‘Art enables me to face my body and my life with courage.’
Chronic 24/7 pain, fatigue, swelling, and a host of other symptoms are all part of my journey with rheumatoid arthritis, axial spondyloarthritis, osteoarthritis, fibromyalgia, and other chronic conditions I’ve been living with for years. I’ve loved drawing since I was a child, and after my RA diagnosis in 2011, I started to create art more regularly. As my diseases progressed and multiplied, my art became more integral to expressing my experiences.
Over this past year, I’ve been fortunate to start sharing my artwork on a much bigger platform than my own social media pages. Chronicwoman started publishing my art regularly — and the supportive, empathetic, and eye-opening responses I’ve been receiving from the chronic illness community have gone beyond my wildest expectations. I gave a keynote address about how my arthritis impacts my art at the annual meeting of the National Organization of Rheumatology Managers (NORM) and presented my artwork at the Spring/Summer 2020 New York Fashion Week show of designer Michael Kuluva, who also lives with rheumatoid arthritis.
I’m particularly proud of developing an abstract about how my artwork helps me cope with arthritis for the 2019 American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) Annual Meeting in Atlanta. It’s part of the Patient Perspectives Poster Session, which invites patients like me to address “adaptations developed with their health care team that have improved their health.” I gave a lot of thought to the specific ways that creating artwork that visually conveys patients’ experiences of arthritis symptoms has helped me and others cope with our diseases.
Here’s what I realized — and shared in my ACR abstract:
Art helps me to listen to my body, enabling a more flexible reaction to pain episodes or flares. Listening to my body in the first place got me diagnosed and got me the medical help that I needed. My health and body took an upturn when I learned to not fight the cycles of flares, pain, and disease. Listening to my body for cues allowed me to function more because I rested or pushed when needed. I learned my patterns and strengths, allowing me to accomplish more when I have energy without overdoing it.
2. Visual art enables me to express my journey while reaching out to others.
I am an expressive person and found myself discussing my diseases a lot due to the need for accommodation or support. But symptoms like constant exhaustion, lack of sleep, high pain levels, RA flares, and bouts of back pain left me without the capacity to use words.
When I began to publish these pieces on social media, the overwhelming response reminded me that I’m not alone on this journey and that my body is telling the truth.
I’m able to process my grief over lost abilities, deteriorating health, and describe my experience and journey with inflammatory arthritis in a more universal way, without words.
3. My art allows me to show my life and struggles in a way that makes abled folks stop and take notice.
Visual representation helps other patients point to a piece that validates their pain and creates better connections between people.
4. People with inflammatory arthritis need to know that what they are experiencing is normal.
My art helps me and others cope better because we see visually what is happening invisibly to our bodies. It validates our experiences and lets us know we are not alone in what is happening to us.
5. Art reminds me how powerful my mind and heart are so I can pick myself up one more day and live for good instead of being lost in pain.
It gives me the ability to look back on a piece of artwork and remember the pain and my resilience and power in the face of intense circumstances.
It fulfills my need to be creative but also my need to take control of my life and body in a way that makes sense, allowing me to accept where I am.
It gives me the chance to process what is happening so I don’t fight the disease process. Art enables me to face my body and my life with courage and hope.
No matter who you talk to in the chronic pain, arthritis, and musculoskeletal disease community — patients, clinicians, researchers, public health experts — medical marijuana is controversial. Is it safe? Is it effective for treating pain and inflammation? Should it be legal?
While more clinical trials are sorely needed to understand the benefits and side effects of using medical marijuana to treat conditions like arthritis, it’s important to understand how patients think about and use marijuana to manage their conditions. The United States has a complicated quilt of state laws about the legal use of marijuana. Presently, 33 U.S. states have laws that allow for the legal use of marijuana for medical reasons, according to the National Conference of State Legislatures. (When you add recreational marijuana use and the legality of cannabidiol or CBD to the mix, things get even more confusing.) We have to recognize that its legal status may, in fact, influence whether patients use marijuana — or feel comfortable talking to their doctor about it. So researchers, including those from our non-profit organization, the Global Healthy Living Foundation (GHLF), set out to study this.
In research presented at the 2019 American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) Annual Meeting in Atlanta, researchers surveyed 1,059 patients through the Chronicwoman patient community and the Chronicwoman research registry. Of those, 37 percent of people reported using marijuana for medical purposes, either presently or in the past. Of those, the majority said they did so to manage a specific health condition, such as:
In this study, 77 percent of current or past marijuana users live in a state where it is legal for medical reasons. Just 40 percent of current or past users said they used a medical marijuana card to purchase it. Among the 60 percent of study participants who did not use a medical marijuana card, the top reasons included:
Not being legal where the patient lives: 42 percent
Cost of marijuana is more expensive through a dispensary: 19 percent
Difficulty getting a card: 18 percent
Of the approximately two-thirds of patients surveyed who said they had never used marijuana for medical purposes, illegality played a big role: 40 percent cited that as a reason they haven’t used it. Other reasons for not using marijuana included:
Our research found that there was a link between whether medical marijuana was legal where patients lived and whether patients spoke with their doctor about their usage. Among patients who live in states where marijuana is medically legal, 68 percent said they told their doctor about using it, while only 54 percent of patients in states where medical marijuana was not legal talked with their doctor about it.
“It’s alarming that not everyone is telling their doctor about their marijuana use, regardless of its legal status,” says study co-author W. Benjamin Nowell, PhD, director of Patient-Centered Research at the Global Healthy Living Foundation. “It is important that your rheumatologist and other providers are aware of what you might be using in addition to prescribed medication.”
A Lack of Research and Mixed Messages About Effectiveness
If you’re a patient who uses medical marijuana (or CBD, for that matter) to help treat your arthritis symptoms, your health care providers should know about it. Ideally, providers would make patients aware of potential side effects and interactions with other medications they use, advise on dosages, and help patients monitor and evaluate whether these treatments are helping. But our research, and that of others, indicates this isn’t always the case.
Earlier findings from the same survey, for example, noted that only 42 percent of patients perceived that their health care provider integrated their medical marijuana usage into their overall care (for example, made note of it and discussed how it fits in with other medications they take).
In a separate, unrelated study presented at the 2019 ACR meeting, when researchers at the University of Vermont Medical Center surveyed rheumatology clinicians about their patients’ usage of medical marijuana and CBD, they found that 45 percent of more than 100 doctors disagreed that marijuana or CBD should be recommended as medical therapy for people with rheumatologic conditions.
Here, legality may play a role too: More doctors who practiced in states where marijuana was legal for medical and recreational use said they were comfortable addressing questions about usage than in states where it was not legal. The authors concluded that “surrounding laws likely impact clinician perception and comfort with medical use.”
Part of this challenge is a dearth of solid research that rheumatologists and other doctors need to feel comfortable making recommendations to patients. In fact, in a recent paper published in the journal Expert Review of Clinical Immunology, researchers reviewed animal and human clinical studies on the use of cannabis for treating rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, systemic sclerosis, and fibromyalgia. “Despite the presence of studies supporting the benefits of cannabis, the researchers were unable to definitively conclude that cannabis or cannabis-related products are safe and effective for treatment of rheumatic diseases,” reported Clinical Pain Advisor. “They noted a gap between animal and clinical studies, as well as the paucity of studies examining long-term adverse effects. Large-scale clinical trials are necessary to examine the safety and efficacy of cannabis before it can be recommended for the management of rheumatoid arthritis, osteoarthritis, and fibromyalgia.”
