Fibromyalgia For Dummies E-Book

Roland Staud

• Herausgeber: John Wiley & Sons
• Kategorie: Ratgeber
• Sprache: Englisch

Seitenzahl: 543

Veröffentlichungsjahr: 2025

Beschreibung

Discover the latest science on fibromyalgia and get proven, practical steps to recover your quality of life

Fibromyalgia For Dummies helps you understand the symptoms and causes of this challenging disease and guides you through steps you can take to reduce or eliminate your symptoms,  decreasing your pain and fibro fog to manageable control. You’ll learn about and benefit from clear, easy-to-understand coverage of the newest and best medications, over-the-counter drugs, topical remedies, hands-on therapies, and alternative treatments. Learn about the pros and cons of medical marijuana and cannabinoids. You’ll also discover how to deal with people who can’t wait to tell you that your fibromyalgia symptoms aren’t “real.” (Even though they are.) Plus, receive proven tips for managing stress, exercising, and diet and lifestyle changes to reduce inflammation and improve your symptoms. This completely updated Dummies guide is your source of information on new research, the latest therapies (like low-dose naltrexone and portable transcutaneous electrical nerve stimulation or TENS), and finding what treatments work best for you.

• Find out what causes fibromyalgia and determine the best treatments for your specific situation
• Identify triggers, cope with sleep problems, reduce emotional distress, and alleviate pain
• Discover the four pillars of treatment: education, fitness, medication, and mental health treatment
• Learn about types of fibromyalgia pain, including central sensitization, neuroinflammation, small fiber neuropathy, and post-COVID pain

Fibromyalgia For Dummies is for anyone, of any age, who thinks they might be suffering from fibromyalgia—as well as loved ones who want to know more about this disease.

Leseprobe

Fibromyalgia For Dummies®

To view this book's Cheat Sheet, simply go to www.dummies.com and search for “Fibromyalgia For Dummies Cheat Sheet” in the Search box.

Table of Contents

Cover

Table of Contents

Title Page

Copyright

Introduction

About This Book

Foolish Assumptions

Icons Used in This Book

Beyond the Book

Where to Go from Here

Part 1: The What, When, and Why of Fibromyalgia

Chapter 1: Fibromyalgia Is Real

Dumping Your Doubts on Whether FMS Is Real

Examining Symptoms, Causes, and Pain of Fibromyalgia

Considering Who Gets Fibromyalgia

Looking at Related Medical Problems

Taking a Self-Test for Fibromyalgia

Finding a Knowledgeable FMS Doctor

Treating the Problem

Making Lifestyle Changes: Pulling Yourself into a Non-Fibro World

Coping with FMS at Home and Work

Chapter 2: Recognizing Key Fibromyalgia Symptoms

Describing Where It Hurts: Almost Everywhere!

Being Terribly Fatigued

Facing Fibro Fog: Mental Malaise

Reeling from Your Reactions to Weather

Dealing with Common Sleep Disorders

Dealing with Depression

Considering Related Medical Problems

Chapter 3: Learning Possible Causes of FMS

Down But Not Out: Physical Trauma

Catching Fibromyalgia

Considering Combat Stress

Studying Chemical Imbalances

Examining Environmental Causes

Exploring Other Theories

Chapter 4: Understanding FMS Pain

Grasping Pain and Why People Need It

Chronic Pain Categories in FMS

Surveying Key Aspects of Fibromyalgia Pain

Working with Your Doctor to Manage Fibromyalgia Pain

Part 2: Finding Out if You Have Fibromyalgia

Chapter 5: Who Gets Picked to Have Fibromyalgia?

Looking at the Numbers: Who Has Fibromyalgia?

Wondering Why Women Suffer More than Men from Fibromyalgia

Considering Fibromyalgia and Women’s Ages

Fibromyalgia and Men: It Isn’t Just a Woman Thing

Chapter 6: Identifying Diseases Often Confused with FMS

Understanding the Uncertainty

Chronic Fatigue Syndrome

Myofascial Pain Syndrome

Arthritis

Thyroid Disease

The Other Suspects

Chapter 7: Working with a Good Fibromyalgia Doc: You Need a True Believer

Working with Your Primary-Care Doctor

Looking Elsewhere for a Doctor: How to Know if It’s Time

Considering Types of Specialists

Finding a Good Specialist or a New Primary-Care Doctor

Interviewing Your Physician Candidate: What’s Up, Doc?

