Diseases like cancer, diabetes, and heart disease receive a lot of attention in the media. Conditions like fibromyalgia, however, may seem mysterious because they are not as well understood as some more lethal conditions
Fibromyalgia is a chronic pain disorder characterized primarily by flare-ups of musculoskeletal pain and exhaustion. There are many factors, like gender, family history, and levels of stress, that can compound the risk of developing the condition.
Although fibromyalgia involves changes to the central nervous system, both the brain and spinal cord, the condition is not an inflammatory disease. It is believed to involve changes in how the CNS processes pain signals, which can lead to increased levels of pain. Physical, psychological, and sexual trauma can trigger fibromyalgia. About 2-4 percent of the United States population, or about 6 million people, struggles with fibromyalgia, and more women are diagnosed with this disorder than men.
What Is Fibromyalgia?
There are no specific causes of fibromyalgia. Like many chronic conditions, one’s risk of developing fibromyalgia is based on a combination of genetics, family history, gender, surrounding environment, stress levels, and personal history. The condition may be triggered by life experiences, including:
- Stressful or traumatic events, including car accidents or sexual assault
- Repetitive injuries, like neck strain
- Mental health conditions, like depression
- Physical illnesses, like rheumatoid arthritis or an infection
Although a blood test to detect fibromyalgia is in the works, there are currently no specific tests to determine conclusively if a person has this chronic pain condition. Instead, a physician will use a questionnaire to determine which symptoms may indicate fibromyalgia.
The main symptoms of this condition include:
- Widespread pain: Typically, this is a constant, dull ache across most or all of the body that lasts for three months or more. Widespread is defined as both above and below the waist. People with fibro may also experience flulike aches and pains, tenderness, and soreness, especially at specific points in the body. They are more likely to experience stiffness in joints in the morning.
- Fatigue: With consistent pain, it is hard to rest well; however, fibromyalgia is also characterized by other sleep disorders, including restless leg syndrome and sleep apnea.
- “Fibro fog”: Cognitive difficulty is concurrent with other symptoms and can be exacerbated by pain and sleeplessness. People with fibromyalgia struggle to focus, remember important details, and complete tasks. This can lead to difficulty in daily tasks.
A physician will ask about specific pain points in the body, and if 11 of 19 are painful, this will indicate fibromyalgia. Older tests required physicians to put pressure on these points, but this is no longer standard practice. Additionally, if pain lasts for a week or more at these points, this will indicate fibro. Poor sleep and fibro fog are also parts of the diagnostic questionnaire, and there should be no other underlying problem that would explain symptoms, like withdrawal from opioids, an autoimmune condition, or cancer.
Trigger points, the tender points on the body during a fibromyalgia flare, include:
- Either side of the breast bone
- Back of the head
There are 18 or 19 points, in pairs. Aside from the trigger points, other diagnostic criteria will include blood tests to rule out other conditions. These blood tests include:
- Complete blood count
- Sedimentation rate
- Vitamin D levels
- Thyroid function levels
Why Does Fibromyalgia Affect More Women?
According to the National Institutes of Health (NIH), 80-90 percent of fibromyalgia diagnoses are female. Women, often in middle age, are the most likely to develop fibromyalgia. This may be associated with increased trauma or other pain conditions throughout life. People who struggle with fibromyalgia are at risk of suffering from co-occurring disorders, many of which are more common in women due to biology:
- Chronic fatigue syndrome
- Inflammatory bowel syndrome (IBS)
- Temporomandibular joint dysfunction (TMJ)
- Interstitial cystitis, or painful bladder syndrome
- Vulvodynia, or pain in the vulva
Additionally, hormonal fluctuations in women because of menstruation may affect levels of serotonin, which changes mood and response to pain. Some fibro symptoms have occurred around menopause or perimenopause, as estrogen levels change.
Cultural issues may also increase a woman’s risk of developing fibro. Not only are women more likely to deal with sexual assault and harassment, but they are more likely to carry more stress, especially in the home, and struggle with mood disorders like depression and anxiety compared to men. The increased stress, risk of mental illness, and hormonal changes may all collide to trigger fibromyalgia.
Treating Fibromyalgia without Addictive Drugs
There are many approaches to treatment. Care may include medication as well as lifestyle changes, such as:
- Exercise, especially low-impact exercise like yoga or tai chi
- Consistent sleep
- Healthy eating, with a focus on fruits and vegetables and moving away from refined sugar, meat, and dairy
- Stress-relief techniques like meditation or mindfulness
- Weight loss, as being overweight exacerbates pain and the number of flare-ups
Painkillers may be prescribed, although opioid drugs are less likely to be used to treat the underlying nerve pain. Instead, nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants, or anti-seizure medications may be prescribed, depending on the severity and duration of pain episodes.
Therapy is also an important part of treating fibromyalgia. Approaches may include:
- Occupational therapy to adjust work area to reduce stress
- Physical therapy to learn exercises to improve strength, flexibility, and stamina
- Counseling to improve stress management techniques and boost self-esteem
Although opioids were once a frontline treatment for chronic pain issues like fibromyalgia, these drugs are very addictive, and they are not the most appropriate treatment for most people. In fact, opioids can increase one’s experience of hyperalgia, or intense pain. These drugs change the brain’s response to pain because they replace naturally released opioids; the brain stops producing natural opioids, so without synthetic opioids like morphine or Vicodin present, the body will feel pain more intensely.
As fibromyalgia is better understood by medical professionals, it is distinguished from other chronic pain issues, including drug or alcohol withdrawal symptoms, and better treatment approaches that do not involve addictive prescription drugs are found and applied.