How it Feels & Treatment Tips

Written by Julie Canter

• They’re Real
• Slow but Steady Exercise
• Scale Back
• Get Organized
• Make Your Day More Fibro-Friendly
• Better Sleep
• Help Others See What You Feel
• More

Fibromyalgia goes beyond pain. It can also affect your thinking ability, a symptom called fibro fog, and your energy level, leaving you with extreme fatigue. Even though you feel these symptoms, they aren’t visible, and there aren’t any tests that can measure them.

You’ll need to work closely with your medical team to address your specific challenges with fatigue and fibro fog, because they’re a little different for everyone. Do your part by taking steps to conserve energy and overcome concentration and memory issues to power through your day.

Severe fatigue — more than just being tired — affects up to 4 out of 5 of people with fibromyalgia. It often goes hand-in-hand with sleepless nights. Together, they leave you drained and exhausted.

While scientists are learning more about what’s happening in your brain that causes the pain and some other symptoms, what’s behind fibro fog remains unclear. That name says it all: a fuzzy-headed feeling that keeps you from thinking clearly. You may get distracted, forget or lose things, and struggle to keep up with conversations.

Over half of people with fibromyalgia say they have these kinds of problems, and many feel the fog impacts their lives more than the pain, tenderness, and fatigue.

Given how you feel, you may want to shy away from exercise. But it’s one of the most effective ways to handle fibromyalgia.

When you’re too tired to exercise, that lack of activity leads to greater muscle weakness and more fatigue. Over time, regular exercise lessens fatigue. Consistency can have a greater impact than intensity.

It’s possible that exercise also creates a positive chain reaction that boosts brain function. Studies show a link between physical ability and thinking ability. People who can do more physically often do better in areas like attention and decision-making.

Start out at an easy pace. Work with a physical therapist to find the right beginner program for you and adapt it as you get stronger. This is especially helpful if you’re nervous about exercising.

Strength training helps you regain muscle, and that helps with pain and fatigue for some people. Use resistance bands or a light weight to start.

Very gentle movement therapies like yoga, tai chi, and qi gong all get you moving, but yoga often has best effect on fatigue.

If you’re frustrated by what you can’t do, try pacing yourself. Cut back on less important activities to have the energy to enjoy more meaningful ones.

Break down big tasks into manageable bites. As you complete each one, you’ll have a sense of accomplishment rather than feel discouraged.

Build in short rest periods between tasks. Keep a journal to find the best activity/rest balance for you.

Use an online calendar or app that lets you color-code activities by importance. Plan work projects and home responsibilities at least a week in advance.

Then take a big-picture look. Are there too many high-priority items and not enough down time? Make adjustments, even if it means sometimes saying “no.”

Take a fibromyalgia education program to learn healthy behaviors and how to tweak everyday activities for less stress.

If you work outside the home, talk to your employer about things that might help you do your job:

• Take breaks more often
• Change your work schedule
• Switch to a different position that better matches your abilities

A psychologist or neurologist may be able to suggest more adaptations, or use biofeedback or cognitive behavior therapy to boost your focus. An occupational therapist can show you how to make physical changes, from a better workstation to stretches you can do at your desk.

There’s a strong connection between sleep quality and your level of fatigue. While some fibromyalgia medications may help, they may not be enough. In addition to regular exercise and pacing yourself, practice good sleep habits. These include a regular bedtime and wake-up time and a dark, cool, quiet room

Some people with fibromyalgia have a second condition that causes fatigue, like an inflammatory disease, anemia, or low thyroid. Get tested and, if needed, treated.

Because fibro fog and fatigue aren’t obvious, it can be hard for friends and loved ones to understand what you’re dealing with.

Let the people in your life know that you have a disease that affects your muscles and causes pain, fatigue, and thinking problems. It might help to say researchers are pretty sure that certain areas of the brain don’t process nerve signals correctly, leading to a wide range of symptoms.

When you ask for help — and it’s OK to do that — be specific about what you need.

Top Picks

How it Feels & Treatment Tips

Written by Julie Canter

• They’re Real
• Slow but Steady Exercise
• Scale Back
• Get Organized
• Make Your Day More Fibro-Friendly
• Better Sleep
• Help Others See What You Feel
• More

Fibromyalgia goes beyond pain. It can also affect your thinking ability, a symptom called fibro fog, and your energy level, leaving you with extreme fatigue. Even though you feel these symptoms, they aren’t visible, and there aren’t any tests that can measure them.

You’ll need to work closely with your medical team to address your specific challenges with fatigue and fibro fog, because they’re a little different for everyone. Do your part by taking steps to conserve energy and overcome concentration and memory issues to power through your day.

