Fibromyalgia is defined as a long-term disorder associated with widespread chronic pain from damaged nerves, muscles, and bones that result in areas of tenderness and general fatigue.
In addition to the pain and fatigue, people with fibromyalgia may experience a wide range of other symptoms such as:
- Cognitive and memory problems (sometimes referred to as “fibro fog”)
- Sleep disturbances
- Morning stiffness
- Irritable bowel syndrome
- Painful menstrual periods
- Numbness or tingling of the extremities
- Restless legs syndrome
- Temperature sensitivity
- Sensitivity to loud noises or bright lights
Some of those who have fibromyalgia may also have two or more co-existing chronic pain conditions. Those conditions include:
- Chronic fatigue syndrome
- Endometriosis: A disorder in which tissue that normally lines the uterus grows outside the uterus.
- Inflammatory bowel disease
- Interstitial cystitis: A chronic, painful bladder condition.
- Temporomandibular joint dysfunction: Pain and compromised movement of the jaw joint and the surrounding muscles.
- Vulvodynia (women only): A chronic, unexplained pain in the area around the opening of the vagina.
It is unknown as to whether these disorders share a common cause.
But, it doesn't end there. We are here to break it down into the six phases of fibromyalgia.
You began to encounter more pain and exhaustion than ever before. The truth, you aren't sure what's happening inside of your body. All you do know is that it hurts to walk up the stairs and forget about sitting long enough to finish the 9-to-5 work day. Then, it gets worse. Maybe you start Googling your symptoms but it doesn't add up. This is the beginning of your diagnosis.
Your pain and tired feelings are still there. Maybe you started taking an anti-inflammatory over-the-counter medication, but it doesn't really help. You do muster the courage to make that dinner date with friends and you only called out of work three times instead of five. At this point, maybe you've shared how you feel with a loved one. Maybe you made an appointment with your doctor.
The truth is though, according to The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), "Research shows that people with fibromyalgia typically see many doctors before receiving the diagnosis. One reason for this may be that pain and fatigue, the main symptoms of fibromyalgia, overlap with those of many other conditions."
At this point, doctors often have to cross out other inherent causes of your symptoms before presenting a diagnosis of fibromyalgia.
Another reason that diagnosing fibromyalgia is often difficult, is the fact that there are no diagnostic laboratory tests for fibromyalgia.
Standard laboratory tests fail to exhibit a physiologic rationale for your pain. And, objective testing for fibromyalgia is generally rejected. Unfortunately, some doctors may assume a patient is making up their pain or they may advise them there is little they can do.
Now, your pain is constant. As each day ends a new one begins, that tired feeling gets worse. You almost become hopeless to the fact that you will never feel normal again. You are resting more than ever while at the same time restless. You've been to two doctors and no one can figure out the cause of this pain.
Back to Google, it is. You find out that the cause of fibromyalgia is still unknown to the medical community. Many people correlate the progression of fibromyalgia with either a physically or emotionally stressful or traumatic event. Some connect it to repeated injuries or other illness. And others, say it occurs spontaneously.
Researchers are looking into other reasons, such as difficulties with how our central nervous systems (the brain and spinal cord) process pain. They also say that genetics and family history play a pivotal role as well.
According to the DNA theory, patients with fibromyalgia may have a gene or genes that provoke a strong reaction to stimuli that most people would not perceive as pain.
There have already been several genes identified that occur more commonly in fibromyalgia patients. NIAMS-supported researchers are currently looking at other possibilities (stay tuned).
So you carry on...
In this phase, you begin to feel more alone, and more people are starting to think you complain too much. This stage can last a long time, possibly years.
You are constantly saying no to invitations and maybe you want to go but you literally have no energy to get dressed and leave the house. So maybe the invites eventually stop coming, which only leads you to feel more isolated than ever. And work — is getting harder and harder. All you can do is rest but even then you're uncomfortable — all over.
Maybe you missed to much work and they had to let you go. Now, you are trying to seek permanent disability but that process doesn't always end well. Plus, it takes forever. So the stress of your finances begins to take a toll — notwithstanding the severe pain everywhere.
Maybe you need someone to help take care of you or at least the household chores because you spend most of your time in bed. You're sore and tired. There may be a good day mixed in with the bad so you try to focus on that. Most days though, you feel like a prisoner of your own making.
By this time, most of your friends have stopped calling because all you ever do is say how much you hurt. And it's true. Your pain is real — you just wish everyone around you thought that as well.
You may or may not still be waiting for your disability pension because work is out of the question. At this point, let's hope that one of your many doctors figured out that you have fibromyalgia.
It's almost normal now but not in a good way. Everything you do takes all your energy. Once simple daily tasks you took for granted in the early phases such as using the restroom, washing your hair, showering, dressing, tying your shoes — take everything out of you.
You become annoyed by anything touching you and the desire to look somewhat presentable is nowhere to be found.
At this point, your doctor has prescribed medication that you are on or have tried, but on top of that, you are forced to deal with the side effects of those pills and your constant pain.
There are only three medications that are Food and Drug Administration (FDA) approved, which include duloxetine, milnacipran, and pregabalin for the treatment of fibromyalgia.
Duloxetine was incipiently developed for and is still employed to treat depression. Milnacipran is similar to that of Duloxetine but is only FDA approved for fibromyalgia. Pregabalin is a medication developed to treat neuropathic pain (chronic pain caused by damage to the nervous system).
Not all physicians are familiar with fibromyalgia, so treating it —is difficult, so it's crucial to obtain a doctor who is. Many family doctors, general internists, or rheumatologists (doctors who specialize in arthritis and other conditions that affect the joints or soft tissues) can help manage fibromyalgia.
The NIAMS says that fibromyalgia treatment often demands a team approach, including your doctor, a physical therapist, possibly other health professionals, and most importantly, yourself, all playing an active role.
They also notate that it can be tough to assemble this team, and you may grapple to locate the appropriate professionals to treat you. When you do, however, the blended expertise of these diverse professionals can help improve your quality of life.
Does this progression sound familiar? If you think your chronic pain could be fibromyalgia, make an appointment to see your physician today. As for finding the hope to see a pain-free future, just know that you are not alone. Fibromyalgia affects 5 million Americans age 18 or older.