What a Pain: The Ups and Downs of Fibromyalgia

If you’re living with persistent muscle pain, fatigue memory and mood problems, it can be physically, mentally and emotionally draining.

More than 3.7 million Americans are living with fibromyalgia, according to the Arthritis Foundation. While researchers and doctors work to better understand the cause of fibromyalgia, you can empower yourself through lifestyle, diet, and medication changes as well as alternative treatments proven to help reduce the severity of symptoms and your improve quality of life.

How is fibromyalgia diagnosed?

There are no laboratory or imaging test that can identify fibromyalgia specifically. It’s one of many pain disorders with similar symptoms, including rheumatoid arthritis, lupus, osteoarthritis, hypothyroidism, metabolic myopathy, and neurologic disorders like multiple sclerosis and sciatica. “Yet, these other diseases and conditions come with additional red flags in the patient’s medical history, physical examination, X-rays, and blood test results that are not usually seen in those with fibromyalgia,” says Dr. Adriana D. Valbuena Valecillos, who specializes in rehabilitation for musculoskeletal syndromes at the University of Miami Health System.

A fibromyalgia diagnosis is typically based on:

• a complete physical exam
• blood tests and X-rays used to rule out other conditions
• a patient’s personal and family medical histories
• a patient’s self-reported and professionally documented mental health issues
• a patient’s self-reported ineffectiveness of pain relief medications (such as anti-inflammatory and analgesic drugs)

What causes fibromyalgia?

As difficult as it is to pinpoint a fibromyalgia diagnosis, doctors are getting closer to understanding what can lead to this type of chronic, widespread pain and related symptoms and how to best respond to them.

“Various physical or emotional factors — such as viral infection, repetitive joint injuries, and severe emotional stress — may play a role in triggering fibromyalgia symptoms,” says Dr. Valbuena Valecillos. “Although, a specific cause isn’t known, and many patients report a lifelong history of chronic pain.”

Other risk factors include obesity, sex (women are more likely than men to have fibromyalgia), PTSD, a family history of the condition (fibromyalgia tends to run in families), and an existing diagnosis of rheumatoid arthritis or lupus.

While preventive medicine isn’t available, if you’re at risk for developing fibromyalgia, there are ways you can reduce your chances of triggering it.

• Regular exercise (at least 30 minutes three times per week), such as walking, swimming, or biking
• Stress-reduction programs, relaxation techniques
• Mind-body practices with gentle, flowing movements (such as Tai chi and yoga)
• Balanced diet rich in antioxidants, avoiding carbohydrates and sugar

What are the available treatments?

Once you’ve been diagnosed, your health care provider should focus on helping you better understand this condition and how to manage its symptoms, without relying on over-the-counter and prescription drugs. With no known cure, the goal of treatment is to improve your quality of life.

Because regular exercise is an effective way to improve sleep quality while reducing the severity of fibromyalgia pain, fatigue, and depression, your doctor may recommend an aerobic (improving the body’s ability to absorb and move oxygen) and progressive-resistance (muscle building) exercise program.

“Additional treatments are tailored to the patient’s specific needs, such as psychological and behavioral therapies that can reduce distress, promote self-efficacy, and enable self-management,” says Dr. Valbuena Valecillos. “These include coping strategies, relaxation training, activity pacing, visual imagery, and distraction techniques.”

If you need additional pain management options, “pharmacotherapy can target chemicals in the brain and spinal cord that are important in processing pain,” Dr. Valbuena Valecillos says. “These drugs include antidepressants, anticonvulsants, and muscle relaxers.” Medications that work to decrease symptoms of pain locally, such as anti-inflammatory drugs and analgesics, are less effective.

“Trigger point injections, acupuncture, chiropractic manipulation, and myofascial release (connective tissue massage) are usually well received by patients and can be beneficial, but results are not long lasting,” Dr. Valbuena Valecillos reports. Alternative treatments that may help manage fibromyalgia symptoms include noninvasive brain stimulation and medical marijuana use, which is believed to be effective because those with fibromyalgia may have a clinical endocannabinoid deficiency.

What to expect if you’ve been diagnosed with fibromyalgia

While fibromyalgia is not a life-threatening disorder, many sufferers worry that their symptoms are the early stages of a more serious condition. However, those with fibromyalgia don’t have an increased risk of developing other rheumatic diseases or neurologic conditions.

“While most fibromyalgia patients continue to have chronic pain and fatigue of varying degrees throughout their lives, the majority are able to work and do normal activities,” Dr. Valbuena Valecillos explains. “Understanding your condition and managing your symptoms, learning effective coping techniques and having strong family and social support can really help improve and maintain your quality of life.”

Dana Kantrowitz is a contributing writer for UMiami Health News.

Tags: arthritis, autoimmune disease, chronic pain, Dr. Adriana D. Valbuena Valecillos, fibromyalgia, fibromyalgia doctor