Fibromyalgia 101

“Fibromyalgia” is a term that most of us have heard once or twice before. But what is Fibromyalgia? Fibromyalgia is a form of Dysautonomia characterized by widespread pain and chronic fatigue. As of 2021 an estimated 4 million adults in the United States have Fibromyalgia (1). It is thought to impact more women than men, but questions have been raised in recent years about whether or not that is truly the case. There is speculation that men may just not be seeking out treatment or getting diagnosed as often as women because of gender biases. Regardless of who gets Fibromyalgia, it is a serious illness. In this article we will talk about what Fibromyalgia is, who develops it, and how to start the process of getting a diagnosis and treatment.

What is Fibromyalgia?

Fibromyalgia is a form of dysautonomia. Dysautonomia is an umbrella term used to describe a set of conditions that negatively impact the autonomic nervous system. The autonomic nervous system (ANS) is a branch of the body’s peripheral nervous system. The ANS further branches into the sympathetic and parasympathetic nervous systems which control the “fight or flight” and “rest and digest” body functions. The sympathetic nervous system controls the fight or flight response and releases chemical messengers to prepare the body to fight off danger or participate in a strenuous or stressful activity. Similarly, the parasympathetic nervous system controls the body's rest and digest functions by releasing chemical messengers to relax the body and enable things like sleep and digestion. When you put these things together and observe the functions of the ANS as a whole, you will see that the autonomic nervous system regulates all of the body’s unconscious activities. Unconscious body activities are the ones that do not need to be thought about such as breathing, heart beat, digestion, and sexual response (2). When a patient develops a form of Dysautonomia, one or more of these body functions do not work properly.

By understanding what Dysautonomia is, you will be better able to work proactively in your diagnosis and/or treatment.

Who develops Fibromyalgia?

Anyone can develop Fibromyalgia, but it is most commonly diagnosed in women between the ages of 35 and 45 years old (1). However, even though diagnosis often comes later in life, the symptoms frequently started long before then. Some of the most common symptoms of Fibromyalgia are (1):

• Widespread chronic pain

• Cognitive issues (“brain fog”)

• Extreme fatigue

• Mood problems

• Sleep problems

• Muscle problems (cramps, twitches, fatigue, ect..)

• Painful periods

• Headaches

• IBS

• Temperature sensitivity (e.g. not being able to regulate your body temperature)

• Numbness or tingling in hands or feet

• Restless leg syndrome

• Sensitivity to loud noises or bright lights

• Depression or anxiety

Fibromyalgia will present differently for everyone and sufferers will not necessarily experience all of the symptoms on this list, but if you suspect you may have Fibromyalgia you should see a doctor to discuss diagnosis and treatment options.

How do you develop Fibromyalgia?

Fibromyalgia is one of those things nobody ever thinks will happen to them, but once you have it, you probably wonder where it came from. Fibromyalgia can develop from a lot of different causes, but no concrete answers are known yet. There are hypotheses about genetics, trauma, and neurotransmitter levels. Regardless of how exactly Fibromyalgia develops, treatment is the priority.

How is Fibromyalgia diagnosed?

Fibromyalgia is a process of elimination diagnoses, meaning there are no ways to test for it so doctors have to rule out more common ailments first. If you think that you might have Fibromyalgia, the first step is to see a general practitioner for basic testing. Doctors will often ask about your current symptoms, medical history, and do some basic examinations of your heart, blood pressure, blood work, and urine among other things. These tests will help to rule out more common causes such as nutritional deficiencies, infections, or anemia so that you and your healthcare team can look towards other possibilities.

In order to be diagnosed with Fibromyalgia you have to have had persistent pain for at least three months and other Fibromyalgia symptoms such as fatigue, cognitive issues, or sleep problems. It may be helpful to start keeping a diary of your daily habits and symptoms so that you have a better overview of how your symptoms present. This can expedite the diagnostic process by giving a concrete timeline of how long you have been having symptoms and/or what you are experiencing.

Once you are ready to pursue a Fibromyalgia diagnosis, you can talk to your general practitioner. They may be able to diagnose you themselves or they can give you a referral to a doctor or specialist who can. By ruling out common causes, keeping a patient diary, and making the decision to talk to your doctor about Fibromyalgia you may be able to expedite the diagnosis and treatment process. If you think you might have Fibromyalgia or another form of Dysautonomia, a proactive approach to treatment is essential. Approaching your healthcare team about a diagnosis or treatment can feel daunting, but it is important to remember that they are here to help. If you feel that you are not being heard by your healthcare team, you may have to try going elsewhere. If you have Dysautonomia, having a team that will listen and be attentive to your questions and needs is paramount.

Symptom Management

Treatment options will vary widely from person to person and are tailored to the patient by the healthcare team, but there are some general lifestyle tips that can be helpful. Eating a low inflammatory diet, engaging in gentle and consistent exercise, getting proper sleep, and managing stress are all helpful for managing symptoms. Focusing on ergonomics is also helpful in reducing pain. Ensuring that you use proper posture and investing in ergonomic office chairs, pillows, shoes, and keyboards can all be helpful in reducing pain.

For coping with daily pain it can be helpful to use TENs units, numbing creams, heating pads, braces, and/or OTC pain relievers. Finding ways to cope with daily pain can be helpful in improving overall quality of life. When you have Fibromyalgia, small aches and pain can quickly become more serious without management. Massage or sensory deprivation therapies have also shown some success in reducing pain in chronic pain patients

Fibromyalgia is irreversible, but it is manageable. By taking the first steps in getting a diagnosis, you bring yourself one step closer to successful treatment. The earlier you address your illness, the less overall impact it will have on your lifestyle. You can live a long and fulfilling life with a Fibromyalgia diagnosis with proper symptom management.

References

1. https://www.womenshealth.gov/a-z-topics/fibromyalgia#:~:text=Who%20gets%20fibromyalgia%3F,million%20Americans%2018%20and%20older.&text=The%20average%20age%20range%20at,in%20women%20than%20in%20men.

2. Cherry, Kendra. “What Is the Autonomic Nervous System?” Verywell Mind, Verywell Mind, 6 Oct. 2022, https://www.verywellmind.com/what-is-the-autonomic-nervous-system-2794823#:~:text=The%20autonomic%20nervous%20system%20regulates,flow%2C%20breathing%2C%20and%20digestion.