Diagnosis of Fibromyalgia
Fibromyalgia is diagnosed based primarily on having pain all over the body, along with other symptoms. Currently, there are no specific laboratory or imaging tests for fibromyalgia. The main symptoms—pain and fatigue—are shared with many other conditions, so doctors typically try to rule out other causes for your symptoms.
Doctors may do the following to diagnose fibromyalgia:
- Take your medical history. Your doctor will likely ask about the location, severity, and duration of pain, and whether you have experienced severe fatigue or cognitive problems, such as confusion or memory issues. They may also ask if you have other conditions, because some people with fibromyalgia have other diseases at the same time.
- Perform a physical exam. Your doctor will examine your joints to see if you may have another condition, such as rheumatoid arthritis or systemic lupus erythematosus.
Your doctor may order laboratory or imaging tests to help rule out other diseases and conditions.
Treatment of Fibromyalgia
There is no cure for fibromyalgia, so treatment focuses on relieving the symptoms. Your treatment plan will likely include a combination of psychological and behavioral therapy, medications, and self-management approaches, such as physical exercise and other movement therapies like yoga or tai chi.
Cognitive behavioral therapies. A type of therapy called cognitive behavioral therapy, which aims to change the way you think about pain, can be helpful, especially when combined with other types of treatment. This type of therapy can be either one-on-one or in groups with a therapist. Other types of mental health counseling may also be helpful.
Medications. A number of medicines can help relieve the pain and improve sleep. You may be prescribed more than one type of medication at the same time.
- Antidepressants. Drugs that treat depression may also work for fibromyalgia even if you are not depressed. Doctors may prescribe one of several classes of antidepressants.
- Anti-seizure medicines. These medicines can lessen pain and improve sleep. They work by interfering with the transmission of pain signals to the brain.
- Analgesics (pain-relieving medicines). These may be used for people who need additional pain relief. Anti-inflammatory pain medications are usually not effective because fibromyalgia does not cause tissue inflammation, but they may help with other painful conditions that may coexist with fibromyalgia.
You may need to try different drug combinations and dosages before finding relief from symptoms, and improvement is often gradual.
Complementary and Integrative medical therapies. Some people seek therapies such as acupuncture, massage, and hypnosis, but many of these have not been well tested in people with fibromyalgia. Before using these therapies, talk to your doctor about the best options for you.
Who Treats Fibromyalgia?
Fibromyalgia treatment often requires a team approach, but it is primarily treated by:
- Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles. Fibromyalgia is not a form of arthritis, nor does it damage the bones, joints, or muscles, but rheumatologists usually treat it because the symptoms are similar to those of arthritis.
Other health care professionals who may be involved in your care include:
- Exercise physiologists, who are trained in understanding the body’s response to physical activity.
- Mental health professionals, who help people cope with difficulties in the home and workplace that may result from their medical conditions. A counselor trained in cognitive behavioral therapy can help you learn skills and techniques to better control the pain.
- Pain management specialists, who are trained in the evaluation and treatment of pain.
- Physical therapists, who improve quality of life through prescribed exercise, hands-on care, and patient education.
- Primary health care providers, including family doctors, internists, or pediatricians, who coordinate care between the different health care providers and treat other problems as they arise.
- Sleep specialists, who address problems related to sleep, sleep disorders, and sleep health.
Living With Fibromyalgia
Having fibromyalgia can significantly impact your quality of life and your ability to take part in everyday activities. There are things you can do to help you live with fibromyalgia, including:
- Educating yourself and getting support.
- Combatting fatigue.
Exercise is a mainstay of therapy for fibromyalgia. Although pain and fatigue may make exercise difficult, it is important for you to be as physically active as possible. Research shows that regular exercise is one of the most useful ways to combat fibromyalgia, and even modest levels are helpful. Aerobic activity can also improve sleep and lessen anxiety and depression.
You should start exercising at a low level and gradually increase over time. Low-impact aerobic activities—such as walking, biking, swimming, and water exercises—are especially helpful. Activities that engage the mind and body, such as yoga and tai chi, are also helpful. Physical therapists or exercise physiologists can prescribe an exercise program and provide ongoing support.
Be sure to check with your doctor before beginning an exercise routine.
Educating Yourself and Getting Support
Learn as much as you can about fibromyalgia, and join an online or in-person support group that includes others who are dealing with it. Having a support network can help you manage difficult times.
Visit a mental health professional if emotional problems arise. Research has shown that a type of therapy called cognitive behavioral therapy, which teaches skills for better controlling the pain, can be helpful.
Persistent fatigue is one of the most troubling symptoms of fibromyalgia. The following strategies may help you sleep better and feel more rested.
- Create a relaxing sleep environment and establish a sleep routine.
- Go to sleep and get up at the same time every day.
- Reserve your bed for sleeping. Watching TV, reading, or using a laptop or phone in bed can keep you awake.
- Keep your bedroom comfortable. Try to keep your bedroom dark, quiet, and cool.
- Avoid stimulants like caffeine and nicotine, and limit alcohol intake.
- Wind down before bed. Avoid working or exercising close to bedtime. Try some relaxing activities that get you ready for sleep, such as listening to soft music, meditating, or taking a warm bath.
- Pace yourself during the day. You may not be able to do all the things you once did, or not in the same amount of time. Try not to use up all your energy each day, because doing too much can make your symptoms worse.