The information contained in this section has been procured from  John Hopkins Medicine , the Mayo Clinic and NewLifeOutlookFibromyalgia.

It is all for educational purposes and not intended to be taken as medical advice.

What is Fibromyalgia?

Fibromyalgia is a condition that causes pain in muscles and soft tissues all over the body. It is an ongoing (chronic) condition. It can affect your neck, shoulders, back, chest, hips, buttocks, arms, and legs.


The pain may be worse in the morning and evening. Sometimes, the pain may last all day long. The pain may get worse with activity, cold or damp weather, anxiety and stress.


The condition affects about 1 in 50 to 1 in 25 people in the U.S. It is most common in middle-aged women.

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Source: John Hopkins Medicine


What causes Fibromyalgia?

The cause is unknown. Researchers think there may be a link with sleep problems and stress. It may also be linked to immune, endocrine, or biochemical problems.

Source: John Hopkins Medicine

What are the symptoms of Fibromyalgia?

Each person’s symptoms may vary. But chronic pain is the most common symptom. The pain most often affects the muscles and the points where muscles attach to bones. These are the ligaments and tendons.

Pain may start in one part of your body, such as your neck and shoulders. Any part of the body can be affected. . The pain ranges from mild to severe. It may feel like burning, soreness, stiffness, aching, or gnawing pain. You may have sore spots in certain parts of your muscles. It may feel like arthritis, but it’s not a condition that gets worse. And it doesn't damage muscles or bones.

Other common symptoms of fibromyalgia include:

  • Medium to severe tiredness (fatigue)

  • Less exercise endurance

  • Sleep problems at night

  • Depressed mood

  • Anxiety

  • Headaches

  • Irritable bowel symptoms, such as belly (abdominal) pain and bloating, diarrhea, and constipation

  • Restless legs

  • Painful menstrual periods

  • Trouble thinking clearly (called "fibro fog")

Fibromyalgia symptoms include widespread body pain, fatigue, unrefreshing sleep and mood problems. But all of these symptoms are common to many other conditions. And because fibromyalgia symptoms can occur alone or along with other conditions, it can take time to tease out which symptom is caused by what problem.

To make things even more confusing, fibromyalgia symptoms can come and go over time. That's why it can take a long time to go from fibromyalgia symptoms to a fibromyalgia diagnosis.

Source: John Hopkins Medicine

Source: Mayo Clinic

How is Fibromyalgia diagnosed?

There are no tests that can confirm a diagnosis of fibromyalgia. Instead, diagnosis is based on your symptoms, a physical exam, and possibly ruling out other conditions.

Fibromyalgia appears to be linked to changes in how the brain and spinal cord process pain signals. As a result, your doctor will usually rely on your group of symptoms to make a diagnosis.

Diagnostic guidelines from the American College of Rheumatology now include widespread pain throughout your body for at least three months. "Widespread" is defined as pain on both sides of your body, as well as above and below your waist.

Source: John Hopkins Medicine

Source: Mayo Clinic

Old guidelines required tender points

Fibromyalgia is also often characterized by additional pain when firm pressure is applied to specific areas of your body, called tender points. In the past, at least 11 of these 18 spots had to test positive for tenderness to diagnose fibromyalgia.

However, given that fibromyalgia symptoms can come and go, a person might have 11 tender points one day but only eight tender points on another day. And many doctors were uncertain about how much pressure to apply during a tender point exam.

While specialists or researchers may still use tender points, they are no longer required for your family doctor to make a diagnosis of fibromyalgia.

Source: Mayo Clinic

Excluding other possible causes

It's important to determine whether your symptoms are caused by some other underlying problem. Common culprits include:

  • Rheumatic diseases. Certain conditions — such as rheumatoid arthritis, Sjogren's syndrome and lupus — can begin with generalized aches and pain.

  • Mental health problems. Disorders such as depression and anxiety often feature generalized aches and pain.

  • Neurological disorders. In some people, fibromyalgia causes numbness and tingling, symptoms that mimic those of disorders such as multiple sclerosis and myasthenia gravis.

Source: Mayo Clinic

Tests that may be needed

Your doctor may want to rule out other conditions that may have similar symptoms. Blood tests may include:

  • Complete blood count

  • Erythrocyte sedimentation rate

  • Cyclic citrullinated peptide test

  • Rheumatoid factor

  • Thyroid function tests

  • Anti-nuclear antibody

  • Celiac serology

  • Vitamin D

Your doctor may also perform a careful physical exam of your muscles and joints, as well as a neurological exam to look for other causes of your symptoms. If there's a chance that you may be suffering from sleep apnea, your doctor may recommend a sleep study.

Source: Mayo Clinic

More clues for Fibromyalgia diagnosis

People who have fibromyalgia also often wake up tired, even after they've slept continuously for more than eight hours. Brief periods of physical or mental exertion may leave them exhausted. They may also have problems with short-term memory and the ability to concentrate. If you have these problems, your doctor may ask you to rank how severely they affect your day-to-day activities.