“Indeed, our [Chronicillness.co and Chronicwoman.com] research shows that despite a lack of quality evidence to guide the usage of medical marijuana and regardless of its legal status, many patients with arthritis are using it — and need more support,” says study co-author Kelly Gavigan, MPH, manager of research and data science at the Global Healthy Living Foundation (GHLF). “We need high-quality randomized controlled clinical trials to better understand whether and how medical marijuana might be used to help patients manage these diseases, in conjunction with their recommended medication.”
One of the main reasons people with arthritis visit the rheumatologist frequently — every three months is common among patients with inflammatory arthritis — is for doctors and patients to assess how arthritis patients are managing their disease. Typical check-ins may include a doctor’s physical exam and assessment as well as reviewing the results of blood tests and imaging tests.
What’s also critical at these visits is something arthritis researchers and doctors call PROs, or patient-reported outcomes. PROs are a patient’s own assessments of how arthritis affects daily tasks — including how you rank or define the difficulty of simple activities like getting in and out of your car or buttoning your shirt — and are a very important tool for measuring and monitoring your disease.
PROs are also important during clinical trials for medications or other treatments, as they can assess how different therapies affect patients and the symptoms that matter to them.
There are many different PRO measures and questionnaires doctors and researchers can use, but which symptoms are most important to patients? This is an important topic that the rheumatology community needs to know more about, so researchers, including those from our non-profit organization, the Global Healthy Living Foundation (GHLF), set out to study this.
“PRO measures are important indicators of disease activity, but as we learn more about the importance of their role in evaluating treatment effectiveness, we need to also learn more about the specific symptoms that patients find most important to track,” says study co-author Kelly Gavigan, MPH, manager of research and data science at GHLF.
In research presented at the 2019 American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) Annual Meeting in Atlanta, researchers surveyed 253 patients through our ArthritisPower research registry with various self-reported conditions, including rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), osteoporosis (OP), osteoarthritis (OA), and fibromyalgia syndrome (FMS).
At the start of the study, patients could select up to 10 different symptoms they wanted to track via short health assessment questionnaires. Study participants would then go on to complete the assessments once a month for the next three months. The symptoms that patients could track included:
In evaluating the PROs that were most popular among study participants at baseline, three stood out:
Fatigue: 83 percent of patients chose fatigue as a PRO they wanted to track.
Pain: 83 percent of patients chose pain as a PRO they wanted to track.
Mental health: 82 percent of patients chose mental health as a PRO they wanted to track. Within mental health, 54 percent of patients wanted to track depression and 44 percent of patients wanted to track anxiety.
Here is the percentage of patients who wanted to track other PROs in the study:
Physical Function: 72 percent
RA Flare: 70 percent (only offered to RA patients)
Study participants were also asked to share any self-reported comorbidities, or other diseases they have along with their arthritis diagnosis. The most common comorbidity was depression, reported by 51 percent of participants. This may partly explain why so many participants were interested in tracking aspects of their mental health.
National data show that depression and anxiety are common among people living with arthritis. According to a 2018 CDC report, 23 percent of people with arthritis reported symptoms of anxiety and 12 percent reported depression. These rates are likely even higher among specific populations of arthritis patients. For example, a 2019 study found that people with ankylosing spondylitis were twice as likely to have depression as people without AS. Other research has indicated that depression rates are higher among people with psoriatic arthritis than other rheumatologic conditions.
“Our research shows us that mental health is a top priority for patients and they do want to keep track of it,” says Gavigan. “But we know it can be challenging for some people to discuss mental health issues with their rheumatologist or other providers.”
In fact, other GHLF data suggest patients aren’t talking about their mental health with their rheumatologist. In a 2018 poll of ArthritisPower users, 59 percent of nearly 1,000 respondents said that their rheumatologist or primary care doctor does not ask about their mental health.
“We hope that being able to log and track mental health symptoms through ArthritisPower can facilitate these discussions and ensure that patients get the care and support they need to cope better with chronic illness,” Gavigan adds.
As many patients — 83 percent — reported wanting to track their fatigue as they did pain, which is important for rheumatology clinicians and researchers alike to know.
“We often hear from our arthritis patient community that fatigue is difficult to talk about with care providers,” says Seth Ginsberg, president and co-founder of Chronicwoman, which is part of GHLF. Patients report that doctors don’t always take their fatigue as seriously as other symptoms. What makes this even more challenging is that loved ones and caregivers also often struggle to understand the impact of fatigue on someone living with arthritis — that it’s more than just feeling tired. People who have fatigue from chronic illness are not “lazy” or “just need to get more sleep.” Fatigue is a physical manifestation of their disease, just like pain, stiffness, or swelling.
“The more patients can quantify difficult-to-discuss symptoms like fatigue, and mental health concerns, the more we as a rheumatology community can evaluate disease activity, treatment effectiveness, and overall health in a broader context that more fully takes into account patients’ complex experiences living with complicated, lifelong chronic diseases,” says W. Benjamin Nowell, PhD, director of Patient-Centered Research at GHLF.
If you are diagnosed with arthritis or another musculoskeletal condition, we encourage you to participate in future studies by joining Chronicwoman’ patient research registry, ArthritisPower. ArthritisPower is the first-ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions.
Fibromyalgia and lupus are both chronic diseases with no cure, can both cause some similar symptoms, and can both take a long time to get the right diagnosis. But fibromyalgia — often called fibro — and lupus are two very distinct health conditions with very different causes and treatments, despite having some features in common.
Lupus is an autoimmune disorder that involves widespread inflammation and impacts many organs throughout the body. Fibromyalgia a disorder that causes widespread chronic pain and tenderness. Unlike lupus, fibromyalgia is not an inflammatory or autoimmune disease.
Still, many signs and symptoms of fibromyalgia and lupus overlap and it’s not uncommon for fibromyalgia to be misdiagnosed as lupus, says rheumatologist George Stojan, MD, an assistant professor of medicine at Johns Hopkins University School of Medicine and co-director of the Johns Hopkins Lupus Center in Baltimore, Maryland. Both fibromyalgia and lupus can cause muscle/joint pain, brain fog, and fatigue. Both are also more likely to occur in younger and middle-aged women.
Interestingly, another factor that makes fibromyalgia and lupus difficult to differentiate from each other is that some people have both at the same time. “Having both lupus and fibromyalgia is extremely common,” says Dr. Stojan. “In our cohort here at Hopkins about 30 percent of lupus patients have fibromyalgia too.”
People with other rheumatic diseases such as rheumatoid arthritis, osteoarthritis, and axial spondyloarthritis are also at an increased risk of also having fibromyalgia.
Read more to learn about the different symptoms of fibromyalgia vs. lupus, how fibromyalgia and lupus are each diagnosed, and how treatments for fibromyalgia and lupus differ.
The U.S. Centers for Disease Control and Prevention (CDC) estimates that about 4 million American adults have fibromyalgia. While doctors don’t know what causes fibromyalgia, it is a disorder in which people often experience widespread chronic pain and sensitivity to touch, in addition to many other symptoms (more on this below).
