What is fibromyalgia?
What are the main signs and symptoms of fibromyalgia?
Chronic widespread pain is the most common and well-known symptom. However, further research has found that people with FM also experience a myriad of symptoms, such as:[2]
- Fatigue
- Sleep disturbances
- Cognitive dysfunction
- Migraines
- Anxiety/depression
- Digestive disturbances
- Sensitivity to odors, lights, and sounds.
How is fibromyalgia diagnosed?
Diagnosis is based upon a thorough clinical evaluation from a healthcare provider. Currently, there are no tests for diagnosing FM. Since the symptoms of FM can also be caused by many other health conditions, other causes must be ruled out. It is a diagnosis of exclusion. [3]
What are some of the main medical treatments for fibromyalgia?
FM is typically treated with a combination of lifestyle changes and pharmacological interventions. [3]
Lifestyle changes that may be implemented include:
- Improving sleep
- Gradually increasing physical activity
- Stress management
- Dietary changes
- Cognitive behavioral therapy
Medications that may be prescribed include:
- Antidepressants
- Anticonvulsants
- Muscle relaxants
- Antipsychotics
- Medical cannabis
The treatment must be tailored to the individual's responses to any of the previously mentioned interventions.[3]
How could diet affect fibromyalgia?
Some studies found that dietary changes can improve symptoms of FM. However, the quality of these studies was poor and varied in their dietary interventions. More randomized controlled trials are needed to understand the relationship between diet and FM.[4]
Have any supplements been studied for fibromyalgia?
Since there are no standard treatments for FM, dietary supplements are often used to ameliorate symptoms. The supplements with the greatest amount of research are vitamin-d and coenzyme-q10. With that being said, the findings are inconsistent and more evidence is needed before recommendations can be made.[5]
Are there any other treatments for fibromyalgia?
If initial therapies are not effective, people with FM may pursue alternative treatments to reduce symptoms. These treatments include:
- Massage
- Chiropractic
- Acupuncture
The evidence surrounding these interventions is scarce. Therefore, it is recommended to consult a healthcare professional before implementing any alternative treatments. [3]
What causes fibromyalgia?
The cause of FM is unknown. Current research suggests that environmental and genetic factors may play a role in the development of FM. Nonetheless, more research is needed before any conclusions can be drawn.[3]
Examine Database: Fibromyalgia
Research FeedRead all studies
Frequently asked questions
Chronic widespread pain is the most common and well-known symptom. However, further research has found that people with FM also experience a myriad of symptoms, such as:[2]
- Fatigue
- Sleep disturbances
- Cognitive dysfunction
- Migraines
- Anxiety/depression
- Digestive disturbances
- Sensitivity to odors, lights, and sounds.
The widespread pain, fatigue, and cognitive dysfunction of FM can cause significant bodily stress, so any additional stressors (like physical activity, psychological distress, sleep disturbances, poor diet, or infections) can cause a flare-up of FM symptoms. People with FM often have a decreased quality of life, which can further cause psychological distress, thereby creating a worsening cycle of symptoms. As such, finding ways to reduce stress is key to managing flare-ups.[8]
Diagnosis is based upon a thorough clinical evaluation from a healthcare provider. Currently, there are no tests for diagnosing FM. Since the symptoms of FM can also be caused by many other health conditions, other causes must be ruled out. It is a diagnosis of exclusion. [3]
The most widely used tool for diagnosing FM is the American College of Rheumatology (ACR) criteria. In order to reach a diagnosis of fibromyalgia, the following 3 conditions must be met:[6]
- Widespread pain index (WPI) (the patient marks where their pain is located) ≥ 7 AND symptom severity scale (SSS) (the patient indicates how their symptoms interfere with their daily life) score ≥ 5 OR WPI of 4–6 AND SSS score ≥ 9.
- Generalized pain, defined as pain in at least 4 of 5 regions (left upper region, left lower region, right upper region, right lower region, and axial) must be present.
- Symptoms have been present for 3 months.
The ACTTION-APS Pain Taxonomy (AAPT) diagnostic criteria can also be used, albeit less frequently[7]:
- Pain in 6 or more of the following pain sites: head, left arm, right arm, chest, abdomen, upper back and spine, lower back and spine/buttocks, left leg, and right leg.
- Moderate to severe sleep problems OR fatigue.
