The main symptom of fibromyalgia is widespread pain in your body. How this feels to you will vary. It may feel like a deep ache in your muscles or you may feel a burning, throbbing, intense and persistent pain all over your body. The pain may come and go and move about to different areas of your body. Fibromyalgia can also make you more sensitive to pain – you might find that even the slightest touch is painful.
Fibromyalgia can cause other symptoms too, which include:
- feeling stiff, especially when you wake up
- constant tiredness
- sleeping badly
- problems with your memory or thinking clearly
If you have had these symptoms for at least three months, your GP may diagnose you with fibromyalgia.
Other symptoms and conditions can be associated with fibromyalgia. These include:
If you think you have fibromyalgia, see your GP. He or she will ask about your symptoms and examine you. Your GP may also ask about both your, and your family's, medical history.
Your GP will examine you to see how widespread the tenderness is in your muscles and joints. In particular, if you have lots of 'trigger points' without symptoms of any other joint or muscle disease, you're likely to have fibromyalgia.
There are no blood tests, X-rays or scans that can diagnose or rule out fibromyalgia. However, you may be offered blood tests to check you don’t have another condition with symptoms similar to those of fibromyalgia.
Your GP may refer you to a number of specialists for diagnosis and treatment, such as a pain specialist or a rheumatologist. A rheumatologist is a doctor who specialises in identifying and treating conditions that affect the musculoskeletal system, particularly the joints and surrounding tissues.
There are a variety of treatments to help you to manage the symptoms of fibromyalgia. A key part of treating fibromyalgia is trying to carry on working and do some regular exercise. Both these activities can be challenging if you have fibromyalgia but there are benefits in the long term if you can keep going.
Part of the treatment for fibromyalgia involves looking at how you do things and finding ways to make tasks more manageable. One way to do this is by ‘pacing’. This means working within your limits to do what you can without aggravating the pain or making yourself even more tired. On a good day you may feel you can catch up on many things you didn’t feel able to do on a bad day.
But be careful that this doesn’t lead to a cycle of doing too much in one go, followed by being able to do very little. The pacing approach helps to prevent this.
Heat may help to ease your pain. It may help to have a hot bath or shower, or to soak your hands or feet in warm water. Using heat pads on painful areas may help to reduce pain and stiffness too.
You may find it helps to learn a relaxation technique and do this before you go to bed to help you sleep. Ask your GP for information on how to learn these techniques. It's important to take steps to improve your sleep as this will help to manage symptoms such as pain and depression. For information on how to get a good night's sleep, see Related information.
Doing some exercise every day has been shown to help relieve pain and stiffness and improve balance and how easily you can move around. This can give an increased sense of wellbeing. Starting to exercise when you’re in pain and feeling exhausted may, at times, seem like an impossible task. However, you can get advice from your doctor or see a physiotherapist to find ways that you can exercise safely and effectively. A physiotherapist is a health professional who specialises in maintaining and improving movement and mobility.
This may mean starting with a few minutes of gentle stretching and gradually building up the time you spend doing this each day. Walking or water-based exercises are both good forms of exercise to start with. Another type of exercise that can have positive effects for some people with fibromyalgia is t’ai chi. This is a low-impact, meditative form of exercise.
Whatever you choose to do, aim to do at least 30 minutes of moderate intensity exercise, five days a week.
A talking therapy called cognitive behavioural therapy (CBT) may help if you have fibromyalgia. It helps to challenge negative thoughts, feelings and behaviours and how you manage pain.
You may find over-the-counter painkillers, such as paracetamol and ibuprofen, helpful for relieving pain caused by fibromyalgia. However, these aren’t effective for everyone and your GP may refer you to a pain clinic for stronger pain medicine, such as tramadol. This is a type of medicine called an opioid.
Other types of medicine, such as pregabalin and gabapentin, may help with both pain and tiredness. These medicines work by blocking the overactivity of nerve cells involved in transmitting pain. You will need a prescription from your GP for these.
You may be prescribed a low dose of an antidepressant, for example amitriptyline or fluoxetine. The nerve cells involved in transmitting pain are the same as those involved in depression. Antidepressants block the action of these and will therefore help to control pain from fibromyalgia. Some antidepressants can also improve your sleep.
Always ask your GP for advice and read the patient information leaflet that comes with your medicine.
The exact reasons why you may develop fibromyalgia aren't fully understood at present. A number of theories are currently being investigated to try to pinpoint the cause so that effective treatments can be developed.
Researchers have found that people with fibromyalgia have high levels of certain pain chemicals in their nervous system. They also have low levels of chemicals that can damp down a pain response. For these reasons it seems possible that, if you have fibromyalgia, you have a heightened sense of pain that lasts longer than usual.
Fibromyalgia may run in families. You’re more likely to get fibromyalgia at some time in your life if one of your relatives has it.
Some people with fibromyalgia have been through a traumatic event before the condition began, such as a car accident or serious illness. It’s possible that events such as these may trigger the start of fibromyalgia.
