Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 10, 2016

Fibromyalgia is a chronic disorder that affects over five million Americans, causing debilitating fatigue, muscle pain, and discomfort. It has been suggested that it is caused by biological abnormalities in the nervous system.


Definition & Facts

Approximately two to eight percent of the population in America suffers from this condition that produces physical and psychological symptoms. Patients experience pain from abnormal pain processing pathways in the body. Both neuropathic pain and depression are common with this condition. These abnormalities in pain processing can trigger other problems in patients such as fatigue, low energy levels, mood disorders, and sleep disorders.

This chronic condition causes symptoms that never completely disappear. Fibromyalgia is not a brain disorder, but is the result of the effects of pain and stress on the central nervous system. These factors can lead to brain changes. The condition is not age or gender specific, but usually affects those between 20 and 60. Even though it can occur at any time, the number of cases do increase with age.

Because the symptoms can mimic other diseases and vary significantly from one person to another, fibromyalgia remains a diagnosis challenge for the medical community. Some clinical studies conducted within the last ten years give patients hope for reducing their symptoms and offer them a better quality of life.

Symptoms & Complaints

Widespread pain is the number one symptom of fibromyalgia. Those with this condition complain of chronic pain that they describe as muscular aches as well as shooting and stabbing plan that moves from one area of the body to another. Throbbing and twitching pain is experienced by some.

The type and intensity of the symptoms vary with some patients reporting only one or two mild symptoms, while others suffer from many. Because symptoms are not consistent and tend to come and go, many patients are unable to understand what triggers them or figure out a pattern. Many of the symptoms they experience overlap with others including arthritis and irritable bowel syndrome.


Even though much research has been conducted, the underlying cause of this condition is still unknown. Because it is found among siblings, mothers and children, it is believed that there may be a genetic factor in some patients. There are also instances of fibromyalgia occurring following an emotional trauma, viral infection, or physical injury. It is usually labeled as a chronic condition rather than a disease.

Some experts believe it is triggered in certain people by several abnormal responses to stress. The sensation of pain seems to more intense in these patients than in healthy individuals. Researchers agree that fibromyalgia patients suffer from decreased opioid receptors in the brain that could contribute to depression and some resistance to opioid painkillers. Many experts suggest that these patients have a lower threshold of pain that could be attributed to biological abnormalities that cause them to react differently to pain.

Diagnosis & Tests

Because of the irregularities associated with this condition, it is difficult to definitively diagnose. Even after three to five years of study, it is challenging to finally get a diagnosis. Because there is no medical test that can determine whether a person suffers from this condition, medical professionals must rely on interpreting symptoms. Some of the symptoms may resemble other diseases, which must be ruled out before a final diagnosis can be made.

Once physicians rule out other possible causes for the patient's symptoms, it is easier to confirm a diagnosis of this condition. Chronic fatigue syndrome presents many of the exact symptoms as fibromyalgia and must be ruled out prior to making a diagnosis. Some chronic conditions that affect the central nervous system such as multiple sclerosis and lupus produce many similar symptoms.

Treatment & Therapy

There are ways to treat the chronic pain associated with fibromyalgia and more are being developed each year. Three new medications have received approval from the U.S. Food and Drug Administration since 2007. Three more are in the development stages. New diagnostic criteria have been established to help understand and classify the pain experienced by these patients.

Patients are treated with a variety of prescription medications specially designed to reduce pain and improve sleep patterns. The first approved medication was pregabalin followed by duloxetine and milnacipran. Medical professionals stress the importance of including therapies along with the medications for a more successful experience. Cognitive behavioral therapy and aerobic exercise contribute additional benefits.

Prevention & Prophylaxis

Even though there is no known way to prevent fibromyalgia, patients can reduce the frequency and severity of flare-ups with proper treatment and small changes in lifestyle. Eating a balanced diet can help reduce gastrointestinal problems. Improved nutrition helps minimize many symptoms associated with this condition. A healthy diet should include all the essential nutrients, vitamins, and minerals.

Avoiding stressful situations helps minimize the risk of suffering from a flare-up. Walking or participating in any regular exercise program is beneficial for those who suffer from this painful condition.