Many years ago, people who suffered from chronic, debilitating muscle and joint pain along with constant fatigue were said to ‘have the rheumatism’ or thought simply to be old and achy. But after physicians continued to document patients with characteristic symptoms during the 20th century, the medical community added ‘fibromyalgia’ to the lexicon of medical conditions in 1976. The term literally means ‘fibrous tissue and muscle pain.’
Modern physicians look for a combination of symptoms that are common in patients who have fibromyalgia. “They tend to be long-term, body-wide pain and tenderness in the joints, muscles, tendons and other soft tissues,” explains Dr. Katherine Lichtenberg of Mercy Clinic Family Medicine Eureka. Other symptoms include fatigue, sleeping problems, headaches, anxiety and depression, and memory or concentration difficulties. Women are more likely than men to develop fibromyalgia, and the condition sometimes occurs along with autoimmune disorders or irritable bowel syndrome.
A patient must have widespread pain for at least three months and tenderness in at least 11 of 18 specific points throughout the body to be diagnosed with fibromyalgia. The telltale tender points are found at the elbows, chest, knees, low back, ribcage, shoulders, thighs and buttocks. Other types of conditions, such as thyroid disorders, arthritis and chronic fatigue syndrome, may cause similar symptoms and should be ruled out during the diagnostic process.
Simply recognizing that fibromyalgia is a real condition is noteworthy after decades of doubt and dismissal of the disorder’s sometimes vague symptoms. “Myths about fibromyalgia include that it is not a real diagnosis and that it’s ‘all in the head,’ ” says Dr. Kanwal Khan, an internal medicine specialist on staff at St. Luke’s Hospital. “Fibromyalgia is a real diagnosis, and patients experience pain due to overactive nerves.”
Fibromyalgia’s cause is unknown. The disorder may be genetic, and some people link the onset of symptoms to a traumatic event or injury. Anxiety and depression related to coping with fibromyalgia can exacerbate symptoms, creating a cycle of worsening pain and anxiety.
There is no cure for fibromyalgia. “The goal of treatment is to help relieve pain and to let patients live as normal a life as possible,” Lichtenberg says. “There are medicines that can be used, but there are associated side effects, and they can be expensive. Other, more atypical drugs used to treat fibromyalgia include anti-seizure medicines, muscle relaxers, pain relievers, sleeping aids and anti-depressants.” Smoking cessation also can help reduce pain, she says.
“In addition to medications, other therapies, such as physical therapy, exercise, stress relief with relaxation techniques, cognitive behavioral therapy and good sleep hygiene, help relieve the symptoms,” Khan adds.
There is no one-size-fits-all treatment for fibromyalgia, but it can be managed better if “a patient works closely with a healthcare professional who understands their condition,” Khan says, adding that honest, regular communication between patient and physician is key to managing the disease.