Fibromyalgia

4 M

U.S. adults are living with fibromyalgia, that’s 2% of the U.S. adult population.

75%-90%

of people living with fibromyalgia are women- it also occurs in men and children of all ethnic groups.

20-50

Most people are diagnosed with fibromyalgia around the ages of 20-50.

What is fibromyalgia?

Fibromyalgia is a chronic condition that is characterized by widespread pain in the muscles, bones, ligaments, tendons, and nerves of your body.

Researchers believe that your brain plays an important role in this experience of widespread pain. [1] When you have fibromyalgia, you may have an abnormal increase in certain chemicals in your brain called neurotransmitters. The presence of more of these chemicals in your brain can change how your brain functions, and make it more sensitive to pain signals from other parts of your body.

Who is affected?

Anyone can be diagnosed with fibromyalgia. But women are twice as likely to have the condition as men. [2] The condition generally starts in middle age or older. [2] Among those who have fibromyalgia, black women and people with lower socio-economic status tend to experience more widespread pain. [3] [4]

Doctors aren’t sure about what causes fibromyalgia, but it tends to run in families, so it may be passed down genetically. Other factors which are thought to trigger or aggravate fibromyalgia are infections, physical trauma (such as deep cuts or broken bones), and emotional trauma (involving psychological stress). [1]

What happens in your body?

Common symptoms of fibromyalgia include:

  • Dull, widespread pain (occurs on both sides of your body, and above and below your waist) that has lasted for at least three months [1]
  • Tender points (small, sensitive spots around the body, which are painful when pressure is applied)
  • Stiffness that is usually worse in the morning
  • Fatigue, disrupted sleep, and waking up tired
  • Difficulty focusing or concentrating on mental tasks

How do I know if I have fibromyalgia?

Fibromyalgia symptoms are similar to the symptoms of other conditions, such as hypothyroidism, so it can take some time to diagnose it. But it is important to get an accurate diagnosis as quickly as possible to make sure that the condition does not worsen. The best way to do this is by visiting your doctor and, if possible, getting a referral to visit a rheumatologist, a doctor who specializes in treating fibromyalgia.

Some ways that your doctor can assess whether you have the condition is through reviewing your medical history and possibly conducting blood tests.

How is it treated?

There is no known cure for fibromyalgia, but integrative interventions have shown to reduce pain and discomfort and improve quality of life by slowing the condition’s progression and easing the severity of symptoms. [5] 

Integrative interventions offer a holistic approach to treatment. Instead of just conventional medicine, integrative treatments combine conventional medicine with nutritional tools, mind-body medicine, and manual medicine for a holistic approach to treating fibromyalgia.

For those new to integrative medicine, learn more here

Conventional Medicine

Many people with fibromyalgia find that certain medications work for them and others do not. So, in order to find an effective conventional treatment, people with fibromyalgia often work with their doctors to determine which medication works best with their body and needs. 

With the right medication, it is possible to manage symptoms like pain and inflammation and prevent the rapid worsening of the condition. Before starting to take any medication, be sure to ask your doctor about possible side effects. And if you notice any of the side effects once you start your treatment, let your doctor know as soon as possible. [1]

Examples of conventional treatments:

  • Anti-seizure medications can help to reduce pain, fatigue, and other fibromyalgia symptoms.

  • Non-steroidal anti-inflammatory drugs (common name: ibuprofen), or NSAIDs, are the most commonly used treatments for inflammation and pain.

  • Analgesics (common name: aspirin) are intended to relieve pain, and are often recommended for patients who have previously experienced negative side effects when taking NSAIDs.

  • Antidepressants are intended to fight depression that can come with experiences of chronic pain, and are often used among patients with fibromyalgia.

Mind-Body Medicine

Research shows that gentle, low-intensity mind-body treatments can help Fibromyalgia patients with mobility, mood, decreased pain, and more. There are a wide variety of mind-body treatments for fibromyalgia, ranging from deep breathing to aqua-therapy.

When living with chronic pain, engaging in regular movement and exercise may feel difficult and unnecessary. But doing so can actually improve your symptoms. 

Before starting a physical exercise regimen, consult with your doctor about what might be the best activities for you and your body.

Examples of mind-body medicine:

  • Tai chi is a Chinese practice of slow, low-intensity movements that researchers have found can improve sleep quality and improve fibromyalgia symptoms.

