Fibromyalgia

Fibromyalgia involves long-term pain or pain in the muscles at several places in the body. With fibromyalgia, you also have increased pain sensitivity. There are treatments that can relieve the hassle so you can live a good life despite the illness.

Symptoms of fibromyalgia

Fibromyalgia is characterized by this:

  • You have pain in your body for a long period of time.
  • You have increased sensitivity to pain. This means that you can get hurt from things that do not hurt in healthy people.
  • You have stiff muscles and numbness.

Other symptoms of fibromyalgia such as stomach upset are also common.

In fibromyalgia, you have a widespread pain problem

The pain must be present in several places in the body for you to be diagnosed with fibromyalgia.

Often it can hurt more in some body parts than others. The most common thing is that you have pain in the neck, shoulders and lower back. Some also have joint pain.

Pain over a long period

For you to be diagnosed with fibromyalgia, you must have had pain for at least three months. How it hurts can vary from one day to another.

The pain can come and go in different parts of the body

Where in the body it hurts can vary. Many people who have fibromyalgia have pain in the muscles all the time, but in some the pain can come and go. The pain also spreads easily to several places in the body and becomes more or less persistent.

Increased sensitivity to pain

People with fibromyalgia have an increased sensitivity to pain. This means that you get hurt from things that usually do not hurt in healthy people. This means that even light pressure or muscle contractions that do not usually hurt will feel painful.

This distinguishes fibromyalgia from other diseases or conditions with muscle pain:

  • In fibromyalgia, increased pain sensitivity is more evident.
  • In fibromyalgia, the pain is more widespread than the muscle pain is in, for example, a myofascial pain syndrome or in muscle pain caused by how the muscle has been loaded.

Stiff muscles and numbness

When a muscle hurts, it is harder to move. Many people who have fibromyalgia find it difficult to lift and carry heavy and to run or walk stairs. You may also feel stiff in the muscles, especially in the morning. It is also common to get numbness and tingling.

Other bodily disorders

In fibromyalgia it is also common for you to have the following problems:

  • You have stomach problems, such as stomach cramps, increased amounts of gases, alternating diarrhea, and constipation.
  • You need to pee unusually often.
  • You feel dry in your mouth.

This is a problem that many people may have, but they are more common in people with fibromyalgia.

When and where should I seek care?

Contact a health care center if you have recent body aches that do not go away for a couple of weeks, or if the pain causes problems in everyday life.

Causes of fibromyalgia

There may be several reasons why a person may get fibromyalgia. For example, it may be that you have been suffering from a certain part of the body for several years before you develop fibromyalgia. It can also be that stress, poor sleep, and monotonous movements can contribute. For example, a work where you always move in the same way can strain muscles so that you get long-lasting pain.

Different people have different risks of getting fibromyalgia, and the disease can be hereditary.

How can I prevent fibromyalgia?

Fibromyalgia may not be preventable, but there are probably some things you can do to reduce the risk of getting the disease. Prolonged pain can increase the risk of developing fibromyalgia. Therefore, you should seek help at an early stage if you have any pain in the body.

You may need to change your work technique and ergonomics if you have pain caused by your work. Try to keep the work at a reasonable level so that you have the time and energy to exercise and rest.

Don’t wait to seek help if you feel stressed or have too much to do and have trouble sleeping.

What can I do for myself?

It is important that you who have fibromyalgia know as much as possible about the disease and how you can live a good life with fibromyalgia.

Although it is difficult to have a disease that produces long-term pain, it is good to know that the disease itself is not dangerous and does not increase the risk of getting autoimmune diseases, such as arthritis.

Move

Touch yourself in a way that feels good and that you can handle it. Even if you temporarily get more hurt, physical activity counteracts pain in the future. Many people also feel calmer and sleep better by physical activity.

Some who have been in pain for a long time may be afraid to move and therefore become more and more sedentary. This causes the muscles to become weaker and the condition deteriorates. Then you can easily get a headache if you strain in a way you are not used to. Such a workout is not a sign that something is wrong.

Find a form of exercise that suits you

Activities that are often a good fit are walking, water gymnastics and swimming. You get to try out an activity you like. Strength training has also proven to be good for fibromyalgia, but it has to be adapted to what you can handle.

Increase your training a little at a time

Increase exercise slowly if you feel you want to exercise more. It is better to take a short walk of ten minutes than not moving at all. Eventually, you can increase to going a little longer and maybe slightly faster.

Heat can relieve

Heat is experienced by many as temporary pain relief. You can buy a heating pad at the pharmacy or take a hot shower or bath to lessen the pain, become less rigid or relax.

