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Signs And Symptoms Of Fibromyalgia To Watch Out For

Signs And Symptoms Of Fibromyalgia

A chronic disorder that manifests as widespread pain in the body along with a diffused tenderness, fibromyalgia is a serious health issue that affects the work-life balance of the sufferer. While muscle spasms and chronic pain are the primary symptoms, there are neurological symptoms like numbness, difficulty in walking, etc that could accompany the pain. Sleep would be affected, so would the bowel function. Depression and mood swings are common, too.

Do you wake up in the morning with pain all over your body? Are you often fatigued without any real exertion? Do you have points in your body that feel tender or sore to the touch even though there are no apparent injuries? If the answers to these questions are “yes”, then you might be suffering from fibromyalgia.

The word fibromyalgia comes from Latin words fibro meaning fibrous tissue, Greek myo meaning muscle and algia meaning pain. Fibromyalgia is now seen as a chronic disorder that manifests as widespread pain in the body with a diffused tenderness caused by a certain level of damage to the central nervous system. This leads to a highly sensitized neurological state where external causes like infection, trauma, and stress can trigger this painful disorder.1

According to American College of Rheumatology, there are 18 tender points from where the pain radiates; and if 11 of those points are found to show tenderness along with widespread musculoskeletal pain, then it can be diagnosed as fibromyalgia.2

Fibromyalgia, in some cases, can become such a serious health issue that it could impact the work-life balance of the sufferer. Clinical trials show that people with fibromyalgia lose some levels of their functional abilities due to chronic pain.3

What Causes This Pain?

While medical researchers are still trying to find out the exact cause of fibromyalgia, there are many reasons, from stress to genetics, behind it. Here’s a look at the causes.

  • Stress, physical trauma or even a serious bout of flu or similar infections can result in fibromyalgia. This is because during a stressful situation, the body’s hypothalamic-pituitary-adrenal (HPA) axis, which plays a major role in regulating the body’s metabolic system, cardiovascular system, immune system, reproductive system and central nervous system, gets disrupted resulting in an upset stress response system in the body which in turn leads to excessive sensitivity to pain, and pain-point triggers.4
  • Fibromyalgia is recognized as a post-traumatic disorder. Experts believe that these symptoms might be the result of chemical imbalance in the brain which triggers a chain reaction. It is seen that sleep deprivation or disturbed sleep pattern decreases the pain threshold in people and they can develop fibromyalgia. Experts have proposed that low levels of serotonin and other abnormalities in the neuroendocrine axis that regulates our immune and nervous system can lead to widespread pain and tenderness that is associated with fibromyalgia.5
  • You could even have it in your genes. If one family member, especially your mother, has it, then you are at a high risk of developing this disorder.6

What Are The Symptoms Of Fibromyalgia?

If you have been in a state of general pain with tender spots for over three months but no cause has been found in medical tests, you are likely to be suffering from fibromyalgia.

Nowadays, doctors look beyond the tender points for a multi-pronged approach. Besides the widespread pain, they look for symptoms like sleeplessness, depression, trauma or stress since cases of primary fibromyalgia syndrome shows symptoms like these.7

Here are some of the symptoms in detail:

1. Muscle Spasm And Chronic Pain

At the initial stages when the pain has just begun, it is quite possible to confuse fibromyalgia with arthritis. While it is now recognized as a rheumatic disease, fibromyalgia is closer to osteoarthritis in terms of fatigue and physical pain. While it is a musculoskeletal condition with widespread pain, osteoarthritis only hits the joints.