  • Yoga comes in many different styles, often engaging both the body and the mind through controlled breathing and stretching. A study conducted at the Oregon Health & Science University found that patients with fibromyalgia that practiced yoga therapy had improved symptoms and functioning, including pain, fatigue, and mood, and in pain catastrophizing, acceptance, and other coping strategies.  

  • Aqua-therapy and warm water exercise can help you stay active without aggravating your joints, and is particularly useful for individuals who have difficulty with other forms of physical exercise. Research shows aquatic exercises can relieve pain and improve physical functioning in fibromyalgia patients.

  • Gentle exercise programs guided by instructors who understand your condition can help you both lose weight and manage your symptoms. Weight loss has shown to relieve pressure on joints and curb pain-causing inflammation.

  • Relaxation therapies like deep breathing techniques, meditation, and biofeedback can help fibromyalgia patients ease anxiety and better manage their pain. Researchers have shown that meditation can significantly reduce the symptomatology of fibromyalgia.

Manual Medicine

Manual treatments are administered by certified clinicians, using physical pressure and stimulation on the body to reduce fibromyalgia symptoms. Treatments can vary in intensity and incorporate other elements such as heat and aromatherapy to enhance relief. 

Examples of manual medicine:

  • A widely-adopted Chinese treatment administered by certified acupuncturists who insert very thin needles at strategic points on the body to support overall wellness. Research shows that acupuncture is effective in treating chronic pain.

  • Licensed massage therapists use different techniques, like shiatsu, hot stone, and Swedish massage, to provide temporary pain relief. Studies suggest that massage therapy may have beneficial immediate effects on improving pain, anxiety, and depression in patients with fibromyalgia.

  • Physical therapy can help with physical strengthening, mobility, and overall functionality. Licensed therapists provide one-on-one treatment and teach patients self-management techniques so that they can improve their condition on their own too. 

  • Osteopathic manipulative treatment, or OMT, is a form of manual therapy used by osteopathic physicians (DOs) which has been shown to relieve muscle pain and increase range of motion in the joints. Osteopathic physicians perform this treatment by moving muscles and joints through techniques like stretching, gentle pressure and resistance. 

Nutritional Tools

Nutrition plays a crucial role in your overall health, and is a tool you can use to combat joint damage, reduce inflammation, and manage other fibromyalgia symptoms. 

Just like with conventional, mind-body, and manual medicines, there is not one ideal treatment for every fibromyalgia patient. When selecting nutritional tools to treat your condition, it is best to consult with your doctor or work with a dietitian, naturopath, or nutritionist to find out the best diet for you.

Examples of nutritional tools:

  • Anti-inflammatory diets

    • Anti-inflammatory diets include nutrient-dense foods that contain antioxidants and intend to reduce inflammation in the body. A popular anti-inflammatory diet is the Mediterranean diet which has been shown to reduce signs of inflammation.

  • Plant-based diets

    • Vegetarian and vegan diets have shown to promote gut health, which may have an anti-inflammatory impact . Some research suggests that a plant based diet helps alleviate the symptoms of fibromyalgia.

  • Elimination diet

    • While some foods can help reduce symptoms, other foods may trigger them. An elimination diet, which is an eating plan that eliminates certain foods or food groups believed to be causing negative bodily reactions, can help you figure out which foods are triggering those symptoms and bring you closer to your ideal diet. Some research has shown that an elimination diet that consisted of nutrient rich foods was able to curb the symptoms of fibromyalgia.

  • Fish

    • Research suggests that eating fish reduces overall inflammation in adults.

    • Recommendation: Eat three to four ounces of fish (salmon, tuna, sardines, anchovies, or other cold-water fish) twice a week.

  • Fruits and vegetables

    • Fruits and vegetables have antioxidants, which support your immune system and may fight inflammation.

    • Recommendation: Eat one and a half to two cups of fruit (like blueberries, blackberries, cherries, and strawberries) and two to three cups of vegetables (like spinach, kale, and broccoli) per meal.

  • Nuts

    • Nuts are rich in healthy fat, protein, and fiber, and help fight inflammation.

    • Recommendation: Eat one and a half ounces–about a handful–of nuts (like walnuts, pine nuts, pistachios, and almonds) per day.

  • Beans

    • Beans (like red, pinto, navy, and black beans) are rich in fiber and protein, and are full of both antioxidants and anti-inflammatory properties.

    • Recommendation: Eat at least one cup of beans per week.

  • Olive Oil

    • This heart-healthy ingredient contains healthy fat, antioxidants, and oleocanthal, an anti-inflammatory compound. 

