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Fibromyalgia: Causes, Symptoms, And Diagnosis

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Fibromyalgia is a condition in which you might feel pain in the muscles all over the body. In addition to widespread pain, it is characterized by disturbances in sleep, physical exhaustion (fatigue) and memory problems. It occurs in people all over the world with a prevalence of around 2% – 8% reveals a 2014 research study published in the Journal JAMA[1]. The condition is typically diagnosed in people around 40 to 60 years of age. However, off late, even children and teenagers are suffering from fibromyalgia. It is more common in women than in men.

Before knowing about the symptoms of fibromyalgia, let’s discuss in detail about the causes of fibromyalgia and what does it mean.

What Causes Fibromyalgia?

Researchers and doctors are not aware of the exact cause of fibromyalgia. However, certain studies have reported that there are few factors which might work together to cause the condition. These include:

Genetics: Researchers believe that certain genetic mutations may play a role in increasing your risk of fibromyalgia, however, no specific genes have been identified to date. The condition runs in families, which means that if you have a family member with fibromyalgia, you are at higher risk of suffering from the condition.

Infections and diseases: Although no direct relationship between infections and fibromyalgia is reported, infections due to bacteria and viruses such as HCV, HIV might be involved. It is seen to be common in people suffering from autoimmune diseases such as lupus and rheumatoid arthritis.

Trauma/stress: Be it physical or emotional trauma, people suffering from trauma may develop fibromyalgia. Stress, which causes hormonal changes in the body, may also contribute to fibromyalgia.

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Doctors do not fully understand the exact causes and factors which lead to such widespread pain in people with fibromyalgia. Some researchers believe that in people suffering from fibromyalgia, the muscles and tendons are excessively irritated due to various painful stimuli. This is amplified into severe painful sensations because it affects the way your brain processes pain signals. This heightened perception of pain is termed as central sensitization. Other conditions which may be developed due to central sensitization include irritable bowel syndrome, chronic fatigue syndrome, and headaches.

What Are The Symptoms Of Fibromyalgia?

The three common symptoms of fibromyalgia include pain, fatigue, and sleep disturbance. As fibromyalgia causes pain all over the body, people with fibromyalgia also have “tender points,” places on the body that hurt when touched or when a standard amount of pressure (about 4 kg) is applied[2]. These include the shoulder girdle, hip (buttock, trochanter), jaw, upper back, lower back, upper arm, upper leg, chest, neck, abdomen, lower arm, and lower leg.

A chronic, widespread and persistent pain in the muscle and soft tissues is one of the primary symptoms of fibromyalgia. However, there is no visible inflammation or abnormality reported in these muscles. The pain is described as throbbing, soreness, stiffness and burning. In some cases, patients might feel numbness and tingling sensation in the arms and legs. The pain may aggravate due to stress, poor sleep, anxiety or exposure to cold.

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The other common symptoms of fibromyalgia include:

-Persistent fatigue

-Difficulties falling asleep

-Feeling unusually light, or unrefreshing sleep

-Feeling exhausted even after a night’s sleep

-Frequent headaches

-Memory problems

-Pain in the bladder or the need to urinate in a hurry or often

-Jaw pain

-Frequent abdominal pain

-Flu-like symptoms

-Anxiety and depression

Diagnosis Of Fibromyalgia: When To Go To A Doctor?

There isn’t a lab test that can detect fibromyalgia. However, your doctor might order a few blood tests as it helps to rule out the other potential causes of chronic pain such as arthritis or a hormonal condition.

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The American College of Rheumatology (ACR) has developed a guideline to help diagnose fibromyalgia. According to the guideline, a person can be diagnosed with fibromyalgia if he or she has widespread musculoskeletal pain along with severe tenderness (pain when touched) in at least 11 of 18 specific “tender points”.

People suffering from any pain, difficulty in sleeping and excessive fatigue should consult a doctor at the earliest to rule out other possible conditions and get diagnosed. Moreover, early diagnosis help in the management of the symptoms.

The painful tissues are not accompanied by tissue inflammation which is the reason why despite being suffering from potentially disabling body pain; patients with fibromyalgia do not develop tissue damage or deformity. Fibromyalgia isn’t a life-threatening condition as it doesn’t affect any organs nor does it affect your life expectancy.

There isn’t any specific cure for fibromyalgia but the treatment is aimed at reducing the severity of the symptoms and improving the quality of life. The treatment options for fibromyalgia include the use of medications to relieve pain and inflammation along with lifestyle changes such as exercising every day and maintaining a fixed sleep schedule.

(The article is reviewed by Dr. Lalit Kanodia, General Physician)

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References:

1. Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014 Apr 16;311(15):1547-55.

2. Bellato E, Marini E, Castoldi F, et al. Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain Res Treat. 2012;2012:426130.

3. Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006. Fibromyalgia: Overview. 2018 Mar 8.

4. Jahan F, Nanji K, Qidwai W, Qasim R. Fibromyalgia syndrome: an overview of pathophysiology, diagnosis and management. Oman Med J. 2012 May;27(3):192-5.

5. Bradley LA. Pathophysiology of fibromyalgia. Am J Med. 2009 Dec;122(12 Suppl):S22-30.

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