Do the lightest of touches trigger a bout of pain in certain areas of the body? If your pain threshold is low and you feel it in the skin folds as well, then you could be having this chronic pain disorder. This is often accompanied by increased blood flow to the area referred to as reactive skin hyperemia.8 The chronic pain is further aggravated by physical activity and improved with rest.9

2. Neurologic Symptoms

Over the last few years, research has shown that fibromyalgia is more of a neurological problem from an injury to the nervous system than muscular or joint inflammation. In fact, it is seen that fibromyalgia occurs more often after a neck or shoulder injury rather than any injury to the lower part of the body. Other than fibromyalgia, the injuries result in other symptoms like numbness, weakness, blurred vision, along with head and neck pain and difficulty in walking.10

3. Sleep Disorder And Fatigue

A clinical research done on patients with fibromyalgia showed that 76 to 90 percent of them showed signs of disturbed sleep and fatigue. In fact, most patients live with a strange predicament where the painful condition prevents restful sleep which in turn causes excessive fatigue which increases pain and stiffness throughout the body.11 This discomforting pain also leads to troubled sleep through the night and the feeling of not rested. It is also seen that the person suffering from this disorder tends to wake up early in the mornings only to remain exhausted the rest of the day. They often suffer not just from insomnia but also other sleep-related disorders like sleep apnea and mid-sleep arousals.12

Moreover, this reduction in sleep efficiency or lack of restful sleep not only leads to a sense of discomfort and fatigue but also decreases the pain threshold in a person.13

4. Depression, Mood Disorder, And Memory Problems

Unexplained depression, anxiety, and mood swings are also signs of fibromyalgia, especially when these are accompanied by pain. Logically the lack of sleep that is caused by chronic pain disorder triggers other symptoms. The weakened central nervous system, which is also a symptom of fibromyalgia, is also seen as another reason why people suffer from depression and mood issues.14

Research also shows that those suffering from excessive pain develop memory problems and cognitive issues as well.15 Fibromyalgia patients are also found to exhibit signs of hypochondriasis or heightened health anxiety. This is less of a personality disorder and more from being hyper vigilant of any event that could cause pain.16

5. Irritable Bowel Syndrome And Bowel Dysfunction

Frequent complaints of bad stomach, constipation and bloating are common in people suffering from fibromyalgia. Actually, over 40 percent of people with this painful disorder have high chances of developing various gastrointestinal issues and suffer these symptoms frequently.17

You’re At Risk For Fibromyalgia If…

  • You are a woman, especially in the age group of 20-55 years.18 Women tend to develop low pain threshold due to an abnormality in the central nervous system and low cerebral blood flow.19 If you are pregnant and already have fibromyalgia, it can worsen during the 9 months, especially in the last trimester.20
  • You have a high body mass index or are overweight or obese. There is a “hidden link” between obesity and fibromyalgia, though studies have not been able to conclusively prove if obesity is a cause or consequence of fibromyalgia.21
  • You have diabetes. People with the diabetic condition also suffer from this painful disease. However, with systematic sugar control, both diabetes and fibromyalgia can be controlled.22

References   [ + ]

