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23 November, 2009

Home > Fact sheets by category > Diseases and conditions > Neuromuscular system > Other conditions > Fibromyalgia.

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Fibromyalgia

Fibromyalgia syndrome is a condition where pain occurs in muscles and surrounding structures without any obvious tissue damage. The pain is usually widespread and people often experience fatigue.

Fibromyalgia affects mostly women between the ages of 35 and 60 years, from all nationalities and culture groups. It can also affect children.

The symptoms of fibromyalgia can go up and down. Many people find the symptoms are worst first thing in the morning and last thing at night. The symptoms can be mild, moderate or severe. There may be extended periods of time – perhaps even years – when symptoms disappear. Other people have pain every day or there may be variations between these two extremes.

The cause or causes of fibromyalgia are not known. There is no cure but treatment can help some symptoms.

Common symptoms
The symptoms of fibromyalgia can vary widely from mild to severe. The most common symptoms include any of the following:

Fatigue and exhaustion
Pain – this may present in a variety of ways (such as aching, burning, throbbing or stabbing) and may be generalised or in one area
Sleep disturbance
Headaches
Slowed mental processing
Stiffness, usually worse in the morning.

Other symptoms
Some people with fibromyalgia may also have other symptoms such as irritable bowel syndrome, cystitis, and swelling and numbness or tingling in the arms and legs. These symptoms tend to be worse first thing in the morning and last thing at night. The symptoms may be present every day or may recur in bouts lasting days, weeks or months. Living with ongoing pain and fatigue can also often lead to secondary problems such as anxiety and depression.

The body’s pain system
Fibromyalgia seems to make the body’s pain perception system oversensitive to pain. The body may even interpret pain from things that would not normally cause pain.

In effect, the central nervous system of the body changes its response pattern so that the body interprets even small things as being painful. This is not something that a person has conscious control over. It is the result of internal body mechanisms that are not yet fully understood.

Some of the suggested theories for this altered pain threshold include:

Prior physical trauma
Severe illness
Viral infection (although no associated virus has been identified)
Emotional trauma
Abnormal changes in brain chemistry or in the central nervous system
Hereditary factors
Changes in blood flow in the muscles or parts of the brain.

Aggravating factors
Fibromyalgia may be aggravated by a number of factors, including:

Weather changes
Hard physical labour
Mental stress
Infections
Allergies
Overexertion
Other musculoskeletal disorders, such as rheumatoid arthritis or osteoarthritis.

Diagnosis
The first step in diagnosing fibromyalgia is a full assessment by a doctor. Blood tests, x-rays and other tests may be used to help exclude other conditions.

There are signs that may suggest a diagnosis of fibromyalgia. These are:

A history of widespread pain for three months or longer
Abnormal tenderness at particular points around the neck, shoulder, chest, hip, knee and elbow
Disturbed sleep patterns.

Treatment
There is no cure for fibromyalgia. Effective management of fibromyalgia starts with a correct diagnosis. A management program should then be designed to meet the individual person’s needs.

Generally, management will include a combination of the following:

Education – people with fibromyalgia need to understand the condition in order to decide what management approach will help their individual circumstances. Self-management courses can teach new skills to help people with fibromyalgia manage their condition.
Medication – combined with other strategies, medication may be used to manage pain, reduce stress or promote sleep.
Exercise – a gentle exercise program, such as Tai Chi or water-based exercise, can help to manage symptoms such as pain, fatigue and sleep disturbance.
Stress management and relaxation – stress may aggravate symptoms. Skills that can help manage stress include planning, relaxation, assertiveness and emotional management.
Balancing rest and activity – may be helpful.
Massage – can aid muscle relaxation and stress management.
Nutrition – a balanced diet that includes a variety of foods will support optimal health.
Dietary supplements – magnesium supplements may be helpful. Discuss any supplements with your doctor, particularly if you have any kidney problems.
Support from others – contact Arthritis Victoria for information about support group locations and contact details.

Where to get help

Your doctor
Arthritis Victoria Tel. (03) 8531 8000 or 1800 011 041

Things to remember

Fibromyalgia is a name given to a collection of symptoms that include fatigue and generalised or localised muscular aches and pains.
Fibromyalgia seems to make the body’s pain perception system oversensitive to pain.
There is no cure but symptoms can be managed.

You might also be interested in:
Neuromuscular system.
Pain management.

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