What is Fibromyalgia?

Fibromyalgia (FM) is a chronic pain syndrome that amplifies pain sensations. People with fibromyalgia experience symptoms of widespread body pain, fatigue and stiffness.

Most people with fibromyalgia find their symptoms are worse in the morning. Symptoms can be aggravated by stress, physical activity and lack of sleep.

While the exact causes of fibromyalgia aren’t fully understood by health experts, they believe that it is a neurologic problem related to how the body transmits and interprets pain signals to the brain.

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Dr. Pamela Squire, MD, CCFP, DCAPM, ISAM, CPE, discusses What is Fibromyalgia.

Quiz: Do You Understand Fibromyalgia?

Test your knowledge by answering the following questions:

Questions
True
False
1

The cause of fibromyalgia is thought to be the nerves and brain amplifying pain signals.

Explanation:
The cause of fibromyalgia is thought to be the nerves and brain amplifying pain signals. The brain loses the ability to send signals to stop pain, and over time classifies everything as a pain signal.
2

If you have fibromyalgia, stiffness and pain can be worse in the morning.

Explanation:
Symptoms of fibromyalgia include stiffness and pain - which can be worse in the morning or after activity, severe fatigue, difficulty sleeping or concentrating and emotional changes.
3

Fibromyalgia is not associated with any other conditions.

Explanation:
Fibromyalgia is associated with other conditions including depression, irritable bowel or bladder, migraine headaches and restless leg syndrome.
4

There is a specific test for fibromyalgia.

Explanation:
There is no test that shows fibromyalgia, so other conditions that cause widespread pain have to be ruled out. A healthcare professional can diagnose fibromyalgia with a thorough assessment and examination. While fibromyalgia can’t be diagnosed with an x-ray or blood test, your provider may perform those to rule out other conditions.
5

Antidepressants are one of the treatments for fibromyalgia.

Explanation:
Fibromyalgia treatments include pain medication, antidepressants, exercise, physiotherapy, stress reduction techniques and cognitive behavioural therapy.
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Dr. André Bélanger MD, CFCP, discute Fibromyalgie.

Symptoms of Fibromyalgia

Stiffness and Pain

While no patients experience the same fibromyalgia symptoms, there are some common ones, including:

Pain and stiffness throughout the entire body. While pain can be severe, there is no tissue damage as there is nothing actually wrong with the muscles or joints.

Fatigue

Most people who have fibromyalgia have episodes of fatigue, often severe.

Mental Symptoms

People who have fibromyalgia may have depression, anxiety, difficulty concentrating, remembering and sleeping and other emotional changes.

Other Symptoms

Some patients experience migraines, headaches, restless legs syndrome, irritable bowel and irritable bladder.

Diagnosis of Fibromyalgia

To diagnose fibromyalgia, a physician will use the process of elimination to rule out other diseases. Because fibromyalgia doesn’t damage tissues, it can be challenging to diagnose.

Your physician will take a complete medical history, perform a physical exam and order blood tests to confirm the diagnosis.

Causes of Fibromyalgia

While the exact cause isn’t known, fibromyalgia is thought to happen because the brain and nerves amplify pain signals in the joints and muscles a local physiotherapist might help..

Experts believe that fibromyalgia is problem caused by the body sending painful signals, with the nerves and brain not able to turn off these signals as they normally would. This abnormal processing of pain signals may be triggered by a prior injury or an autoimmune/viral illness.

Descending Inhibitors 

If your brain receives pain signals over a long period of time, the nerves called descending inhibitors die off. These nerves normally shut off pain signals, but now they can reach the brain in a limitless way.

As a result, the brain becomes so sensitized to pain that even light touches can feel incredibly painful.

Who Gets Fibromyalgia?

Women are more often affected by fibromyalgia than men, and it’s most common in middle-aged people. For most patients, fibromyalgia occurs following an emotional or physical injury.

Treatments for Fibromyalgia

Most fibromyalgia treatments work to relieve specific symptoms. Fibromyalgia treatments include:

Pacing

Some days, you may feel better, while other days you feel extremely fatigued and run down. People tend to overdo it on their good days, which can lead to a fibromyalgia flare.

By moderating activity, people may feel consistently better, rather than experiencing such drastic physical ups and downs.

Cognitive Behavioural Therapy

Cognitive Behavioural Therapy (CBT) has been shown to be helpful for people with fibromyalgia. Sometimes called talk therapy, it involves teaching patients how to cope with the pain and fatigue of fibromyalgia.

Exercise

A healthy fitness routine is important if you have fibromyalgia. It’s essential to start slowly and work with your doctor or physiotherapist to ensure you don’t strain yourself. Some examples of exercises that are good for fibromyalgia include walking, swimming and cycling.

Improved Sleep Hygience

By getting enough sleep and practicing healthy sleep hygiene, you may find your pain and fatigue is reduced.

Lifestyle Changes

Like with many conditions, having a healthy lifestyle makes a huge difference. For patients with fibromyalgia, reducing stress, getting proper nutrition and maintaining a healthy weight can help reduce pain and improve quality of life.

Medications

It’s important for patients with fibromyalgia to understand that no medication can cure the disease. However, the right medications can help to decrease pain and stiffness. Here are some common medications for fibromyalgia:

Amitriptyline

One of the most commonly used medications for fibromyalgia is amitriptyline. It belongs to a family of medications called tricyclic antidepressants. Your rheumatologist will prescribe you the lowest dose possible in order to reduce grogginess.

Analgesics (Pain Relievers)

These include over-the-counter medications such as acetaminophen or other anti-inflammatory drugs. If a patient requires a stronger medication, they may benefit from short acting opiates such as codeine or Tylenol 3. You must be careful when taking these narcotics as it’s easy to become dependent on them.

Serotonin-Norepinephrine Reuptake Inhibitors

These drugs may reduce fibromyalgia pain, and include Cymbalta (duloxetine) and the selective serotonin reuptake inhibitor known as Prozac (fluoxetine).

Muscle Relaxants

Some patients find relief from stifness and pain with over-the-counter muscle relaxants.

Lyrica and Gabapentin

These medications work by blunting pain signals in the spinal cord.

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