Fibromyalgia is a musculoskeletal condition that causes widespread chronic pain, among other symptoms. Although fibromyalgia is not a rare condition, it is not well-understood and often misdiagnosed. Some of its symptoms mimic those of other conditions, further complicating the diagnostic process.
The most common and distinctive symptom of fibromyalgia is muscle pain that manifests as a persistent, dull ache, possibly lasting for several weeks or even months. In some cases, the pain is similar to the sensation of a pulled muscle or the overall muscle soreness one might feel after an intense workout. For this nature of chronic pain to be diagnosed as fibromyalgia, it needs to occur on both sides of the body, both above and below the waist, in certain spots called tender points. The American College of Rheumatology guidelines for the diagnosis of fibromyalgia explain that patients must feel pain in at least 11 tender points out of 18, in response to simple pressure, to qualify for the diagnosis.
People with fibromyalgia often feel pain in the elbows, knees, ankles, and shoulders with enough severity that they feel the need to report it to their doctors. In some cases, this can lead to misdiagnoses of the condition as a form of arthritis, especially when the pain is not localized. There is a distinctive quality of these joint aches that separates fibromyalgia from other possible causes: when pressure is applied to the tender points, the pain intensifies considerably.
Fibromyalgia patients often complain of constant fatigue during a flareup of their condition. They may wake up feeling tired, which causes lethargy and lack of energy throughout the day. Anyone with fibromyalgia who is finding this symptom interfering with daily life can work with a doctor to develop exercises and practices that may help boost energy levels.
Insomnia and disturbed sleep are also common in individuals with fibromyalgia. This may be in part because the pain prevents deep sleep. Aside from this, fibromyalgia itself tends to disrupt sleep cycles, interrupting sufficient rest. Over time, this symptom adds to the fatigue the individual is already experiencing, which only exacerbates symptoms. A doctor may prescribe sleeping medication.
Cognitive dysfunction may also accompany fibromyalgia. An individual may have difficulty focusing on tasks, often losing track of what is happening around them. This is colloquially referred to as "fibro-fog." The extent of this symptom varies from patient to patient; one may notice significant changes to his or her mental state or the symptom may be mild enough not to hamper everyday functioning.
Persistent and severe headaches are also common among people with fibromyalgia. Such chronic headaches are more prevalent in individuals of childbearing age, and the headaches may mimic migraines. Many people will not make the connection between headaches and fibromyalgia, although this symptom is quite common; about 50% of people with fibromyalgia experience headaches.
Irritable bowel syndrome (IBS) can be a secondary condition in people with fibromylagia. Individuals may deal with frequent diarrhea, constipation, or indigestion. Other associated health issues, such as flatulence, bloating, acid reflux, nausea, and vomiting, may also occur. These symptoms are more common in people who remain undiagnosed and untreated for a long time. Up to 70% of people with fibromyalgia experience IBS.
Numbness and tingling in the limbs or face can affect people with fibromyalgia. The sensation may arise sporadically and without warning, causing unexpected discomfort. In some instances, the skin may also burn or itch. Such symptoms are particularly hard to treat, but fortunately, they are not too common in people with fibromyalgia.
The reasons for this are not well understood yet, but many people experiencing fibromyalgia develop hypersensitivity to one or multiple kinds of stimuli. Some researchers suggest that fibromyalgia is caused by an "oversensitive" nervous system that overreacts to various stimuli such as pain, strong smells or loud noises. One may have an aversion to noise and bright light or specific odors. Some people become uncharacteristically sensitive to foods or medications that never posed a problem before. In rare cases, an individual may also experience sensitivity to temperatures or particular weather conditions.
One common byproduct of fibromyalgia is depression, which tends to leave the affected individuals sad and anxious for long periods. People with fibromyalgia-related depression often describe feeling uninspired and irritable, finding no joy or pleasure in previously enjoyable experiences. This fibromyalgia-fueled depression is most likely associated with chronic pain, which is a common contributor to depressive disorders in general.
Although the reason for the correlation is unclear, urinary, pelvic, and bladder pain and related symptoms are common in people with fibromyalgia, especially women. People with fibromyalgia are also more likely to develop interstitial cystitis, a bladder condition that leads to the frequent urge to urinate and increased urination. These symptoms can grow worse during a woman's period.
The intensity and severity of fibromyalgia symptoms do not appear to have a relationship with female sex hormones, so scientists are still investigating why fibromyalgia is more common in women and exacerbated by certain stages of the menstrual cycle. Women with fibromyalgia report higher pain severity and higher fatigue during menstruation. Those with more severe symptoms, such as sleep disturbances, numerous tender points, and psychological distress, typically experience more severe menstrual symptoms. Other menstrual problems may also be related to the disease. During menopause, when a woman stops having periods, some people with fibromyalgia find their symptoms become more prevalent. According to one study, menopause symptoms nearly double the risk of chronic pain in people with fibromyalgia, back pain, and arthritis.
Fibromyalgia can cause various unusual skin sensations. Itching or pruritus can occur on and off. Some people with fibromyalgia develop chronic urticaria or hives. This is caused by the dysfunction of some nerve fibers, which is another possible symptom of the disorder. Burning sensations of the skin and mucous membranes are also common in people with fibromyalgia.
Some people with fibromyalgia bruise easily. Like many other aspects of this common yet enigmatic disease, the reason is not entirely clear. One possible reason is that nutritional deficiencies cause weakened blood vessels. These weak veins easily collapse if impacted, making a person more susceptible to bruising. There may also be an immunesystem link between bruising and the various other skin conditions that people with fibromyalgia experience.
Excessive sweating or hyperhidrosis can be caused by poor regulation of body temperature. Some people with this condition sweat heavily. Scientists believe that this happens due to what is called an autonomic dysfunction within the hypothalamus, the area in the brain that controls sleep and regulates sweating, bowel movements, and other body functions. Fluctuations in temperature and sweating can also occur when people with fibromyalgia experience stress. Stress aggravates not only sweating but also pain and other symptoms of fibromyalgia.
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