1. Ablin, Jacob, Lily Neumann, and Dan Buskila. “Pathogenesis of fibromyalgia–a review.” Joint Bone Spine 75, no. 3 (2008): 273-279.
2. Giesecke, Thorsten, David A. Williams, Richard E. Harris, Thomas R. Cupps, Xiaoming Tian, Thomas X. Tian, Richard H. Gracely, and Daniel J. Clauw. “Subgrouping of fibromyalgia patients on the basis of pressure‐pain thresholds and psychological factors.” Arthritis & Rheumatism 48, no. 10 (2003): 2916-2922.
3. Cathey, Mary Ann, Frederick Wolfe, and Sue M. Kleinheksel. “Functional ability and work status in patients with fibromyalgia.” Arthritis & Rheumatism 1, no. 2 (1988): 85-98.
4. Griep, Eduard N., J. W. Boersma, E. G. Lentjes, A. P. Prins, J. K. Van der Korst, and E. R. De Kloet. “Function of the hypothalamic-pituitary-adrenal axis in patients with fibromyalgia and low back pain.” The Journal of rheumatology 25, no. 7 (1998): 1374-1381.
5. Doherty, Michael, and Adrian Jones. “ABC of rheumatology. Fibromyalgia syndrome.” BMJ: British Medical Journal 310, no. 6976 (1995): 386.
6. Buskila, Dan, Lily Neumann, Ilia Hazanov, and Rivka Carmi. “Familial aggregation in the fihromyalgia syndrome.” In Seminars in arthritis and rheumatism, vol. 26, no. 3, pp. 605-611. WB Saunders, 1996.
7. Yunus, M. B., U. P. Kalyan-Raman, and K. Kalyan-Raman. “Primary fibromyalgia syndrome and myofascial pain syndrome: clinical features and muscle pathology.” Archives of physical medicine and rehabilitation 69, no. 6 (1988): 451-454.
8. Granges, G., and G. O. Littlejohn. “A comparative study of clinical signs in fibromyalgia/fibrositis syndrome, healthy and exercising subjects.” The Journal of rheumatology 20, no. 2 (1993): 344-351.
9. Staud, Roland, Richard C. Cannon, Andre P. Mauderli, Michael E. Robinson, Donald D. Price, and Charles J. Vierck. “Temporal summation of pain from mechanical stimulation of muscle tissue in normal controls and subjects with fibromyalgia syndrome.” Pain 102, no. 1 (2003): 87-95.
10. Watson, Nathaniel F., Dedra Buchwald, Jack Goldberg, Carolyn Noonan, and Richard G. Ellenbogen. “Neurologic signs and symptoms in fibromyalgia.” Arthritis & Rheumatism 60, no. 9 (2009): 2839-2844.
11. Roizenblatt, Suely, Harvey Moldofsky, Ana Amelia Benedito‐Silva, and Sergio Tufik. “Alpha sleep characteristics in fibromyalgia.” Arthritis & Rheumatism 44, no. 1 (2001): 222-230.
12. Harding, Susan M. “Sleep in fibromyalgia patients: subjective and objective findings.” The American journal of the medical sciences 315, no. 6 (1998): 367-376.
13. Lentz, Martha J., Carol A. Landis, J. S. H. A. V. E. R. J. L. Rothermel, and J. L. Shaver. “Effects of selective slow wave sleep disruption on musculoskeletal pain and fatigue in middle aged women.” The Journal of rheumatology 26, no. 7 (1999): 1586-1592.
14. Clauw, Daniel J. “Fibromyalgia: a clinical review.” Jama 311, no. 15 (2014): 1547-1555.
15. Dick, Bruce, Chris Eccleston, and Geert Crombez. “Attentional functioning in fibromyalgia, rheumatoid arthritis, and musculoskeletal pain patients.”Arthritis Care & Research 47, no. 6 (2002): 639-644.
16. Rollman, Gary B., and Stefan Lautenbacher. “Hypervigilance effects in fibromyalgia: pain experience and pain perception.” Progress in fibromyalgia and myofascial pain. Amsterdam: Elsevier (1993): 149-59.
17. Sivri, A., A. Cindaş, F. Dincer, and B. Sivri. “Bowel dysfunction and irritable bowel syndrome in fibromyalgia patients.” Clinical rheumatology 15, no. 3 (1996): 283-286.
18. Bennett, Robert M., Hugh A. Smythe, and Frederick Wolfe. “Recognizing fibromyalgia.” Patient Care 23, no. 12 (1989): 60-73.
19. Wolfe, Frederick, Kathryn Ross, Janice Anderson, I. Jon Russell, and Liesi87 Hebert. “The prevalence and characteristics of fibromyalgia in the general population.” Arthritis & Rheumatology 38, no. 1 (1995): 19-28.
20. Østensen, Monika, Anne Rugelsjoen, and Sigrid Horven Wigers. “The effect of reproductive events and alterations of sex hormone levels on the symptoms of fibromyalgia.” Scandinavian journal of rheumatology 26, no. 5 (1997): 355-360.
21. Ursini, Francesco, Saverio Naty, and Rosa Daniela Grembiale. “Fibromyalgia and obesity: the hidden link.” Rheumatology international 31, no. 11 (2011): 1403-1408.
22. Tishler, Moshe, Tatyana Smorodin, Mirit Vazina-Amit, Yoram Ramot, Michael Koffler, and Beno Fishel. “Fibromyalgia in diabetes mellitus.” Rheumatology international 23, no. 4 (2003): 171-173.

Disclaimer: The content is purely informative and educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.