    • Recommendation: Consume two to three tablespoons of extra virgin olive oil per day by using it in your cooking or salad dressings.

  • Onions

    • These simple, flavor-rich vegetables are packed with antioxidants and may help reduce inflammation, improve heart health, and help control cholesterol levels.

  • Fiber

    • Fiber is found in foods like beans, whole grain breads, and fresh vegetables. It makes you feel fuller for longer and boosts digestive health. It also may help reduce inflammation.

    • Recommendation: Incorporate a good mix of insoluble fiber (from vegetables, wheat, and seeds) and soluble fiber (from fruits and oats) in your diet or try fiber supplements.

  • Fish oils

    • Fish oils may reduce inflammation. Researchers have also shown in early studies that fish oils may be of benefit in the management of patients with neuropathic pain.

  • Gamma linolenic acid (GLA)

    • Gamma linolenic acid is mostly found in plant seed oils like borage seed, evening primrose, and blackcurrant seed oil. Some research suggests it may help with fibromyalgia symptoms and reduce inflammation. 

  • Turmeric

    • Researchers in Belgium were able to demonstrate that the key chemical compound (curcumin) in turmeric is beneficial in improving fibromyalgia symptoms.

    • Recommendation: Turmeric is a popular spice which you can add to any food or drink (like vegetables, rice, tea, or smoothies). Add it to your meals or take it in supplement form. Some supplements combine turmeric curcumin with black pepper for enhanced health benefits.

  • Folic Acid

    • Folic and folinic acid supplements have been shown to improve liver function and ease gastrointestinal intolerance (the digestive system’s difficulty processing certain foods, which can lead stomach pain and bloating).

  • Vitamin D

    • Vitamin D supplements are good for bone health, and they can also help keep the immune system functioning properly. A trial conducted by researchers in Austria found a marked reduction in pain with Vitamin D supplementation in fibromyalgia patients. 

  • Antioxidants

    • Research conducted on fibromyalgia patients support the hypothesis that  fibromyalgia is an oxidative disorder. Antioxidants can help prevent this form of cell damage.

    • Selenium supplements can help keep your immune system functioning properly and prevent cell damage (also known as oxidative stress) caused by rheumatoid arthritis.

    • Other antioxidants that can help prevent cell damage and keep the body in a balanced state are vitamin A and vitamin C.

    • The antioxidant quality of pomegranates may ease symptoms of fibromyalgia.

  • Probiotics

    • Fibromyalgia can have a negative impact on gut health. Some research suggests that probiotic supplements may help improve gut health and even lead to lower levels of pain, improved sleep and functional status. 

  • [1] Fibromyalgia. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780. Published August 11, 2017. Accessed July 27, 2020. 
  • [2] Walitt B, Nahin RL, Katz RS, Bergman MJ, Wolfe F. The Prevalence and Characteristics of Fibromyalgia in the 2012 National Health Interview Survey. PLoS One. 2015;10(9):e0138024. Published 2015 Sep 17. doi:10.1371/journal.pone.0138024 
  • [3] Gansky SA, Plesh O. Widespread pain and fibromyalgia in a biracial cohort of young women. J Rheumatol. 2007;34(4):810-817. 
  • [4] Fitzcharles M-A, Rampakakis E, Ste-Marie PA, Sampalis JS, Shir Y. The Association of Socioeconomic Status and Symptom Severity in Persons with Fibromyalgia. The Journal of Rheumatology. https://www.jrheum.org/content/41/7/1398.short. Published July 1, 2014. Accessed July 27, 2020. 
  • [5] Martínez-Rodríguez A, Leyva-Vela B, Martínez-García A, Nadal-Nicolás Y. Efectos de la dieta lacto-vegetariana y ejercicios de estabilización del core sobre la composición corporal y el dolor en mujeres con fibromialgia: ensayo controlado aleatorizado [Effects of lacto-vegetarian diet and stabilization core exercises on body composition and pain in women with fibromyalgia: randomized controlled trial]. Nutr Hosp. 2018;35(2):392-399. Published 2018 Mar 1. doi:10.20960/nh.1341 
  • [6] Fibromyalgia. (2020, January 06). Retrieved June 12, 2020, from https://www.cdc.gov/arthritis/basics/fibromyalgia.htm 
  • [7] Wray, A. (2015, December 04). Prevalence of Fibromyalgia. Retrieved October 22, 2020, from https://fibroandpain.org/prevalence-2 
The information on this page is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek medical advice from your physician or health provider for your specific needs.