Fibromyalgia: Real or Imagined

Fibromyalgia is a common condition that affects millions of people worldwide. It’s called Fibromyalgia Syndrome (FMS) because it causes many symptoms similar to those of rheumatoid arthritis, but without any pain relief. Many doctors believe FMS may have some genetic component, though there are no known treatments yet.

The symptoms of fibromyalgia include:

• Chronic fatigue syndrome (CFS), which is characterized by chronic physical and emotional exhaustion, muscle weakness, headaches, sleep problems, digestive disorders such as nausea and vomiting, joint pain and other musculoskeletal complaints. CFS often occurs together with depression.

• Post-traumatic stress disorder (PTSD). PTSD is a severe form of post traumatic stress disorder (PTSD) that occurs after experiencing a life threatening event. It includes flashbacks, nightmares, anxiety and panic attacks, feelings of hopelessness and helplessness, anger outbursts and suicidal thoughts.

• Depression. People suffering from fibromyalgia experience depression at high levels. They may feel sad or empty inside all the time.

They may lose interest in activities that they once enjoyed and have trouble concentrating. These symptoms can become bad enough that they interfere with the ability to perform daily tasks.

• Sleep disorders such as sleep apnea, restless leg syndrome and sleep paralysis may also be present.

There is no telltale test for FMS and it can only be diagnosed through a process of elimination. The patient is given a thorough medical examination, usually including blood and urine tests, an EKG and other heart tests, plus tests for thyroid problems. Malnutrition frequently occurs in people with FMS and may cause many of the above symptoms.

A dietician should be consulted if this is the case.

There are two main types of treatment for fibromyalgia. The first is drug therapy and the second is complementary medicine.

Drug therapy for FMS includes non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or prescription strength naproxen. These should be used with caution in people with heart conditions and may cause stomach ulcers or intestinal bleeding. Some antidepressants such as amitriptyline (Elavil) or milnacipran (Savella) may also be prescribed and can help treat the depression that often occurs with this condition.

The second main type of treatment for FMS is complementary medicine. A combination of therapies from this category are often used with drug therapy, and should be discussed with your doctor.

Complementary medicine for FMS includes:

• Massage therapy. Massage may help relieve pain and improve flexibility and muscle strength, although more research is needed to confirm these benefits.

• Acupuncture. This ancient Chinese medical practice uses thin needles pressed into the body at specific points to relieve pain. It may be helpful in relieving FMS pain.

• Yoga and tai chi. These mind-body practices may help improve overall health and quality of life, although further research is needed to confirm these benefits.

You can do many things to help yourself if you suffer from FMS. Most importantly, you should avoid anything that causes pain and learn new ways to doing things that don’t. Other steps you might want to try include:

Maintain a healthy diet. Eat a well-balanced, healthy diet and drink plenty of water.

Exercise regularly. Regular exercise can help improve your overall sense of well-being and may help relieve pain and improve flexibility and strength. Consult your doctor before starting any strenuous exercise program.

Get enough rest. Get seven to eight hours of sleep each night.

Manage stress. Explore different ways to manage stress in your life. Some relaxation techniques include meditation, tai chi, yoga, deep breathing and listening to music.

Learn pain-management techniques. Educate yourself about pain and teach yourself some techniques to help you cope with it more effectively. Some techniques you might try include:

– Distraction. Try to concentrate on something else when the pain gets bad.

– A hot water bottle or heating pad applied to the affected area may help relieve pain.

– Massage can temporarily relieve pain by improving blood flow and loosening tight muscles.

– Meditation, yoga or tai chi may help you better cope with any pain you experience.

– Practice slow, smooth breathing. Fast, erratic breathing can intensify pain.

Maintain a positive attitude and sense of humor. Although it may be difficult at times, try to maintain a positive attitude and have a sense of humor.

Helpful products include:

Back braces that apply firm, steady pressure on the spine can help prevent episodes of severe back spasms. They’re available without a prescription, but you should consult your doctor before trying one.

Sources & references used in this article:

Fibromyalgia–real or imagined? by DA Gordon – The Journal of rheumatology, 2003 –

Fibromyalgia–real or imagined? by A Morris – The Journal of rheumatology, 2004 –

Usefulness of pain drawings in identifying real or imagined pain: accuracy of pain professionals, nonprofessionals, and a decision model by RN Jamison, GJ Fanciullo, JC Baird – The Journal of Pain, 2004 – Elsevier

Struggling to maintain balance: a study of women living with fibromyalgia by KM Schaefer – Journal of advanced nursing, 1995 – Wiley Online Library

Analgesic effects evoked by real and imagined acupuncture: a neuroimaging study by J Cao, Y Tu, SP Orr, C Lang, J Park, M Vangel… – Cerebral …, 2019 –

The effects of emotional content on source monitoring in fibromyalgia patients by F Robin, T Cébron, M Letellier… – The Journal of General …, 2018 – Taylor & Francis

Fibromyalgia and the therapeutic domain. A philosophical study on the origins of fibromyalgia in a specific social setting by I Hazemeijer, JJ Rasker – Rheumatology, 2003 –

“It’s not all in my head. The pain I feel is real”: How Moral Judgment Marginalizes Women with Fibromyalgia in Canadian Health Care by M Oldfield – 2013 –

Characterizing the analgesic effects of real and imagined acupuncture using functional and structure MRI by J Cao, Y Tu, G Wilson, SP Orr, J Kong – NeuroImage, 2020 – Elsevier