Severe fatigue — more than just being tired — affects up to 4 out of 5 of people with fibromyalgia. It often goes hand-in-hand with sleepless nights. Together, they leave you drained and exhausted.

While scientists are learning more about what’s happening in your brain that causes the pain and some other symptoms, what’s behind fibro fog remains unclear. That name says it all: a fuzzy-headed feeling that keeps you from thinking clearly. You may get distracted, forget or lose things, and struggle to keep up with conversations.

Over half of people with fibromyalgia say they have these kinds of problems, and many feel the fog impacts their lives more than the pain, tenderness, and fatigue.

Given how you feel, you may want to shy away from exercise. But it’s one of the most effective ways to handle fibromyalgia.

When you’re too tired to exercise, that lack of activity leads to greater muscle weakness and more fatigue. Over time, regular exercise lessens fatigue. Consistency can have a greater impact than intensity.

It’s possible that exercise also creates a positive chain reaction that boosts brain function. Studies show a link between physical ability and thinking ability. People who can do more physically often do better in areas like attention and decision-making.

Start out at an easy pace. Work with a physical therapist to find the right beginner program for you and adapt it as you get stronger. This is especially helpful if you’re nervous about exercising.

Strength training helps you regain muscle, and that helps with pain and fatigue for some people. Use resistance bands or a light weight to start.

Very gentle movement therapies like yoga, tai chi, and qi gong all get you moving, but yoga often has best effect on fatigue.

If you’re frustrated by what you can’t do, try pacing yourself. Cut back on less important activities to have the energy to enjoy more meaningful ones.

Break down big tasks into manageable bites. As you complete each one, you’ll have a sense of accomplishment rather than feel discouraged.

Build in short rest periods between tasks. Keep a journal to find the best activity/rest balance for you.

Use an online calendar or app that lets you color-code activities by importance. Plan work projects and home responsibilities at least a week in advance.

Then take a big-picture look. Are there too many high-priority items and not enough down time? Make adjustments, even if it means sometimes saying “no.”

Take a fibromyalgia education program to learn healthy behaviors and how to tweak everyday activities for less stress.

If you work outside the home, talk to your employer about things that might help you do your job:

• Take breaks more often
• Change your work schedule
• Switch to a different position that better matches your abilities

A psychologist or neurologist may be able to suggest more adaptations, or use biofeedback or cognitive behavior therapy to boost your focus. An occupational therapist can show you how to make physical changes, from a better workstation to stretches you can do at your desk.

There’s a strong connection between sleep quality and your level of fatigue. While some fibromyalgia medications may help, they may not be enough. In addition to regular exercise and pacing yourself, practice good sleep habits. These include a regular bedtime and wake-up time and a dark, cool, quiet room

Some people with fibromyalgia have a second condition that causes fatigue, like an inflammatory disease, anemia, or low thyroid. Get tested and, if needed, treated.

Because fibro fog and fatigue aren’t obvious, it can be hard for friends and loved ones to understand what you’re dealing with.

Let the people in your life know that you have a disease that affects your muscles and causes pain, fatigue, and thinking problems. It might help to say researchers are pretty sure that certain areas of the brain don’t process nerve signals correctly, leading to a wide range of symptoms.

When you ask for help — and it’s OK to do that — be specific about what you need.

Top Picks

causes, symptoms and treatment in Moscow at the FSCC FMBA

Fibromyalgia (fibromyalgia syndrome) is a complex, long-term disorder that is accompanied by widespread pain, severe fatigue, sleep problems. Pain occurs in muscles and joints throughout the body for no apparent reason.

The disease can develop in anyone, including the elderly and children. It is worth noting that fibromyalgia is more often recorded in adult women aged 25 to 55 years.

Scientists suggest that the cause of fibromyalgia is an abnormal reaction of the central nervous system to pain signals that are transmitted throughout the body. In the process of complex diagnostics, it is not possible to establish the nature of the symptoms. Laboratory and instrumental diagnostic parameters are within the normal range.

In clinical practice, doctors use criteria to make a diagnosis. The hallmarks of fibromyalgia are the presence of widespread, intense pain that persists for three months or more, as well as the lack of a clear explanation for the development of symptoms.

A rheumatologist specializes in the diagnosis and treatment of fibromyalgia. Treatment options include patient education, exercise, management of comorbid conditions that may contribute to symptoms, and medication.

Symptoms

Prolonged, widespread pain in all parts of the body is the main manifestation of fibromyalgia. Pain may be more pronounced in some parts of the body, such as the neck or back. The pain may feel like burning or tingling. The pain syndrome grows slowly, patients seek medical help after a few years, when pain reduces the quality of life.

