Fibromyalgia- Symptoms, and causes

What is fibromyalgia? Fibromyalgia is a long-term (chronic) condition. It is a common and chronic syndrome that causes bodily pain and mental distress. It causes:

  • pain in the muscles and bones (musculoskeletal pain)
  • areas of tenderness
  • general fatigue
  • sleep and cognitive disturbances

In particular, this condition can be hard to understand, even for healthcare providers. Such as its symptoms mimic those of other conditions, and there aren’t any real tests to confirm the diagnosis. As a result, fibromyalgia is often misdiagnosed.

In the past, some healthcare providers even questioned whether fibromyalgia was real. Today we better understand what is fibromyalgia. Some of the stigma that used to surround it has eased.

It can still be challenging to treat. But medications, therapy, and lifestyle changes can help you to manage your symptoms and to improve your quality of life.

Fibromyalgia symptoms

Fibromyalgia causes what’s now referred to as “regions of pain.” Some of these regions overlap with what was previously referred to as areas of tenderness called “trigger points” or “tender points.” However, some of these previously noted areas of tenderness have been excluded.

Such as the pain in these regions feels like a consistent dull ache. Generally, your healthcare provider will consider a diagnosis of fibromyalgia if you’ve experienced musculoskeletal pain in 4 out of the 5 regions.

This diagnostic protocol is referred to as “multisite pain.” It’s in contrast to the 1990 fibromyalgia diagnostic criteria definition for “chronic widespread pain.”

This process of diagnosis focuses on the areas of musculoskeletal pain and severity of pain as opposed to an emphasis on pain duration, which was previously the focal criteria for a fibromyalgia diagnosis.

Other symptoms of fibromyalgia include:

  • fatigue
  • trouble sleeping
  • sleeping for long periods of time without feeling rested (nonrestorative sleep)
  • headaches
  • depression
  • anxiety
  • trouble focusing or paying attention
  • pain or a dull ache in the lower belly
  • dry eyes
  • bladder problems, such as interstitial cystitis

In people with this disease, the brain and nerves may mistake or misrepresent normal pain signals. This may be due to a chemical imbalance in the brain. Or maybe an abnormality in the dorsal root ganglion Trusted Source affecting central pain (brain) sensitization.

Fibromyalgia can also affect your emotions and energy level.

Fibromyalgia fog | Fog

Generally, Fibromyalgia fog – also known as “fibro fog” or “brain fog” – is a term some people use to describe the fuzzy feeling they get. Signs of fibro fog include:

  • memory lapses
  • difficulty concentrating
  • trouble staying alert

According to a 2015 study trusted Source published in Rheumatology International, some people find mental fogginess from fibromyalgia more upsetting than pain.

Symptoms in women | Symptoms in women

Symptoms have generally been more severe in women than in men. Women have more widespread pain, IBS symptoms, and morning fatigue than men. Painful periods are also common.

However, when the 2016 revisions to the diagnostic criteria are applied. More men are being diagnosed with fibromyalgia, which may reduce the degree of distinction between the pain levels men and women experience. More analysis is required to further evaluate that distinction.

Such as the transition to menopause could make fibromyalgia worse.

Symptoms in men

Men also get fibromyalgia. Yet, they may remain undiagnosed because this is seen as a woman’s disease. However, current statistics show that as the 2016 diagnostic protocol is more readily applied, more men are being diagnosed.

Men also have severe pain and emotional symptoms from fibromyalgia. For the most part, the condition affects their quality of life, career, and relationships.

Trigger points

In the past, people were diagnosed with this disease if they had widespread pain and tenderness in at least 11 out of 18 specific trigger points around their body. Particularly healthcare providers would check to see how many of these points were painful by pressing firmly on them.

Common trigger points included the:

  • back of the head
  • tops of the shoulders
  • upper chest
  • hips
  • knees
  • outer elbows

For the most part, trigger points are no longer a part of the diagnostic process.