Your family, friends and work colleagues may be able to help you live more easily with fibromyalgia in various ways. Encourage them to learn more about fibromyalgia with you so that they have a greater understanding of what you’re dealing with. As well as helping with tasks that you find too painful or tiring sometimes, they may be able to support you with your exercise goals. Symptoms of fibromyalgia can make you feel isolated, depressed or anxious so it’s important to maintain your social circle.
If your symptoms are very severe, you may feel that you have to stop working. However, this can increase your awareness of the pain and tiredness because you have fewer things to focus on. You may be able to take a short period of sick leave so that you can adjust to having fibromyalgia. An occupational health adviser may be a useful person to talk to about any changes that will help you in your workplace.
Many people with fibromyalgia who get treatment are able to manage their symptoms and live a full life. The condition doesn't damage your joints or have any effect on your lifespan.
Can children get fibromyalgia?
Yes, you can get fibromyalgia at any age. However, in younger people the condition is more likely to get better with time.
Your GP will ask about your child's symptoms. They may do some tests to rule out other conditions that can cause similar symptoms to those of fibromyalgia. Your child may need to be referred to a paediatrician (a doctor who specialises in children’s health) to reach a diagnosis. Once fibromyalgia has been diagnosed and other conditions ruled out, you and your child can start to manage the symptoms. This may involve pacing your child’s activities so that he or she doesn’t do too much of one thing on any one day. This will help to prevent muscle strain and tiredness.
It’s important to talk to your child’s school so they understand he or she has a condition that causes symptoms of pain and tiredness. Your child may need to have alternative arrangements for attending school if their symptoms are severe. For example this might mean a shortened day or planned rest breaks.
If I have severe fibromyalgia, can I work? If I can’t work, can I apply for any welfare benefits?
It can be challenging to continue working if you’re often in pain and tired from having fibromyalgia. But work can be a good thing for many reasons – keeping up your physical abilities, self-esteem, confidence and social relationships. If you feel your only option is to stop working, you may be able to apply for welfare benefits. These will be based on how much fibromyalgia affects your ability to work and take care of yourself.
Before you decide to stop working, it’s important to consider all your options and weigh up the pros and cons of not going to work. A lack of routine, social interaction, physical and mental stimulation may develop if you’re at home more. This can lead to other stresses that could make your symptoms worse.
You may be able to keep working if you make some adaptations to your workplace. Have a talk with your employer to discuss what your options are. An occupational health adviser can give you advice about making any changes that will help you in your workplace.
If fibromyalgia is severely affecting your daily life and you can’t work, talk to your GP. He or she may be able to offer you alternative treatments that might help. You might be able to claim welfare benefits if you can't work but you will need to meet certain criteria to be eligible. There are a number of different types of benefits, such as:
At present, there are a number of different types of benefits. These all have different criteria that you will need to meet. Current benefits you can apply for are:
- Personal Independence Payment
- Employment and Support Allowance
- Attendance Allowance (if you're 65 or over)
For more information about welfare benefits, see the GOV.UK website, your local job centre or Citizen’s Advice Bureau.
Won't exercise just make my pain from fibromyalgia worse?
Not usually. It has been shown that certain types of exercise can help to relieve pain from fibromyalgia. Ask your GP or a physiotherapist (a health professional who specialises in maintaining and improving movement and mobility) for advice about exercise.
Exercise is recommended if you have fibromyalgia. It may take a little while to find the type of exercise that brings you the most benefit. Start with some gentle stretching and build up to some short distance walking or water-based exercises. These are things you can do without aggravating your pain or making yourself more tired.
One exercise regime that has been studied in people with fibromyalgia is t’ai chi. This low-impact, meditative form of exercise has been shown to improve symptoms in small groups of people who have fibromyalgia. You may need to pace your activities so that your pain and tiredness don’t become overwhelming. If you pace your exercise by doing a little every day, even on the bad days, you’re likely to feel fitter and more mobile. You’ll also have more energy.
Is it possible to have both depression and fibromyalgia?
Yes, you may find you feel depressed alongside your other symptoms of fibromyalgia because these two conditions may be linked.
Fibromyalgia has a range of symptoms, which can affect different aspects of your health and wellbeing. If you find it difficult to manage your symptoms and are in pain or don't get much sleep, you may feel depressed. It’s also possible that whatever is causing your fibromyalgia also causes depression, such as low levels of certain brain chemicals. Visit your GP for advice on ways to manage fibromyalgia, or get in touch with a support group to find better ways of coping.
It can be difficult to stay positive when you’re in pain and feeling tired. You may find a short course of antidepressants helps to bring back some balance. However, it's important to make some changes so that you can manage your fibromyalgia better in the long term. Exercise is one important factor that will help improve your symptoms.
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Reviewed by Rachael Mayfield-Blake, Bupa Health Content Team, September 2014.
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