Chapter 8: Getting Physical: Your Initial Exam and Diagnosis

Diving into Your Medical History: What the Doctor Should Ask You

Volunteering Info if the Doc Doesn’t Ask You about It

Getting All Your Questions Out in the Open

Identifying the Tender Points of Fibromyalgia

Testifying about FMS

Part 3: Looking At All Your Treatment Options

Chapter 9: Medicating the Problem: Over-the-Counter Drugs

Relieving Pain with OTC Painkillers

Considering Cannabidiol (CBD)

Talking about Topical Remedies

Chapter 10: Prescribing Health with Medications

Relaxing Your Fibromyalgia: Muscle Relaxants

Easing Pain with Painkillers

Navigating Low-Dose Naltrexone

A Possible Game-Changer for Fibromyalgia Pain: GLP-1 Agonists

Lessening Pain with Lidoderm

Reducing Inflammation with Nonsteroidal Anti-Inflammatory Drugs

Fighting Fibromyalgia with Antidepressants

Mulling Medical Marijuana

Other Medicines Prescribed for Fibromyalgia

Opening Your Eyes to Sleep Remedies

Pondering Future Remedies

Chapter 11: Using Hands-On Therapies

Getting Heated: Heat Therapy

Chilling Out! Icing the Pain

Wetting Down Your Fibromyalgia Symptoms

Rubbing Out Pain: Massage Therapy

Electrifying Yourself: Transcutaneous Electrical Nerve Stimulation

Considering Chiropractors

Chapter 12: Considering Alternative Remedies and Treatments

Thinking About Alternative Remedies

Fighting Fibromyalgia with Herbs and Supplements

Pinning Down a Solution: Acupuncture

Saying Yes to Yoga

Taking On Tai Chi

Part 4: Modifying Your Lifestyle: Small Changes, Big Results

Chapter 13: Depressurizing Yourself: Controlling the Stress-Eyed Monster

Knowing When You’re Too Stressed

Chilling Out with Relaxation Therapy

Stress-Busting with Biofeedback

Musing About Mindfulness

Doing Yoga and Praying

Chapter 14: Sweet Dreams! Resolving Sleep Issues

What Is Sleep?

Knowing the Importance of Sleep Stages

Identifying Key Sleep Problems

Analyzing Your Sleep: A Self-Test

Adjusting Your Lifestyle to Sleep Better

Slipping into Slumber Using Medications and Other Remedies

Chapter 15: Exercising, Losing Weight, and Avoiding Problem Foods

Exercising Relieves Fibromyalgia Pain

Exploring Pain-Relieving Exercises

Losing Weight to Decrease Pain and Fatigue

Discovering Dietary Effects: Good Foods/Bad Foods

Chapter 16: Coping with Emotions: Your Own

Dealing with Depression

Understanding Anxiety Disorders

Taking Your Emotional Temperature

Finding a Therapist

Treating Emotional Problems with Medication

Part 5: Managing Fibromyalgia at Work and at Home

Chapter 17: Working with Fibromyalgia — Or Going on Disability

Explaining Fibromyalgia to Your Boss and Co-Workers: Should You?

