Fibromyalgia        www.arthritis.org.nz

What is fibromyalgia?

The word ’fibromyalgia’ comes from the Latin term for fibrous tissue (fibro), and the Greek for muscle (myo) and pain (algia). It is called a ‘syndrome’ because it is a collection of symptoms such as muscular pain, stiffness, fatigue, rather than a disease.

Who gets fibromyalgia?

Around 1 in 50 people will develop fibromyalgia at
some time in their life. It most commonly develops
between the ages of 25-55; and women are more
likely to develop this syndrome than men. Fibromyalgia
often runs in families, a person is more likely to develop
fibromyalgia if a relative also has the condition.
People with rheumatoid arthritis, lupus or ankylosing
spondylitis are also more likely to develop fibromyalgia.
Often people with fibromyalgia are more likely to have
a history of past psychological trauma, e.g. abuse in
childhood, and may have been diagnosed with posttraumatic
stress disorder.

What causes fibromyalgia?

No one knows what causes fibromyalgia. Researchers speculate that it may be many different factors, alone or in combination. It may be helpful to think of fibromyalgia as resulting from the loss of the pain blocking signals that flow down the spinal cord from the brain. Stress and sleep disturbance can weaken these blocking signals while exercise, good quality sleep, relaxation techniques and some medications can boost these pain blocking signals.

Sites tested for tenderness in diagnosing fibromyalgia syndrome-clustering around the neck, shoulder, chest, hip,
knee and elbow regions.

What are the symptoms?

Fibromyalgia affects people in different ways. The most common symptoms include:
? pain - usually widespread muscle aching and stiffness. It can feel like your whole body is hurting.
The neck and back are most commonly affected. Pain can vary throughout the day. It can be worse
after rest (e.g. first thing in the morning), and/or after activity. Overwhelming tiredness or fatigue making it
difficult to do your normal daily activities ? insomnia or poor sleep - waking up without feeling refreshed
tingling, numbness in the hands or feet due to poor circulation irritability or feeling low forgetfulness and/or poor concentration tender points in certain areas of the body.
The good news is that fibromyalgia is not progressive and does not cause permanent damage to your
muscles, bones or joints.

Fibromyalgia is often difficult to diagnose
as the symptoms vary considerably. It often overlaps with other conditions such as tension headache, irritable bowel syndrome, chronic fatigue syndrome, non-specific low back pain, restless leg syndrome and anxiety/depression. Your doctor may suggest some tests to rule out other conditions.
New diagnostic criteria have recently been developed that include the full spectrum of fibromyalgia symptoms and related conditions. Most people diagnosed with fibromyalgia have symptoms of widespread pain not explained by other conditions, and tenderness in at least 11/18 specific sites. However some people may still have fibromyalgia even without these symptoms.

Treatment options

There is currently no known cure for fibromyalgia. It is important to remember that, with help and better
understanding, the symptoms can be effectively managed. Contact your doctor when the pain is more
severe and affecting your normal activities.

Medications

Medications alone are seldom successful in treating fibromyalgia but they can be part of the management
of this syndrome. Medications will be prescribed based on each individual’s experience of the variety
of fibromyalgia symptoms. Medications can help reduce the pain of fibromyalgia and improve sleep,
they may include:

Painkillers such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), they are
usually ineffective or only minimally effective in fibromyalgia, although they may still be useful for
the treatment of underlying arthritic pain.

Tricyclic anti-depressants such as amitriptyline and nortriptyline, are usually used in very low
doses to improve quality of sleep and to address the imbalance of neurotransmitters in the pain
conduction pathways. You do not need to suffer from depression to benefit from this type of
medication.

Newer drugs like gabapentin and pregabalin can help by acting directly on the pain pathways.

Physical exercise

Aerobic exercise will help to improve your mood, increase muscle tone, improve blood flow, ease
digestive problems and aid sleep. The key to an exercise programme, especially if you are in pain, is to
start gradually. Ideally the programme should include stretching, strengthening and aerobic exercise. The
best way to begin a fitness program is to start with short sessions of just a few minutes of gentle, lowimpact exercises such as walking and swimming. Warming-up before exercise is very important.
Psychological interventions and relaxation techniques. A psychological technique known as Cognitive
Behavioral Therapy (CBT) has been shown to help people with fibromyalgia. This should be undertaken
with a trained therapist or clinical psychologist. For people with severe psychological trauma, counseling
or psychotherapy may be required. Other therapies and relaxation techniques may help ease muscle tension and anxiety. They can also improve mobility and decrease muscle tightness.

They include:

acupuncture
massage
Tai Chi & Qi Gong
hypnotherapy
infrared heat
hydrotherapy
hot and cold packs
yoga
meditation.

Fibromyalgia PAGE