Fibromyalgia (FM) is a medical condition characterized by chronic widespread pain – sometimes severe and often debilitating – and a heightened pain response to pressure.

Fibromyalgia is a chronic condition that affects the centre nervous system causing pain throughout the body. It is often accompanied by fatigue, depression and sleep problems. It affects mostly women and their multiple symptoms often go years without a proper diagnosis and treatment.

“One million Canadians have fibromyalgia and the time has come to take their suffering seriously. This is a real condition that greatly impacts patients and their families. Finally, there are national guidelines to help diagnose and treat this syndrome.”
Dr. John Pereira, a study co-author from the University of Calgary’s Faculty of Medicine and a physician at the Calgary Chronic Pain Centre (2012)

The term “fibromyalgia” is from New Latin fibro-, meaning “fibrous tissues”, Greek myo-, “muscles”, and Greek algos, “pain”; thus the term literally means “muscle and fibrous tissue pain”.

Other symptoms include tiredness to a degree that normal activities are affected; sleep problems and troubles with memory. Some people also report restless legs syndrome, bowel or bladder problems, numbness and tingling and sensitivity to noise, lights or temperature. Fibromyalgia is frequently associated with depression, anxiety and posttraumatic stress disorder. Other types of chronic pain are also frequently present.

The cause or causes of the symptoms associated with fibromyalgia has not been proven, therefore, is unknown; however, it is believed to involve a combination of genetic and environmental factors, with each playing a substantial role.

It may be that the condition runs in families and many genes are believed to be involved. Environmental factors may include psychological stress, trauma and certain infections.

The pain appears to result from processes in the central nervous system and the condition is referred to as a “central sensitization syndrome”.

There is no specific diagnosis test. Diagnosis involves first ruling out other potential causes and verifying that a set number of symptoms are present.

There are very few physicians practicing that specialize in these conditions – leaving many people feeling unsupported and isolated.

The treatment of fibromyalgia can be difficult. Recommendations often include getting enough sleep, exercising regularly, and eating a healthy diet. Cognitive behavioral therapy (CBT) may also be helpful.

The medications duloxetine (Cymbalta), milnacipran (Savella – not approved in Canada) or pregabalin (Lyrica) may be used.

While fibromyalgia can last a long time, it does not result in death or tissue damage.

Fibromyalgia is estimated to affect 2-8% of the population. Women are affected about twice as often as men.

Fibromyalgia was first defined in 1990, with updated criteria in 2011. There is controversy about the classification, diagnosis and treatment of fibromyalgia. While some feel the diagnosis of fibromyalgia may negatively affect a person, other research finds it beneficial.

What are some of the symptoms of fibromyalgia?

  • Fatigue
  • Morning stiffness
  • Tingling or numbness in hands and feet
  • Headaches, including migraines
  • Irritable bowel syndrome
  • Sleep disturbances/insomnia
  • Cognitive dysfunction with thinking and memory (sometimes called “fibro fog”)
  • Painful menstrual periods and other pain syndromes
  • Sound sensitivity, light sensitivity, temperature sensitivity
  • Sharp and aching pain in connective tissue areas (next to joints)
  • Muscle twitches
  • And more

Who gets fibromyalgia?

The prevalence of fibromyalgia is about 2% of the population, affecting an estimated 5 million adults in 2005.

  • Most people with fibromyalgia are women (female to male ratio of 7:1). However, men and children also can have the disorder.
  • Most people are diagnosed during middle age, and prevalence increases as a generation gets older.

How is fibromyalgia diagnosed?

Diagnosing fibromyalgia is achieved by the physician comparing the patient’s symptoms to a criteria or by doing a “tender point” test. If 11 of the 18 connective tissue areas of the body are tender when pressure is applied, and no other explanation for this pain is found, then the person likely has fibromyalgia.

The above definitions are taken with permission from Pandora Org and CDC. 

Progress in ME/CFS research may also help find answers about fibromyalgia because many of the symptoms are the same or very similar. Additionally, many people with a fibromyalgia diagnosis also have ME/CFS and don’t know it.

Fibromyalgia is usually diagnosed by rheumatologists but due to the high prevalence of the disease many patients are not able to seek advice from a specialist. Therefore, primary care physicians are best positioned to take over this role, as recommended by the 2012 Canadian Fibromyalgia Guidelines.  In the review, the authors provide evidence-based tools for primary care physicians to make the diagnosis and manage the condition long-term.

“We are the first ones to develop guidelines that look at diagnosis, treatment and follow-up of fibromyalgia,” says Dr. Mary-Ann Fitzcharles, corresponding author from the Research Institute of the MUHC and MUHC’s rheumatologist. “Currently, there is no cure for fibromyalgia but the guidelines set out the most appropriate management strategy.” (2013)

Treatment Options

Authors recommend non-pharmaceutical interventions such as exercise, relaxation techniques, cognitive behavioral therapy as well as medications tailored to the individual patient. The main treatment goal is to improve quality of life by alleviating the most troublesome symptom(s), with pain recognized as the most common and serious.

Sources: McGill University Health Centre (MUHC) and the University of Calgary- New Canadian guidelines for treating fibromyalgia – Published May 8 2013 in the CMAJ (Canadian Medical Association Journal)