Common Questions About Arthritis

What is Fibromyalgia & How Is It Treated?

Question: What is fibromyalgia and what can be done to treat it?

Answer: Fibromyalgia is a widespread chronic musculoskeletal syndrome that causes diffuse aching and stiffness along with tender areas in muscles on examination. It is often accompanied by fatigue and sleep disturbances, and sometimes is associated with irritable bowel syndrome, headaches, and other systemic symptoms. Although the cause of fibromyalgia is unknown at this time, it is a common condition reported in up to 6 percent of patients in a general medicine clinic. Most patients are women between the ages of 20 and 50, although the syndrome has also been described in adolescents and the elderly.

Fibromyalgia is also referred to as fibrositis, generalized soft tissue rheumatism, and other names. The American College of Rheumatology, a national organization of physicians who specialize in treating the syndrome, has published criteria for the diagnosis of fibromyalgia. The material includes specific symptoms and signs on physical examination. Unfortunately, there is no specific blood test or x-ray study to confirm this diagnosis. However, if your doctor suspects you have fibromyalgia, she may order blood tests and other studies to rule out conditions that can cause similar symptoms such as thyroid disease.

At this point, there is no known cure for fibromyalgia. Treatment is aimed at improving poor quality sleep and relieving pain. Many patients respond to a group of medications called tricyclic antidepressants at low doses. For pain control, simple analgesics such as Tylenol(r) can be helpful. The mainstay of treatment, however, is non-pharmacologic therapy with education about the condition, reassurance, a healthy diet, stress reduction, and routine exercise.

In my practice, I recommend 20 to 30 minutes of aerobic exercise such as swimming, water aerobics, walking, or bike riding every other day with good long-term results for improving sleep and reducing pain. Remember: Most patients with fibromyalgia experience some degree of pain when they begin their exercise program. It is important to continue the program over a number of weeks to see the benefits.

A number of alternative therapies for fibromyalgia, such as malic acid with magnesium and evening primrose oil, have been mentioned in case reports and other studies. Although these and other remedies may hold some place in treatment regimens for fibromyalgia in the future, there is not enough data available to routinely recommend them at this time.

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