- Pain and fatigue or sleep problems must be persistent for at least 3 months.
To date, there are no imaging or blood tests used for diagnosis.
FM is typically treated with a combination of lifestyle changes and pharmacological interventions. [3]
Lifestyle changes that may be implemented include:
- Improving sleep
- Gradually increasing physical activity
- Stress management
- Dietary changes
- Cognitive behavioral therapy
Medications that may be prescribed include:
- Antidepressants
- Anticonvulsants
- Muscle relaxants
- Antipsychotics
- Medical cannabis
The treatment must be tailored to the individual's responses to any of the previously mentioned interventions.[3]
Some studies found that dietary changes can improve symptoms of FM. However, the quality of these studies was poor and varied in their dietary interventions. More randomized controlled trials are needed to understand the relationship between diet and FM.[4]
Since there are no standard treatments for FM, dietary supplements are often used to ameliorate symptoms. The supplements with the greatest amount of research are vitamin-d and coenzyme-q10. With that being said, the findings are inconsistent and more evidence is needed before recommendations can be made.[5]
If initial therapies are not effective, people with FM may pursue alternative treatments to reduce symptoms. These treatments include:
- Massage
- Chiropractic
- Acupuncture
The evidence surrounding these interventions is scarce. Therefore, it is recommended to consult a healthcare professional before implementing any alternative treatments. [3]
The cause of FM is unknown. Current research suggests that environmental and genetic factors may play a role in the development of FM. Nonetheless, more research is needed before any conclusions can be drawn.[3]
Historically, whether fibromyalgia was a true condition has been debated, as many researchers and clinicians believed it was a purely psychological phenomenon. However, recent research has discovered that this is a true disorder with physical characteristics that can significantly impact quality of life.
Now, fibromyalgia is thought to be a disorder characterized by improper pain signaling. People with FM tend to be hypersensitive to pain when compared to people without FM.[9] Additionally, people with FM also tend to have higher brain levels of glutamate[10] (an excitatory neurotransmitter) and decreased levels of GABA[11] (an inhibitory neurotransmitter), which may play a role in pain hypersensitivity.
References
- ^Rosalba Siracusa, Rosanna Di Paola, Salvatore Cuzzocrea, Daniela ImpellizzeriFibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options UpdateInt J Mol Sci.(2021 Apr 9)
- ^Daniel J ClauwFibromyalgia: a clinical reviewJAMA.(2014 Apr 16)
- ^The content of this page was partially adapted from MedlinePlus of the National Library of Medicine
- ^Laura Tomaino, Lluís Serra-Majem, Stefania Martini, Maria Rosaria Ingenito, Paola Rossi, Carlo La Vecchia, Fabrizia Bamonti, Luisella VignaFibromyalgia and Nutrition: An Updated ReviewJ Am Coll Nutr.(Sep-Oct 2021)
- ^Giuditta Pagliai, Ilaria Giangrandi, Monica Dinu, Francesco Sofi, Barbara ColombiniNutritional Interventions in the Management of Fibromyalgia SyndromeNutrients.(2020 Aug 20)
- ^Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RL, Mease PJ, Russell AS, Russell IJ, Walitt B2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria.Semin Arthritis Rheum.(2016-12)
- ^Arnold LM, Bennett RM, Crofford LJ, Dean LE, Clauw DJ, Goldenberg DL, Fitzcharles MA, Paiva ES, Staud R, Sarzi-Puttini P, Buskila D, Macfarlane GJAAPT Diagnostic Criteria for Fibromyalgia.J Pain.(2019-06)
