The precise cause of fibromyalgia is as yet unknown. However, it is generally thought to be related to certain hormone and chemical changes in the body. The pain associated with fibromyalgia is often described as a throbbing, aching, stabbing or shooting sensation all over the body. Although often severe, the pain is not thought to cause or be caused by any physical damage to the body itself.
Because little is known about fibromyalgia, there is no single cure - only treatment methods and pain management.
Symptoms of fibromyalgia
Fibromyalgia symptoms can vary greatly from person to person and often tend to appear and disappear over time.
The main symptoms of fibromyalgia include:
- Pain - This could be muscle pain, or an ache, burning sensation, or sharp, stabbing pains across the whole body.
- Heightened sensitivity - Sometimes even the slightest touch can feel extremely painful. Pain can also last much longer than it usually would. The word 'hyperalgesia' is the medical term for extreme sensitivity to pain, and 'allodynia' defines pain felt as a result of something that should not normally cause pain- such as a light touch.
- Stiffness - This can feel more severe after staying in the same position for a long duration, such as on a flight, a long car journey, or after sleep. Fibromyalgia can also cause muscles spasms, which can make it even harder to sleep.
- Fatigue - Extreme fatigue can come on very suddenly and drain the sufferer of all energy. This often means that the sufferer feels too tired to do anything at all.
- Unable to sleep - Due to the pain and muscle spasm associated with fibromyalgia, sufferers can find it very difficult to sleep.
- Cognitive problems - Fibromyalgia can cause problems with mental processes (known as 'fibro-fog'), such as: Having difficulty with memory and learning new things, having problems with concentration and attention span, experiencing slowed or confused speech.
- Headaches - The pain and stiffness associated with fibromyalgia can often cause headaches. Headaches can range between mild aching, to severe migraines.
- Irritable bowel syndrome - People with fibromyalgia have been known to also develop irritable bowel syndrome (IBS), which involves symptoms of bloating, abdominal pain, constipation and diarrhoea.
Less common symptoms of fibromyalgia include:
- Depression - Extreme and prolonged low moods.
- Tinnitus - The perception of a persistent, high-pitched ringing.
- Restless legs syndrome - Unpleasant sensation in the legs.
- Abnormally painful periods - For menstruating women.
- Anxiety - Feelings of agitation, stress and worry.
- Unable to regulate body temperature - Feeling too hot or too cold.
The frequency and intensity of fibromyalgia symptoms often depends on a number of external factors, including:
- changes in the weather
- level of physical activity
- stress levels.
People who suffer from fibromyalgia may also find that they are extra sensitive to other things, such as bright lights, certain foods and smoke. The occurrence of any of these factors could cause fibromyalgia symptoms to flare up even more.
What causes fibromyalgia?
There is no known exact cause of fibromyalgia. However, there are a number of theories, including the following:
Disturbed pain signals
The most likely cause of fibromyalgia is a disturbance in the way signals are passed through the body to the brain. Pain signals are transmitted through the central nervous system, which is a network of nerves linking the brain and spinal chord. Fibromyalgia is thought to form as a result of disturbances in the process of transmittance. This would explain why sufferers feel constant pain and sensitivity to touch.
Studies have shown that people suffering from fibromyalgia tend to have abnormally low levels of the following hormones:
- Noradrenaline - Known to help determine how an individual responds to stressful situations.
- Serotonin - This helps to regulate appetite, sleep patterns and moods.
- Dopamine - This controls behaviours, moods and the way a person learns.
Health experts are not yet sure whether having a sleep problem is a symptom of fibromyalgia or a cause. On one hand, muscle pain can upset sleeping patterns. On the other hand, people who suffer from extreme fatigue are thought to be more sensitive to pain.
It is generally thought that some factors can make fibromyalgia more likely to occur, including:
- physical trauma - damage to body tissue
- psychological trauma - emotional damage
- viral infection- hepatitis B and C, HIV and AIDS
According to research, an individual has more chance of developing fibromyalgia if somebody in their family also has the condition. This suggests that some people are genetically predisposed to develop fibromyalgia.
Some health conditions have been known to lead to fibromyalgia. In the event of a separate condition leading to fibromyalgia, the fibromyalgia will be described as 'secondary fibromyalgia'. Conditions known to lead to secondary fibromyalgia include:
- metabolic disturbances such as an underactive thyroid
- inflammatory disorders such as rheumatoid arthritis.