Unlike lupus, fibromyalgia is not an autoimmune disease, which occurs when then body’s immune system mistakenly attacks your own cells and tissues. Fibromyalgia is not related to inflammation, nor is it a joint or muscle disorder caused by physical injury.
People at higher risk of fibromyalgia include women, the middle-aged, and those with certain diseases, including different types of arthritis, or a family history of fibro. While fibro can impair your quality of life, it doesn’t damage your tissues and organs, or cause medical problems like heart disease. It is not life-threatening.
Fibro’s hallmark symptom is persistent pain in soft tissues and muscles all over the body. It may involve tender points, or areas of tenderness in specific parts of body. Frequently described as a deep ache, fibro pain may move around, persist for long periods, and disappear.
More than nine in 10 fibromyalgia patients experience exhaustion. Fatigue can be especially noticeable when you first wake up in the morning, even when you’ve gotten plenty of sleep; light activity can make pain and fatigue worse.
The Lupus Foundation estimates that 1.5 million people in America have a form of lupus. Lupus is an autoimmune disease that occurs when your immune system cells — which are supposed to protect the body from different germs — start treating normal, healthy cells like invaders, attacking them and causing flare-ups that can affect the joints, skin, heart, lungs, kidneys, and almost any other system in the body.
Women of childbearing age (between 15 and 44) are at the highest risk of developing lupus, according to the CDC; some 90 percent of people with lupus are women. People of color — particularly African Americans — are at a higher risk of lupus than white people are, and the disease tends to affect populations differently. Native American and black patients tend to have higher mortality rates than white patients, while Hispanic and Asian patients have a lower risk of lupus.
There are several types of lupus, but most people refer to the most common form: systemic lupus erythematosus, also known as SLE. About 70 percent of people with lupus have SLE, according to the Lupus Foundation of America. Lupus can cause a range of complications; some, such as heart disease and kidney disease, can be severe and even life-threatening without early and proper medical treatment. Regular medical care that utilizes an integrated team of specialists is important to help lupus patients avoid life-potentially serious complications.
Unexplained weight loss — not due to dieting, other illness, or medication side effects — can be a sign of lupus. On the other hand, weight gain caused by fluid retention can also be a sign of the disease.
The characteristic rash across the cheeks and nose (called a malar rash) is one of the most recognized symptoms of lupus, although a similar-looking rash can also occur in other skin issues. Another type of lupus skin issue is a discoid rash that causes raised, red, and scaly patches.
Sun exposure can cause a lupus rash to develop or flare. People with lupus are also at risk of developing Raynaud’s, a condition in which the small blood vessels in the hands and feet suddenly constrict when exposed to cold or stress.
Other lupus symptoms include fever; neuropsychiatric issues such as depression, anxiety, seizures, or psychosis; brain fog; fatigue; headaches (including migraine-like attacks); mouth ulcers; kidney problems; and chest pain.
Despite the similarities in some of the symptoms, there are a few clear differences doctors and patients should be on the lookout for, says Dr. Stojan.
1. The nature of fatigue:Fatigue is common during a lupus flare, but it will subside once the attack is over, says Dr. Stojan. In fibromyalgia, however, exhaustion is more chronic — it’s less likely to come and go.
2. The nature of pain: Although both fibromyalgia and lupus can cause muscle and joint pain, lupus pain persists until it’s treated, says Dr. Stojan. The pain of fibromyalgia comes and goes. “The transient quality of the symptoms is a reliable sign that pain is not related to lupus,” he says.
3. Whether skin is involved: Fibromyalgia doesn’t cause nose and/or mouth ulcers or rashes like lupus does, such as the typical “butterfly” rash on the cheeks and bridge of the nose that can pop up during a lupus flare.
4. Whether there is inflammation: In lupus, a patient’s immune system starts to attack organs and other body tissues, leading to widespread inflammation that will likely show up in lab tests or imaging, says Dr. Stojan. Fibromyalgia, on the other hand, does not cause inflammation.
There are no definitive tests for either fibromyalgia or lupus, so differentiating between the two relies mostly on a thorough history of your symptoms, a physical exam, and sometimes blood tests or imaging to rule out other conditions. Read more here about how fibromyalgia is diagnosed.
Your doctor will ask you to describe your pain — and if they suspect fibromyalgia, may perform a “tenderness” test, pressing on several parts of your body to gauge where the tenderness is, and how severe it is.
Your doctor will likely also ask whether you experience fatigue, wake up tired every morning, or have trouble concentrating or experience brain fog — and for how long you’ve had these symptoms.
Your doctor may order some blood tests in order to rule out diseases that can cause fatigue, such as hypothyroidism type 2 diabetes. They may order blood tests to check for levels of inflammation in the body or for antibodies that could signal an autoimmune disease. One test ordered to help confirm or rule out lupus is the blood test for antinuclear antibodies (ANA). A positive test can be one sign of lupus, but it doesn’t necessarily mean you have it. “ANA is a very common marker people have in the blood. Almost one-third of people in the U.S. will test positive — and that alone doesn’t mean you have lupus,” Dr. Stojan says. However, most people who have lupus will have a positive test.
If you have a positive ANA test and other signs that point to lupus, your doctor may do additional antibody tests that help confirm or rule out the illness.
Your doctor may also order imaging tests like X-rays or MRIs to narrow down the cause of your symptoms. Neither fibromyalgia or lupus cause erosion in the joints (the way rheumatoid arthritis does) or visible inflammation of the lower back (the way axial spondyloarthritis does).
Neither disease has a cure, but medication can treat symptoms and help prevent serious lupus complications. The medications used to treat lupus are very different from those used to treat fibromyalgia.
For fibro patients: Some drugs commonly used to treat depression, called antidepressants, may ease pain and fatigue; these include duloxetine (Cymbalta) and milnacipran (Savella). Anti-seizure medications, frequently prescribed to people with epilepsy, can also help manage pain in fibromyalgia. Among these, the FDA has specifically approved pregabalin (Lyrica) for the treatment of fibro.
For lupus patients: Many different types of medications can be used to treat lupus, including:
Non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation
Hydroxychloroquine or chloroquine, a malaria drug that is also useful at treating lupus flares, joint pain, and skin rashes
Glucocorticoids, or steroids, to relieve inflammation and treat flares
Immunosuppressive medications, such as azathioprine, cyclophosphamide, methotrexate, mycophenalate mofetil
Targeted biologics, such as rituximab (Rituxan) and belimumab (Benlysta), which reduce the activity of the immune system by targeting specific immune cells
Other medications to help manage complications of lupus, including those for cholesterol, blood pressure, osteoporosis, and others
Patients with lupus and fibro can also benefit from healthy lifestyle practices, too, including:
Exercise: Regular physical activity can help manage symptoms of fibro or lupus, and may improve mood, fitness and function. Swimming, walking, tai chi, and yoga are smart options. Exercise can be very important in helping people with lupus reduce their risk of cardiovascular disease complications. Consult a health care provider or physical therapist about a new exercise regimen, so it can be adapted to individual needs.
Diet: Though there is no specific diet recommended for lupus or fibro, a healthy eating plan may boost your immune system, help manage co-existing conditions, and promote overall good health. Read more about a following a healthy diet for lupus and a healthy diet for fibromyalgia.
Sleep: Getting adequate rest is vital for both conditions. It’s recommended that adults between ages 18 and 64 should aim for seven to nine hours nightly.