- ^Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni FFibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment.Nat Rev Rheumatol.(2020-11)
- ^O'Brien AT, Deitos A, Triñanes Pego Y, Fregni F, Carrillo-de-la-Peña MTDefective Endogenous Pain Modulation in Fibromyalgia: A Meta-Analysis of Temporal Summation and Conditioned Pain Modulation Paradigms.J Pain.(2018-08)
- ^Harris RE, Sundgren PC, Craig AD, Kirshenbaum E, Sen A, Napadow V, Clauw DJElevated insular glutamate in fibromyalgia is associated with experimental pain.Arthritis Rheum.(2009-Oct)
- ^Foerster BR, Petrou M, Edden RA, Sundgren PC, Schmidt-Wilcke T, Lowe SE, Harte SE, Clauw DJ, Harris REReduced insular γ-aminobutyric acid in fibromyalgia.Arthritis Rheum.(2012-Feb)
Examine Database References
- Fibromyalgia Symptoms - Elísabet Alcocer-Gómez, Jose Antonio Sánchez-Alcázar, Mario D CorderoCoenzyme q10 regulates serotonin levels and depressive symptoms in fibromyalgia patients: results of a small clinical trialJ Clin Psychopharmacol.(2014 Apr)
- Fibromyalgia Symptoms - Mario D Cordero, Elísabet Alcocer-Gómez, Manuel de Miguel, Ognjen Culic, Angel M Carrión, José Miguel Alvarez-Suarez, Pedro Bullón, Maurizio Battino, Ana Fernández-Rodríguez, José Antonio Sánchez-AlcazarCan coenzyme q10 improve clinical and molecular parameters in fibromyalgia?Antioxid Redox Signal.(2013 Oct 20)
- Fibromyalgia Symptoms - Sawaddiruk P, Apaijai N, Paiboonworachat S, Kaewchur T, Kasitanon N, Jaiwongkam T, Kerdphoo S, Chattipakorn N, Chattipakorn SCCoenzyme Q10 supplementation alleviates pain in pregabalin-treated fibromyalgia patients via reducing brain activity and mitochondrial dysfunctionFree Radic Res.(2019 Aug)
- Fibromyalgia Symptoms - Miyamae T, Seki M, Naga T, Uchino S, Asazuma H, Yoshida T, Iizuka Y, Kikuchi M, Imagawa T, Natsumeda Y, Yokota S, Yamamoto YIncreased oxidative stress and coenzyme Q10 deficiency in juvenile fibromyalgia: amelioration of hypercholesterolemia and fatigue by ubiquinol-10 supplementationRedox Rep.(2013)
- Fibromyalgia Symptoms - Cordero MD, Cano-García FJ, Alcocer-Gómez E, De Miguel M, Sánchez-Alcázar JAOxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvementPLoS One.(2012)
- Fibromyalgia Symptoms - Christiano R R Alves, Bianca M Santiago, Fernanda R Lima, Maria C G Otaduy, Ana Luisa Calich, Aline C C Tritto, Ana Lúcia de Sá Pinto, Hamilton Roschel, Cláudia C Leite, Fabiana B Benatti, Eloisa Bonfá, Bruno GualanoCreatine supplementation in fibromyalgia: a randomized, double-blind, placebo-controlled trialArthritis Care Res (Hoboken).(2013 Sep)
- Fibromyalgia Symptoms - Avi Leader, Daniella Amital, Alan Rubinow, Howard AmitalAn open-label study adding creatine monohydrate to ongoing medical regimens in patients with the fibromyalgia syndromeAnn N Y Acad Sci.(2009 Sep)
- Fibromyalgia Symptoms - K Kaartinen, K Lammi, M Hypen, M Nenonen, O Hanninen, A L RaumaVegan diet alleviates fibromyalgia symptomsScand J Rheumatol.(2000)
- Fibromyalgia Symptoms - Carolina Chaves, Paulo Cesar T Bittencourt, Andreia PelegriniIngestion of a THC-Rich Cannabis Oil in People with Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Clinical TrialPain Med.(2020 Oct 1)
- Fibromyalgia Symptoms - Tine van de Donk, Marieke Niesters, Mikael A Kowal, Erik Olofsen, Albert Dahan, Monique van VelzenAn experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgiaPain.(2019 Apr)
- Pain - Martín-Sánchez E, Furukawa TA, Taylor J, Martin JLSystematic review and meta-analysis of cannabis treatment for chronic painPain Med.(2009 Nov)