You need a good sleep

It is important to sleep well. Sleep can be disturbed if you are in pain, while poor sleep causes more pain. Try to avoid resting or sleeping during the day, as it interferes with night sleep. Some may need medication sometimes to be able to sleep well enough. Talk to a doctor and tell you that you have fibromyalgia so that you get the drug that is best for you.

Treatment of fibromyalgia

Treatment of fibromyalgia may include several parts:

  • physical treatments, such as physical exercise and relaxation exercises
  • drug
  • psychological treatment of fibromyalgia
  • multimodal pain treatment when several different methods are used simultaneously.

Physical activity as a treatment

You can get a  prescription for physical activity, FaR, printed from healthcare. For example, doctors, nurses, and physiotherapists print them out and suggest activities that may be a good fit.

The exercise led by a physiotherapist is the treatment for which there is the best scientific support for fibromyalgia. The physical therapist can help you try out a good exercise program that you then train on your own.

Treatment with relaxation, tens and massage

You can get help from a physical therapist or a psychologist to practice a  relaxation technique or to train mindfulness. It can relieve the aches and make it easier to fall asleep.

Tens, transcutaneous nerve stimulation, is a method of pain relief that can also help. 

Many people find that massage can relieve the pain, at least for the moment. Massage can also be a way to reach relaxation.

For most people with fibromyalgia,  acupuncture does not have a good effect, although there are exceptions.

Prescription-free painkillers

There is no medicine that will make you fully recover from fibromyalgia, but there are several drugs that can relieve the hassle.

If you have mild pain, non-prescription painkillers containing the active substance paracetamol may help, but there are no studies to indicate that the preparation is effective in fibromyalgia.

Anti-inflammatory drugs, called NSAIDs, which contain the active substance ibuprofen or naproxen do not have a pain-relieving effect in fibromyalgia, but if you also have any other pain they can help.

You should only use these medicines if you really feel that they reduce your pain and help you to be more active.

If you are over 75, have any cardiovascular disease or have previously had a stomach ulcer, you should use acetaminophen instead of NSAIDs.

Medicines that you can get on prescription

Different types of drugs can be used to treat fibromyalgia:

  • SNRIs are used in the treatment of nerve injury pain and also in the treatment of depression and anxiety. They have been shown to reduce pain and improve the function of fibromyalgia, although they do not help everyone.
  • Tricyclic antidepressants may help with fibromyalgia. They also work in pain caused by damaged nerves in the body, or by injuries or diseases of the central nervous system, such as the brain. Medicines containing the active substance tramadol can sometimes be used. They should only be used temporarily for very severe pain due to the risk of becoming addicted. To reduce the risk of becoming addicted, you should always use long-acting tramadol drugs.
  • Medicines containing pregabalin or gabapentin can reduce pain, relieve anxiety and even improve sleep in fibromyalgia. They should be prescribed by a pain relief specialist because of the risk of addiction.

Psychological treatment

How you think about your problems is of great importance to how you manage your situation. The best thing is if you can get help with both exercise training, medicines that provide good relief and pain management if needed.

The psychological method called  KBT, cognitive behavioral therapy has proven to be helpful. With the help of a psychologist or another behavioral scientist, you can learn individually or in groups about how to live a good life despite having fibromyalgia. During treatment, you get to work with your thoughts, ideas, and behavior when you are in pain. You get help to make reasonable demands on your body, to dare to move without being afraid, and to reduce the negative thoughts. Often, the processing consists of a series of conversations with practical tasks that you can perform between the meetings.

Multimodal pain treatment

If you have had back, neck or shoulder pain for more than three months, you may be entitled to so-called multimodal pain treatment. Then different methods are used at the same time to relieve the problems. A doctor will determine if the treatment is appropriate.

Multimodal pain management is adapted to the problems you have. The treatment lasts for a couple of months and you often get to meet both physical therapists, occupational therapists, doctors and curators or psychologists during that time. This includes lectures on how to manage pain and stress and individual discussions about your situation. You can also try different forms of exercise and can have exercises to do at home and if needed you can get medication prescribed. The purpose of the treatment is primarily to increase your chances of living as normal a life as possible both in your spare time and in working life.

What happens in the body during fibromyalgia?

In fibromyalgia, the pain signals are amplified. This means that things that don’t usually hurt are painful if you have fibromyalgia. Fibromyalgia pain is not a warning signal and should therefore not be interpreted as a sign that something in the body is hurting.

The nerves send signals to the brain

The pain system is part of the body’s nervous system. As the pain nerves in the muscles tease, signals are sent to the nerve cells in the spinal cord. There, the pain signals can go further unchanged or attenuated and become weaker, or amplified and become stronger.

From the spinal cord, the pain signals then pass to the brain. It is only when the signal reaches the cerebral cortex that you consciously experience the pain. Then you feel how strong the pain is, how uncomfortable it feels, and where it sits. Signals are also sent to those parts of the brain that control the emotional responses to pain.