Complementary practices: Some patients report that activities like meditation, acupuncture, deep breathing, and massage help them relax and ease symptoms.
While lupus and fibro may have some symptoms in common, they are ultimately distinct conditions with very different causes and treatments. Visiting a health care provider can help you get to the bottom of your symptoms quickly and begin the correct therapies. The faster you start, the faster you can start feeling better.
If you’ve had a nagging sore throat, your doctor may take a swab to check for strep. If you’re suffering from a high fever and bad cough, your doctor may order a chest X-ray to look for pneumonia. But not all diagnoses are that straightforward.
Case in point: Fibromyalgia, a condition that causes widespread chronic pain — as well as fatigue, sleep disturbances, and cognitive difficulties — is often challenging for a physician to pinpoint.
“Fibromyalgia can be difficult to diagnose because there’s no gold standard test like an X-ray or blood work,” says Lenore Brancato, MD, a board-certified rheumatologist at NYU Langone Ambulatory Care in New Hyde Park, New York. “It’s a diagnosis of exclusion, which means you first have to rule out other diseases that may be causing symptoms. It’s not a cookie-cutter condition.”
Fibromyalgia is also a diagnosis that’s been subject to change. Back in 1990, when the first diagnostic criteria were set by the American College of Rheumatology (ACR), a doctor had to find the following elements in order to say their patient had fibromyalgia: pain in at least 11 of 18 designated “tender points” throughout the body, plus a history of widespread pain lasting more than three months.
In 2010, however, those diagnostic criteria for fibromyalgia were updated to eliminate the tender point requirement and instead focus on findings that a patient has widespread pain, as well as sleep disruptions, fatigue, and cognitive difficulties.
Whereas the validity of fibromyalgia as a diagnosis was once questioned in the medical community — leading to a stigma it’s still overcoming — ongoing research has led to a number of possible explanations for physical causes of fibromyalgia (ranging from genetics to physical triggers) and mechanisms (involving the central nervous system).
What we know for sure is that fibromyalgia affects approximately 2 percent of adults in the United States, and your risk of developing the condition increases if you are middle-aged or older and have been diagnosed with lupus or rheumatoid arthritis, says the Centers for Disease Control and Prevention (CDC). You may also be at a higher risk if you are female (most fibromyalgia patient are women), have suffered a trauma or repetitive injury, or if you are obese.
But statistics and risk factors can’t describe how fibromyalgia actually feels to the person living with it. What follows are the descriptions doctors hear patients use when they talk about both usual and less common symptoms of fibromyalgia.
While every fibromyalgia patient is different, their descriptions of overwhelming, debilitating pain throughout the entire body are very common. “My patients report feeling sore and stiff with an achy pain that goes from the top of their head to their toenails,” says Christopher Morris, MD, a board-certified rheumatologist with Arthritis Associates in Kingsport, Tennessee, and a fellow of the American College of Rheumatology. “They tell me the pain is in the muscles and soft tissues rather than joints.” Dr. Brancato hears similar concerns, with some of her patients saying the pain is lacerating, “like being cut by knives.”
Fibromyalgia could also make you overly sensitive to touch and temperature. “If you’re a patient with fibromyalgia, and someone brushes up against you in a crowded room it can be very painful,” says Dr. Brancato. “I’ll hear that my female patients can’t tolerate a massage.” Even though the stimulus is taken away, like removing your hand from a hot stove, the pain can continue, she explains.
If you have fibromyalgia, you may have trouble falling asleep or staying asleep. “My patients say they toss and turn, or their mind wanders,” Dr. Brancato says. “I’ll hear that my patients wake up throughout the night and end up feeling as tired as when they went to bed,” Dr. Morris adds.
One of the most common issues for fibromyalgia patients is fatigue. “It’s exhausting for them,” says Dr. Brancato. “If you ask a patient how they feel in the morning, you’ll hear they felt awful, they never feel ready to go, they feel like they can’t get their head above water.”
“My patients describe having a ‘fibro fog,’” says Dr. Morris. “They have a hard time concentrating.” For her part, Dr. Brancato sees a lot of memory problems. “If you tell a fibromyalgia patient three things during an office visit, then ask them to recall them later during the same visit, they have difficulty,” she explains. “With fibromyalgia, short-term recall can be very poor.”
For many patients, fibromyalgia may also bring feelings of sadness and other negative moods. Some researchers suspect a connection between fibromyalgia and certain types of chronic anxiety and depression.
Though less common, headaches can occur among fibromyalgia symptoms. “Stress- and tension-type headaches tend to travel with fibromyalgia,” Dr. Brancato reports, adding that they can be triggered differently than in patients without fibromyalgia. “These headaches can be induced by regular sounds, background music, or even odors like perfumes.”
Fibromyalgia can sometimes occur alongside digestive problems, such as bloating, constipation, abdominal pain, and irritable bowel syndrome (IBS), says the CDC.
Some patients with fibromyalgia might also have an increased incidence of interstitial cystitis, says Dr. Brancato. This condition can cause chronic pain or pressure in the bladder and pelvis.
It’s possible for fibromyalgia to be linked to pain in the muscles of the jaw and face (temporomandibular joint disorder) or to myofascial (skeletal muscle) pain in one part of the body. Such occurrences could be considered forms of regional or localized or incomplete fibromyalgia.
The relationship between fibromyalgia and different types of arthritis can be complicated. For one thing, there’s misdiagnosis: Depending on how your symptoms present, you could be told you have fibromyalgia when you actually have a kind of arthritis, or vice versa. Read about how ankylosing spondylitis and fibromyalgia can be mistaken for each other, for example.
At the same time, having a painful chronic disease like arthritis may in turn trigger the onset of fibromyalgia. Inflammatory diseases like arthritis can affect the way your central nervous system processes pain, creating a double-whammy of having both diseases at the same time.
If you suspect your combination of symptoms could be fibromyalgia, it’s a good idea to start with your primary care doctor. Because fibromyalgia is a diagnosis of exclusion, you’ll likely need a through physical exam, blood tests, and imaging tests to figure out what could be causing your symptoms.
Having AS with psoriasis may have some things in common with psoriatic arthritis, but research shows these are two distinct conditions.
About 25% of people who have an autoimmune condition develop at least one more; some people live with three, four, or more. In fact, certain pairs of inflammatory diseases commonly occur together.
For one, people with ankylosing spondylitis (AS) (also known as axial spondyloarthritis) — which is best-known for causing chronic lower back pain — are also more likely to have psoriasis — an autoimmune disease that manifests in the form of scaly red and silvery skin patches. That combination might sound pretty similar to the autoimmune condition psoriatic arthritis (PsA), which, by definition, is a form of inflammatory arthritis that typically causes joint pain as well as skin plaques.
To further add to the confusion, PsA is considered part of the same family of rheumatic diseases as ankylosing spondylitis — they’re both considered types of spondyloarthritis, which is an umbrella term for a group of types of arthritis that have similar traits in common.
And while most psoriatic arthritis patients develop arthritis in the small joints of the fingers and toes, the joints in the back can sometimes be impacted. PsA patients who have arthritis in the back or sacroiliac joints in the pelvis may be told that they have “axial PsA.”
If the sometimes overlapping details of these conditions are making you wonder if people with AS and psoriasis really have axial PsA, you’re in good company. Researchers at the University of Toronto weren’t sure, either. To find out, they compared data on more than 2,000 patients. One group had been diagnosed with AS and psoriasis; another had been diagnosed with axial PsA; and a third had only been diagnosed with AS (without psoriasis).
According to their findings, which appear in the journal Rheumatology, axial PsA is not, in fact, the same thing as AS plus psoriasis.
The researchers found that AS patients (with or without psoriasis) were more apt to be male, more likely to be positive for HLA-B27 (a genetic marker), and much more likely than those with PsA to report back pain as a chief complaint.
“AS patients, with or without psoriasis, seem to be different demographically, genetically, clinically, and radiographically from [axial PsA] patients. [Axial PsA] seems to be a distinct entity,” they concluded.
Fibromyalgia — a disorder that causes widespread chronic pain and tenderness — affects 2 to 4 percent of women and men in the United States (women ages 20 to 50 are the most affected) and impacts patients in many different ways.
Thus, fibromylagia remains mysterious, and questions still linger — like why are more women affected by fibromyalgia than men? And why is fibromyalgia so hard to diagnose and treat? Why do some patients with fibromyalgia have more back pain than others?
“What causes fibromyalgia has puzzled many scientists for a long time,” says Elena Schiopu, MD, a rheumatologist and internist at Michigan Medicine in Ann Arbor. While the exact cause of fibromyalgia isn’t certain, doctors do know that the disorder can be triggered by an injury, surgery, infection, psychologicaltrauma (like an extremely stressful period), or even just from an accumulation of symptoms that leads to the eventual classification of fibromyalgia.
The reason for the heightened pain? Fibromyalgia may affect the way your brain interprets pain signals. “Fibromyalgia is basically a miscommunication between the central, peripheral, and autonomic [vegetative] nervous system, which results in abnormal or amplified sensations,” says Dr. Schiopu. This is known as central pain sensitization. It causes your nervous system to become “wound up” and in a constant state of hyperactivity, which creates a lower threshold for experiencing pain.
When you poke someone without fibromyalgia, for example, it might be no big deal, but for someone with fibro, that same level of touch can cause significant pain or discomfort.
Unlike arthritis, in which pain occurs in specific joints, the pain that fibro patients experience is more in the muscles. It’s a widespread pain, which means you feel pain all over you body. According to the latest diagnostic criteria for fibromyalgia, patients must experience pain in four out of five general regions of the body. These include left upper, right upper, left lower, right lower, and low back.
People with fibromyalgia may experience long-term back pain along with a number of other symptoms. “Back pain that’s patient-reported and physician-observed — called paraspinal lumbar tenderness — is very common,” says Dr. Schiopu. “All the areas of the body that are being ‘used’ on a regular basis could hurt, like your hands, neck, or upper or lower back.”
“The back is a common area to have pain in fibromyalgia because muscles in general are often painful in fibromyalgia, and the human back has a large quantity of muscle fibers to support posture,” says Amanda Sammut, MD, a rheumatologist and assistant clinical professor of medicine at Columbia University Medical Center in New York City.
Also, says Dr. Schiopu, patients with fibromyalgia could have a degree of wear-and-tear arthritis of the lumbar spine, which is amplified by fibro. In fact, it’s common to have fibro at the same time as other diseases, such as inflammatory arthritis or osteoarthritis.
Lower back pain is an extremely common medical complaint — some 80 percent of Americans experience it at some point in their lives. So if you have lower back pain, how do you know if it could be from fibromyalgia or something else?
The answer is complicated. If you’re experiencing back pain as well as other symptoms, it’s possible you could have a different health problem entirely — or a health problem plus fibromyalgia at the same time.
Misdiagnoses are common with fibromyalgia — both in terms of not being diagnosed with fibro when you really have it, or in terms of being diagnosed with fibro when you actually have a different health problem.
“Fibromyalgia is technically an exclusion diagnosis,” says Dr. Schiopu. This means you shouldn’t be diagnosed with fibromyalgia until a doctor has fully ruled out the possibility of having other diseases.
That’s why a thorough visit with a rheumatologist is critical. If you’ve already been diagnosed with fibromyalgia but find that your current treatment plan isn’t helping your back pain, you could have a different or additional diagnosis, such as one of the following:
Maybe you lifted a heavy box, strained to reach something in a high cabinet, or picked up your child or grandchild, which could have triggered a back muscle strain. A sudden movement can cause a strain, as well as constant use of your back (like doing repetitive motions), especially if you’re not in good physical shape.
If you have lower back pain as well as pain in other places — say, your knees, jaw, neck, or shoulders — it could be from the widespread aches of fibromyalgia, or it could be another condition you may not be familiar with: axial spondyloarthritis (AxSpA), which is an inflammatory type of arthritis in your spine and the area where your spine meets the pelvis (sacroiliac joints). Back pain is a primary symptom of AxSpA, though it can also affect other joints and areas around your body.
AxSpA is often divided into two categories. Radiographic AxSpA (which is often called ankylosing spondylitis), means that evidence of joint damage is visible on X-rays. Non-radiographic AxSpA (nr-AxSpA) is essentially the same condition, but without joint damage being visible on X-rays.
Fibromyalgia and axial spondyloarthritis are caused by very different things (AxSpA is inflammatory and due to an overactive immune system that’s attacking the joints) and thus have very different treatments. It’s important to get the right diagnosis so you can get on the right treatment and start feeling better.
You may have never realized it, but your spine could curve to the side, a condition known as scoliosis. The physical changes of scoliosis often start in childhood but the condition might not start causing back pain until middle age.
The cushiony discs between your vertebrae may bulge or rupture, which can then put pressure on a nerve in your spine. While some people may not feel any pain when this happens, others may find it excruciating.
A frustrating part about aging: The vertebrae in your spine may develop compression fractures if your bones become too brittle (a condition known as osteoporosis). These fractures can then lead to back pain.
While you may experience back pain if you have fibromyalgia, if you’re experiencing back pain alone, and not other fibromyalgia symptoms, then your pain is likely not due to fibromyalgia, says Dr. Schiopu.
In addition to pain, sleep problems are a big part of patients’ experience with fibromyalgia. Even if fibro patients sleep for hours, they still may wake up feeling unrefreshed. That could be due to pain waking people up at night, or they may experience other sleep issues, like restless leg syndrome or sleep apnea. This troubled sleep, in turn, can contribute to debilitating daytime fatigue.
Many patients with fibromyalgia complain of fibro fog, in which people feel like they can’t concentrate, hold conversations, or even remember certain things, like plans or where they placed objects. One reason for the fibro fog could be lack of sleep. Another explanation is that there is potentially something happening in the brain that’s unique to people with fibromyalgia.
Fibromyalgia often co-exists with other ailments, like irritable bowel syndrome, migraine, interstitial cystitis (a painful bladder syndrome), and TMJ (a jaw disorder). “That’s all followed by a slew of hypersensitivity to cold, light, noises, smells,” adds Dr. Schiopu. Thus, it can seem like fibromyalgia patients have a laundry list of health woes, which can be incredibly frustrating.
If you have fibromyalgia and are experiencing back pain as a symptom, then you’ll want to come up with a treatment game plan with your doctor. “Gentle stretching, warm pool exercises, and even a supportive belt would help,” says Dr. Schiopu. “Daily strengthening of the lumbar musculature [muscles in the lower back] is key as well,” she adds.