Patients have many other symptoms that may come and go, get worse or worse over time. It is often difficult to establish a pattern in the appearance of symptoms.

The main signs of fibromyalgia include:

• Generalized pain. The pain is often described as dull. To be considered common, pain must occur on the right and left sides of the body, and above and below the waist;
• Fatigue. “Broken” condition, fatigue immediately after waking up accompanies patients, even despite prolonged sleep;
• Cloudiness of consciousness. Patients complain of problems with thought processes, memory loss, difficulty concentrating.

Fibromyalgia is a multi-symptom disorder.

Common associated features include:

• Hypersensitivity to pain
• Constant muscle tension
• Stiffness in the joints more in the morning and evening hours
• Touch sensitivity
• Sleep disorder
• Headaches, migraines
• Symptoms of anxiety disorder, depression
• Gastrointestinal disorders, irritable bowel syndrome, which is manifested by abdominal pain, bloating, stool disorder

Fibromyalgia patients are more likely to have functional symptoms such as cold hands and feet, wet palms, dry mouth and eyes, and dizziness when changing body position.

Symptoms may worsen or improve depending on the following factors:

• Stress level
• Cold weather, high humidity
• Climate Change
• Morning Hours
• Physical activity level

Reasons

The exact causes of fibromyalgia remain unknown and continue to be the subject of scientific debate.

Recent studies show the genetic nature of fibromyalgia. The disease often runs in families among siblings and their parents.

Fibromyalgia is not an autoimmune disease or a pathology caused by inflammation. The main role is played by changes in the functioning of the nervous system. It is believed that people with fibromyalgia have an increased reaction of the central nervous system in response to stimuli in the form of pain symptoms. This reaction is associated with an excessive accumulation of chemicals in the brain that signal pain. It is worth noting that usually these stimuli do not cause pain in healthy people.

The development of fibromyalgia can provoke acute conditions. These include acute infectious diseases, traumatic injuries. Provoking factors also include intense physical activity, emotional stress.

Diagnostics

Fibromyalgia is a diagnosis of exclusion. There is no specific diagnostic test for fibromyalgia, and the symptoms that patients describe are similar to a number of other conditions. Before making a diagnosis, the doctor must rule out all possible causes of symptoms.

Fibromyalgia can occur in isolation, as well as against the background of other rheumatic diseases. Often coexists with psychiatric disorders such as anxiety and depression. For this reason, each patient at the appointment is asked to fill out an anxiety and depression questionnaire.

A rheumatologist deals with diagnostic issues, confirms the diagnosis and prescribes effective treatment to control the symptoms of fibromyalgia.

Attention is drawn to the three characteristic features of fibromyalgia, which include:

• Generalized severe pain
• Presence of symptoms for three months
• Absence of other health problems that could explain the pain and other symptoms

Diagnostic criteria include widespread pain in all parts of the body for at least three months, as well as pain when pressure is applied to trigger points in certain anatomical locations. The pain threshold at these points is reduced.

Painful points are identified symmetrically on both halves of the body. The force of pressure should not exceed 4 kg. The doctor can use a dolorimeter – a device that gives a dosed load.

It should be noted that according to the latest recommendations from 2016, the determination of sensitive points is not required. The key criteria are widespread pain for at least three months.

To qualify, pain must be in at least four of these five areas:

• Left upper area including shoulder, arm, jaw
• Right upper region including shoulder, arm, jaw
• Left lower region including thigh, buttock, leg
• Right lower region including thigh, buttock, leg
• Vertical which includes the neck, back, chest or abdomen

The doctor conducts a physical examination, during which he identifies or excludes other causes of muscle pain. An underactive thyroid gland (hypothyroidism) as well as polymyalgia rheumatica can mimic fibromyalgia. Blood tests allow you to establish the presence of the described diseases.

The symptoms of fibromyalgia are also similar to those of rheumatoid arthritis and systemic lupus erythematosus. A careful examination, questioning, as well as laboratory and instrumental diagnostics allow the attending physician to detect these conditions.

To exclude other conditions that may have similar symptoms, the doctor prescribes tests:

• General and biochemical blood test;
• Erythrocyte sedimentation rate;
• Antibodies to cyclic citrulline-containing peptide;
• Rheumatoid factor;
• Thyroid hormones;
• Antinuclear antibodies.

Treatment at the Federal Scientific and Practical Center

Standard approaches to the treatment of fibromyalgia include drug therapy, behavioral therapy and patient education, and exercise programs. The maximum effect is achieved when using several types of treatment.

