What is Fibromyalgia?

You've been exhausted, despite sleeping for 9, 10, and sometimes 12 hours at night. You ache all over, and your doctor is baffled, because all the usual tests come back fine. If this sounds like you, you might just have fibromyalgia.

Fibromyalgia, also known as fibromyalgia syndrome, or FMS, is a chronic pain condition characterized by widespread body aches usually confined to the soft tissues (muscles, ligaments, and tendons) of the body, as well as 18 "tender points" (also sometimes called "trigger points" though that is a less correct term), and exhaustion that is not alleviated by sleep. It is more common in women than men, though many doctors believe that this could be due to the fact that many men simply won't seek a doctor's help for "aches and pains," though fibromyalgia is more than just aches and pains.

Fibromyalgia can also be accompanied by irritable bowel syndrome (constipation, diarrhea, abdominal pain, and bloating), headaches or migraines, temporomandibular joint pain or dysfunction (TMJ), heightened sensitivity to odors, noises, bright lights, and sounds, depression, numbness or tingling in the hands and feet, dry eyes, painful menstrual periods, dizziness, and anxiety. Because of the wide range of symptoms, and the fact that each individual fibromyalgia patient will experience different symptoms (and sometimes an individual patient will experience different symptoms at different times), it is an incredibly difficult illness to diagnose. The other big problem?

Doctors have no idea what really causes fibromyalgia.

There are two major schools of thought and several minor ones. The "trauma" school of thought believes that fibro is brought on by a traumatic accident, like a car accident. They believe that the nerves that are triggered by the accident are oversensitized by the accident, and the body never recovers from that trauma to return to its previous level of pain sensitivity. The second major school of thought is that people with fibromyalgia have a lower threshold for pain because of increased sensitivity in the brain to pain signals. This theory is called "central sensitization." Essentially, the brain's pain receptors that receive the pain signals develop a memory for each pain signal they receive and become more and more sensitive, and thus begin to overreact to future signals. However, they have no idea which theory is correct, or even if it could be a combination of the two, or what initiates the process of either theory.

The minor theories include sleep disturbances, infection, abnormalities of the autonomic (sympathetic) nervous system, changes in muscle metabolism, psychological stress, or hormonal changes as possible causes. Because fibromyalgia hits women more often than men (about 80% of fibromyalgia sufferers are women) the hormonal theory is gaining prominence among many doctors.

The likeliest theory is that it is a combination of some of the above. One thing they do know is that there are certain risk factors for developing fibromyalgia. If you are a woman, in your 30s, with sleeping disorders (such as insomnia, restless leg syndrome, or sleep apnea), a family history of the illness, or related illnesses (such as lupus, rheumatoid arthritis, or Lyme disease), you have a higher risk of developing fibromyalgia.

If you think you have fibromyalgia, you should seek a doctor's advice as soon as possible. There are treatments, and the earlier treatment is begun, the better. While there is no cure, often early treatment can contain the damaging effects, so that you are able to continue to live an almost normal life. Also, because fibro is such a difficult illness to diagnose, there are many other illnesses that must be ruled out first. Once the other illnesses are ruled out, the doctor will do the "tender point test," by pressing on the 18 tender points that all fibromyalgia patients have in common. If you have 11 or more of the 18, then you most likely have fibromyalgia, and you will be given a treatment plan.

In general, the most successful treatment for fibromyalgia is a combination approach, that of medication, exercise, and alternative therapies. Each individual will have to experiment to see what works for them. In general, however, doctors will start with pain medication (such as tramadol) or possibly a muscle relaxer (such as flexeril or soma), and antidepressants (which can help with a variety of problems for fibromyalgia patients, such as Cymbalta or Effexor). Your doctor will also recommend an exercise regimen, because despite the pain that we experience, exercise actually does help fibromyalgia patients. However, you'll want to start slowly and work carefully, to make sure that you don't overtax your muscles. In general, a low-impact exercise such as yoga, water aerobics, or swimming is best for people with fibromyalgia. Finally, exploring alternative therapies can be very helpful to those of us with fibromyalgia. You'll want to investigate to see which one is best for you, but acupuncture, chiropractic care, massage therapy, and osteopathic medicine are all areas that are highly recommended for fibromyalgia patients.

One thing that many medical doctors won't recommend, but that I, as a sufferer of fibromyalgia highly recommend is to develop a good support system. You're going to go through stages of grief, because you've just been hit with a huge life change. Don't discount your grief, anger, and frustration at the new limitations that your body is putting upon you. A good support group (there are several available online- check Yahoo Groups or if you have a Livejournal, there are some there, too) is absolutely a must so that you don't forget that you're not alone. Your friends may be confused by your new refusal to hang out because of your pain or tiredness, too. Hopefully they will be supportive and helpful, but it is almost a guarantee that some of your friendships will change as you learn how this illness is going to turn your life upside down. Share as much as you can with them, so that they're not blindsided- do not be ashamed of what you're going through. Fibromyalgia is just like arthritis. Would you be embarrassed to tell someone you had arthritis, and that's why you couldn't go hiking for a day?

Be gentle with yourself. And don't be afraid to reach out. You'll get through this. We have all been there.

With the right team, and a good support structure, your new life won't be that different from your old. And that's the best part of all.