• Fibromyalgia is a chronic condition that causes widespread pain and tenderness (sensitivity to touch) all over body.
  • Usually there is decrease pain threshold and patient will have pain sensation to mild touch or pressure which is usually not painful in a normal person.
  • This may be associated with decrease sleep or memory disturbance or depression.
  • Most common in females, usually start in middle adulthood
  • – Sometimes may be associated with other rheumatic condition like rheumatoid arthritis, lupus , ankylosing spondylitis etc.
  • In true sense, fibromyalgia is not an inflammatory arthritis or autoimmune disease
  • This is a painful condition when the pain is due to decrease pain threshold and derangement of chemical mediators of pain generator in the brain
  • Fibromyalgia mainly affect women than men.This is not uncommon and affect up to 4-5 % of normal population.
  • There is no laboratory test to detect this disease. But sometimes tests ordered to exclude other arthritis
  • Management includes multimodal approach including cognitive behavioral therapy. exercise, sleep hygiene etc.
  • Medications has partial and supportive role. Though there is no cure, medications can reduce symptoms in some patients.
  • Pain all over the body
  • Muscle or skin soreness
  • Severe fatigue
  • Decrease Sleep or waking up unrefreshed
  • Memory disturbance or thinking clearly
Some associated symptoms may include:
  • Depression or anxiety
  • Migraine or tension headaches
  • Digestive problems
  • Irritable or overactive bladder
  • Pelvic pain
  • Symptoms including face or jaw pain, jaw clicking, and ringing in the ears)
It is still considered benign disease as it does not cause any major physical illnesses like heart attacks, stroke, cancer , deformities, or loss of life
  • The exact cause of Fibromyalgia is not known and it is multifactorial and varies from patient to patient
  • This is not an autoimmune disease or inflammatory arthritis
  • Fibromyalgia may be seen in families because of certain genes but Genes alone, cannot cause fibromyalgia
  • There are many factors that triggers fibromyalgia. It may be spine problems, long-term arthritis, injury, or other type of physical or emotional stress
  • This result in change in the way the body “talks” with the spinal cord and brain affecting the Levels of brain chemicals and proteins that generate pain
  • More recently, this has been described as Central Pain Amplification disorder or in other words the pain threshold goes down
When a patient complains of generalized body pain but there is no clinical signs of inflammation on examination, a patient is suspected to have fibromyalgia. As there is no blood tests or X ray tests to prove it, usually doctors take the help of classification criteria for diagnosis as recommended by American of Rheumatology in 2010 (see Below).
  • Pain and symptoms over the past week, based on the total of number of painful areas out of 19 parts of the body plus level of severity of these symptoms:
    • Fatigue
    • Waking unrefreshed
    • Cognitive (memory or thought) problems
    • Plus number of other general physical symptoms
  • Symptoms lasting at least three months at a similar level
  • No other health problem that would explain the pain and other symptoms
Source: American College of Rheumatology, 2010
  • Fibromyalgia cannot be treated by only giving drugs. It can be treated by multimodal approach where medicines have to be combined with non-medical therapy
  • Cognitive behavioral therapy (CBT) or mindfulness exercise is a type of therapy focused on understanding how thoughts and behaviors affect pain and other symptoms. It is usually done by clinical psychologist.
  • Other complementary and alternative therapies (CAM or integrative medicine) includes acupuncture, chiropractic and massage therapy. Although they can be tried, their role is doubtful.
  • Patients benefit most from regular aerobic exercises. Other body-based therapies, including Tai Chi and yoga, can ease fibromyalgia symptoms
  • Address risk factors like sleep disorders, such as sleep apnea, and mood problems such as stress, anxiety, panic disorder, and depression.
  • USFDA has approved 3 drugs for the treatment of fibromyalgia which include duloxetine, milnacepran and pregabalin. The first two drugs alter the brain chemicals (serotonin and norepinephrine) that help control pain levels. Pregabalin work by blocking the over activity of nerve cells involved in pain transmission.
  • Regular pain killers like opoids and NSAIDs are usually not effective and they can be avoided
  • With Proper treatment, a Fibromyalgia patient can lead a normal life without pain and deformity
  • But if not treated properly from an early stage, there may be erosion of bones leading to loss of natural movements and severe joint deformity
  • This may increase risk of heart attack
  • The hip joint may be fused for which the patient will be unable to walk or sit and may require joint replacement therapy.
At OARC, we offer holistic care to patients suffering from all kind of arthritis and autoimmune diseases by our renowned rheumatologist. Because of severe chronic illness of the disease, we spend some time with the patient helping them to know about their disease, and demystify the myths regarding the disease and treatment. We have collaboration with NABL accredited laboAStory where all kind of blood tests can be done at reasonable costs. Our physiotherapist helps the patients and advise them to do needful therapy for preservation of joint and muscles. We also have patient support system where patient can approach in case of any emergency. We believe in a friendly relation with patients so that they can share all their sufferings and get the best possible treatment.