Non-drug therapy

• Physical exercise. Research shows that outdoor exercise is the most effective treatment. They activate a powerful pain relief system, it is recommended to perform in addition to drug treatment;
• Cognitive Behavioral Therapy (CBT) is a psychotherapeutic technique that has shown the greatest effectiveness in the treatment of fibromyalgia. CBT focuses on understanding how thought processes and ingrained habits affect pain and other symptoms. The technique focuses on changing the emotional response and behavior;
• Alternative acceptable therapies that include acupuncture, physiotherapy, massage, myofascial relaxation may be useful in combination with primary treatment.

Medical therapy

The goal of conservative therapy is to relieve symptoms and improve quality of life.

To control the manifestations of fibromyalgia, drugs from the following groups are used:

• Pain medications available without a prescription. Acetaminophen, ibuprofen may be effective in reducing pain symptoms;
• Antiepileptic drugs. Epilepsy medicines help reduce certain types of pain. Pregabalin is the first drug approved for the treatment of fibromyalgia. This drug blocks the excessive activity of nerve cells involved in the transmission of pain impulses;
• Antidepressants. The drug relieves pain and fatigue.

Complications

Pain, chronic fatigue, sleep problems disrupt the daily routine at home and at work, reduce the quality of life. Lack of understanding of one’s own condition, difficulties at the stage of diagnosis, long-term treatment lead to persistent depression and health-related anxiety. To correct the complications of fibromyalgia, you need to contact psychotherapists, psychiatrists.

Forecast

Fibromyalgia is a chronic pathology that significantly affects the quality of life, but it is still considered benign. Timely seeking medical help, the doctor’s attentive attitude to the patient, the patient’s desire to provide self-help and adjust their lifestyle are key factors in achieving recovery.

Prevention

Prevention is to eliminate provoking factors. The following recommendations will help control the manifestations of fibromyalgia:

• Allow enough time for rest and recovery each day. Deep breathing exercises and meditation practices help reduce the stress that triggers symptoms;
• Organize a sleep schedule. It is recommended to go to bed and get up at the same time. An hour before bedtime, as well as in the first two hours after waking up, it is worth limiting the time on the phone. Limit your intake of caffeinated beverages, avoid daytime naps. These factors can disrupt nighttime sleep;
• Exercise regularly in the fresh air, move, stay active. Regular exercise reduces pain, promotes a surge of energy, and eliminates fatigue. It is recommended to slowly increase physical activity day by day.
• Focus on things to come, not on things that are painful.

References

1. Teplyakova OV, Popov AA, Volkova LI, Sarapulova AV. Fibromyalgia: clinical picture and variants of the disease. Modern rheumatology. 2020;
2. Chichasova N.V. Fibromyalgia syndrome: clinic, diagnosis, treatment. breast cancer. 1998.

This article is an informational material and is not intended for self-diagnosis and self-treatment. If signs of discomfort appear, you should contact your doctor.

How to distinguish fibromyalgia from chronic fatigue?

Fibromyalgia and chronic fatigue syndrome: two often underestimated and poorly recognized chronic conditions

But can they be distinguished? How are they diagnosed? And what can be done to relieve often disabling symptoms?

Fibromyalgia: what it is and how it manifests itself

The term fibromyalgia means pain in the muscles and fibrous structures of the connective tissue, i.e. ligaments and tendons.

Fibromyalgia is characterized by:

• widespread musculoskeletal pain present for more than 3 months;
• fatigue;
• non-restorative sleep;
• difficulties with memory and attention,
• rigidity and mood disorders.

Disturbance of sleep and its quality is almost the rule.

It has been suggested that the alteration of his cycles, especially the shortening of the deep sleep phase, during which the pain threshold is normally elevated, is responsible for the increased sensitivity to pain characteristic of fibromyalgia.

In people who already have a pre-existing migraine, fibromyalgia causes an increase in the intensity and frequency of headaches, which may even become daily.

Link between fibromyalgia and long-term Covid

The ongoing Covid-19 pandemic leads to the observation that while most people recover after a few weeks, chronic and complex symptoms, not just respiratory ones, may persist or even manifest at a distance in some recoveries from infection.

This condition is called long covid and its main component is pain.

Many people who are recovering months after contracting the coronavirus complain of complex neurological symptoms such as:

• fatigue;
• persistent headache, often aggravated by lying down;
• insomnia;
• malaise after exercise;
• memory problems;
• speech problems and cognitive dysfunction;
• muscular and neuropathic pain.

Diagnosis

Fibromyalgia is described as a generalized non-inflammatory form of uncertain origin.

This is why the diagnosis and clinical features of fibromyalgia have long been controversial.

