“It’s all in your head.” Sadly, this is what so many patients have heard in the past when they have tried to explain their symptoms of pain to family, friends, or even doctors. It is challenging to describe a hard-to-pinpoint pain that seems to be everywhere and nowhere. It can be endlessly frustrating and demoralizing to know something is wrong in your body and yet not be able to figure out what is happening.
While more research has been done over the years, there is still much that isn’t understood about this chronic condition. Additionally, it doesn’t have the same kind of widespread public understanding that many other diseases and conditions do, so it isn’t often considered as a possibility. Indeed, many people even dismiss their own symptoms for years before even thinking of talking to a doctor about them.
What is Fibromyalgia?
Part of the reason fibromyalgia isn’t popularly known is that it is a relatively new concept. The name fibromyalgia wasn’t even used until a 1976 article by Dr. P.K. Hench about nonarticular rheumatism, a group of similar conditions that involves musculoskeletal pain deriving from a source other than joints. The idea slowly took root amongst researchers and eventually started to gain traction as a definable condition that explained a certain type of aches and pains.
Fibromyalgia—also known as fibromyalgia syndrome (FMS)—is a condition that is primarily defined as causing general aches and widespread pain all around the body. The term ‘syndrome’ is used because fibromyalgia at its core is a set of symptoms that are concurrent but not necessarily interrelated; doctors and researchers are still unsure about many aspects of the disease.
Over several decades, since it was first identified and began to be researched, fibromyalgia has been the subject of scientific controversy. Doctors and researchers have debated everything from whether or not it’s even a real condition to its potential causes. In the most recent studies, though, fibromyalgia syndrome has become widely accepted.
What are the Symptoms of Fibromyalgia?
One of the most challenging aspects of fibromyalgia is the difficulty in its diagnosis. Unlike many other conditions, where particular tests can be run to show specific biochemical or physical markers, there is no simple test that can lead doctors to a diagnosis of fibromyalgia. On the contrary, the doctor has to rely on the symptoms as the patient describes them in order to arrive at fibromyalgia as the possible cause.
The most obvious symptom experienced by most people with this condition is widespread chronic pain that is hard to localize; it most often presents generally in the muscles, bones, or joints. This pain can’t be seen on an X-ray or MRI, and it doesn’t produce swelling or inflammation as in something like arthritis. On the surface, it appears as pain without a cause.
It is this hard-to-define quality that has made fibromyalgia controversial for doctors and patients alike. Because doctors can’t “see” the physical or cellular effects of this condition, it is very hard to spot. Indeed, many people’s complaints of this kind of general pain or achiness is often dismissed as psychological and therefore something that can be “gotten over.” Doctors have sometimes looked to the 18 so-called “tender points” to determine whether or not somebody has the condition; these points are allegedly typical spots where sufferers have reported pain, but in recent years they have become relied upon less as a diagnostic tool.
In addition to widespread aches and muscle pain, fibromyalgia patients will likely also experience extreme tiredness/fatigue and cognitive problems (sometimes described as the ‘fibro fog’), like a tendency to forget things or a lack of concentration. The whole effect of these symptoms taken together can very much disrupt daily life on a regular basis and make it difficult to engage with the world around you.
Some additional common symptoms may include:
- Dry eyes or dry mouth
- Pain in the abdomen or chest wall
- Heart palpitations
- Sleep problems or sleep disturbances
- Bladder problems
- A feeling of numbness or tenderness in the limbs or around the body
- Pelvic pain
- Weight gain
- Sensitivity to certain chemicals
What Causes Fibromyalgia?
The unfortunate truth is that doctors and scientists still don’t know for sure the cause of fibromyalgia. The fact that it is hard to diagnose—and the fact that individual symptoms could be related to completely different illnesses—makes it additionally hard to do research. Moreover, the lack of a specific test for the syndrome makes it difficult to say for sure if a patient actually has the affliction.
The most recent research does point to possible genetic differences in the way the brain processes electrical pain signals. The brains and spinal cords of those who have fibromyalgia may contain pain-sensitive neurotransmitters that are more reactive than in other people. So when some signals are sent, even weak ones are felt as pain. This theory is bolstered by the fact that many patients also have other conditions related to pain processing in the central nervous system; some examples of this are rheumatoid arthritis or irritable bowel syndrome.
There is also evidence that various physical or emotional stress factors may “trigger” fibromyalgia. Studies have shown an apparent correlation between the development of fibromyalgia and traumatic or stressful events (like a car accident, for example). The thinking goes that a sufficiently traumatic event can cause the pain pathways in the central nervous system to begin functioning abnormally. The likelihood of this happening may also be genetic/hereditary.
For now, the research is ongoing and there isn’t much that can be said definitively about the causes of fibromyalgia. But it doesn’t appear that there are necessarily any lifestyle choices that can help you avoid it. Women are, however, twice as likely to develop fibromyalgia syndrome as men.
What is the Treatment of Fibromyalgia?
Like many other medical conditions that are currently unexplained or still a matter of debate, there is no known cure for fibromyalgia. Similarly, there is also no default treatment that is universally accepted by doctors. At this point in the understanding of the syndrome, the typical treatment employed by doctors involves a strategy of symptom or pain management.
Fibromyalgia treatment tends to involve a mixture of medication, physical therapy/exercise, and psychological therapy. This kind of integrated plan has been shown to yield results for patients in providing improved quality of life as well as relief for pain, fatigue, and other associated symptoms.
Medication: doctors tend to prescribe medication that is both nerve pain relievers and antidepressants; some examples are pregabalin, duloxetine, and milnacipran. Additionally, over-the-counter pain medications can be useful in lessening the pain.
Physical activity: though it often runs counter to the feelings and motivations of those with fibromyalgia, an aerobic exercise program is important for treating the symptoms. Studies continue to show short term physical benefits as well as long term health and wellbeing from a program that includes exercises like biking, walking, and swimming.
Talk therapy: as it continues to be demonstrated in studies, stress seems to play a role in the initial development of and periodic “flare-ups” of fibromyalgia. Therefore talk therapy or cognitive behavioral therapy with a counselor or psychologist has become an important part of treatment; being able to talk through stressful or traumatic events can help with syndrome-related depression as well as the emotional impact of the pain.
Chronic pain can be a terrible burden, especially when it’s unclear precisely the source. For those with fibromyalgia, it often takes a long time to even recognize the symptoms as a pattern and to begin to seek medical help. Fortunately, ongoing research continues to shed new light on the understanding of this condition. For outstanding healthcare and help finding the source of your chronic pain, contact The Woman’s Clinic to make an appointment today.