Instead, healthcare providers may diagnose fibromyalgia if you’ve had pain in 4 out of the 5 areas of pain as defined by the 2016 revised diagnostic criteria. So then you have no other diagnosable medical condition that could describe the pain.

Fibromyalgia pain

Generally, pain is the hallmark fibromyalgia symptom. In short, you’ll feel it in various muscles and other soft tissues around your body.

The pain can range from mild achiness to an intense and almost unbearable discomfort. In conclusion, its severity could dictate how well you cope day today.

Fibromyalgia appears to stem from an abnormal nervous system response. Your body overreacts to things that shouldn’t normally be painful. And you may feel the pain in more than one area of your body.

However, available research still doesn’t pinpoint an exact cause for this pain. Research continues to result in a better understanding of this condition and its origin.

Chest pain

When fibromyalgia pain is in your chest, it can feel frighteningly similar to the pain of a heart attack.

Chest pain in fibromyalgia is actually centred in the cartilage that connects your ribs to your breastbone. The pain may radiate to your shoulders and arms.

Fibromyalgia chest pain may feel:

  • sharp
  • stabbing
  • like a burning sensation
  • and similar to a heart attack, it can make you struggle to catch your breath.

Back pain

Your back is one of the most common places to feel pain. About 80 percent of Americans have low back pain at some point in their lives. If your back hurts, it may not be clear whether fibromyalgia is to blame, or another condition like arthritis or a pulled muscle.

Other symptoms like brain fog and fatigue can help pinpoint fibromyalgia as the cause. It’s also possible to have a combination of fibromyalgia and arthritis.

The same medications you take to relieve your other fibromyalgia symptoms can also help with back pain. Stretching and strengthening exercises can help provide support to the muscles and other soft tissues of your back.

Leg pain

You can also feel pain in the muscles and soft tissues of your legs. Leg pain can feel similar to the soreness of a pulled muscle or the stiffness of arthritis. It can be:

  • deep
  • burning
  • throbbing

Sometimes fibromyalgia in the legs feels like numbness or tingling. You may have a creepy crawling sensation. An uncontrollable urge to move your legs is a sign of restless legs syndrome (RLS), which can overlap with fibromyalgia.

Fatigue sometimes manifests in the legs. Your limbs can feel heavy as if someone is pulling down by weights.

Fibromyalgia causes

Healthcare providers and researchers don’t know what causes this pain.

According to the latest study, the cause appears to be a multiple-hit theory that involves genetic disposition (hereditary characteristics) complemented by a trigger, or a set of triggers, such as infection, trauma, and stress.

Let’s take a closer look at these potential factors and several more that may influence why people develop this pain.


A past illness could trigger fibromyalgia or make its symptoms worse. The flu, pneumonia, GI infections, such as those caused by Salmonella and Shigella bacteria, and the Epstein-Barr virus all have possible links to fibromyalgia.


This disease often runs in families. If you have a family member with this condition, you’re at higher risk for developing it.

Researchers think certain gene mutations may play a role. They’ve identified a few possible genes that affect the transmission of chemical pain signals between nerve cells.


People who go through severe physical or emotional trauma may develop fibromyalgia.


Like trauma, stress can leave long-lasting effects on your body. Stress also has a connection to hormonal changes that could contribute to fibromyalgia.

Healthcare providers don’t fully understand what causes the chronic widespread nature of this pain. One theory is that the brain lowers the pain threshold. Sensations that weren’t painful before become very painful over time.

Another theory is that the nerves overreact to pain signals. They become more sensitive, to the point where they cause unnecessary or exaggerated pain.

Fibromyalgia and autoimmunity

In autoimmune diseases like rheumatoid arthritis (RA) or multiple sclerosis (MS), the body mistakenly targets its own tissues with proteins called autoantibodies. Just like it would normally attack viruses or bacteria, the immune system instead attacks the joints or other healthy tissues.