The body’s system works together

Fibromyalgia can cause many symptoms of fibromyalgia and it can be difficult to know what caused the disease from the beginning.

One explanation for this is that the brain’s pain system has connections to the systems that regulate the immune system, sleep, mood and how we respond to stress.

The connections between the pain system and the other systems go in both directions. This means, for example, that stress can aggravate pain and pain can cause stress.

The same goes for the relationship between sleep and pain. It is very common for people who have been suffering for a long time to have sleep problems and that people who have problems with sleep have pain. It can be difficult to determine if sleep problems or pain problems come first.

Investigations

There are no samples or X-ray examinations that can show if you have had fibromyalgia. Instead, the doctor makes a diagnosis based on what you can tell and what the doctor can find during the examination.

You can tell us about your problems

The study is to determine if it is fibromyalgia you have or any other illness that may explain that you are in pain. Therefore, it is important that you tell us about your complaints. Often you also get to fill out an interview form on physical and mental disorders. It is also common for you to do a so-called pain drawing, where you indicate in a picture where on the body it hurts.  

The doctor does a body examination and tests the pain sensitivity by pressing different parts of your body.

Other diseases can cause similar symptoms

Some rheumatic diseases may have symptoms similar to fibromyalgia. There are also other diseases that can cause muscle pain. To exclude other diseases, the doctor does a thorough body examination. You may also need a blood test or an x-ray to rule out other illnesses.

Complications and sequelae

Living with long-term pain increases the risk of both mental and physical illness. For example, constant pain can lead to anxiety and depression. It is also easy to get physically passive and gain weight because it hurts when you move. Sleep is also negatively affected and fatigue causes some to withdraw from social interaction. This, in turn, can further increase mental ill-health and passivity.

In this way, it is easy to get caught in a negative spiral that reduces both health and well-being. It is important that you are aware of this and that despite your pain, you try to live as healthy as possible and give way in your life to things that bring joy and energy.

Pregnancy and fibromyalgia

You should avoid medication when you are pregnant and therefore it may be good to discuss other forms of pain relief with a doctor. It is also important that you stay physically active so that you are as strong as possible at the end of pregnancy and when the baby has arrived.

There are no barriers to vaginal delivery due to fibromyalgia.

Living with fibromyalgia

Some get-well already during the first few years, but most have been hurt for many years. The severity of the symptoms can vary greatly from one person to another, and at the same person at different times.

Having pain affects your entire life

It is good if you try to see more of what you actually can and do, than what feels difficult and impossible. It is important that you do not let the pain take over life, but that you continue with what you previously thought about doing and measured well. Although you may temporarily get more pain as you move, that pain is not dangerous or a sign that you are worse.

You who have fibromyalgia often cannot exert themselves in the same way as the one who has no pain. You may have to give up the leisure activities that are most physically demanding, but that doesn’t mean you should rather be quiet.

At work, you may need help from occupational health care to find the right technology and equipment at work. Here, small changes can often make a big difference.

Problems with sleep

Many people with fibromyalgia have problems with sleep due to their constant pain. The pain can cause you to wake up at night, often several times, and therefore not feel rested in the morning. It is mainly the deep sleep that is affected and it makes many who have fibromyalgia constantly feel tired.

Poor sleep, stress, and pain can together make it harder for you to concentrate and remember things.

Prolonged pain can put you down

Fibromyalgia is not a mental illness, but prolonged pain can cause you to become depressed and anxious. Having pain also often leads to long-term stress.

How you feel is important to how you experience the various symptoms. This applies not only to fibromyalgia but to all long-term pain conditions. Concerns, anxiety, stress, and depression can aggravate symptoms such as pain, fatigue, and poor sleep.

Advice to relatives and relatives

As a relative, it can be difficult to see someone who is constantly in pain. It is important that the person with fibromyalgia is physically active. Therefore, it is good if you who are relatives do not help too much, but let the person who has fibromyalgia continue to be active in the family and in the working life.

At the same time, people with fibromyalgia cannot cope with the greatest physical challenges. This can be a difficult balancing act. As a relative, it can also feel difficult to balance between being listening and compassionate, while at the same time wanting the person who is in pain to be able to think of things other than their troubles.

It may be wise to talk through these things together. For example, you can turn to family counseling for calls if you feel it is needed.

Sex and cohabitation in fibromyalgia

The increased pain sensitivity that people with fibromyalgia have can make sex life more difficult. As a partner, for example, you may be afraid of causing pain.

It is important that you can talk to each other about what feels good and what feels less good. Often, joint positions that do not involve strong pressure on the body usually work better.

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