Fibromyalgia: How you can cope with a painful disease

August 3, 2016 Gordon A. Irving, MD

If fibromyalgia could be summed up in one word, it would be “pain.” But people who suffer from this chronic disease also face a range of other debilitating symptoms. Together they can limit daily life and the ability to work.
Five million Americans are thought to have fibromyalgia. Here’s a guide to help explain how this condition could affect you or a loved one. There’s no cure, but there are ways to ease the symptoms of this complicated disease.

What causes fibromyalgia?

The causes of fibromyalgia are unknown, but there likely are several factors at work. 

  • Fibromyalgia often is associated with a traumatic physical or emotional event. It’s also been linked to prolonged stress, anxiety and illness.
  • Some researchers believe that people with fibromyalgia have hypersensitive central nervous systems that process any form of touch as pain.
  • Fibromyalgia also can be thought of as one of the mind-body syndromes. Watch this video to learn more. 

What are the symptoms? 

People who suffer from fibromyalgia commonly describe it as constant “all over body pain.” Another significant symptom is “fibro fog,” a mental haze that makes it difficult to think clearly.

People with fibromyalgia also suffer from: 

  • Fatigue
  • Morning stiffness
  • Sleep problems
  • Depression
  • Mood and anxiety disorders

How is fibromyalgia diagnosed? 

Since fibromyalgia’s symptoms are common to many conditions, diagnosing it is usually a process of eliminating other health problems through various tests. Key blood tests look at thyroid function, inflammatory markers, and liver and kidney functions. Low levels of vitamin D have been linked to fibromyalgia so patients also are tested for this vitamin.

For the physical examination, a health care provider presses on certain areas of the body to check for pain.

Fibromyalgia is diagnosed if a patient experiences pain in response to pressure on more than 11 of 18 “tender points.” This pain must last more than three months and be felt on both sides of the body, above and below the waist.

Because it’s hard to standardize how much pressure to use when checking pain points, some care givers use these slightly different criteria for a diagnosis: 

  • Widespread pain lasting more than three months
  • Additional symptoms, including trouble thinking, fatigue and waking unrefreshed
  • Elimination of other possible conditions

How is fibromyalgia treated? 

Unfortunately, most medications often provide only moderate relief. Here’s a rundown of what works for some patients, and which drugs to avoid.

  • The federal Food and Drug Administration has approved pregabalin, milnacaprin and duloxetine for treating fibromyalgia. These drugs are thought to ease pain by lowering the sensitivity of the central nervous system.
  • Naltrexone is an “anti-opioid” that in very low doses is thought to improve the immune system of the central nervous system. This can decrease pain and fibro fog, and improve sleep. 
  • Fibromyalgia patients often use anti-inflammatory drugs such as Aleve and Advil, and opioids such as hydrocodone and oxycodone. But these drugs can do more harm than good. Anti-inflammatories come with side effects that can worsen over time. Opioids are addictive and may increase the sensitivity of the central nervous system, keeping pain levels high. 
  • Sleeping pills, especially benzodiazepines such as clonazepam or temazepam, are better avoided for long-term use. 

What can patients do?

These steps have helped some people with fibromyalgia ease their pain:

  • Ease emotional stress with relaxation methods such as mindfulness meditation. Swedish’s STOMP program can help you with these and other pain management techniques.
  • Use cognitive behavioral therapy to ease insomnia. Reset poor sleep patterns and improve sleep biorhythms by taking melatonin in the evening and waking up to bright light. This previous blog post on sleeping with chronic pain has more information.
  • Stopping smoking is crucial because it interferes with oxygen flow to tight muscles.
  • If a patient is obese, losing weight is important to reduce pain and sleep problems.
  • Exercise regularly. Studies are divided on what’s best. Some recommend intermittent high velocity exercise while others say regular aerobic exercise is best.

To learn more, visit the websites of the National Fibromyalgia & Chronic Pain Association and the American Fibromyalgia Syndrome Association.

Swedish specialists also can help. We work with the latest research and techniques to create a personalized care plan for each patient. 

We offer: 

Pain Services, at 206-386-2013

Sleep Medicine, at 206-386-4744

Mindfulness-based Stress Reduction, at 206-320-2404

Talk with your primary care provider about which service is best for you and schedule a consultation.

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