Deciding Whether You Should Stay at Your Job

Getting Your Insurance Company to Pay for Treatment

Taking the Next Step if FMS Is Disabling

Finding an Attorney to Help You

Chapter 18: Helping Loved Ones with Your Fibromyalgia

Understanding How Fibromyalgia Can Affect Your Relationships

Moving to a Better Frame of Mind

Opening Up for Honest Dialogue

Anticipating Difficulties

Helping Your Significant Other Cope

Explaining Fibromyalgia to Your Kids

Chapter 19: Helping Someone You Care for Who’s Hurting

Understanding Without Feeling Their Pain

Coping with Your Own Emotions

Chapter 20: Parenting a Child or Teen with Fibromyalgia

Looking at Fibromyalgia Symptoms in Children and Teens

Accurately Diagnosing the Problem

Finding Help for Your Child with FMS

Treating a Child with Fibromyalgia

Including Your Children Who Don’t Have Fibromyalgia

Working with Your Child’s Teacher

Dealing with Jeers from Peers

Part 6: The Part of Tens

Chapter 21: Ten Alternative Remedies That Help People with Fibromyalgia

Herbs

Magnesium

Echinacea

Green Tea

Massage Therapy

Aromatherapy

Mud Baths

Acupuncture

Dietary Changes

Transcutaneous Electrical Nerve Stimulation Units

Chapter 22: Ten Mistakes to Avoid with Fibromyalgia

Wishing Your Pain Away

Believing a Doctor Who Says Fibromyalgia Is “All in Your Head”

Trying One Medication or Therapy, and if It Doesn’t Work, Giving Up

Assuming the Problem Is Your Fault

Assuming the Problem Is Everyone Else’s Fault

Turning to Substances

Believing

All

Your Problems Are Caused by Fibromyalgia

Overeating to Try and Feel Better

Feeling You’re a Defective Person Because of Fibromyalgia

Hiding Your Symptoms from Others

Chapter 23: Ten Ways to Beat Brain Fog

Avoiding Brain and Energy Drains When You’re Hurting or Tired

Setting Up a Signal System

Making Lists — Checking Them Twice

Banning Self-Blame

Avoiding Blaming Others

Getting Enough Sleep

Keeping a Calendar of Activities

Watching What You Eat

Putting Things in Their Places

Catching Yourself Slipping Away

Chapter 24: Ten Fibromyalgia Myths

People with FMS Are Lazy or Crazy

People with FMS Just Want Attention

People with FMS Just Want Drugs

Looking Well Means You

Are

Well

Pain Is Pain: It’s All the Same

You Feel Good, So You Must Be Well

Relaxing Will Cure What Ails You

“Take Some Pills and You’ll Be Fine”

“Just Don’t Focus on the Symptoms”

Therapy Always Works

Part 7: Appendixes

Appendix A: Glossary

Appendix B: Fibromyalgia Medications.

Pondering Prescribed Medications

Other Medications That May Help

Reviewing Over-the-Counter Medications

Appendix C: Resources and Support

Organizations

Finding Information on the Internet

Index

About the Author

Connect with Dummies

End User License Agreement

List of Tables

Chapter 4

TABLE 4-1 A Sample Pain and Symptom Diary

TABLE 4-2 Tom’s Pain/Symptom Diary

Chapter 6

TABLE 6-1 Comparing Fibromyalgia with Chronic Fatigue Syndrome

Chapter 7

TABLE 7-1 Comparing Doctors’ Approaches to FMS

Chapter 15

TABLE 15-1 A Sample Walking Program

TABLE 15-2 Body Mass Index Chart

TABLE 15-3 Body Mass Index Levels

Chapter 16

TABLE 16-1 Symptomatic Differences in Generalized Anxiety Disorder, Clinical Dep...

TABLE 16-2 Common Medications for Depression and Anxiety

Chapter 26

TABLE B-1 Anti-Anxiety Medications

TABLE B-2 Antidepressants

TABLE B-3 Anticonvulsive Medications

TABLE B-4 Muscle Relaxants

TABLE B-5 Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

TABLE B-6 Opioids

TABLE B-7 Sleep Medications

TABLE B-8 Other Prescribed Medications for FMS

TABLE B-9 OTC Painkillers

List of Illustrations

Chapter 8

FIGURE 8-1: The 18 tender points of fibromyalgia. One part of the diagnosis is ...

Chapter 15

FIGURE 15-1: Shoulder arm extension. This exercise will help your upper back an...

FIGURE 15-2: Side stretch. Stretching is important in fibromyalgia, and this ex...

FIGURE 15-3: Mini sit-up. This simple exercise will tighten your abdominal musc...

FIGURE 15-4: Knee-to-chest stretch. This stretching exercise is excellent for t...

