Fibromyalgia, also known as fibrositis or simply FM, is a common disorder that causes widespread musculoskeletal pain, fatigue, memory problems, sleep problems, and mood issues. Fibrositis is believed to affect up to 10 million people in the United States alone and up to 6% of the world as one of the most common chronic pain conditions.
Symptoms of Fibromyalgia
FM leads to a range of symptoms affecting everything from the muscles to sleep, mood, and ability to exercise. The most common and disabling symptom of the condition is chronic muscle pain, muscle tightness, and/or muscle spasms. The pain associated with FM is often described as a dull ache that is constant and lasts for at least 3 months. Widespread means the pain occurs above and below the waist and both sides of the body.
Many people with FM also report:
⦁ Fatigue. People suffering from fibrositis often feel tired when they wake up, even after being asleep for a long time. Sleep is often interrupted by pain.
⦁ Sleep disorders. Because it’s difficult to sleep well with chronic pain, many people FM have sleep disorders like insomnia, sleep apnea, and restless leg syndrome.
⦁ Cognitive problems. The fatigue and sleep disorders associated with FM often cause mild to moderate cognitive impairment, including trouble concentrating, paying attention, or focusing on tasks. This symptom is also known as “fibro fog.”
⦁ Stiffness. The muscle pain and cramps of FM often lead to stiffness upon waking or remaining in the same position for too long.
⦁ Migraine or tension headaches.
⦁ Reduced tolerance for physical activity with muscle pain after exercise.
⦁ Numbness or tingling in the face and extremities.
⦁ Sensitivity to bright lights, medicine, noise, odors, cold, and/or certain foods.
⦁ Tenderness of the jaw and face.
⦁ Irritable bowel syndrome. This disorder leads to bloating, nausea, abdominal pain, and alternating diarrhea and constipation.
⦁ A false sensation of swelling in the feet and hands.
⦁ Depression and/or anxiety. FM sufferers are at a higher risk of suicide.
These signs of FM can intensify during different times of the day. For most people, chronic pain gets worse in the morning and evening. It can also worsen in the cold, when the weather changes, during stress, or due to hormonal changes. The signs of FM can sometimes go away for months untreated before returning.
Trigger Points of FM
Fibrositis leads to many specific trigger or tender points in addition to widespread pain. These pain points are localized areas of tenderness that are around joints and hurt when pressed. These points lead to superficial pain that seems to be just under the surface of the skin. Actual trigger points are usually very small, or about the size of a penny, and much more sensitive than areas of skin very close by. The pain from pressing on a tender point can cause the individual to flinch or pull away. FM tender points are located across the chest, back, neck, knees, elbows, buttocks, and hips. A physician will use the presence of tender points to make an FM diagnosis.
Fibrositis and Disability
FM can be severe enough to lead to disability. The disorder can lead to reduced quality of life and difficulty performing many activities that involve concentration or physical activity. Unfortunately, it can be extremely difficult to win a Social Security or workers’ compensation disability claim based on fibrositis because side effects of the disorder are mostly self-reported. Social Security updated its rules in 2012 in regard to FM, finding that the disorder is only a medically determinable impairment (MDI) and qualifying for benefits when:
What Causes Fibrositis?
⦁ There is evidence of widespread chronic pain for a minimum of 3 months</li>
⦁ Objective tests like x-rays and lab tests have ruled out other conditions
⦁ Positive tender spots in a minimum of 11 of 18 tested areas AND repeated occurrence of at least six problems associated with the disorder such as “fibro fog,” irritable bowel syndrome, depression, and chronic fatigue.
It’s still unknown what causes FM as the cause may differ from one person to the next. The disorder does tend to run in families so there are likely genes that can make people more susceptible to the disorder, although genes alone do not cause FM. There is usually a cause that triggers FM, such as arthritis, spinal problems, or emotional stress that changes the way the body communicates with the spine and brain.
Risk Factors for FM
Several risk factors have been identified that may increase someone’s chance of developing FM:
⦁ Genetics. The disorder can run in families. People with FM may have one or more genes that can make them susceptible to the disorder.
⦁ Sleep problems. Trouble getting enough sleep or spending too little time in deep sleep can raise the risk of FM. People with sleep disorders like restless leg syndrome and sleep apnea are more likely to have fibrositis.
⦁ Gender. Women are 8-9 times more likely to develop FM than men.
⦁ Age. FM is usually diagnosed between 20 and 50, although the risk increases with age.
⦁ Rheumatic disease. Having rheumatic disease like lupus, rheumatoid arthritis, or osteoporosis increases the risk of FM.
Diagnosing FM can be difficult as there is no single test that can pinpoint the disease. Instead, the disorder is diagnosed through a physical exam and medical history. Criteria necessary for an FM diagnosis include:
⦁ Pain with signs of the disorder over the last week based on the number of tender areas out of 19 parts of the body plus the severity of cognitive impairment, feeling tired upon waking, and fatigue
⦁ Signs of the disorder last at least 3 months at the same level
⦁ No other health problems that could cause the problems
Widespread pain is the hallmark of FM so a physician will ask that the pain be described in detail to help differentiate FM from other diseases like hypothyroidism.
Medications to Treat Fibrositis
There are three drugs approved to treat of fibrositis. Two of these drugs (duloxetine or Cymbalta and milnacipran or Savella) change levels of serotonin and norepinephrine in the brain to control pain. Other drugs that also change the levels of these chemicals may also be used. The other medication used in the treatment of FM is pregabalin (Lyrica) which blocks over activity of nerve cells involve in the transmission of pain.
Opioid narcotic medication is not recommended for FM as they are not effective, may make pain persist, or could increase pain sensitivity.
Other medications may also be used to treat signs of the disorder like cyclobenzaprine (Flexeril) and gabapentin (Neurontin) for sleep problems.
Natural and Alternative Treatments for FM
Research indicates that FM can be effectively managed with many natural and alternative treatments. The most effective treatment for the disorder appears to be physical exercise, particularly aerobic exercise. Yoga can also ease chronic pain and improve sleep in FM patients.
Other alternative treatments for FM include:
Diet Recommendations for People with FM
⦁ Cognitive behavioral therapy to learn reduction techniques to reduce pain
⦁ Massage therapy
⦁ Chiropractic care
People with FM often have food sensitivities, although research hasn’t yet found a link between FM and diet or found that people with fibrositis should avoid certain foods. Still, a recent study published in Rheumatology International found that 30% of people with FM had made changes in their diet to improve their condition. Avoiding the following foods and ingredients may improve symptoms:
Is There a Cure for Fibromyalgia?
⦁ Aspartame, an artificial sweetener.
⦁ Caffeine, which can interfere with sleep.
⦁ Sugar. One study published in the Journal of Pain found obese FM patients have more severe pain, stiffness, and sleep troubles.
⦁ Dairy, which can cause bloating and gas in people who are lactose-intolerant or lactase-deficient.
There is no cure for FM, although treatment can provide relief from issues like depression, anxiety, sleep problems, and pain. Depending on the person, care may include therapy, medicine, physical exercise, stress management, and relaxation techniques.
Fibrositis Statistics & Facts
⦁ Affects approximately 6 to 10 million people in the United States
⦁ Predominantly affects women (75% to 90% of people diagnosed with FM)
⦁ Occurs in men, women, and children of all ethnic groups
⦁ Affects about 8% of adults by the age of 80
⦁ The risk of FM is higher among people with rheumatoid arthritis (RA), lupus, obesity, and a family history of FM
⦁ FM can lead to pain, disability, a lower quality of life, more hospitalizations, and higher rates of rheumatic conditions like osteoporosis and RA