Fibromyalgia: Causes, Symptoms & Treatment
Fibromyalgia: What It Is
Fibromyalgia is a fairly common syndrome in the general population, with a prevalence of 2-3% of people worldwide. Women are 3x as likely to have Fibromyalgia than men.
Fibromyalgia has a wide array of symptoms including widespread pain, fatigue, changes in sleep and cognition, brain fog, hypersensitivity and other somatic symptoms. Many people living with fibromyalgia also have irritable bowel syndrome, anxiety, and depression.
Fibromyalgia: What Causes It?
Unfortunately, it isn’t entirely known what causes fibromyalgia. What we do know, is that fibromyalgia seems to be related to sensitivity in pain processing. Levels of neurotransmitters are known to change with fibromyalgia with excitatory neurotransmitters such as substance P and glutamate being elevated and serotonin and norepinephrine being decreased in the spinal cord. This shows that there are central (brain and spinal cord factors) related to fibromyalgia. There are also peripheral (outside the brain and spinal cord) inflammatory processes that occur.
There may also be a genetic component to fibromyalgia. It is known that there are a variety of genes related to pain sensitivity. This may relate to fibromyalgia.
Fibromyalgia: Diagnosis
Because the symptoms of fibromyalgia are very widespread and often seen in many other diseases, the diagnoses of the condition can be…well…uneventful. Being diagnosed with fibromyalgia doesn’t give you an explanation into what exactly it is, but there are some specific things that medical practitioners look for when diagnosing someone. These include:
- Moderate sleep problems or fatigue for at least 3 months
- Generalized sleeping problems and fatigue
- Tenderness to touch
- Sensitivity to cold, light, or noise
In brief, the diagnosis of fibromyalgia is clinical. A physical examination is not diagnostically useful but it is important to exclude other diseases that might explain the presence of pain and fatigue.
Fibromyalgia: Treatment
Fibromyalgia is often treated by using a variety of treatment methods. Methods often include physical activity, medications, and psychological interventions. In terms of physical activity, it can be an excellent option to work alongside a trained physical therapist or kinesiologist as they can guide you on appropriate exercise recommendations. If you live in BC and would like to see someone for exercise recommendations for fibromyalgia, you can book with me HERE. Physical activity recommendations often include a variety of strength exercises, mobility exercises, and cardiovascular exercises keeping principles of pain management in mind. My YouTube channel has some classes appropriate for fibromyalgia. Although exercise is helpful in general, it is also something that may exacerbate fibromyalgia pain. This is why working with someone trained in fibromyalgia treatment can be beneficial.
There are a variety of medications and supplements that may be useful for fibromyalgia. Often, people are put on antidepressants as these can help with fatigue, sleep, and pain. Pregabalin and gabapentin may also be used for pain control. Studies have also shown that supplementation of CoQ10, vitamin D, alpha-lipoic acid, magnesium, and tryptophan helped with pain reduction and quality of life. It is best to work with a doctor when determining which medications and supplementation may be beneficial for fibromyalgia.
Finally psychological interventions have been seen to be beneficial for fibromyalgia. acceptance and commitment therapy, cognitive behavioural therapy as well as mindfulness are commonly used in fibromyalgia treatment. All have been shown to be beneficial for symptoms.
As with many diseases and disabilities, using an individualized approach to treatment based on your symptoms and needs will be most beneficial.
In summary, Fibromyalgia is a common syndrome with a wide array of symptoms including pain and fatigue. Although the cause is not known, pain processing in both the brain and the body are evident. The diagnosis of fibromyalgia is clinical, and does not give an exact explanation of what it is, but it does help practitioners to rule out other diseases and disorders. Fibromyalgia is treated using a multimodal approach including medications, physical activity and psychological interventions.
References:
Assavarittirong, Chanika, Samborski, Włodzimierz, Grygiel-Górniak, Bogna, Oxidative Stress in Fibromyalgia: From Pathology to Treatment, Oxidative Medicine and Cellular Longevity, 2022, 1582432, 11 pages, 2022. https://doi.org/10.1155/2022/1582432
Kundakci, Buraka,b,c,*; Kaur, Jaspreeta,b,d; Goh, Siew Lie; Hall, Michellea,b,f,g; Doherty, Michaela,b,f; Zhang, Weiyaa,b,f; Abhishek, Abhisheka,b,f. Efficacy of nonpharmacological interventions for individual features of fibromyalgia: a systematic review and meta-analysis of randomised controlled trials. PAIN 163(8):p 1432-1445, August 2022. | DOI: 10.1097/j.pain.0000000000002500
Siracusa R, Paola RD, Cuzzocrea S, Impellizzeri D. Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update. International Journal of Molecular Sciences. 2021; 22(8):3891. https://doi.org/10.3390/ijms22083891