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What you need to know about fibromyalgia

Some people experience persistent pain—not just isolated to an achy tooth with a cavity or bruised knee after a tumble. Such pain can be so severe that even hugs hurt. This type of pain affects millions of Americans, and is often stigmatized. So, let's better understand fibromyalgia.

What is fibromyalgia?
Fibromyalgia is a chronic pain condition characterized by widespread pain all over, excessive fatigue and a sensitivity to touch or mild pressure. Other symptoms include restless sleep, irritable bowel symptoms, poor concentration, short-term memory problems, anxiety and depression.

What causes fibromyalgia?
Fibromyalgia is caused by a condition called central sensitization, which is when your body's nervous system becomes excessively reactive to stimuli. The nerves in your body, spinal cord and brain communicate with each other in a way that the whole system gets stuck in a heightened state of reaction, making simple touch, like a hug, painful.

How is fibromyalgia diagnosed?
There is no "fibromyalgia test" that providers can send to the lab. So, our first line of defense is to determine what symptoms aren't present. First, we'll rule out things like rheumatoid arthritis, lupus or other rheumatic diseases, as well as  orthopedic  or  spinal conditions or ligament tears. We also make sure the pain isn't related to cancer. Once we've made sure that the pain is not the result of these other conditions, the diagnosis is based simply on a patient's self-report of having experienced widespread pain for more than three months.

Who gets fibromyalgia?
Studies show that upward of 90 percent of people who have fibromyalgia are women. We don't know exactly why that is. Like any chronic health condition—heart disease or diabetes—there are many causes to consider, and the same goes for fibromyalgia. Biological, social, genetic and psychological factors all play a role in your health.

How is fibromyalgia treated?
Fibromyalgia cannot be cured, but in the last 20 years, we've found effective ways to help patients live better with less pain and more energy. They can be broken into four categories:

1.Exercise. Mild aerobic activities such as walking, pool therapies and biking help minimize symptoms when done regularly over an extended period of time. With fibromyalgia, movement can be fatiguing, but working up to 20, 30 or 40 minutes, a few times a week, can significantly reduce your symptoms over time.

2.Cognitive behavioral therapy (CBT). Participating in CBT means working with an expert who coaches you on healthy lifestyle changes as well as teaches you specialized cognitive and emotional coping strategies. By making healthy behavior changes over time, you can reduce pain and fatigue, and get back into life.

3.Relaxation therapy. Mindfulness, meditation, tai chi and yoga all have been shown to be helpful for all kinds of chronic pain and especially fibromyalgia.

4.Medication. There are two types of medication prescribed for fibromyalgia that have been shown to be helpful in clinical trials. They are anti-epileptics and antidepressants; however, they are not the sole solution. It's the combination of all four categories that's really been shown to be the most beneficial over time.

Why is fibromyalgia stigmatized?
People who live without pain can have a difficult time understanding how someone could have severe pain without some sort of injury. Much like the stigma around people with mental health conditions, people with fibromyalgia can be seen as overreacting or as a hypochondriac. However, these beliefs about fibromyalgia are false. While it's easier said than done, my suggestion is to try not to let the false beliefs of others get you down. Remind yourself that just because they say it or think it, it doesn't make it true.

Who do I talk to about my pain?
A conversation about central sensitization with a health care professional is the best place to start on the road to understanding—and managing—your pain. 

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