Fibromyalgia medications may help relieve back pain. Some antidepressant drugs are prescribed to help ease pain and fatigue; these include duloxetine (Cymbalta) and milnacipran (Savella). Anti-seizure medications can also help manage pain in fibromyalgia. Among these, the FDA has specifically approved pregabalin (Lyrica) for the treatment of fibro.
If you have back pain — especially back pain that’s lasting more than three months and doesn’t improve with your current treatment — it’s important to talk to your doctor about your symptoms and medical history. Your back pain could be due to fibromyalgia, but it could also stem from various other health issues.
“If your back pain continues despite medical therapy and despite physical therapy, patients should then consider seeing a rheumatologist or a pain management specialist,” says Dr. Sammut.
Fibromyalgia and multiple sclerosis are both chronic diseases with no cure. Fibromyalgia and multiple sclerosis can both cause some of the same symptoms. They can both take a long time to get the right diagnosis. They’re both more common in women. But fibromyalgia — often called “fibro” — and multiple sclerosis (MS) are two very distinct health conditions with very different causes and treatments, despite having some features in common. Read on to find out the differences and similarities of fibromyalgia vs. MS.
Fibromyalgia and MS may have some more vague symptoms in common, such as problems with focus and concentration, fatigue, and depression. If you’re Googling potential causes of these symptoms, you may find yourself researching both diseases to see if your symptoms match up. But despite some similarities, “for the most part, there is no mistaking symptoms of MS with fibromyalgia,” says Philip Cohen, MD, a rheumatologist, professor of medicine and professor of microbiology and immunology at the Lewis Katz School of Medicine at Temple University in Philadelphia.
This is especially true once you see a health care provider and start the process of seeking a diagnosis. Fibromyalgia is often diagnosed and managed by a rheumatologist, which is an internal medicine doctor who has specialized training in joint and musculoskeletal diseases. Multiple sclerosis is diagnosed and managed by a neurologist, which is a doctor who specializes in treating disorders of the brain and nervous system.
Read more to learn about the different symptoms of fibromyalgia vs. multiple sclerosis, how fibromyalgia and multiple sclerosis are each diagnosed, and how treatments for fibromyalgia and multiple sclerosis differ.
The Centers for Disease Control and Prevention estimates that about 4 million American adults have fibromyalgia. While doctors don’t know what causes fibromyalgia, it is a disorder in which people often experience widespread chronic pain and sensitivity to touch, in addition to many other symptoms (more on this below).
“Fibromyalgia is poorly understood,” says Dr. Cohen. “But it’s thought by many to be a disorder of pain perception, perhaps due to abnormalities in parts of the brain.”
Unlike MS, fibromyalgia is not an autoimmune disease, which occurs when then body’s immune system mistakenly attacks your own cells and tissues. Fibromyalgia is not related to inflammation, nor is it a joint or muscle disorder caused by physical injury.
People at higher risk of fibromyalgia include women, the middle-aged, and those with certain diseases, including different types of arthritis, or a family history of fibro. While fibro can impair your quality of life, it doesn’t damage your tissues and organs, or cause medical problems like heart disease and cancer. It is not life-threatening.
Though someone with fibro may experience a range of symptoms, the condition’s hallmark symptom is persistent pain in soft tissues and muscles all over the body. “Fibromyalgia pain is diffuse [all over], with particular involvement of what are called ‘tender points,’ or areas of tenderness elicited by pressing in specific parts of the neck, trunk, and extremities,” says Dr. Cohen. Frequently described as a deep ache, the pain may move around, persist for long periods, and disappear.
More than nine in 10 fibromyalgia patients experience unrelenting exhaustion. The sleep problems that often accompany fibro, including light sleep and repeated awakenings, can contribute to fatigue, but treating fatigue in fibromyalgia isn’t just about getting more sleep.
“Fibromyalgia patients often have headaches, irritable bowel symptoms, and depression,” adds Dr. Cohen. “Although these problems may occur in MS, they are less commonly seen.”
About 1 million Americans are thought to have multiple sclerosis. Unlike fibro, MS is considered an autoimmune disease in which the immune system is attacking part of the central nervous system. Specifically, MS affects the protective sheath (myelin) that covers nerve fibers throughout your body, which can cause a wide range of symptoms depending on which nerves are affected. Over time, multiple sclerosis can permanently damage your brain and spinal cord.
Doctors don’t know what causes MS but believe that it’s due to a combination of genes and environmental factors. Women, Caucasians, people between the ages of 20 and 50, and those who live farther from the Equator have a higher risk of developing MS.
There are four main kinds of MS; symptoms and disease progression depend on what type you have. While many people with MS develop relatively mild issues (especially with newer treatments that can help prevent MS flares and disease progression), those with severe illness can lose mobility and speech and experience other complications.
MS symptoms vary among patients, depending on which parts of the nervous system are affected. The most common type of MS — called relapsing-remitting MS, which is what 85 percent of patients are first diagnosed with — is characterized by attacks, or flares, of new symptoms followed by periods of remission. Among the more common symptoms of MS are:
Numbness and tingling in the limbs often occur with MS, as do muscle spasms. Frequently, someone with MS will feel an electric impulse sensation when they move their neck a particular way; this is called the Lhermitte sign.
Dizziness and weakness can contribute to balance and coordination troubles. People with MS often complain of feeling suddenly clumsy or report tripping, stumbling, or falling more than usual.
When MS affects the optic nerve in your eye, it can cause eye problems such as blurry eyesight, double vision, and vision loss, and may involve eye pain and unexpected movement of the eye. You may find yourself partially color blind and have issues such as picking out clothes that don’t match.
People with MS may experience eye pain or pain elsewhere in the body. It can be acute or mild, and may be related to neurological issues or musculoskeletal problems. Occasionally, some MS patients do not develop pain. For fibro patients, pain is a defining aspect of the disease. Without its presence, you cannot get a fibromyalgia diagnosis.
Constant weariness is widespread in both MS and fibro. The vast majority of people with either condition often feel physically exhausted, and may find it interrupts their lives at home, school and work.
“Fibro fog” is common in fibromyalgia. About half of MS patients report brain fog-like symptoms as well.
When considering your symptoms, it is important to keep in mind that people with multiple sclerosis may experience a wide variety of other issues not common to people with fibromyalgia, such as mobility problems and speech troubles. What’s more, many unusual symptoms may be caused by a condition unrelated to either disease. As a result, it’s crucial to get an an accurate diagnosis.
If you suspect you might have either fibromyalgia or MS, says Dr. Cohen, “begin with [your] internist or general practitioner.” They can assess your symptoms and medical history and refer you to the right specialist for further testing.
Both fibromyalgia and multiple sclerosis can be difficult to diagnose. There’s no single test that confirms you have either disease, and doctors must rule out other conditions that can have similar symptoms. Read more about diseases that can mimic fibromyalgia.
When diagnosing fibromyalgia vs MS, providers must eliminate the possibility of those other illnesses, which include rheumatoid arthritis, lupus, spondyloarthritis, thyroid disorders, and others. To do this, they’ll typically use a combination of patient history, physical exam, and laboratory tests to narrow the field. At the same time, they can look for three diagnostic criteria:
Diagnosing MS is different from diagnosing fibromyalgia since clinicians can rely on certain tests in addition to symptoms, medical history, and a physical exam. Magnetic resonance imaging (MRI), for example, takes pictures of your brain and helps detect damaged nerves. Other tests may include spinal taps, optical coherence tomography — which scans your eyes for symptoms of MS — and evoked response tests, which look at how your nerves respond to certain stimulation.
