Fibromyalgia is a common syndrome in which a
person has long-term, body-wide pain and
tenderness in the joints, muscles, tendons,
and other soft tissues.
Fibromyalgia has also been linked to
fatigue, sleep problems, headaches,
depression, and anxiety.
incidence, and risk factors :
The cause is unknown. Possible causes or
triggers of fibromyalgia include:
Physical or emotional trauma
Abnormal pain response - areas in the brain
that are responsible for pain may react
differently in fibromyalgia patients
Infection, such as a virus, although none
has been identified
Fibromyalgia is most common among women aged
20 to 50.
The following conditions may be seen with
fibromyalgia or mimic its symptoms:
Chronic neck or back pain
Chronic fatigue syndrome
Hypothyroidism (underactive thyroid)
Pain in the main symptom of fibromyalgia. It
may be mild to severe.
Painful areas are called tender points.
Tender points are found in the soft tissue
on the back of the neck, shoulders, chest,
lower back, hips, shins, elbows, and knees.
The pain then spreads out from these areas.
The pain may feel like a deep ache, or a
shooting, burning pain.
The joints are not affected, although the
pain may feel like it is coming from the
People with fibromyalgia tend to wake up
with body aches and stiffness. For some
patients, pain improves during the day and
gets worse at night.
Some patients have pain all day long. Pain
may get worse with activity, cold or damp
weather, anxiety, and stress. Fatigue,
depressed mood, and sleep problems are seen
in almost all patients with fibromyalgia.
Many say that they can't get to sleep or
stay asleep, and they feel tired when they
Other symptoms of fibromyalgia may include:
Irritable bowel syndrome (IBS)
Memory and concentration problems
Numbness and tingling in hands and feet
Reduced ability to exercise
Tension or migraine headaches
To be diagnosed with fibromyalgia, you must
have had at least 3 months of widespread
pain, and pain and tenderness in at least 11
of 18 areas, including
Thighs Blood and urine tests are usually
normal. However, tests may be done to rule
out other conditions that may have similar
The goal of treatment is to help relieve pain and
other symptoms, and to help a person cope with the
The first type of treatment may involve:
Exercise and fitness program
Stress-relief methods, including light massage and
If these treatments do not work, your doctor may
prescribe an antidepressant or muscle relaxant. The
goal of medication is to improve sleep and pain
tolerance. Medicine should be used along with
exercise and behavior therapy.
Cyclosed is a medication approved specifically
for treating fibromyalgia.
However, many other drugs are also used to treat the
Cognitive-behavioral therapy is an important part of
treatment. This therapy helps you learn how to:
Deal with negative thoughts
Keep a diary of pain and symptoms
Recognize what makes your symptoms worse
Seek out enjoyable activities
Support groups may also be helpful.
Other recommendations include:
Eat a well-balanced diet
Practice good sleep routines to improve quality of
Acupressure and acupuncture
Severe cases of fibromyalgia may require a referral
to a pain clinic.
Fibromyalgia is a long-term disorder. Sometimes, the
symptoms improve. Other times, the pain may get
worse and continue for months or years.
There is no known prevention.
Abeles M, Solitar BM, Pillinger MH, Abeles AM. Update on
fibromyalgia therapy. Am J Med. 2008;121:555-561.
Häuser W, Bernardy K, Üceyler N, Sommer C. Treatment
of fibromyalgia syndrome with antidepressants. JAMA.
2009;301:198-209. Wolfe F, Rasker JJ. Fibromyalgia.
In: Firestein GS, Budd RC, Harris ED Jr., et al.,
eds. Kelley's Textbook of Rheumatology. 8th ed.
Philadelphia, Pa: Saunders Elsevier; 2008:chap 38.
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL,
Katz RS, Mease P, et al. The American College of
Rheumatology preliminary diagnostic criteria for
fibromyalgia and measurement of symptom
severity. Arthritis Care Res. 2010;62(5):600-610.
Review Date: 2/2/2012. Reviewed by: Ariel D. Teitel,
MD, MBA, Clinical Associate Professor of Medicine,
NYU Langone Medical Center. Review provided by
VeriMed Healthcare Network. Also reviewed by David
Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.