Take this quick quiz:
- Is there pain/tenderness in all or almost all the parts of your body at the same time?
- Do you struggle with fatigue?
- Are you having trouble thinking or remembering?
- Do you wake up tired/unrefreshed?
- In the past 6 months, have you had pain or cramps in your lower abdomen?
- Have you experienced depression in the last 6 months?
- In the past 6 months, have you experienced headaches?
- Have all of these symptoms been present at a similar level for at least 3 months?
- Do any of your family members have Fibromyalgia?
- Do you have any other diagnosis/condition (e.g. Arthritis) that might explain the pain/tenderness you have?
If you answered “yes” to the first 9 questions and “no” to no. 10, you may have Fibromyalgia. Consult your GP about your concerns and the next steps to take. A comprehensive pain evaluation is vital for managing Fibromyalgia.
What is Fibromyalgia?
Fibromyalgia (FM) is one of the “invisible illnesses” i.e. symptoms are not usually outwardly visible. Chronic widespread pain is the main symptom. In fact, some people just call it “Chronic Widespread Pain”! The pain may be aching or burning (or a combination of both) and can vary in severity from day to day. The list of possible symptoms is extensive but the other main ones are fatigue, mood disturbances (anxiety and depression) and sleep difficulties.
Many people have flare-ups when the symptoms suddenly worsen for a while. Environmental, emotional or physical stressors can trigger these.
The name Fibromyalgia can be confusing because it sounds like something affecting the joints and muscles (‘Fibro’- fibrous, ‘myo’ – muscle, ‘algia’ – pain). Although these are places you may perceive pain/tenderness and experience some stiffness, FM does not directly affect these parts.
FM is mainly a condition of the nervous system – especially the central nervous system (brain and spinal cord). This might explain the variety of symptoms and widespread nature of the pain.
What causes Fibromyalgia symptoms?
We don’t yet know exactly what causes FM, but research shows there’s an interaction between physical, neurological and psychological factors that creates a malfunctioning “pain system”. This malfunctioning then gives rise to a variety of symptoms.
Pain: your alarm system
Our brains use pain for protection. It works like an alarm system: The nerves all over our bodies create an intricate detection system. When there is a “break-in” (injury) the alarm goes off and your security company’s central command (your brain) responds quickly. Protective and healing forces are sent to repair the breach and tighten security, if necessary. This is how a good alarm system and security company works. This is how your brain responds to acute injuries/damage – whether they are physical (e.g. whiplash) or psychological (e.g. emotional abuse/trauma).
Fibromyalgia: a too-sensitive system!
But – have you ever had an alarm system that malfunctions? An alarm system set too sensitively can go off when just a bird flies past the window! The command centre still responds the same way even though there is no actual break-in. It sends messages out and summons forces to the area.
People with FM have developed an overly sensitive alarm system in their bodies. The sensitivity may start with an identifiable break-in (physical or psychological ‘injury’/trauma) but the system gets stuck on high alert. Then things that normally don’t register as dangerous (e.g. light touch, sounds) can set it off too! They experience pain with or without actual injury. And the pain is more intense than what others experience.
The central command (Brain) soon can’t cope with the excess signals and stops responding properly – shutting down some areas (“brain fog”!) and diverting signals all over the place (spreading pain to new body parts).
Fibromyalgia and your mood
Having an alarm going off repeatedly is also really annoying and stressful! Pain affects your feelings – you feel irritable, anxious and depressed. The more you feel this way, the worse the pain becomes. A vicious cycle! Sleep disturbances and gradual deconditioning of your body (because you’re less active) just compound this.
So, with FM, you can experience pain without any physical damage to your body because your central nervous system has become oversensitive. It’s also why you experience more pain if you are physically injured. We call this: Central Sensitization. Although people with FM can have other kinds of pain too (e.g. neuropathic), Central Sensitization is the main culprit.
Individual differences in Fibromyalgia
FM varies greatly from one person to another, and from day to day. This is why each person with FM needs a comprehensive assessment and a treatment plan tailor-made for them. FM is not considered life-threatening or progressive but it can have a major impact on your quality of life. See my next blog for more on assessing and managing FM.
Also: Mail me at email@example.com to receive a pdf of my Fibromyalgia information pamphlet.
2011 Modification of the American College of Rheumatology Diagnostic Criteria for Fibromyalgia- Patient self-report survey.
Fibromyalgia Fundamentals: There’s no time to waste! A 2017 publication of National Fibromyalgia Partnership, Inc. (NFP)
Unravelling Fibromyalgia—Steps Toward Individualized Management. Hauser, Daniel, Clauw & Fitzcharles. 2018. The Journal of Pain.