What is Fibromyalgia?

Fibromyalgia is a chronic condition characterised by symptoms that include pain, stiffness and tenderness of the muscles, tendons and joints. It is a common condition, which affects about one in 20 people across the globe. Everyone is at risk of getting fibromyalgia, though it affects more women than men. It occurs most often between 30 and 60 years of age, but can affect any age group including children and the elderly.

Causes

The exact cause of fibromyalgia is not understood. Some of the possible causes or triggers of fibromyalgia include:

• physical or emotional disturbance
• abnormal pain response (pain centres in the brain that are responsible for pain may react differently in fibromyalgia patients)
• sleep disturbances
• infection with a virus (although no virus can be identified)

Symptoms of fibromyalgia

Pain is the main symptom of fibromyalgia, which can vary in severity from mild to severe. The person experiences pain upon touch and these painful areas are called tender points. Pain is present all over the body, though it tends to be worse in particular areas, such as the back or neck. Pain may seem like a deep ache or an acute burning sensation. The person may feel as if the pain is starting from the joints, but the joints are not affected.

Other major symptoms of fibromyalgia include:

• extreme sensitivity to touch and pain
• stiffness all over body
• fatigue
• poor quality sleep
• cognitive problems ('fibro-fog')
• headaches

Treatment of fibromyalgia

Fibromyalgia is diagnosed based on clinical history and physical exam. There is no simple blood test or X-ray, which can diagnose fibromyalgia. Treatment is started based on clinical signs and symptoms. There is no cure for fibromyalgia. Treatment aims to minimise the symptoms as much as possible and improve general health and quality of life. Current treatment for fibromyalgia includes both medication and self-care.

Several different types of medicines are used for the treatment of fibromyalgia. Medications prescribed for fibromyalgia include painkillers, antidepressants and anti-seizure medicines, all of which are given to ease the pain and other symptoms. Muscle relaxants are helpful in reducing stiffness. Besides medication, therapy, such as psychotherapy and cognitive and behaviour therapy are also used in the treatment of fibromyalgia. These therapies help the person to deal with their thoughts and feelings positively.

Long term outlook

Fibromyalgia is a chronic illness, which can have recurrence (exacerbations) and remissions (decrease) of symptoms over time. Most cases of fibromyalgia do not worsen over time, but in some people, the pain and stiffness may increase progressively. Long-term studies have shown that fibromyalgia symptoms usually remain stable and about 25 - 35% of patients have improvement in pain symptoms.