a traumatic or stressful event, anything from a virus to a divorce. Anyone can develop fibromyalgia at any age, but it predominantly affects women between the ages of 30 and 50. Some studies believe up to 1 in 20 people may be affected to some degree.

What are the symptoms?
Unfortunately there is no specific test for fibromyalgia so diagnosis is made purely on presentation and history.  This makes life difficult, as the symptoms of fibromyalgia can be caused by many things. Symptoms vary hugely from person to person both in specifics and intensity. Symptoms may be aggravated by many things, from stress to the weather.

These symptoms include:

Widespread pain
If you have fibromyalgia, one of the main symptoms is likely to be widespread pain. This may be felt throughout your body, but could be worse in particular areas, such as your back or neck. The pain is likely to be continuous, although it may be better or more severe at different times.
The pain could feel like:
•   an ache
•   a burning sensation
•   a sharp, stabbing pain
Extreme sensitivity
Fibromyalgia can make you extremely sensitive to pain all over your body, and you may find that even the slightest touch is painful. If you hurt yourself – such as stubbing your toe – the pain may continue for much longer than it normally would.
You may hear the condition described in the following medical terms:
•   hyperalgesia – when you’re extremely sensitive to pain
•   allodynia – when you feel pain from something that shouldn’t be painful at all, such as a very light touch
You may also be sensitive to things such as smoke, certain foods and bright lights. Being exposed to something you’re sensitive to can cause your other fibromyalgia symptoms to flare up.

Fibromyalgia can make you feel stiff. The stiffness may be most severe when you’ve been in the same position for a long period of time – for example, when you first wake up in the morning.
It can also cause your muscles to spasm, which is when they contract (squeeze) tightly and painfully.

Fibromyalgia – The Facts As We Know Them Fibromyalgia can cause fatigue (extreme tiredness). This can range from a mild, tired feeling to the exhaustion often experienced during a flu-like illness.
Severe fatigue may come on suddenly and can drain you of all your energy. If this happens, you may feel too tired to do anything at all.

Poor sleep quality
Fibromyalgia can affect your sleep. You may often wake up tired, even when you’ve had plenty of sleep. This is because the condition can sometimes prevent you from sleeping deeply enough to refresh you properly. You may hear this described as “non-restorative sleep”.

Fibromyalgia – The Facts As We Know ThemCognitive problems (‘fibro-fog’)
Cognitive problems are issues related to mental processes, such as thinking and learning. If you have fibromyalgia, you may have:
•   trouble remembering and learning new things
•   problems with attention and concentration
•   slowed or confused speech


If fibromyalgia has caused you to experience pain and stiffness in your neck and shoulders, you may also have frequent headaches.
These can vary from being mild headaches to severe migraines, and could also involve other symptoms, such as nausea (feeling sick).

Irritable bowel syndrome (IBS)
Some people with fibromyalgia also develop IBS. This is a common digestive condition that causes pain and bloating in your stomach. It can also lead to constipation or diahorrhea.

Other symptoms
Other symptoms that people with fibromyalgia sometimes experience include:

•   Dizziness and clumsiness
•   Feeling too hot or too cold – this is because you’re not able to regulate your body temperature properly
•   Restless leg syndrome (an overwhelming urge to move your legs)
•   Tingling, numbness, prickling or burning sensations in your hands and feet.
•   In women, unusually painful periods.
•   Anxiety
•   Depression

In some cases, having the condition can lead to depression. This is because fibromyalgia can be difficult to deal with, and low levels of certain hormones associated with the condition can make you prone to developing depression.

Fibromyalgia – The Facts As We Know ThemDepression can cause many symptoms, including:
•   Constantly feeling low
•   Feeling hopeless and helpless
•   Losing interest in the things you usually enjoy
If you think you may be depressed, it’s important to get help from your GP or your fibromyalgia healthcare professional, if you’ve been seeing one.

So what can be done to help?

First and foremost you need a good diagnosis from your healthcare practitioner to make sure they think you have fibromyalgia and not other conditions that may need treating differently, or more importantly investigating differently to be safe. Once this is done and other conditions have been ruled out, and fibromyalgia has been diagnosed, you may need to try a variety of treatments to find a combination that suits you.

Fibromyalgia has numerous symptoms, meaning that no single treatment will work for all of them. Treatments that work for some people won’t necessarily work for others. These treatments include medication, lifestyle changes (from diet to identifying and avoiding trigger factors), exercises, physical treatment, relaxation techniques, counseling and CBT.

Some of the specific areas of fibromyalgia may need their own tailored treatment, for instance IBS or depression.
The musculo-skeletal side of the condition can respond well to hands on treatment by an osteopath or physiotherapist. Other treatments that can be of huge benefit are Massage and Myofascial Release.
There are many helpful bodies out there who can help and support if you are concerned you may suffer from fibromyalgia including UK Fibromyalgia, Fibromyalgia Action UK and the National Fibromyalgia Association.

Andrew Doody