- Myotonia Symptoms - Federica Montagnese, Kristina Stahl, Stephan Wenninger, Benedikt SchoserA role for cannabinoids in the treatment of myotonia? Report of compassionate use in a small cohort of patientsJ Neurol.(2020 Feb)
- Fibromyalgia Symptoms - Jacob E Teitelbaum, Clarence Johnson, John St CyrThe use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot studyJ Altern Complement Med.(2006 Nov)
- Fibromyalgia Symptoms - Merchant RE, Carmack CA, Wise CMNutritional supplementation with Chlorella pyrenoidosa for patients with fibromyalgia syndrome: a pilot studyPhytother Res.(2000 May)
- Fibromyalgia Symptoms - Jacobsen S, Danneskiold-Samsøe B, Andersen RBOral S-adenosylmethionine in primary fibromyalgia. Double-blind clinical evaluationScand J Rheumatol.(1991)
- Fibromyalgia Symptoms - Florian Wepner, Raphael Scheuer, Birgit Schuetz-Wieser, Peter Machacek, Elisabeth Pieler-Bruha, Heide S Cross, Julia Hahne, Martin FriedrichEffects of vitamin D on patients with fibromyalgia syndrome: a randomized placebo-controlled trialPain.(2014 Feb)
- Fibromyalgia Symptoms - Atalay Dogru, Ayse Balkarli, Veli Cobankara, Sevket Ercan Tunc, Mehmet SahinEffects of Vitamin D Therapy on Quality of Life in Patients with FibromyalgiaEurasian J Med.(2017 Jun)
- Fibromyalgia Symptoms - J F de Carvalho, F A G da Rocha Araújo, L M A da Mota, R B Aires, R P de AraujoVitamin D Supplementation Seems to Improve Fibromyalgia Symptoms: Preliminary ResultsIsr Med Assoc J.(2018 Jun)
- Fibromyalgia Symptoms - Rossini M, Di Munno O, Valentini G, Bianchi G, Biasi G, Cacace E, Malesci D, La Montagna G, Viapiana O, Adami SDouble-blind, multicenter trial comparing acetyl l-carnitine with placebo in the treatment of fibromyalgia patientsClin Exp Rheumatol.(2007 Mar-Apr)
- Fibromyalgia Symptoms - Axel Finckh, Isabelle Carey Berner, Bérengère Aubry-Rozier, Alexander Kai-Lik SoA randomized controlled trial of dehydroepiandrosterone in postmenopausal women with fibromyalgiaJ Rheumatol.(2005 Jul)
- Fibromyalgia Symptoms - Ana Paula Marum, Cátia Moreira, Fernando Saraiva, Pablo Tomas-Carus, Catarina Sousa-GuerreiroA low fermentable oligo-di-mono saccharides and polyols (FODMAP) diet reduced pain and improved daily life in fibromyalgia patientsScand J Pain.(2016 Oct)
- Fibromyalgia Symptoms - Selda Bagis, Mehmet Karabiber, Ismet As, Lülüfer Tamer, Canan Erdogan, Ayçe AtalayIs magnesium citrate treatment effective on pain, clinical parameters and functional status in patients with fibromyalgia?Rheumatol Int.(2013 Jan)
- Quality of Life - Macian N, Dualé C, Voute M, Leray V, Courrent M, Bodé P, Giron F, Sonneville S, Bernard L, Joanny F, Menard K, Ducheix G, Pereira B, Pickering GShort-Term Magnesium Therapy Alleviates Moderate Stress in Patients with Fibromyalgia: A Randomized Double-Blind Clinical Trial.Nutrients.(2022-May-17)
- Fibromyalgia Symptoms - Chad S Boomershine, Todd A Koch, David MorrisA Blinded, Randomized, Placebo-Controlled Study to Investigate the Efficacy and Safety of Ferric Carboxymaltose in Iron-Deficient Patients with FibromyalgiaRheumatol Ther.(2018 Jun)
- Fibromyalgia Symptoms - Mansoor Shakiba, Ehsan Moazen-Zadeh, Ahmad Ali Noorbala, Morteza Jafarinia, Parisa Divsalar, Ladan Kashani, Nazila Shahmansouri, Abbas Tafakhori, Hannaneh Bayat, Shahin AkhondzadehSaffron ( Crocus sativus) versus duloxetine for treatment of patients with fibromyalgia: A randomized double-blind clinical trialAvicenna J Phytomed.(Nov-Dec 2018)
- Fibromyalgia Symptoms - Yeh SW, Hong CH, Shih MC, Tam KW, Huang YH, Kuan YCLow-Level Laser Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis.Pain Physician.(2019-May)
- Pain - Donna D ZampiEfficacy of Theta Binaural Beats for the Treatment of Chronic PainAltern Ther Health Med.(Jan-Feb 2016)