Pain Management: Fibromyalgia

Fibromyalgia syndrome (FMS), or fibromyalgia for short, is a musculoskeletal disorder that causes pain in the muscles, ligaments, and tendons -- -the soft fibrous tissues in the body. Fibromyalgia symptoms vary from person to person but people with the condition usually experience pain most acutely during rest.

FMS can occur in people of any age, but more women than men have FMS.

What Are the Symptoms of Fibromyalgia?

Fibromyalgia symptoms vary from person to person, but the most common symptoms are:

• Pain
• Fatigue
• Sleep disturbances

Many people with fibromyalgia say that their entire bodies ache as if they have the flu. Their muscles may feel like they have been pulled or overworked. Sometimes the muscles twitch or burn.

What Causes Fibromyalgia?

The exact cause of fibromyalgia is not known, but there are triggering events that may make the condition more likely to occur. Some triggers include:

• Infection (viral or bacterial)
• Automobile accidents
• Development of another disorder (rheumatoid arthritis, lupus, or hypothyroidism, for example)

While these triggering events probably do not cause fibromyalgia, they may awaken a physiological abnormality that was already present but previously unnoticed.

Can Fibromyalgia Be Prevented?

There is no known way to prevent fibromyalgia. However, maintaining a good diet, doing safe exercise, and getting adequate rest are important to prevent any medical condition, including fibromyalgia.

How Is Fibromyalgia Diagnosed?

Doctors apply pressure on 18 tender point sites on the patient's body to diagnose fibromyalgia. Patients must have chronic, widespread, musculoskeletal pain that lasts longer than three months in all four quadrants of the body. These quadrants are above and below the waist and on both sides of the body. In addition, back pain of some kind must be present.

How Is Fibromyalgia Treated?

Traditional treatments for fibromyalgia are meant to improve sleep quality and limit pain.

The FDA has approved Lyrica as the first drug treatment for fibromyalgia. It reduces pain and improves daily functions for some patients. The drug's most common side effects include mild to moderate dizziness and sleepiness. Lyrica can also cause blurry vision and trouble concentrating. The FDA advises patients to talk to their doctor about whether the use of Lyrica may impair their ability to drive.

In many cases, medications to increase the body's level of serotonin and norepinephrine (neurotransmitters that modulate sleep, pain and immune system function) are prescribed in low doses. Some of the medicines used to aid sleep include Ambien, Klonopin and Desyrel.

In addition to medications, most people with fibromyalgia will need to use other treatment methods as well. These may include:

• Injections with lidocaine into the pain sites (called trigger points)
• Physical or occupational therapy
• Acupuncture or acupressure
• Relaxation/biofeedback techniques
• Osteopathic manipulation (a whole system of evaluation and treatment designed to achieve and maintain health by restoring normal function to the body)
• Chiropractic care
• Therapeutic massage
• A gentle exercise program

Lifestyle modifications may help people with fibromyalgia conserve energy and minimize pain. A main component of lifestyle management is listening to your body and not trying to over-do-it. Your doctor may be able to help you develop strategies to manage your lifestyle, or may refer you to a therapist who can work with you to change your daily activities to suit your situation.

Reviewed by the doctors at The Cleveland Clinic Neuroscience Center.