Fibromyalgia often coexists with other health problems, so your doctor may also ask if you experience:

  • Irritable bowel syndrome

  • Headaches

  • Jaw pain

  • Anxiety or depression

  • Frequent or painful urination

Source: Mayo Clinic

How is Fibromyalgia treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

There is no cure for fibromyalgia, but symptoms can be managed. Mild cases may get better with stress reduction or lifestyle changes. More severe cases may need to be treated with a team. This may include your primary healthcare provider, a specialist called a rheumatologist, a physical therapist, and a pain management clinic. Treatment may include:

  • Anti-inflammatory medicines, to ease pain and help you sleep

  • Other pain medicines

  • Medicines approved for treating fibromyalgia (duloxetine, pregabalin, and milnacipran)

  • Medicines to ease depression (antidepressants)

  • Exercise and physical therapy, to stretch muscles and improve cardiovascular fitness

  • Relaxation methods

  • Heat treatments

  • Cold treatments once in a while

  • Massage


Talk with your healthcare providers about the risks, benefits, and possible side effects of all medicines.

Source: John Hopkins Medicine

Living with Fibromyalgia

Fibromyalgia is a chronic condition. But you can manage it by working with your healthcare provider.  In addition to medicines, lifestyle changes can help symptoms. These include getting enough sleep and exercise.

Source: John Hopkins Medicine

Key points about Fibromyalgia

  • Fibromyalgia is a chronic condition that causes pain in muscles and soft tissues all over the body.

  • Researchers think it may be linked to sleep problems, stress, or immune, endocrine, or biochemical problems.

  • Symptoms may also include lack of energy (fatigue), sleep problems, depression, headaches, and other problems.

  • There is no cure, but symptoms can be managed.

  • Treatment can include medicine, exercise, relaxation, heat or cold, and massage.

Source: John Hopkins Medicine

Possible Fibromyalgia triggers

In some cases, fibromyalgia symptoms begin shortly after a person has experienced a mentally or physically traumatic event, such as a car accident. People who have post-traumatic stress disorder appear to be more likely to develop fibromyalgia, so your doctor may ask if you've experienced any traumatic events recently.

Because genetic factors appear to be involved in fibromyalgia, your doctor may also want to know if any other members of your immediate family have experienced similar symptoms.

All of this information taken together will give your doctor a much better idea of what may be causing your symptoms. And that's crucial to developing an effective treatment plan.

Source: Mayo Clinic

Fibromyalgia-Gluten Relationship

There may be evidence that supports the notion that fibromyalgia and gluten don't mix.

A recent study published by BMC Gastroenterology took seven female participants diagnosed with fibromyalgia and placed them on a gluten-free diet for one full year. The researchers found that the women showed a “remarkable improvement” in all outcome measures by the end of the study. Their fibromyalgia and IBS symptoms were reduced significantly.

Gluten is the protein constituent of grains like wheat, rye and barley. Some individuals can't tolerate gluten in their system. When gluten comes into contact with the small intestine, it produces an autoimmune-like response called celiac disease.

It is a condition that strikes one in about 133 people, most of whom don’t even know they have it. It may have genetic links, so if someone has a close relative with the condition, it can be passed on.

There are many physical symptoms that celiac disease or gluten intolerance can produce. The following symptoms are among the most common:

  • Abdominal cramping

  • Dehydration

  • Bloating

  • Abdominal distention

  • Muscle cramping

  • Energy loss

  • Appetite increased; cravings

  • Gas or flatulence

  • Weakness and lethargy

  • Back pain

  • Fatigue

  • Night blindness

  • Constipation

  • Decreased ability to clot blood

  • Sores or cracks in corners of mouth

  • Diarrhea

  • Edema

  • Electrolyte depletion

  • Dry skin


Common emotional states associated with gluten intolerance and celiac diseases are:

  • Mood changes

  • Depression

  • Inability to concentrate

  • Irritability

  • Disinterest

  • Brain fog

In an article in published by The New England Journal of Medicine, there are 55 conditions that can be caused by consuming gluten. Among them were osteoporosis, irritable bowel syndrome (IBS), anemia, lupus, and many other autoimmune diseases.

Gluten may be responsible for neurological and psychiatric types of illnesses like depression, dementia and neuropathy. If gluten brings out all of these types of conditions, it isn’t too hard to imagine that it can exacerbate fibromyalgia.

Celiac disease and gluten intolerance creates inflammation throughout the body. It affects the brain, heart, joints, digestive tract and other organ systems. If gluten is the cause of the different conditions in an individual, the elimination of this protein may be the key to resolving many health issues.

Source: NewLifeOutlookFibromyalgia