It can be difficult to diagnose fibromyalgia because there are no specific diagnostic tests.
A GP will usually make a diagnosis based on a patient's answers to certain questions. These questions may include:
- What kind of pain is it?
- What symptoms have you noticed?
- Do you have any other conditions?
- How do the symptoms affect your daily life?
- Are you taking any other medicine?
A GP will often want to rule out other conditions with similar symptoms. These could include:
- Rheumatoid arthritis - a condition that causes inflammation and pain in the joints.
- Multiple sclerosis (MS) - a condition affecting the nervous system, which causes problems with movement and balance.
- Chronic fatigue syndrome (ME) a condition that causes long-term tiredness.
Ruling out these conditions may require physical examinations. These could include:
- blood tests
- MRI scans
- ultra-sound scans.
A GP will only diagnose a condition as fibromyalgia if it fits two particular criteria. These are:
- The patient suffers from widespread pain for three months or longer, on both sides of the body above and below the waist.
- The patient feels pain in 11 or more of the 18 'tender points' when they are pressed. Tender points are places on every person's body where pain is most felt. These are on the back of the neck, above each shoulder and on the inside of the elbows among others.
Treatment for fibromyalgia
There is no known cure for fibromyalgia, but there are ways to manage and treat the symptoms.
The type of treatment available to a fibromyalgia patient will depend on a balance between what the patient feels comfortable with, and what the GP considers appropriate.
Because of the wide range of symptoms associated with fibromyalgia, no one treatment will ever be suitable for everyone. Depending on the severity of the condition, the patient may be referred to a specialist health professional, such as:
- A rheumatologist - specialising in conditions that affect the muscles and joints.
- A neurologist - specialising in conditions that affect the central nervous system.
Available treatment for fibromyalgia includes:
- Painkillers - to help manage pain.
- Antidepressants - to curb low moods.
- Muscle relaxants - to prevent muscle spasms.
- Anticonvulsants - usually used for epilepsy, this type of medication has been known to treat fibromyalgia.
- Antipsychotics - otherwise known as neuroleptics, are sometimes used to treat chronic pain due to their neuromuscular effects.
- Alternative medicine - acupuncture, massage and hypnotherapy.
Fibromyalgia and lifestyle
Treatment for fibromyalgia can reach further than taking pills or going for massages: it can become part of your daily routine.
A common symptom of fibromyalgia is extreme fatigue, which can make physical activity difficult. However, a tailored exercise programme could help to reduce the severity and frequency of your symptoms. Exercise has many benefits, including:
- Increasing the flow of oxygen through the body, making you feel awake and enlivened.
- Releasing 'feel-good hormones' to combat depression.
- Stretching and exercising can ease pain and strengthen muscles.
- Help you lose weight, reducing the strain of excess fat on joints and bones.
- Lowering the risk of diabetes, heart disease and heart failure.
Effective, low-impact physical activity could include:
Relaxation is just as important as exercise for treating fibromyalgia. Relaxing can help to ease stress and reduce the chances of symptoms flaring up.
There is little evidence to suggest that special diets can reduce the symptoms of fibromyalgia. However, many experts agree that a healthy diet can help to promote a healthier body and mind. There is no cure for fibromyalgia, only management methods. One of these methods, as the BBC agrees, is to maintain a healthy, balanced diet. This means:
- getting your 5-a-day
- eating plenty of protein in the form of fish, eggs, dairy, meat, nuts and beans
- drinking plenty of water throughout the day
- eating whole grains like brown rice, pasta and bread to keep energy levels up
- eating 'good fats', which are unsaturated and found in oily fish and nuts.
For more information on how to eat a healthy diet, please visit our balanced diet page.
We are all different - our bodies work in different ways and react differently to various foods. Eating a healthy, balanced diet should ensure that the body is getting enough of all the nutrients necessary for staying healthy.
How can a nutritionist help with fibromyalgia?
There are pages and pages of conflicting information available about what and what not to eat. So how can you easily distinguish the fact from the fiction?
Nutritionists listed on our directory all have the relevant qualifications and experience to offer professional nutritional support, advice and help to those who want it. Many nutritionists focus on fibromyalgia symptoms and factor this into their diet plans.
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