Fibromyalgia symptoms look very similar to those of autoimmune disorders. These symptom overlaps have led to the theory that fibromyalgia could be an autoimmune condition.

This claim has been hard to prove, in part because fibromyalgia doesn’t cause inflammation, and to date reproducing autoantibodies haven’t been found.

Fibromyalgia risk factors

Fibromyalgia flare-ups can be the result of:

  • stress
  • injury
  • an illness, such as the flu

An imbalance in brain chemicals may cause the brain and nervous system to mistake or overreact to normal pain signals.

Other factors that increase your risk of developing this disease include:

  • Gender. Most fibromyalgia cases are currently seen in women, although the reason for this gender disparity isn’t clear.
  • Age. You’re most likely to be diagnosed in middle age, and your risk increases as you get older. However, children can develop fibromyalgia also.
  • Family history. If you have close family members with fibromyalgia, you may be at greater risk for developing it.
  • Disease. Although this disease isn’t a form of arthritis, having lupus or RA may increase your risk of also having fibromyalgia.

Fibromyalgia diagnosis

Your healthcare provider may diagnose you with it if you feel the pain for 3 months or longer. The meaning of widespread is pain is on both sides of your body, and you feel it above and below your waist.

After a thorough examination, your healthcare provider must conclude that no other condition is causing your pain.

No lab test or imaging scan can detect fibromyalgia. Your healthcare provider may use these tests to help rule out other possible causes of your chronic pain.

Fibromyalgia can be hard for healthcare providers to identify from autoimmune diseases because the symptoms often overlap.

Some study points a link between fibromyalgia and autoimmune disease like Sjogren’s syndrome.

Fibromyalgia treatment

Currently, there isn’t a cure for fibromyalgia.

Instead, treatment focuses on reducing symptoms and improving quality of life with:

Medications can relieve pain and help you sleep better. Physical and occupational therapy improves your strength and reduces stress on your body. Exercise and stress-reduction techniques can help you feel better, both mentally and physically.

Fibromyalgia medication

The goal of fibromyalgia treatment is to manage pain and improve quality of life. This is often accomplished through a two-pronged approach of self-care and medication.

Common medications for fibromyalgia include:

Pain relievers

Over-the-counter pain relievers such as ibuprofen (Advil) or acetaminophen (Tylenol) can help with mild pain.

Narcotics, such as tramadol (Ultram), which is an opioid, were previously prescribed for pain relief. However, research has shown they’re not effective. Also, the dosage for narcotics is typically increased rapidly, which can pose a health risk for those prescribed these drugs.

Most healthcare providers recommend avoiding narcotics to treat it.


Antidepressants such as duloxetine (Cymbalta) and milnacipran HCL (Savella) are sometimes given to treat pain and fatigue from this disease. These medications may also help improve sleep quality and work on rebalancing neurotransmitters.

Antiseizure drugs

Gabapentin (Neurontin) was designed to treat epilepsy, but it may also help reduce symptoms in people with fibromyalgia. Pregabalin (Lyrica), another anti-seizure drug, was the first drug FDA-approved for fibromyalgia. It blocks nerve cells from sending out pain signals.

A few drugs that aren’t FDA-approved to treat this disease, including antidepressants and sleep aids, can help with symptoms. Muscle relaxants, which were once used, are no longer recommended.

Researches are also finding out other ways to help people with fibromyalgia in the future.

Fibromyalgia natural remedies

If the medications your healthcare provider prescribes don’t entirely relieve your fibromyalgia symptoms, you can look for alternatives. Many natural treatments focus on lowering stress and reducing pain. You can use them alone or together with traditional medical treatments.

Natural remedies for fibromyalgia include:

  • physical therapy
  • acupuncture
  • 5-hydroxytryptophan (5-HTP)
  • meditation
  • yoga, use with caution if hypermobility is present
  • tai chi
  • exercise
  • massage therapy
  • balanced, healthy diet

Therapy can potentially reduce the stress that triggers fibromyalgia symptoms and depression.

