1 – Fibromyalgia is primarily characterized by widespread muscle pain and tenderness.

Fibromyalgia does not cause inflammation or damage to the joints, muscles, or other tissues.

Therefore, it is not a joint disease, but it is arthritis-related. In 1990, the American College of Rheumatology established criteria to diagnose fibromyalgia:

  • A history of widespread pain in all four quadrants of the body (e.g., above the waist on both sides of the body; below the waist on both sides of the body) for three months or more.
  • Pain at 11 of 18 tender point sites

2 – Fibromyalgia can occur as a primary or secondary condition.

Fibromyalgia can occur as a primary syndrome characterized by muscular pain or as a secondary syndrome to other rheumatic diseases. It is possible to have fibromyalgia syndrome and another rheumatic disease.

Patients with rheumatoid arthritis, systemic lupus erythematosus, or ankylosing spondylitis are at increased risk of also developing fibromyalgia syndrome. Those patients may wonder if they have symptoms that are common to two conditions (i.e., overlapping symptoms) or if they actually have two distinct conditions.

3 – Fibromyalgia is often misunderstood and symptoms are often unrecognized, causing the syndrome to remain undiagnosed for months or years.

Fibromyalgia symptoms are often confused with symptoms typically linked to another condition. Fibromyalgia symptoms can mimic or overlap symptoms associated with other rheumatic diseases.

According to the National Fibromyalgia Association, it takes about 5 years on average to get an accurate diagnosis of fibromyalgia.

4 – Ninety percent of fibromyalgia patients suffer with severe fatigue or a sleep disorder.

Fatigue and sleep problems are major characteristics associated with fibromyalgia. Therefore, problems which develop because of poor sleep, also referred to as non-restorative sleep, are problematic as well (i.e., cognitive problems, memory lapses, lack of energy).

  • What Is Chronic Fatigue?
  • I’m Tired of Being Tired

5 – Fibromyalgia is associated with additional symptoms which seem distinct themselves but are actually included in fibromyalgia syndrome.

Other than muscular pain, fatigue, and tenderness, fibromyalgia patients also may experience:

  • headaches
  • irritable bladder or bowel
  • memory problems
  • temporomandibular joint disorder
  • pelvic pain
  • noise sensitivity
  • temperature sensitivity
  • restless leg syndrome
  • depression
  • anxiety

6 – There are psychological as well as physical aspects associated with fibromyalgia.

In a study of 307 patients evaluated over an 11-year period (reported at an American College of Rheumatology meeting by Yunus and colleagues), one-third of patients had severe physical as well as severe psychological issues.

One-third had mild psychological and moderate physical issues. Another third had moderate pyschological symptoms with mild physical symptoms.

7 – Since there is so much variability in fibromyalgia, the syndrome does not manifest itself identically in all patients.

Since not all fibromyalgia patients experience the same symptoms, there may be sub-types of fibromyalgia which may be discovered later and would influence treatment choices. Until the cause of fibromyalgia is determined, the variability of symptoms will remain part of the puzzle.

8 – Diagnosis of fibromyalgia focuses on tender points but there is no definitive diagnostic test for fibromyalgia, such as a blood test or x-ray.

Diagnosis of fibromyalgia is solely based on symptoms which are presented and found during a physical examination. If diagnostic tests are ordered, it is to rule out other conditions or find out more about other symptoms.

9 – Medication and non-medication treatments are used to manage fibromyalgia.

Medications are used to treat pain, improve sleep, and manage depression and anxiety. Your physician will determine what to prescribe based on symptoms presented. Alternative treatments that focus on pain relief and stress relief also benefit many fibromyalgia patients.

10 – Fibromyalgia affects more women than men. The prevalence of fibromyalgia is between 2 and 4 percent of the population.

Though the statistics reveal the prevalence of fibromyalgia, statistics do not reveal how many people live well with fibromyalgia and have successfully managed the syndrome to the degree of maintaining good quality of life. It’s important to get a proper diagnosis and to follow a treatment regimen which affords you a good quality of life despite your diagnosis.

Research on complementary health approaches for fibromyalgia is preliminary, but there is some encouraging evidence that practices such as tai chi, qi gong, yoga, massage therapy, acupuncture, and balneotherapy may help relieve some fibromyalgia symptoms.

  • Meditative movement therapies such as tai chi, qi gong, and yoga may result in modest improvements in sleep disturbances, fatigue, depressed mood, and health-related quality of life for those with fibromyalgia,according to a 2013 review of scientific studies. But larger, high-quality studies are needed to confirm these results.
  • Massage showed modest, short-term benefits for fibromyalgia symptoms in a review of several small studies. However, the investigators noted that all reviewed studies had problems and that additional rigorous research is needed on massage for fibromyalgia symptoms.
  • Investigators found low-to-moderate evidence that acupuncture, compared with no treatment or standard therapy, improves pain and stiffness in people with fibromyalgia. However, this 2013 review of scientific studies concluded that larger studies are needed.
  • There is a little evidence that balneotherapy may provide short-term improvement in pain and health-related quality of life for those with fibromyalgia, but definite conclusions about the value of balneotherapy cannot be reached based on the current evidence.
  • The mind and body practices discussed here are generally considered safe for healthy people when they’re performed appropriately. If you have any health problems, talk with both your health care provider and the complementary health practitioner/instructor before starting to use a mind and body practice.


Self-education. Understanding the battlefield is often half the battle. As people with fibromyalgia develop a better understanding of their condition, it becomes far easier to cope with and address. Furthermore, for some, simply the realization that the condition does not threaten the body’s organs and often improves over time can greatly relieve anxiety. The anxiety is often due to concern about the cause of the frequent pains of fibromyalgia. I would like to offer MedicineNet.com’s Fibromyalgia article as an excellent resource for patients and their family members to become more familiar with the basic concepts of fibromyalgia and its diagnosis and treatment options. To further complement the consultation with the doctor, other sources of information include the Arthritis Foundation and local hospital support groups.

  1. Stress reduction. Reducing stress can help with muscle relaxation and improve non-Rapid Eye Movement (non-REM) sleep. Inadequate sleepof this type is felt to play a central role in promoting the symptoms of fibromyalgia. The response to stress differs from person to person. The reduction of stress in the treatment of fibromyalgia must be individualized for each patient. Stress reduction might include simple stress modification at home or work, biofeedback, relaxation tapes, psychological counseling, exercise activities such as yoga and/or support among family members, friends, and doctors. Sometimes, changes in environmental factors (such as noise, temperature, and weather exposure) can exacerbate the symptoms of fibromyalgia, and these factors need to be modified.
  2. Exercise. Aerobic activities that exercise the muscles can work together with the methods above to greatly relieve the symptoms of fibromyalgia. Many experts on fibromyalgia feel that exercise works by promoting the non-REM sleep that is commonly deficient in patients with this illness. Low-impact aerobic exercises, such as swimming, cycling,walking, and stationary cross-country ski machines can be very effective. For patients who are unfamiliar with exercising options, a physical therapist can provide an ideal source of instruction. With any new exercise program, it is important to understand that a mild increase in aching in the first two weeks is expected. This increased aching is especially likely to occur when the patient has not been exercising and the muscles are deconditioned. Sometimes, applications of cold packs to sore muscles and tendons after exercising can help relieve muscle inflammation and soreness.

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