Education

Discussing Fibromyalgia

I am frequently asked to distinguish between arthritis conditions and chronic pain related to fibromyalgia. Learning more about fibromyalgia (FM) will help patients cope with their pain.

What is Fibromyalgia?

Fibromyalgia just means "I hurt all over, and I have hurt for more than three months without another reason being found." Fibromyalgia affects at least one part of the spine; the neck, the mid back, or the low back; and at least three other areas on either side of the body's midline, and pain that involves at least one area above and below the belt line. The primary symptom of fibromyalgia is gnawing, aching pain. Patients with FM will describe having a bad bout of the flu that just won't go away. Overdoing it, pushing beyond your usual emotional or physical limits, having worse asleep than usual, more stress, or bad weather can aggravate fibromyalgia. Fibromyalgia is not arthritis, there is no physical disability that can distinguish FM, and there are no diagnostic blood tests or x-rays to confirm the presence of fibromyalgia.

In addition to widespread pain at muscle attachments around the body, patients frequently describe numbness, tingling, or a sensation of swelling of the hands. Many FM patients have fatigue. Doctors have used the number of tender points to help define fibromyalgia. However symptoms of widespread pain and fatigue, when other criteria are met, are adequate for diagnosis, regardless of the number of tender points.

Patients with fibromyalgia are generally more sensitive to their environment. They are sensitive to weather changes, a low bank balance, criticism, or potent smells, a firm mattress, or maintaining postures for long periods of time. Other problems coexist with fibromyalgia including fluctuating numbness and tingling of the fingers and toes (paresthesia) headache, irritable bowel, restless legs, fluctuating mental sharpness (Fibro-fog), even anxiety or depression. Anxiety affects about half of all fibromyalgia patients and about one in six is actively depressed, about the same proportion as actively depressed physicians.

Fibromyalgia / chronic pain and fatigue influence and perpetuate complications with every facet of a FM sufferer's life.

How can Fibromyalgia be managed?

This illness has to be MANAGED. There is NO cure. The management means life style and expectation changes. Accepting the need for change may be one of the first challenges you need to meet. There is no one best way to solve this problem. Social, financial, and physical limitations have to be considered. Warm water exercise is a wonderful help for FM. However everyone does not have access to a warm water pool. Few people lack a shower however. Request that others modify their demands on you so you can make these changes in your life. Don't rely on your doctor, family, or anyone else to make these changes for you. Medications are NO substitute for these life-changing actions and expectations.

Medications help a LITTLE. They all have some potential side effects and benefits always have to be balanced with adverse symptoms. Remember, fibromyalgia patients are also sensitive to medicines.

Start your self management journey by learning more about fibromyalgia, about what pushes your buttons, and about problem solving strategies you can use to survive better with fibromyalgia.

Remember, you cannot control what happens, but you can control your reaction. Take the time to develop reasonable expectations of yourself and those around you. Solutions to problems, even changing your priorities, short and long term goals will become easier.

Manage your symptoms of pain and fatigue. Lifestyle changes, paced physical activity, good postures, and comfortable surroundings all help.

I tell people that if you are stress-free you are probably dead. So don't just complain about stress, do something about it. Say no without guilt. Don't set impossible deadlines or goals for you or others. Use relaxation techniques to defuse the stress that is inevitable.

Control your stress.

Learn how to manage your emotional reactions to stress.
Avoid people that produce negative emotions and steal your precious energy. Build positive relationships around cooperation and better communication.
Avoid manipulating those around you with your symptoms of pain and fatigue. Define your purpose in life, and avoid defining other's behaviors.

In Conclusion:

Management of fibromyalgia is not easy. Your doctor is one member of your team, helping with medications, and making sure there is no other disease contributing to your symptoms. Try to find an exercise buddy. You may also need a coach, someone that can help keep you on track with expectations, help focus your energy, on your FM management goals. That is the secret to successful FM management.

Thanks for taking time to learn more about fibromyalgia. Our team of Mayo Clinic trained, board certified rheumatologists at the Arthritis Center of NE are ready to serve you in the diagnosis and treatment of arthritis and autoimmune diseases. We invite you to call 402-420-1212 to schedule an appointment with one of us.

Categorized in: Fibromyalgia
About the Author

Dr. Robert Valente earned a BS in Microbiology from the University of Minnesota, then graduated from Mayo Medical School. After finishing his internal medicine internship and residency… Read more.