Answers FAQ

Fibromyalgia FAQs

Reviewed by John P. Cunha, DO, FACOEP

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Q:What is fibromyalgia?

A:Fibromyalgia is a disorder that causes aches and pain all over the body.

Tender points are specific places on the neck, shoulders, back, hips, arms, and legs that hurt when pressure is put on them.

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Q:The cause of fibromyalgia is not known. True or false?

A:True.

It is unknown what causes fibromyalgia, but several factors may be at play. Fibromyalgia may occur by itself, but other suspected causes include:
- a family history of fibromyalgia
- being exposed to stressful or traumatic events, such as car accidents
- repetitive injuries, which are caused by performing the same action over and over again
- infections or illnesses
- being sent to war

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Q:Typically, fibromyalgia patients do not get restful sleep. True or false?

A:True.

Many patients with fibromyalgia do not have restful sleep. Pain and sleep disturbance caused by fibromyalgia can become a vicious circle: the pain makes it difficult to sleep, and lack of sleep makes the pain worse. However, often when patients can get a good night's rest, pain symptoms improve.

While not completely understood, there seems to be a link between sleep and pain. Studies have shown that patients experiencing post-surgical pain have disturbed sleep with reduced rapid eye movement (REM), but as they recover and feel less pain their sleep patterns normalize. It is thought that people with fibromyalgia may have a similar experience with an alteration of their slow wave sleep, the deepest stage.

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Q:Fibromyalgia and depression appear to be related. True or false?

A:True.

Fibromyalgia and depression appear to be related. Both illnesses share risk factors, and treatments that are effective for one illness may also work for the other. People with fibromyalgia are more likely to suffer from depression and other mental illnesses than the general population.

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Q:Symptoms of fibromyalgia can include excessive hunger and weight gain. True or false?

A:False.

Excessive hunger and weight gain are not typical symptoms of fibromyalgia. Symptoms of fibromyalgia include the following:
- Numbness or tingling of the extremities
- Cognitive and memory problems (referred to as "fibro fog")
- Difficulty sleeping
- Restless leg syndrome
- Stiffness in the morning
- Headaches
- Irritable bowel syndrome (IBS)
- Painful menstrual periods
- Sensitivity to changes in temperature, loud noises, or bright lights

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Q:With fibromyalgia, normal stimuli can cause pain. True or false?

A:True.

With fibromyalgia, normal stimuli can cause pain. This is possibly due to elevated levels of substance P, a neurotransmitter responsible for sending pain signals to the brain. People with fibromyalgia may have abnormal levels of substance P in their spinal fluid, and researchers are looking at the role of this and other neurotransmitters to determine why people with fibromyalgia have increased sensitivity to pain, and whether there is a genetic component to it.

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Q:Fibromyalgia is a women's disease. True or false?

A:False.

While 80% to 90% of those diagnosed with fibromyalgia are women, it is not just a women's disease. Men and children are also affected. Most people are diagnosed during the middle adult years but some people are diagnosed in childhood or during their teenage years.

Researchers are looking into a genetic connection with fibromyalgia, as some studies show that women with a family member with fibromyalgia are more likely to develop fibromyalgia themselves. It is unknown if this is due to heredity alone, shared environmental factors, or both.

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Q:People are diagnosed with fibromyalgia because of abnormal blood tests. True or false?

A:False.

There are currently no lab tests to diagnose fibromyalgia. The main symptoms of pain and fatigue are symptoms of many other conditions and often patients see many doctors before receiving a diagnosis. Doctors usually rule out other possible causes of the pain and fatigue before diagnosing fibromyalgia.

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Q:A patient with head-to-toe pain will likely be diagnosed with fibromyalgia. True or false?

A:False. Head-to-toe pain is not a factor in diagnosing fibromyalgia. A doctor will make a diagnosis based on two criteria:
1. A history of widespread pain present at least 3 months. Pain is in both sides of the body, as well as above and below the waist.

2. Presence of tender points, which are points that feel pain when pressure is put on them. The body has 18 possible tender point sites. For a fibromyalgia diagnosis a person must have 11 or more of these tender points. People who have fibromyalgia may also feel pain at other sites, but the specific 18 sites on the body are used for diagnosis.

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Q:What are current treatments for fibromyalgia?

A:The U.S. Food and Drug Administration (FDA) has approved three medications to treat fibromyalgia:
- Pregabalin (Lyrica®)
- Duloxetine (Cymbalta®)
- Milnacipran (Savella®)
Non-narcotic pain relievers, low-dose antidepressants, or other classes of medications may also be prescribed to help improve certain symptoms.

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Q:What illness behaves the most like fibromyalgia?

A:Chronic fatigue syndrome (CFS), newly named Systemic Exertion Intolerance Disease (SEID), behaves like fibromyalgia in that both illnesses present with fatigue that impairs daily functioning and pain symptoms.

However, people with CFS/SEID do not have the tender points that accompany fibromyalgia. Still, it is common for people to have both fibromyalgia and CFS/SEID. Some experts believe that fibromyalgia and CFS/SEID may be the same illness, just expressed in different ways in different patients.

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