Fibromyalgia — Symptoms, Treatment, & Diagnosis

Things to remember

Fibromyalgia is a common condition that causes widespread pain and tenderness in the body
Each person with fibromyalgia will have their own set of symptoms
There is no cure for fibromyalgia, but symptoms can be managed
Fibromyalgia research is growing and we’re moving ever closer to understanding this complex disease

Fibromyalgia is a common condition in which people experience symptoms that include widespread pain and tenderness in the body, often accompanied by fatigue and problems with memory and concentration.

Fibromyalgia affects two to five per cent of the population, mainly women, although men and adolescents can also develop the condition. It tends to develop during middle adulthood.

Symptoms

The symptoms of fibromyalgia can vary from mild to severe.

The most common symptoms are:

increased sensitivity to pain due to a decreased pain threshold
increased responsiveness to sensory stimuli such as heat, cold, light and smell
extreme fatigue (tiredness)
problems with memory and concentration (fibro fog)
problems with sleep.

Less common symptoms may include:

irritable bowel syndrome
irritable or overactive bladder
headaches
numbness or tingling in the arms and legs
anxiety and depression.

Not everyone will experience all of these symptoms. Each person with fibromyalgia will have their own unique set of symptoms.

The symptoms of fibromyalgia can vary from day to day. Symptoms may disappear for extended periods of time, perhaps even years.

Causes

No one knows what causes fibromyalgia. It’s thought that it may be the result of genetic factors (or things you’ve inherited) and something from your environment (e.g. exposure to a virus or illness).

It’s also believed that physical or emotional stress can trigger the start of fibromyalgia symptoms. However fibromyalgia may also appear without any obvious cause.

Fibromyalgia is more common in people with:

lupus or rheumatoid arthritis
family history of fibromyalgia
previous pain syndromes
an illness such as a virus (or a recent illness or infection)
pain from an injury or trauma
emotional stress and depression
mood disorders
substance abuse.

There is no cure for fibromyalgia, but treatment can help you manage your symptoms.

Triggers for fibromyalgia flares

At times the symptoms you experience as a result of your fibromyalgia (e.g. pain, fatigue) may become more intense. This is called a flare.

Flares can be triggered or made worse by several factors including:

weather changes
overexertion
mental stress
illness or injury
travelling
hormonal changes
changes in treatment.

Triggers vary from person to person. Understanding the things that cause your fibromyalgia to flare means that you can be prepared and take steps to lessen the effect they will have on you and your life.

Diagnosis

Fibromyalgia can be difficult to diagnose as the symptoms are common to many other conditions. This means that it may take some time to establish a diagnosis of fibromyalgia, which can be very frustrating.

Your doctor will take your medical history, description of your symptoms, and do a physical examination.

According to the most recent assessment guidelines, they will also consider:

widespread pain/tenderness lasting three months or more
cognitive symptoms such as memory problems
waking unrefreshed and experiencing fatigue.

You may also have tests, including blood tests, x-rays or scans. While these tests cannot diagnose fibromyalgia, your doctor may use them to rule out other conditions.

Treatment

While there’s no cure for fibromyalgia, your symptoms can be effectively managed. This starts with a correct diagnosis. A management program will then be designed to meet your specific needs.

Generally management of fibromyalgia will involve a combination of:

learning about your condition – knowing as much as possible about your condition means that you can make informed decisions about your healthcare and play an active role in the management of your condition.
learn way to manage your pain – there are many things you can do to manage pain – and different strategies will work for different situations. For example, heat packs can help ease muscle pain, cold packs can help with inflammation, gentle exercise can help relieve muscle tension. Try different techniques until you find what works best for you.
sleep – it’s important to get a good night’s sleep when you have fibromyalgia. Poor sleep – both quantity and quality – can aggravate your symptoms. However getting a good night’s sleep when you have fibromyalgia and chronic pain can sometimes be difficult. If you’re having problems sleeping, talk with your doctor about ways you can manage this.
exercise – evidence has shown that regular exercise improves symptoms of fibromyalgia such as pain, fatigue and quality of sleep. There’s no one form of exercise that is better than another, but you’ll need to choose something that you enjoy so you’ll keep doing it. Many people find a hydrotherapy pool a good starting point because the water is warm and supportive. The key is to start exercise slowly and build it up very gradually. Talk to a physiotherapist or exercise physiologist to work out the best program for you.
stress management and relaxation – stress may aggravate your symptoms. Things you can do to manage stress include planning your day and setting priorities, using relaxation techniques such as going for a walk, meditation or listening to music, and avoiding people and situations that cause you stress.
pace yourself – keep an eye on your energy levels throughout the day and make sure you take regular breaks as needed. Plan your days ahead of time and try to break up larger tasks into smaller more manageable jobs.
cognitive behavioural therapy (CBT) – CBT is a short-term, task based approach used by psychologists to challenge and change unhelpful ways of thinking. Evidence suggests that CBT can help reduce pain and disability in fibromyalgia.
staying at work – it’s good for your health and wellbeing. Talk to your doctor, occupational therapist or social worker about things you can do to help you get back to work or stay at work.
massage – this can help with muscle relaxation and stress management.
mindfulness – mindfulness-based therapies (MBT) can help you break away from negative thought patterns. When used in the management of fibromyalgia, studies have shown that MBT can help to reduce pain and depression, as well as establish better coping strategies for an improved quality of life.
transcutaneous electrical nerve stimulation (TENS) – a TENS machine is a small battery powered device with leads that connect to sticky pads on your body. It delivers very small electrical currents to your skin that stimulate nerves to relieve pain. Whilst there is insufficient high-quality evidence to say if TENS is effective for treating fibromyalgia symptoms or not, there is evidence to suggest that some people do find it helpful in reducing pain and fatigue. If you were thinking of trialling a TENs machine speak with your doctor to see if it’s a suitable option for you. You can often hire one from your physiotherapist, local pharmacy or local hospital.
acupuncture – there’s low to moderate-level evidence that acupuncture improves pain and stiffness in people with fibromyalgia. However, the effects are shown to be short lived (up to a month) and therefore repeated sessions would be required to maintain any potential benefit.
nutrition – eating a healthy balanced diet can help provide you with better energy levels, help to maintain your weight, and give you a greater sense of wellbeing.
support from others – family, friends, work colleagues and health professionals can help you manage. A peer support group may be another option.

Medication

Combined with other strategies, medication may be used to manage your pain, reduce stress and help you sleep.

There are different types of medication that your doctor may recommend depending on your symptoms:

pain-relievers (analgesics) – e.g. paracetamol – for temporary pain relief
non-steroidal anti-inflammatory medications – for temporary pain relief
anti-depressant medications – may be used in small doses to reduce pain and help you sleep
anti-epileptic medications – may also be used to help reduce pain and promote sleep.

You may need to try some medications for 6 weeks or more to see if they work for you. Not everyone will benefit from such medications but you can discuss your options with your doctor.

Research

Fibromyalgia research is growing and it’s believed that scientists are finally making progress towards understanding this complex condition. It’s still early days but scientists are excited by their findings and the knowledge that they’re moving ever closer to understanding this condition.

Where to get help

Your doctor
Rheumatologist
Physiotherapist
Exercise physiologist
Musculoskeletal Australia
National Arthritis and Back Pain+ Help Line 1800 263 265

How we can help

Call our Help Line and speak to our nurses. Phone 1800 263 265 or email helpline@msk.org.au.

We can help you find out more about:

fibromyalgia and musculoskeletal conditions
ways to live well with these conditions
managing your pain
- read our A-Z guide to managing pain
- watch our excellent videos on pain, your brain and how you can retrain your pain system.
  - Pain, the brain and your amazing protectometer – Lorimer Moseley
  - Treating pain using the brain – David Butler
upcoming webinars, seminars and other events.

More to explore

Download this information sheet (PDF).

Watch the recording of our webinar.

Diagnosing and managing fibromyalgia, presented by rheumatologist Dr Emma Guymer.
This webinar provided information about fibromyalgia and the different ways to manage it.
Recorded on 8 May 2019.

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This information has been produced in consultation with and approved by: Musculoskeletal Australia.