According to the National MS Society, an official MS diagnosis requires the following:
The discovery of damage in two or more separate parts of the central nervous system
While neither illness has a cure, medication can be used to relieve fibromyalgia or MS symptoms. In the case of MS, drugs can also greatly modify the course of the disease. That’s why — though taking medication as prescribed is often key to the treatment of any chronic illness — medication adherence is especially crucial for MS patients.
For fibro patients:Some drugs commonly used to treat depression, called antidepressants, may ease pain and fatigue; these include duloxetine (Cymbalta) and milnacipran (Savella). Anti-seizure medications, frequently prescribed to people with epilepsy, can also help manage pain in fibromyalgia. Among these, the FDA has specifically approved pregabalin (Lyrica) for the treatment of fibro.
For MS patients:There’s been a lot of innovation in recent years to develop different kinds of medications that can help limit damage to the nervous system, reduce relapses, and slow disease progression. These include oral medications as well as medications that are injected or infused. Each medication works differently, but they generally affect immune system activity to prevent it from attacking the nervous system.
People with MS may need additional medication to treat flares, such as corticosteroids, as well as medications to target specific MS symptoms, such as drugs for bladder issues, sexual dysfunction, and muscle stiffness and spasms.
Patients with MS and fibro can also benefit from healthy lifestyle practices, too, including:
Exercise: Regular physical activity can help manage symptoms of fibro or mild MS, and may improve mood, fitness and function. Swimming, walking, tai chi, and yoga are smart options. Consult a health care provider or physical therapist about a new exercise regimen, so it can be adapted to individual needs.
Diet: Though there is no specific diet recommended for MS or fibro, a healthy eating plan may boost your immune system, help manage co-existing conditions, and promote overall good health.
Sleep: Getting adequate rest is vital for both conditions. It’s recommended that adults between ages 18 and 64 should aim for seven to nine hours nightly.
Complementary practices: Some patients report that activities like meditation, acupuncture, deep breathing and massage help them relax and ease symptoms.
Keeping a consistent daily routine is often suggested for both fibro and MS, as is leaning on family, friends, and professionals for emotional support. “If there is depression or anxiety, referral to a psychiatrist or counselor is often helpful,” says Dr. Cohen.
While MS and fibro may have some symptoms in common, they are ultimately distinct conditions with very different causes and treatments. Visiting a health care provider can help you get to the bottom of your symptoms quickly and begin the correct therapies. The faster you start, the faster you can start feeling better.
Fibromyalgia is a disorder characterized by generalized musculoskeletal pain accompanied by fatigue, sleep, memory, and mood problems. Researchers believe that fibromyalgia amplifies painful sensations by affecting how the brain and spinal cord treat painful and non-painful signals.
Symptoms often begin after an event, such as pain, physical trauma, surgery, infection, or severe psychological stress. In other cases, symptoms gradually accumulate over time without a single trigger event. Women are more likely to develop widespread pain in fibromyalgia than men.
Many people with fibromyalgia also have tension headaches, temporomandibular joint disorders (TMJ), irritable bowel syndrome, anxiety, and depression. Although there is no cure for fibromyalgia, a variety of drugs can help control your symptoms. Exercise, relaxation, and stress reduction measures can also help.
May is month is used as fibromyalgia chronic condition awareness.
Widespread pain. Generalized pain. Pain associated with fibromyalgia is often described as a constant dull pain that lasted at least three months. To be considered widespread, pain should occur on both sides of the body and above and below the waist.
Fatigue. People with fibromyalgia often wake up tired, even if they report sleeping for long periods of time. Sleep is often disturbed by pain, and many patients with fibromyalgia have other sleep disorders, such as restless leg syndrome and sleep apnea.
Cognitive difficulties. A symptom commonly called “fibro fog” impairs the ability to focus, pay attention and focus on mental tasks.
The fibromyalgia symptoms list that we present on this page is an addition to the main Fibromyalgia Symptoms page (our unique perspective on dealing with various fibromyalgia symptoms using our protocol) Why do you NEED an accurate SYMPTOMS LIST?
Well, because there are too many generic inaccurate fibromyalgia symptoms list out there that just state a lot of symptoms, without regard to PRIMARY and SECONDARY, and without regard to the possibility of missing other conditions. Please know that it is IMPERATIVE to distinguish between primary and secondary symptoms so that you do not miss another condition outside of the fibro. That is what we do here. This is not a random list of symptoms because that can be very dangerous. Yes, fibro is complex, but we are supporting the WHOLE you.
Some of the following links will be updated as new and more specific articles are published here on the site. This extended fibromyalgia symptoms list will get you familiar with the various symptoms and treatment options (not false cures) as you study our entire protocol for “eating the fibromyalgia elephant one symptom at a time”.
Whether you have been living with fibromyalgia for much of your lifetime, or are newly diagnosed, our site is designed to be user friendly and help you to live a better quality of life with fibromyalgia.
F-G says, “Check below my fibromyalgia symptoms lists.”
Please trust me when I say that fibromyalgia is a very complex syndrome, and there are no “silver bullets”. But there are solutions that will help us to live a better quality of life.
And, those solutions vary depending on the symptom. If we are going to create a better quality of life, following our protocols is the most effective way, but as always, this is NOT about perfection.
Fibromyalgia often co-exists with other conditions, such as:
Many researchers believe that repeated nerve stimulation provokes the change in the brain and spinal cord of people with fibromyalgia.
This change implies an abnormal increase in the levels of certain chemicals in the brain that signal pain. In addition, brain pain receptors seem to develop some kind of painful memory and become sensitized, which means that they can react excessively to painful and non-painful signals.
There are likely many factors that lead to these changes, including:
Genetics. Since fibromyalgia tends to run in families, there may be certain genetic mutations that can make you more sensitive to the development of the disorder.
Physical or emotional events.Fibromyalgia can sometimes be triggered by a physical event, such as a car accident. Prolonged psychological stress can also trigger the condition.
Pain, fatigue and poor sleep quality associated with fibromyalgia can interfere with your ability to operate at home or at work. The frustration of dealing with an often-misunderstood condition can also lead to depression and health-related anxiety.
Fibromyalgia (fi•bro•mi•al•gi•a) is a condition that causes pain throughout the body (also known as generalized pain), sleep problems, fatigue, and often emotional and mental distress. People with fibro pain symptoms may be more susceptible to pain than people without fibromyalgia. This is called the abnormal treatment of pain perception. Fibromyalgia affects about 4 million American adults or about 2% of the adult population. The cause of fibromyalgia is not known, but it can be treated and managed effectively.
Age. Fibromyalgia can affect people of all ages, including children. However, most people are diagnosed during middle age and you are more likely to have fibromyalgia as you get older.
Some other factors have been weakly associated with the onset of fibromyalgia, but more research is needed to see if they are real. These possible risk factors include:
Sex. Women are twice as likely to have fibromyalgia as men.
Stressful or traumatic events, such as car accidents, post-traumatic stress disorder (PTSD)
Repetitive injuries. Injury from repetitive stress on a joint, such as frequent knee bending.
