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The diagnosis of fibromyalgia is mainly based on the presence of a set of tender points at certain precise locations on the body. These tender points can be extremely painful when pressed but otherwise may not hurt at all.
There are 18 tender points and a person with fibromyalgia will have tender points at at least 11 of these sites. Tender points can occur with other conditions and your doctor may order various tests to ensure other conditions are not present. Fibromyalgia will often accompany rheumatoid arthritis and other auto-immune diseases. |
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People with fibromyalgia usually say they ‘hurt all over’. It is a little like toothache in that it could be an ache, a sharp pain, a burning, gnawing or throbbing. It can also seem to move around to different parts of the body at different times. Using a part of the body (by carrying a bag of groceries, writing a letter, or walking) can cause that part to be more painful. Stress, the weather, activity or inactivity may cause the pain to flare, while at other times it seems to get better or worse for no reason at all.
For some, the fatigue of fibromyalgia is hardly noticeable while for others it is profound. This exhaustion may come after a period of exercise or during a social event. Or you may manage things easily one week and not the next. The fatigue is likely to get worse as the day goes on, it may always be present to some degree or it may suddenly sweep over you like a wave, causing you to want to lie down. Rest is, in fact, the best way to deal with this kind of fatigue. Sometimes only a few minutes spent resting may be enough but at other times a whole day of rest may still leave you wishing for more.
When you get up in the morning, much of your pain comes from stiffness. It can also occur after sitting, even for a short time. This can make it difficult to work, drive a car or even enjoy going to the movies or any other event where you have to sit still for some time.
The best way to avoid pain from stiffness is to keep moving round. When driving, take frequent rest stops. In your job, get up and move around every twenty minutes or so, but at least have a good stretch in your chair frequently. You cannot help getting stiff overnight but, to minimize this pain, have a hot shower as soon as you get up, taking a few stretches while you do so.
Most people with fibromyalgia have difficulty achieving restful, restorative sleep. During the night, people go through several stages of sleep with varying time in each stage – REM, the dreaming stage and non-REM sleep (called alpha to delta). Delta-wave sleep is when most of the restorative work goes on in the body such as growth and repair. The chemicals needed by the immune system are also produced during this stage of sleep. Research shows that the brain wave tests (EEG) of people with fibromyalgia have reduced quantity and quality of deep (delta) sleep. No wonder you wake up feeling so tired!
Other sleep disorders which may occur with fibromyalgia include sleep apnea (interrupted breathing), nocturnal myoclonus (spasms in arms and legs) and bruxism (teeth grinding. Each should receive the treatment generally recommended for that condition.
Some people with fibromyalgia may experience other symptoms at some times such as muscle tension and myofascial pain, allergies, dry eyes and mouth, irritable bladder and/or bowel, migraine headaches, tender lymph nodes, sensitivity to the environment, anxiety, mood swings, depression, irritability and trouble concentrating. One doctor described fibromyalgia as the ‘irritable everything syndrome!’
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