Fibromyalgia

Published by Bupa's Health Information Team, March 2010.

This factsheet is for people who have fibromyalgia, or who would like information about it.

Fibromyalgia is condition that causes pain and stiffness in the muscles, ligaments and tendons of the arms, legs, neck and back. Fibromyalgia also causes a general feeling of tiredness.

About fibromyalgia

Fibromyalgia is a common condition. It affects about one in 50 people at some point in their lives and is common in young and middle-aged women. There are no outward signs of fibromyalgia, and people with the condition may look well but feel awful.

The level of pain varies from person to person and from day to day. The pain can be mild most of the time but at times, it may be so severe that it stops you from doing your daily activities.

The symptoms of fibromyalgia can carry on for a long time, sometimes permanently.

Fibromyalgia doesn't cause permanent damage to your body and isn't life-threatening.

Symptoms of fibromyalgia

The pain associated with fibromyalgia tends to feel like aching or burning. The pain can change location. It often becomes more severe in areas of the body you use most, for example in the hips and hands. Fibromyalgia can also make you feel very tired.

As well as the pain and tiredness, you may experience the following symptoms:

• difficulty sleeping
• headaches
• diarrhoea and pain in the abdomen
• feeling an urgent need to urinate
• difficulty concentrating
• feeling irritable
• poor circulation to your hands and feet
• painful periods
• depression or anxiety
• forgetfulness or confusion

These symptoms may be caused by problems other than fibromyalgia. If you have any of these symptoms, you should visit your GP for advice.

Fibromyalgia symptoms are often very similar to those of chronic fatigue syndrome or ME (myalgic encephalomyelitis) although the pain is usually worse. Doctors don't yet know whether the two conditions are different parts of the same condition.

Causes of fibromyalgia

No-one knows the exact cause of fibromyalgia. The condition doesn't seem to be inherited from parents and it doesn't appear to be caused by a virus.

Sometimes fibromyalgia develops after a traumatic event, for example a car accident, which may act as a trigger. However, often no trigger is involved.

People with fibromyalgia tend to have chemical changes in the nervous system that appear to make them more sensitive to pressure and pain.

Some doctors believe fibromyalgia is caused by a shortage of deep sleep, which is when the muscles usually rejuvenate. However, pain and stiffness can affect sleep and this in turn can worsen symptoms such as tiredness, difficulty in concentrating and anxiety. So doctors aren't sure whether the sleep problems cause fibromyalgia, or the other way round.

Diagnosis of fibromyalgia

Fibromyalgia isn't new but because the symptoms are so vague it can be difficult to diagnose. It doesn't show up on X-rays and many of the symptoms of fibromyalgia are similar to other conditions.

If you think you are suffering from fibromyalgia, you should see your GP.

Your GP will ask about your symptoms and examine you. Your doctor may apply pressure to various 'tender' points throughout your body, such as the back of the neck and the shoulder blades. This pressure should only cause a slight discomfort but someone who has fibromyalgia will find it much more painful.

If you have had widespread pain for at least three months and show enough 'tender' points, your GP may diagnose fibromyalgia.

Your GP may carry out some tests, such as X-rays and blood tests, to rule out other conditions that can cause similar symptoms. These conditions include:

• arthritis
• systemic lupus erythematosus 
• under- or overactive thyroid
• multiple sclerosis
• chronic fatigue syndrome
• irritable bowel syndrome
• depression

Your GP may refer you to a rheumatologist or hospital pain clinic for further tests.

Treatment of fibromyalgia

At the moment, there is no cure for fibromyalgia. However, there are treatments available to help manage its symptoms. And some simple changes to your lifestyle can help reduce how much the condition affects your daily activities.

Self-help treatments

There are a number of practical things you can do yourself to help control your symptoms of fibromyalgia.

• Take time out to relax your mind and muscles, for example have a massage.
• Don't drink alcohol, tea or coffee late at night, as these could make sleeping difficult.
• Sleep in a soft collar if your neck is uncomfortable. This may improve your sleep.
• Eat a healthy balanced diet with plenty of fruit and vegetables.

Physical therapies

Try swimming in a heated pool. Heated pool treatment (balneotherapy) can help reduce the pain of fibromyalgia and improve your day-to-day functioning. The benefits can last more than six months. If exercising in the pool is too painful, try bathing alone to begin with. This may also improve your symptoms.

A gentle programme of exercises that increase your heart rate and make you feel slightly out of breath can help improve your symptoms. Gentle muscle stretching exercises two or three times a day and a gentle walk can be good ways to start.

Ask your GP or physiotherapist to help you plan an exercise programme to suit your needs.

Talking therapies

Cognitive behavioural therapy helps some people with fibromyalgia. This is a talking treatment that can help you understand your thoughts (cognition) and beliefs about your pain and develop new ways of coping with it (behaviours). Talking to other people who have fibromyalgia can reassure you that you are not alone.

Complementary therapies

Some people find that complementary therapies such as acupuncture and massage can help. Ask your GP to refer you to a qualified practitioner.

Medicines

Painkillers you would normally take for a headache can help with the muscle pain associated with fibromyalgia. If these don't help, your GP may prescribe stronger painkillers.

Your GP may also prescribe mild antidepressants to control some of your symptoms such as muscle pain, difficulty in sleeping and anxiety. The starting dose will be lower than that usually used for depression. It's best not to take over-the-counter sleeping tablets because they can cause dependence and eventually lose their effect.

Always ask your doctor or pharmacist for advice before taking any medicines and read the patient information leaflet that comes with your medicine.

Living with fibromyalgia

Being diagnosed with fibromyalgia can be distressing, both for you and your family. However, Charities such as Fibromyalgia Association UK can give advice and support. Your GP may also be able to give you details of a local support group, where you can talk to other people with fibromyalgia.

It's important to make sure your family learns about fibromyalgia, so they will know how and when to help you.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.