Fibromyalgia (Chronic Pain)

Fibromyalgia is a common, chronic and widespread pain disorder characterized by a dull, deep pain in the muscles and tendons that may be felt throughout the body. There are as many as 6 million Americans sufferers. Anyone can develop fibromyalgia; however, 80 percent to 90 percent of those diagnosed are middle-age women.

Although any part of the body can be affected, the most common sites of pain are the neck, back, hands and pelvis. These sites are called "tender points." The pain of fibromyalgia often is described as aching, nagging and exhausting. Muscles become tender to the touch with flu-like aching.

People with fibromyalgia tend to sleep lightly and awaken frequently during the night, which increases fibromyalgia pain and stiffness. They wake feeling exhausted and are extremely fatigued throughout the day. Fibromyalgia is not a psychological disorder, but feelings of depression and anxiety commonly accompany it.

What Causes Fibromyalgia?
Doctors have reason to believe fibromyalgia is hereditary. In people who are more likely to develop fibromyalgia, certain events tend to trigger the illness, including accidents and injuries; autoimmune disorders, such as rheumatoid arthritis and lupus; and infections. In addition, studies have shown that more pain signals are sent to the brain and spinal cord of people with fibromyalgia, making them more sensitive to pain.

Diagnosing Fibromyalgia
Fibromyalgia can be difficult to diagnose. No tests confirm the presence of the illness, and its symptoms are similar to those of many other conditions, such as rheumatoid arthritis, lupus and hyperthyroidism. A doctor might first conduct tests to see if any of these other illnesses are the cause of symptoms.

The American College of Rheumatology has developed a set of criteria for physicians to help identify whether someone has fibromyalgia:

  • Pain all over the body (on both the right and left sides of the body and above and below the waist) for at least three months
  • Pain in at least 11 of the 18 tender-point areas of the body when these areas are pressed mildly but firmly
  • Other signs or symptoms, such as fatigue, disturbed sleep and morning stiffness

Some doctors believe that a patient doesn’t need to have 11 tender points in order to be diagnosed with fibromyalgia and that if someone experiences widespread pain throughout his or her body, the presence of tender points is not necessary.

Treating Fibromyalgia
While living with fibromyalgia can be challenging, there are ways to effectively manage the illness:

  • Medication: Two prescription medications recently were approved for the treatment of fibromyalgia. In June 2007, the Food and Drug Administration approved Lyrica (pregabalin), marketed by Pfizer, for the treatment of fibromyalgia. Next, the FDA approved Cymbalta (duloxetine hydrochloride), marketed by Eli Lilly and Co., in June 2008. In addition, over-the-counter nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxen sodium), sleep medications, antidepressants (tricyclic antidepressants, selective serotonin reuptake inhibitors, mixed reuptake inhibitors), muscles relaxants and anti-seizure medications all are used to treat the pain associated with fibromyalgia.

  • Exercise: Studies have shown that the pain of fibromyalgia can be eased with gentle exercise, such as walking, jogging, yoga, stretching or riding on a stationary bike. It’s important to always check with a doctor before starting any exercise program and to start slowly. Intense exercise can make fibromyalgia symptoms worse.

  • Sleep management: Sleep can be improved by: going to sleep at the same time every night, maintaining a cool room, limiting caffeine (coffee, tea, cola, chocolate) and avoiding alcohol before bedtime, exercising in the afternoon, limiting naps earlier in the day to no more than 20 minutes, and developing a relaxing bedtime routine, such as playing soft music or taking a bath.

  • Emotional support: Studies have shown that a type of talk therapy called cognitive behavior therapy can help some people with fibromyalgia manage their pain and improve functioning. Support groups led by trained counselors may provide important information about the condition and encourage discussion of issues of concern to people with fibromyalgia.

  • Complimentary therapies: Acupuncture, yoga, therapeutic massage, light aerobics, acupressure, training in breathing techniques, chiropractic manipulation, physical therapy, water therapy and many other complimentary therapies can be beneficial to people with fibromyalgia.

Source Information

American College of Rheumatology. "1990 Criteria for the Classification of Fibromyalgia" (accessed Aug. 11, 2008).

Food and Drug Administration. "Living with Fibromyalgia." FDA Consumer Health Information, July 17, 2008.

National Fibromyalgia Association. "Fibromyalgia."

National Institute of Arthritis and Musculoskeletal and Skin Diseases. "Questions and Answers About Fibromyalgia" (accessed Aug. 11, 2008).