Fibromyalgia

The list of Fibromyalgia symptoms can vary depending on which website or reference you read.

Below is a list of the main symptoms

  • fatigue
  • lack of energy
  • trouble sleeping
  • depression or anxiety
  • memory problems and trouble concentrating (sometimes called “fibro fog”
  • headaches
  • muscle twitches or cramps
  • numbness or tingling in the hands and feet
  • itching,burning, and other skin problems
  • diarrhoea and/or constipation
  • belly pain
  • bloating
  • gas
  • nausea
  • excess sweating
  • easy bruising
  • swelling
  • sensitivity to noise, light, or temperature
  • jaw pain
  • chest pain
  • bladder pain
  • an urgent need to urinate
  • food allergy symptoms like a stuffed nose, wheezing, diarrhea, or vomiting

Diagram of Fibromyalgia Tender Points

What are Fibromyalgia Tender Points?

Tender points are specific areas of pain that are near your joints but are not the joints themselves. They hurt when you press on them. Even pressure from a finger — like a poke — can make someone wince or flinch.

Where are the Tender Points in the body

Fibromyalgia tender points tend to be symmetrical in the body. They are located both above and below the waist around the neck, chest, shoulders, hips, and knees. The tender point should cause pain in that exact area when the doctor presses on it with enough force to turn their fingernail white. It should be painful in the exact spot that is being pressed.

The 18 tender points for fibromyalgia include:

  • Lower neck in front
  • Edge of upper breast
  • Arm near the elbow
  • Knee
  • Base of the skull in the back of the head
  • Hip bone
  • Upper outer buttock
  • Back of the neck
  • Back of the shoulders

Is there a test for Fibromyalgia?

There is no widely accepted medical test to diagnose fibromyalgia. Instead, diagnostic tests are performed to see if another condition could be causing the symptoms. 

Blood tests are usually ordered to rule out conditions with similar symptoms. Other tests will depend on the symptoms described, but may include X-rays or an electromyography (EMG), to evaluate muscles’ electrical activity.

Treatment

Medication

You may need to take several different types of medicines for fibromyalgia, including painkillers and antidepressants.

Painkillers

Simple painkillers that are available over the counter from a pharmacy, such as paracetamol, can sometimes help relieve the pain associated with fibromyalgia.

But these are not suitable for everyone, so make sure you read the manufacturer’s instructions that come with the medication before using them.

If over-the-counter painkillers are not effective, your GP (or another healthcare professional treating you) may prescribe a stronger painkiller, such as codeine or tramadol.

But these painkillers can be addictive and their effect tends to weaken over time. 

This means that your dose may need to be gradually increased and you could experience withdrawal symptoms if you stop taking them. 

Other side effects include diarrhoea and extreme tiredness (fatigue).

Antidepressants

Antidepressants can also help relieve pain for some people with fibromyalgia.

They boost the levels of certain chemicals that carry messages to and from the brain, known as neurotransmitters.

Low levels of neurotransmitters may be a factor in fibromyalgia, and it’s believed that increasing their levels may ease the widespread pain associated with the condition.

There are different types of antidepressants. The choice of medicine largely depends on the severity of your symptoms and any side effects the medicine may cause.

Antidepressants used to treat fibromyalgia include:

  • tricyclic antidepressants, such as amitriptyline
  • serotonin-noradrenaline reuptake inhibitors (SNRIs), such as duloxetine and venlaflaxine
  • SSRIs such as fluoxetine,prozac and paroxetine

A medication called pramipexole, which is not an antidepressant but also affects the levels of neurotransmitters, is sometimes used as well.

Antidepressants can cause a number of side effects, including:

  • feeling sick
  • a dry mouth
  • drowsiness
  • feeling agitated, shaky or anxious
  • dizziness
  • weight gain
  • constipation

For information on the side effects of your particular medication, check the patient information leaflet that comes with it.

Medication to help you sleep

As fibromyalgia can affect your sleeping patterns, you may want medicine to help you sleep. 

If you’re sleeping better, you may find that other symptoms are not as severe. 

Speak to your GP if you think you could benefit from a medicine like this. 

They may recommend an over-the-counter remedy, or prescribe a short course of a stronger medication. 

Some antidepressants may also improve your sleep quality.

Muscle relaxants

If you have muscle stiffness or spasms (when the muscles contract painfully) as a result of fibromyalgia, your GP may prescribe a short course of a muscle relaxant, such as diazepam.

These medicines may also help you sleep better because they can have a sedative (sleep-inducing) effect.

Anticonvulsants

You may also be prescribed an anticonvulsant (anti-seizure) medicine, as these can be effective for those with fibromyalgia. 

The most commonly used anticonvulsants for fibromyalgia are pregabalin and gabapentin. 

These are normally used to treat epilepsy, but research has shown they can improve the pain associated with fibromyalgia in some people.

Some common side effects of pregablin and gabapentin include: 

  • dizziness
  • drowsiness
  • swelling of your hands and feet
  • weight gain

Antipsychotics

Antipsychotic medicines, also called neuroleptics, are sometimes used to help relieve long-term pain. 

Studies have shown that these medications may help conditions like fibromyalgia, but further research is needed to confirm this.

Possible side effects include: 

  • drowsiness 
  • tremors (shaking) 
  • restlessness

Other treatment options

As well as medication, there are other treatment options that can be used to help cope with the pain of fibromyalgia.

These include:

  • swimming, sitting or exercising in a heated pool or warm water (known as hydrotherapy or balneotherapy)
  • an individually tailored exercise programme
  • cognitive behaviour therapy – a talking therapy that aims to change the way you think about things, so you can tackle problems more positively
  • psychotherapy – a talking therapy that helps you understand and deal with your thoughts and feelings
  • relaxation techniques
  • psychological support – any kind of counselling or support group that helps you deal with issues caused by fibromyalgia

Alternative therapies

Some people with fibromyalgia try complementary or alternative treatments, such as: 

  • acupuncture
  • massage
  • manipulation
  • aromatherapy

There’s little scientific evidence that such treatments help in the long term. 

But some people find certain treatments help them relax and feel less stressed, allowing them to cope with their condition better.

Research into some complementary medicines, such as plant extracts, has found they’re not effective in treating fibromyalgia. 

If you decide to use any complementary or herbal remedies, check with your GP first. 

Some remedies can react unpredictably with other medication or make it less effective.