PATIENT FACT SHEET Fibromyalgia

Fibromyalgia is a chronic nervous system condition norepinephrine, may be off balance, changing reactions that causes widespread pain and tenderness, affects to painful stimuli. Fibromyalgia may cause fatigue, poor 2-4% of people, and usually affects women more often sleep, and mood problems, like anxiety or stress. It does than men. People who have other rheumatic diseases not cause any signs on x-rays or blood tests. are at higher risk of having fibromyalgia. There is currently no cure for fibromyalgia. Medications CONDITION Fibromyalgia is not an inflammatory or autoimmune may relieve symptoms for some people. The treatment DESCRIPTION disease. Research suggests that the nervous system plan includes exercise, diet, a good sleep routine and is involved. Brain chemicals, like serotonin and cognitive behavioral therapy.

Fibromyalgia symptoms are different for each • Migraines or tension headaches person. The most common symptoms are widespread • Digestion problems like IBS or heartburn pain and tender places around the body. People may • Irritable or overactive bladder feel tenderness to even slight pressure on muscles or • Pelvic pain around joints. Severe fatigue and sleep problems are • Temporomandibular disorder (TMJ), or jaw pain or popping also common. Someone with fibromyalgia may not feel Other diseases may cause widespread pain or fatigue. refreshed after sleeping all night. Doctors may ask patients to describe their digestive, Other fibromyalgia signs and symptoms include: sleep or memory problems. Blood tests and x-rays may SIGNS/ • Pr oblems with memory or clear thinking, known be used to rule out other causes, like thyroid problems SYMPTOMS as “fibro fog” or polymyalgia rheumatica. • Depression or anxiety

Fibromyalgia is treated with both nondrug therapies .stress and anxiety. A sleep medicine specialist may help and medications. Exercise is the most effective treatment, patients address sleep disorders. including low-impact aerobic activity and body-based Three drugs are FDA-approved for fibromyalgia: duloxetine therapies like tai chi or yoga. (Cymbalta) and milnacipran (Savella) adjust brain chemicals Cognitive behavioral therapy and mindfulness training can to ease widespread pain, and pregabalin (Lyrica), which help people with fibromyalgia learn skills to help manage blocks overactive nerve cells involved in pain. Older drugs, or reduce their symptoms. Complementary therapies such as amitryptiline (Elavil), cyclobenzaprine (Flexeril) COMMON like acupuncture, chiropractic and massage may help and other antidepressants may be used too. Opioids, TREATMENTS ease symptoms, but there is little evidence to support acetaminophen, nonsteroidal anti-inflammatory drugs effectiveness. Psychotherapy may help patients manage (NSAIDs) and sleep medicines like zolpidem (Ambien) are not recommended for use in treating fibromyalgia symptoms.

Self-care is important to manage fibromyalgia instead of the elevator. Medications may help ease pain symptoms and have good quality of life. This A healthy and make it easier to be more active. lifestyle, along with medications, can be effective at Rest and relaxation are helpful too. Make time to relax reducing pain, improving sleep, easing fatigue and each day. Deep breathing or medication can ease stress. stress, and helping patients cope with fibromyalgia. Set regular sleep habits, like going to bed at the same CARE/ Exercise as often as possible. Start slowly and do more time each night. Don’t take naps or drink coffee to ease over time. Walking, swimming, stretching and yoga are afternoon fatigue. Nicotine is a stimulant, but it makes MANAGEMENT good activities for people with fibromyalgia. Add more fibromyalgia sleep problems worse. Quit smoking or TIPS movement to daily routines, like taking a flight of stairs using tobacco products.

Updated March 2017 by Suleman Bhana, MD, and reviewed by the American College of Rheumatology © 2017 American College of Rheumatology Communications and Marketing Committee. This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.