By Tim Boughton, M.Sc.
Reviewed by Dr. Mary Cooke, Ph.D.

Fibromyalgia is one of the most common chronic pain conditions, which affects approximately 4 million individuals in the United States, and around 0.2-6.6% of the world’s population. It is more prevalent in women, and most people with Fibromyalgia are diagnosed during middle age.

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Symptoms

The syndrome is characterised by symptoms of widespread pain all over the body and as yet research has not identified what causes the condition. People with fibromyalgia are thought to have an increased sensitivity to pain, or an abnormal perceptual processing of pain.

Other common fibromyalgia symptoms include: extreme tiredness (fatigue), muscular stiffness, psychological distress (anxiety and depression), and impaired cognitive function (such as reduced working memory and concentration, which is also called ‘fibro-fog’).

Many patients have one or more comorbidities or associated disorders, including: non-restorative sleep and sleep disorders, clumsiness, dizzy spells, numbness or tingling in the hands and feet, anxiety and depression, headaches and migraines, irritable bowel syndrome (IBS), and restless leg syndrome.

Symptoms vary considerably between patients, with some only enduring one or two while others may have many. A person with fibromyalgia may experience certain symptoms on a regular basis, however, symptoms can also come and go or fluctuate in intensity.

A ‘flare’ is when one or many symptoms are worsened for a prolonged period of time (multiple days or weeks). An individual’s predominant symptoms during a flare can change over time. For instance, you may experience worse back and neck pain during one flare up, but greater levels of migraines and headaches in the next.

Triggers of Fibromyalgia flares

Determining the causes of your flares (often called ‘triggers’) may be an effective strategy to preventing them. Triggers vary between individuals, but often include:

• Hormonal changes
• Temperature and weather changes – people often report of pain symptoms worsening during cold or wet weather.
• Dietary changes – some research suggests levels of dietary fructose gained from carbohydrates may impact on fibromyalgia symptoms.
• Changes in schedule or increases in travel
• Reduced sleep or non-restorative sleep
• Changes in treatment
• Increased or reduced levels of exercise
• Physical or psychological stress

It is clear that there are a range of psychological, physical, behavioural and environmental factors that may trigger or aggrivate flares.

Some triggers, such as diet and level of exercise, can be somewhat controlled for by appropriately adjusting your behavior. It is also useful to be mindful of environmental triggers, such as weather, that are not in your control.

It may be beneficial to develop an awareness of your triggers, by keeping a log of your activities, daily routines, and how they affect your symptoms. This may highlight a pattern in your triggers, and give you greater insight into how to manage or prevent the impact that certain triggers have on your symptoms in the future.

Treatment

While there is currently no cure for fibromyalgia, there are several treatments to help manage the symptoms of fibromyalgia. These include:

• Medication – such as antidepressants and painkillers can be prescribed in some instances.
• Talking therapies, such as cognitive behavioural therapy (CBT) and counselling can be provided to help individuals cope with the psychological burden and stress of Fibromyalgia.
• Lifestyle changes – such as learning to pace your schedule and not over exert yourself may be beneficial to help with the management of fatigue and triggers.
• Dietary changes – there is anecdotal and limited empirical evidence that dietary changes, such as reducing the amount of fructose in your diet, may help with the management of fibromyalgia. However, it is always recommended that you consult with a dietician or physician before making dietary adjustments.
• Exercise programmes have been found to help reduce pain in the long term.
• Relaxation strategies can help to reduce the impact that stressful events have on your symptoms.