Some experts think that fibromyalgia is underdiagnosed. It can be difficult to diagnose because many of its symptoms are the same as those of other conditions, such as chronic fatigue syndrome, polymyalgia rheumatica, underactive thyroid, Lyme disease, lupus, and multiple chemical sensitivity. Fibromyalgia is usually diagnosed after other possible causes have been ruled out.
To diagnose fibromyalgia, your doctor will take a thorough history and do physical and neurological exams. She will also determine whether you have any tender points, a key trait of fibromyalgia.
Because of the difficulty in diagnosing fibromyalgia, it is best to see a doctor who is knowledgeable about the condition, such as a rheumatologist. Diagnosis is important because the earlier fibromyalgia is detected, the sooner you can make lifestyle changes to reduce the symptoms.
What Are the Treatments for Fibromyalgia?
There is no cure for fibromyalgia, and people with the condition usually have it for life. However, it is not likely to get worse as you age and it does not damage muscles, tendons, or ligaments. Many people are able to reduce their symptoms with a combination of exercise, medication, physical therapy, and relaxation.
Also, treatment of some of the conditions associated with fibromyalgia -- like depression, sleep apnea, or rheumatoid arthritis -- may improve fibromyalgia symptoms overall.
Lifestyle Choices for Fibromyalgia
A vital part of treating fibromyalgia is frequent, low-impact aerobic exercise. Examples include walking, biking, water aerobics, and swimming. Exercise tends to reduce pain and tenderness and to improve muscle fitness and sleep. Stretching is also important and may help reduce stiffness and pain.
At first, pain and fatigue may make it difficult for you to exercise. Keep in mind that persisting with an exercise routine may ultimately reduce fibromyalgia symptoms, while becoming unfit may make symptoms worse. If you have not exercised recently, be sure to talk with your doctor before beginning an exercise program and start slowly. Your doctor or a physical therapist can help you work up to 20 to 30 minutes of exercise on most days of the week.
Better-quality sleep may also help reduce fibromyalgia symptoms. Low-dose tricyclic antidepressants help relieve sleep problems and pain in many people with fibromyalgia. Also, try to go to bed and wake up at the same time every day; some people notice that symptoms get worse when they stay up just an hour or two later than usual.
Avoid alcohol and caffeine. These disrupt deep, restorative sleep, and may aggravate symptoms.
Relaxation techniques can help relieve muscle tension and reduce stress. Evaluating the causes of stress and learning new ways to cope may also lessen symptoms. Cognitive behavioral therapy (CBT) is a type of therapy that may be helpful in learning to cope with stress by analyzing a person's individual causes of stress.