The first step in diagnosis, as this is a condition with a predominantly neuropathic pain component, is to see a neurologist for an initial evaluation, which can be followed up with in-depth examinations if necessary.

Diagnosis is mainly based on history and finding painful muscle areas.

It is also important to exclude blood, rheumatological, muscular, neurological, psychological and radiological signs.

For this, the neurologist can use

• hematochemical and radiological studies;
• psychological or rheumatological consultation.

therapy

Once the presence of fibromyalgia is recognized, the course of treatment is not short and requires commitment to achieve significant improvements.

Treatment of pain, chronic headache, and other symptoms of fibromyalgia is currently based on medications for

• neuropathic pain
• severe migraine;
• sleep disorders.

In particular, there are specific drugs for neuropathic pain, others for muscle contractures, but the gold standard is certain antidepressants that also have an analgesic effect.

It is also important not to underestimate the psychosomatic component of the disease, which can be negatively affected by psychophysical stresses and anxieties that exacerbate symptoms.

Chronic fatigue: how to recognize?

Fibromyalgia has a lot in common with Chronic Fatigue Syndrome, a problem that mainly affects young women and is often erroneously classified as “feigning illness (intentional faking of symptoms)”.

Chronic fatigue syndrome is a syndrome characterized by disabling asthenia lasting more than 6 months, of unknown origin.

It is associated with various symptoms, including:

• sleep disorders
• feeling cognitive disorder;
• fatigue;
• pain;
• worsening of symptoms on exertion.

Although the term “chronic fatigue syndrome” was first used in 1988, the disorder has been well described since the mid-1700s, but under different names: fever, neuroasthenia, chronic brucellosis, exercise stress syndrome.

Causes of chronic fatigue

The origin of chronic fatigue syndrome is still unknown.

No infectious, hormonal, immunological or psychiatric causes identified. Similarly, there are no allergic markers or immunosuppression.

In the last 2 years of the pandemic, Covid-19 infection has also been suspected as one of the causes of this syndrome, as in part in the case of fibromyalgia.

Some people who recovered from Covid 19 became carriers of chronic fatigue with persistent symptoms, some of which are the result of

Related reports

• organ damage due to infection and/or treatment;
• post-traumatic stress disorder.

Some researchers argue that the etiology will be multifactorial, including predisposition to factors

• psychosomatic;
• genetic;
• exposure to microbes;
• toxins;
• physical injury.

In any case, it is important to emphasize the physiological pattern of chronic fatigue syndrome.

Symptoms: fatigue that does not go away even with rest.

Whereas in fibromyalgia the predominant symptom is pain, in chronic fatigue syndrome, as the name suggests, it is asthenia.

The onset of chronic fatigue syndrome is usually abrupt: it often occurs after a psychologically or clinically stressful event.

Many patients report:

• virus-like illness;
• severe fatigue;
• fever;
• upper respiratory symptoms.

The initial syndrome resolves but causes prolonged and severe fatigue that interferes with daily activities and is usually worse with exertion but little or no improvement at rest.

Important common features are widespread pain and sleep disturbances, which may be associated with cognitive impairments such as memory problems.

How chronic fatigue is diagnosed

If symptoms are present that may lead to suspicion of chronic fatigue syndrome, the first step is to conduct a physical examination in combination with laboratory tests to rule out other pathologies and any possible alternative causes of chronic fatigue syndrome.

Objective examination of a patient with chronic fatigue syndrome is normal, without objective signs of muscle weakness, arthritis, neuropathy or organomegaly.

Laboratory tests are also normal and usually include a blood test with formula and measurements of electrolytes, azotemia, creatinine, erythrocyte sedimentation rate, and thyroid hormones.

If clinical evidence suggests, further investigations in selected patients may include sleep x-rays and tests for adrenal insufficiency.

Thus, the diagnosis of chronic fatigue syndrome is based on characteristic symptoms in patients with a normal clinical examination and normal laboratory findings.

Any abnormal physical findings or laboratory tests should be evaluated and alternative diagnoses causing these findings and/or symptoms should be ruled out.

It is important to emphasize that because people with chronic fatigue syndrome usually appear healthy, friends, family members, and even sometimes healthcare professionals express skepticism about their condition, and this can exacerbate the frustration and depression that patients often experience about their condition. poorly understood disorder.

Treatment

In order to offer effective treatment to patients with chronic fatigue syndrome, the clinician must first recognize and accept the validity of the symptoms.

Whatever the underlying causes, patients are not malingerers but sufferers.

On the other hand, patients should accept and accept their disability by focusing on what they can still do rather than being frustrated with what they can’t do.