Group therapy may be the most affordable option, and it will give you a chance to meet others who are going through the same issues.

Cognitive-behavioural therapy (CBT)is another option that can help you manage stressful situations. Individual therapy is also available if you prefer one-on-one help.

It’s important to note that most alternative treatments for fibromyalgia haven’t been thoroughly studied or proven effective.

Fibromyalgia diet recommendations

Some people report that they feel better when they follow a specific diet plan or avoid certain foods. But research hasn’t proven that anyone diet improves fibromyalgia symptoms.

If you’ve been diagnosed with fibromyalgia, try to eat a balanced diet overall. Nutrition is important in helping you to keep your body healthy, prevent symptoms from getting worse, and provide you with a constant energy supply.

Dietary strategies to keep in mind:

  • Eat fruits and vegetables, along with whole grains, low-fat dairy, and lean protein.
  • Drink plenty of water.
  • Eat more plants than meat.
  • Reduce the amount of sugar in your diet.
  • Exercise as often as you can.
  • Work toward achieving and maintaining your healthy weight.

You may find that certain foods make your symptoms worse, such as gluten or MSG. If that’s the case, keep a food daily Trusted Souce where you track what you eat and how you feel after each meal.

Share this diary with your healthcare provider. They can help you identify any foods that aggravate your symptoms. Avoiding these foods can be beneficial in helping you manage your symptoms.

Fibromyalgia can leave you feeling tired and worn out.

A few foods will give you the energy boost you need to get through your day.

Fibromyalgia pain relief

Fibromyalgia pain can be uncomfortable and consistent enough to interfere with your daily routine. Don’t just settle for pain. Talk to your healthcare provider about ways to manage it.

One option is to take pain relievers such as:

  • aspirin
  • ibuprofen
  • naproxen sodium
  • help with discomfort
  • lower pain levels
  • help you better manage your condition

These medications bring down inflammation. Though inflammation is not a primary part of fibromyalgia, it may be present as an overlap with RA or another condition. Pain relievers may help you sleep better.

Please note that NSAIDs do have side effects. Caution is advised if NSAIDS are used for an extended period of time as is usually the case in managing a chronic pain condition.

Talk with your healthcare provider to create a safe treatment plan that works well in helping you manage your condition.

Antidepressants and anti-seizure drugs are two other medication classes your healthcare provider may prescribe to manage your pain.

The most effective pain reliever does not come in a medication bottle.

Practices like yoga, acupuncture and physical therapy can:

Fibromyalgia fatigue can be just as challenging to manage as pain.

Having better sleep can make you feel alert during the day.

Living with fibromyalgia

Your quality of life can be affected when you live with pain, fatigue, and other symptoms on a daily basis. Complicating things are the misunderstandings many people have about fibromyalgia. Because your symptoms are hard to see, it’s easy for those around you to dismiss your pain as imaginary.

Know that your condition is real. Be persistent in your pursuit of a treatment that works for you. You may need to try more than one therapy or use a few techniques in combination before you start to feel better.

Lean on people who understand what you’re going through, like:

  • your healthcare provider
  • close friends
  • a therapist

Be gentle with yourself. Try not to overdo it. Most importantly, have faith that you can learn to cope with and manage your condition.

Fibromyalgia Facts and statistics

Currently, there’s no cure, and researchers don’t fully understand what causes it. Treatment focuses on medications and lifestyle changes to help ease the symptoms.

About 4 million Americans Trusted Source ages 18 and over, or about 2 percent of the population, have been diagnosed with fibromyalgia. Most fibromyalgia cases are diagnosed in women, but men and children can also be affected.

Most people get diagnosed in middle age.

Fibromyalgia is a chronic (long-term) condition. However, some people may experience remission-type periods in which their pain and fatigue improve.