One of the defining attributes of fibromyalgia and myofascial pain is the effect on mobility about the body in time periods of a few hours to days at a time. This is often the result of severely tender “areas” of the fibro body and multiple trigger points which lie in various layers along the fascia and muscle groups.
Fibromyalgia symptoms are most debilitating when they affect the brain, head, or face. This is due to the close proximity within all of our senses and the effect on them.
Moreover, the fibromyalgia symptoms that affect this area are quite diverse, creating emotional effects; sleep disturbance; hyper sensitivity to lights, noise, and chemical toxins; and all are accompanied by pain ranging from acute and throbbing to incessant dull ache. Mitigating these varied symptoms is just as varied.
GI issues on the fibromyalgia symptoms list are often exacerbated by a common co-condition, Irritable Bowel Syndrome, which has more serious GI tract problems than fibro alone.
However, symptom relief for either pretty much follows the same protocol. Working as a colon therapist for many years, I have utilized some effective, non-invasive remedies to ease symptoms of IBS, constipation and spastic colon.
A couple of the items on the fibromyalgia symptoms list in this category deserve a tip. I personally don’t have much problem with heat, but cold is a different matter. My greatest “cold” issues usually occur in the spring or fall when weather fronts often move thru accompanied by a drop-in temperature. Being better prepared for weather change is essential with fibromyalgia.
Also, the “sensitive to touch” symptom is quite different from the allodynia symptom in which any touch is intolerable. TRPs and the fascia are usually involved in simple “sensitive to touch”. In this case manipulation can be done and some relief can be realized.
In this category of the fibromyalgia symptoms list I just want to explain why MCS (Multiple Chemical Sensitivity) is listed here as well as in the above category of “Brain/Head/Face. I’ve had severe MCS since a young age, and it can be very debilitating. With MCS, it’s all about avoiding exposures.
But, when exposed, the effects in the Head area are really bad and come on quickly; but that’s not the end of the story because MCS is like the worst “endocrine disrupter” really, and associated symptoms can last for days. So, you are probably saying to yourself ” but I don’t have MCS”. Well, hear me out…
Sure, I’m hyper-sensitive to all manner of toxins; but in my years of working with fibro sufferers, I’m convinced that most people with fibromyalgia also react to those same toxins. In a twisted kind of way I’m lucky because my reactions are so “cause and effect” obvious.
When I am exposed, I know it immediately; and, I know my fibro is going to flare. It always does. I’m also convinced that your fibro flares when you are exposed to those same toxins, but you probably don’t make the association in your mind because it’s not as evident as with me.
Consequently, I believe that many fibro sufferer’s fibromyalgia symptoms are exacerbated by the toxins in our everyday lives such as dryer sheets, perfume, deodorant, formaldehyde in our carpet and furniture, and many other sources. You can do something to protect yourself, I have. It is important that we create a safe haven in our own homes. Read more about this on the Environmental Toxins page by clicking on the multiple chemical sensitivity link in the folowing fibromyalgia symptoms list.
Although not listed here, you can also use the SITEMAP to access the articles on “Leaky Gut” and “Underactive Thyroid” (often part of lowered immune symptoms) There are also viral co-conditions such as Epstein Barr, anaplasma and mycoplasma that can exacerbate symptoms within fibromyalgia when these viruses are found through blood testing.
Fibromyalgia can be treated and managed effectively with medication and self-management strategies. You can learn more about self-management strategies in the next section entitled How can I improve my quality of life?
Fibromyalgia should be treated by a doctor or team of health professionals specializing in the treatment of fibromyalgia and other types of arthritis, called rheumatologists. Doctors usually treat fibromyalgia with a combination of treatments, which may include:
Medications, including prescription drugs and over-the-counter pain relievers
Patient education classes, usually in primary care or community settings
Stress management techniques such as meditation, yoga, and massage
Good sleep habits to improve the quality of sleep
Cognitive-behavioral therapy (CBT) to treat the underlying depression. CBT is a type of talk therapy meant to change the way people act or think
In addition to medical treatment, people can manage their fibromyalgia with the self-management strategies described below, which have been shown to reduce pain and disability, so they can perform important activities for themselves.
Fibromyalgia can cause pain, disability, and a lower quality of life. US adults with fibromyalgia may have complications such as:
More hospitalizations. If you have fibromyalgia you are twice as likely to be hospitalized as someone without fibromyalgia.
Lower quality of life. Women with fibromyalgia may experience a lower quality of life.
Higher rates of major depression. Adults with fibromyalgia are more than 3 times more likely to have major depression than adults without fibromyalgia. Screening and treatment for depression are extremely important.
Higher death rates from suicide and injuries. Death rates from suicide and injuries are higher among fibromyalgia patients, but overall mortality among adults with fibromyalgia is similar to the general population.
Get physically active. Experts recommend that adults be moderately physically active for 150 minutes a week. Walk, swim or bike 30 minutes a day for five days a week. These 30 minutes can be divided into three separate ten-minute sessions during the day. Regular physical activity can also reduce the risk of developing other chronic diseases such as heart disease and diabetes. Learn more about physical activity for arthritis. You can exercise alone or participate in a fitness program recommended by CDC.
Go to recommended physical activity programs. Those who are concerned about how to exercise safely can participate in physical activity programs that have proven to be effective in reducing arthritis pain and disability and improving mood and ability to move. Courses are held in local Ys, parks, and community centers. These courses can help you feel better. Learn more about CDC recommended physical activity programs.
Join a self-management education class, that helps people with arthritis or other conditions, including fibromyalgia, have more confidence in how to control their symptoms, live well and understand how the disease affects their lives. Learn more about CDC’s recommended self-management programs.
Fibromyalgia is by any measure a complex syndrome. As I have written (and continue to write) the many articles in the website, I work to answer any question that you might have, and I feel confident that the answers are here. Some of these are also answered on the Facebook postings, in videos, in the blog or informational graphics we provide.
We still have more to cover and convey, so I thank you for being here. What we provide here at Living Smarter comes not only from experience over many years but also the latest science into fibromyalgia, co-conditions and chronic pain. Working as a practitioner/trainer and living with fibromyalgia for over four decades, this is what I do.
These FAQs are based on questions I most often receive through the website and on my two Facebook Pages which together represent a community of over 325,000 followers.
Many fibro websites focus on the primary symptoms of fibromyalgia. They include widespread pain, fatigue, sleep disorders, fibro-fog, and morning stiffness. However, there are many more symptoms and, importantly, not all fibro people suffer with the same symptoms.
For this reason, I have provided an extended symptoms list with each symptom being a link to a treatment protocol, and secondary symptoms detailed within each symptom link as well. I want to also extend a caution to attributing every symptom to fibromyalgia, that can be dangerous. Yes, fibro is complex and affects multiple systems, but we must not miss other conditions.
Is Fibromyalgia approved for disability? Inside and/or outside the U.S.A?
Fibromyalgia is now officially approved for disability benefits in the United States. I have provided the USA’s Social Security Administration’s own words as guidance for those considering applying for disability benefits.
Since I have readers from over 50-countries, it would be impossible to follow each of those countries’ disability claims and allowances, but the information supplied here can be of benefit to anyone seeking guidance on SSI or disability.
What is a fibromyalgia flare and how long does it generally last?
