Rareshare would like to acknowledge Dr. Kim Lawson, Senior Lecturer in Pharmacology at Sheffield Hallam University for reviewing this content.
 

A global mean prevalence of 2.7% is proposed. Some estimates suggest as many as 10 million people in the United States have fibromyalgia. Women make up about 80% of the affected individual population. 

The underlying cause of fibromyalgia is unknown. Researchers believe that the disorder develops because of several different factors including environment and genetics. The nervous system has been the target for a number of years of research of how people with fibromyalgia experience and processes pain. Fibromyalgia has developed in people after suffering physical trauma, such as a car accident, or psychological stress or trauma, such as child abuse or divorce. Sometimes people develop fibromyalgia spontaneously, with no identifiable reason or triggering event. Researchers are continuing to study fibromyalgia to try and learn what factors are necessary for the development of the disorder and what are the underlying causes. 

Fibromyalgia can be associated with core symptoms and co-morbidities. One person can be affected very differently from another. Common symptoms are widespread pain and tenderness in key areas of the body. Pain and tenderness may come and go and affect different areas of the body at different times. Individuals with fibromyalgia are often very tired. Another common symptom is cognitive dysfunction, often referred to as “brain fog” or “fibro fog". Affected individuals describe “fibro fog” as having difficulty paying attention, a poor ability to focus on thoughts or to concentrate, and problems thinking. This can make it hard to complete tasks and can interfere with memory recall.

Other symptoms can include, headaches or migraines, morning stiffness, numbness or tingling of the hands and feet, and sensitivity to bright lights or loud noises. Some women may have painful menstrual periods. Sometimes fibromyalgia can be co-morbid with other disorders, including irritable bowel syndrome, interstitial cystitis, temporomandibular joint disorder, and sleep disturbances including restless legs syndrome.

1. Brain Fog – Cannot recall words (anomia) or names, using the wrong word, the memory lapses, can lose track of current location, can become overwhelmed with performing multiple tasks, and low mental acuity. Brain Fog varies from day to day.
2. Pain – Symmetrical pain (left and right side)  in soft tissues, feels like “bones hurt”. Feels radiating, gnawing, numb, tingling, prickling, “pins and needles”, or aching / burning in hands, arms, feet, legs, and sometimes face / jaw. Some pain is always present. A firm touch can cause discomfort. Sometimes its worse in the morning, improves throughout day, and worsens at night. Pain is affected by activity level, weather, sleep patterns, stress, and foods.
3. Stiffness – Stiffness worsens upon awakening and after sitting or standing in one position for a period of time. Muscle tightness and lack of flexibility in the legs, back, and/or shoulders.
4. Chronic Fatigue – Exhaustion that is disabling. Causes muscle twitching, muscle weakness, shakiness, oversleeping, the constant need to fall asleep. Often times, a quick nap refreshes one. However, unrelenting fatigue returns.
5. Exercise intolerance – Exercising incorrectly or excessively can worsen symptoms
6. Emotional change – Easily irritable, dissatisfied with work, work-life is not balanced, negative thinking, depersonalization, trouble recognizing faces or relating to others.
7. Impaired coordination – Impaired coordination physically and mentally. Some cannot pick their feet up.
8. Tender Points – Painful and sensitive locations all over the body. The points correspond to branches of the arteries.
9. Restless Leg Syndrome – Type of sleep disturbance, can occur when awake as well. Periodic limb movement disorder.
10. Trouble falling asleep – Staying awake at all hours, not resting when awake, easily awakened, abnormal sleep patterns.
11. Sensitivity to smell, noise, or light. Normal stimuli can be excruciating and painful. Certain foods, medicines, weather, or temperature can trigger abnormal and/or increased neurological sensations.
12. Thinning hair
13. Soft fingernails and toenails. Easily break.
14. Chronic headaches – Tension and severe migraine headaches. Often from trapped passages in the sinus, creating severe pressure.
15. Eyes – Difficulty focusing eyes can cause visual confusion, nausea, or vertigo.

According to the American College of Rheumatology, fibromyalgia is defined as a chronic widespread condition associated with fatigue, sleep and cognitive disturbance, and a variety of additional physical symptoms.

There is no test to confirm a fibromyalgia diagnosis, it is based on the presence of the characteristic symptoms. However, tests can be run to rule out another condition of the muscles and/or bones with similar symptoms. 

There is no cure for fibromyalgia. The symptoms can be managed using a combination of non-drug and medication based treatments. 

Non-pharmacologic treatments have been proved really important in fibromyalgia management, especially activity and exercise. Some affected individuals may benefit from low-impact exercise like Tai Chi. Medical education and psychological therapy, such as mindfulness and cognitive behavioral therapy (CBT), are also important. Coping techniques help individuals understand how thoughts and behaviors can affect pain sensation and other symptoms. 

Among the prescription drugs that can be used to treat fibromyalgia are duloxetine , minacipran, and amitriptyline. All these medications alter the brain chemicals that control the pain levels. Pregabalin and gabapentin work by reducing the increased activity of the nerve cells involved in pain transmission. Duloxetine, minacipran, and pregabalin are approved by the U.S Food and Drug Administration (FDA) for the treatment of fibromyalgia. Amitriptyline and gabapentin are commonly used off-label for the treatment of fibromyalgia. 

Affected inidividuals must practice sleep hygiene and have a regular sleep pattern. It is also important to live a healthy lifestyle, including eating a balanced diet, maintain phsyical activity, and take time to relax each day. 

Since fibromyalgia affects individuals differently, each affected individual would require a different combination of interventions for optimal pain management.
 

Although fibromyalgia affects the quality of life of an individual due to its debilitating symptoms, it is considered a benign disease. How it affects one person can be different from how it affects another person.
 

1. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia    
2. Cohen, H. (2017). "Controversies and challenges in fibromyalgia: a review and a proposal." Ther Adv Musculoskelet Dis 9(5): 115-127.
3. Schmidt-Wilcke, T. and M. Diers (2017). "New Insights into the Pathophysiology and Treatment of Fibromyalgia." Biomedicines 5(2).
4. https://www.niams.nih.gov/health_info/fibromyalgia/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662432/
6. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia