Fibromyalgia

Tired woman feeling neck pain, massaging tense muscles, suffering from chronic shoulder back ache

Fibromyalgia is a common cause of chronic pain that is more commonly seen in women between the ages of 20-55 years old.  Patients with fibromyalgia have chronic, widespread pain that is often accompanied by other symptoms, such as fatigue, sleep disturbances, and brain fog. The sleep disturbances typically involve repeated awakenings and a lack of feeling refreshed after a full night’s sleep. Brain fog is a term that describes a number of different cognitive symptoms, including confusion, an inability to focus, forgetfulness, and a lack of mental clarity. 

Fibromyalgia can present alone or in combination with numerous autoimmune diseases, cancers, trauma or infections. Certain conditions are seen more commonly in patients with fibromyalgia, including depression, migraine headaches, irritable bowel syndrome, temporomandibular joint (TMJ) pain, chronic bladder and pelvic pain, and dizziness when rising from a seated position. 

The exact cause of fibromyalgia is not fully known and our understanding of the condition is continuously evolving. The current belief is that there is a change in how your brain perceives and processes pain signals, leading to amplified and widespread pain. Also, there are potential genetic and environmental factors that increase the likelihood of developing fibromyalgia. Disturbances in sleep, along with brain fog and other cognitive difficulties, result in pain amplification, depression, and fatigue. This, in turn, leads to more stress plus physical and cardiovascular deconditioning.

Diagnosis & Treatment

The results of laboratory tests and imaging studies usually are completely normal. The diagnosis of fibromyalgia is aided by a physical examination that reveals multiple symmetric tender points all over the body. In contrast to normal musculoskeletal tenderness, the tenderness of fibromyalgia is characterized by an exaggerated emotional response, withdrawal of the tender part, and worsening of pain after the examination. 

The treatment of fibromyalgia involves stress reduction and a structured aerobic exercise program, including stretching and flexibility exercises. It is also essential to improve sleep so that patients can wake with less fatigue and less pain. Certain medications may also be used to help with the pain associated with fibromyalgia.