What is fibromyalgia, the widespread chronic pain, fatigue condition? - explainer

Many people who suffer from fibromyalgia describe it as a chronic flu, with widespread pain and chronic fatigue.

 Back pain (photo credit: INGIMAGE)
Back pain
(photo credit: INGIMAGE)

For many years, people who suffer from fibromyalgia never got any sort of proper response from medical professionals. They were all told that they were healthy people who had pain, and it was just something they had to live with. But today, this is fortunately no longer the case.

"Fibromyalgia is a chronic pain syndrome characterized by widespread pain throughout the body, which is felt in the muscles, joints, and elsewhere," explained Dr. Valerie Alush, head of the fibromyalgia unit at Sourasky Medical Center (Ichilov). "On many occasions, we hear from patients the term 'chronic flu' – widespread pains throughout the body accompanied by both severe fatigue and a sleep disorder. People struggle to fall asleep, they wake up multiple times throughout the night, and wake up in the morning as tired as if they never slept."

If this isn't difficult enough, there are also several other symptoms that come with the constant pain. This includes a decline in concentration and memory, mood swings, and being in a depressive state. And the worse a fibromyalgia patient's mood is, the less functional they will be – and that just makes their condition even worse. It's a cycle that's hard to break. 

And any other illness someone with fibromyalgia might have, even just a winter cold, is amplified, with worse symptoms and lasting for longer. 

What causes fibromyalgia?

"Fibromyalgia is characterized by some disruption in the nervous system that's supposed to regulate pain. When something goes wrong, the patients start feeling chronic pain and fatigue," explained Alush, who added that this occurs for several reasons. 

Neck and back pain (illustrative).  (credit: MARCO VERCH PROFESSIONAL PHOTOGRAPHER AND SPEAKER/FLICKR)
Neck and back pain (illustrative). (credit: MARCO VERCH PROFESSIONAL PHOTOGRAPHER AND SPEAKER/FLICKR)

"There is probably a genetic factor, with some people having a greater tendency to develop fibromyalgia after trauma," Alush said. She clarified that the condition usually first manifests after physical or mental trauma, but not every person who experiences trauma will develop fibromyalgia, only those who are genetically predisposed will. 

"The condition isn't hereditary, but some genes have been found that have a tendency to cause chronic pain," she said.

The doctor clarified that as research advances, scientists realize that other factors are likely at play in causing fibromyalgia, such as psychological issues hormones, and factors influencing how the body reacts in a state of high stress.

How do you live with fibromyalgia?

Fibromyalgia is a very complex syndrome in terms of its symptoms, causes, and diagnosis – as a result, its treatment is also very complex. 

"We want to improve sleep quality, reduce pain, and above all, improve function. We want to help people get up in the morning, go to work, have fun, take care of their children, and do all the normal things everyone else does," Alush explained.

Treatment for fibromyalgia consists of drugs and non-drug treatments. 

"The drugs are mainly those that can impact the central nervous system to reduce pain," she said, adding that normal painkillers, even the strongest ones, usually don't work for fibromyalgia and taking them isn't advised. 

"What helps is a medication that can change how the brain perceives pain," she explained.

Medical cannabis can also be prescribed to treat fibromyalgia. 

"Cannabis is currently only prescribed in Israel after the other medical treatments have been exhausted," Alush explained, adding that cannabis does help and many people with fibromyalgia use it.

The main non-drug treatment for fibromyalgia is physical activity. 

"The goal of all treatment is to restore functionality because there has been a disconnect between the brain and muscles, so you should start gradually and eventually do it on a daily basis," Alush said. She recommended low aerobic activity like swimming or walking, even 5-10 minutes a day.

"Every time you do this, you restore the normal communication between your brain and muscles, soothing the pain," she added. "People who exercise regularly and take medication can see their condition improve. 

In addition, if you are overweight, try to have a balanced diet and return to a healthier weight. Alush also recommends trying hydrotherapy.