What Does a Fibromyalgia Attack Feel Like?

Fibromyalgia is a chronic condition that causes widespread pain and tenderness throughout the body, sleep problems, fatigue, and depression. 

What Are Symptoms of Fibromyalgia?

Symptoms of fibromyalgia include:

• Pain and stiffness all over the body
  • Increased sensitivity to pain (compared to people without fibromyalgia), called abnormal pain perception processing
  • Morning stiffness
• Fatigue/tiredness
• Depression 
• Anxiety
• Sleep problems
• Problems with thinking, memory, and concentration (sometimes called “fibro fog”)
• Headaches, including migraines
• Tingling or numbness in hands and feet
• Pain in the face or jaw, including temporomandibular joint syndrome (TMJ)
• Digestive problems
  • Abdominal pain
  • Bloating
  • Constipation
  • Irritable bowel syndrome (IBS) 
• Painful menstrual periods
• When symptoms of fibromyalgia temporarily increase in frequency or intensity, it is called a fibromyalgia attack or flare-up. 

The cause of fibromyalgia is unknown. 

Risk factors for fibromyalgia include: 

• Stressful or traumatic events, such as car accidents or post-traumatic stress disorder (PTSD)
• Mood problems such as anxiety, panic disorder, and depression
• Repetitive injuries
• Illness (such as viral infections)
• Certain diseases
• Being female: women are twice as likely to develop fibromyalgia as men
• Obesity
• Genetics: fibromyalgia tends to run in families
• Age: most people are diagnosed during middle age 
• Lupus or rheumatoid arthritis
• Sleep disorders, such as sleep apnea 

Fibromyalgia is diagnosed with a patient history and physical examination, along with tests such as: 

• X-rays
• Blood tests

Criteria used to help diagnose fibromyalgia may include:

• A history of widespread pain and symptoms lasting more than 3 months
• The number of areas throughout the body in which pain has occurred in the past week, based on the total of number of painful areas out of 19 parts of the body, plus the level of severity of these symptoms: 
  • Fatigue
  • Waking unrefreshed
  • Cognitive (memory or thought) problems
• No other health problems that explain the pain and other symptoms

Treatment for fibromyalgia may include: 

• Self-management/lifestyle changes
  • Exercise
    • Research shows this may be the most effective treatment
    • Aerobic exercise
    • Muscle strengthening 
  • Getting adequate sleep
  • Adjusting work demands
  • Eating a healthy, balanced diet
  • Dietary supplements
    • Talk to your doctor about any supplements they recommend
• Medications 
  • Over-the-counter (OTC) pain medications such as aspirin, acetaminophen (Tylenol), and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve) 
  • Tramadol (Ultram) for severe pain (short-term use only)
    • Narcotic medicines are generally not recommended for pain due to fibromyalgia because they may cause greater pain sensitivity
  • Duloxetine (Cymbalta) and minacipran (Savella) to treat pain and fatigue
  • Pregabalin (Lyrica) to help treat nerve pain
  • Older drugs that affect the same brain chemicals such as amitriptyline (Elavil) and cyclobenzaprine (Flexeril)
  • Cyclobenzaprine (Flexeril), amitriptyline (Elavil), gabapentin (Neurontin) or pregabalin (Lyrica) for sleep problems 
    • Sleep medicines such as zolpidem (Ambien) or benzodiazepine medications are not recommended for patients with fibromyalgia
• Patient education classes, usually in primary care or community settings
• Cognitive behavioral therapy (CBT) to treat depression
• Stress management techniques 
  • Meditation
  • Yoga
  • Massage
• Complementary therapies 
  • Movement therapy
  • Chiropractic therapy
  • Acupuncture

Complications of fibromyalgia include:

• Pain
• Disability
• Lower quality of life
• More hospitalizations
• Higher rates of depression
• Higher rates of other rheumatic conditions such as osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis
• Higher death rates from suicide and injuries
  • If you or someone you know are in crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential. http://www.suicidepreventionlifeline.org