Guide

Cover

Table of Contents

Title Page

Copyright

Begin Reading

Index

About the Author

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Fibromyalgia For Dummies®, 3rd Edition

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Introduction

Fibromyalgia is a chronic medical problem that can be terribly aggravating and sometimes even maddening for people with it, especially if they aren’t receiving the latest treatments or medications, such as those discussed in this new edition of Fibromyalgia For Dummies. But if you have fibromyalgia, you may find comfort in the fact you’re not alone. Fibromyalgia affects 6 million or more people in the United States and millions more in other countries. You can also find comfort in the fact that many effective options may help you significantly decrease the problems you’re experiencing, problems stemming from fibromyalgia.

Also known as fibromyalgia syndrome (FMS), fibromyalgia’s major symptom is pain in the muscles, tendons, and bones throughout the body. (And for some people, the pain and its location vary from day to day.) FMS pain often occurs without a specific cause or injury. In other cases, it may be linked to an injury (such as from a car crash), may be tied to a traumatic event (such as past physical or sexual abuse), or may be connected to combat experiences (such as in Afghanistan or Iraq).

Yet some people, including some doctors, persist in thinking fibromyalgia is just another word for hypochondria — or maybe even slacker or goof-off. They think people who say they have fibromyalgia symptoms are lazy or crazy — or both. They dismiss FMS as just another “disease of the month.”

They’re wrong. The pain isn’t imaginary, and the problem is no fad. At the University of Florida, I’ve conducted studies that proved subjects diagnosed with fibromyalgia suffer heightened pain sensitivity and a low pain threshold, and their pain lasts longer than people without the syndrome.

It’s true if people with fibromyalgia are depressed, anxious, or stressed, they’ll feel worse. But depression, anxiety, and stress don’t actually cause fibromyalgia. People with FMS will have pain whether they’re upset or not. But their pain often increases when they’re distressed.

What does fibromyalgia feel like? Many people say to truly understand how FMS can be experienced, you need to imagine how you feel when you have the flu. Recall the aching and pain in parts of your body or in your entire body. Then multiply those achy feelings by about ten times. Now imagine feeling that way nearly every day. That is what fibromyalgia feels like for a lot of people. Pretty nasty.

The good news is you can feel much better with both the traditional and alternative medications and treatments, as well as with the lifestyle choices I describe in this book. They work for other people, and they can help you (or someone you know who has FMS), too.

About This Book

Although this is a new edition, my two primary goals in writing this book remain the same:

I want to show that fibromyalgia pain is real — and now there’s more evidence than ever to help me prove that. This goal is important because some doubters are still out there.

I want to discuss the pain and other symptoms of FMS and provide the most current information on medications, alternative remedies, lifestyle changes, and other treatments that work.

You don’t have to read this book from the first page straight on through to the end — although you certainly can if you want to. You may instead want to read Chapter 1 to get a feel and flavor for the rest of the book. Then you can use the table of contents at the front of the book or the index in the back to help you move on to the chapters that interest you the most. I also give you some ideas of where to head in the later section, “Where to Go from Here.”

Also, keep an eye out for the many personal stories I’ve sprinkled throughout the book. These anecdotes come from real people suffering from fibromyalgia.

Also, you may have noticed that two names appear on the front cover, but I use the singular pronoun I in the text. I do so because this book reflects only my views as a medical professional, while Christine Adamec, an experienced medical writer, assisted with the preparation and production of the book. Thus, she’s also credited on the cover.

Foolish Assumptions

In writing this book, I’m making some basic assumptions about you. I’m assuming:

You have fibromyalgia, think that you have it, or have a friend, child, teenager, or other family member with FMS, and you want information in order to be able to help.

You want information on pain relief and remedies.

You’re curious about alternative remedies and treatments and want to know what works and what to avoid — and you need some basic guidelines on how to know the difference.

Icons Used in This Book

To help you remember the important points of each chapter, this book marks certain paragraphs with the following helpful icons:

This icon denotes critical information that you really need to take away with you. Be sure to read it.

When you see this icon, you find a helpful hint for coping with fibromyalgia that may save you time or money. Or maybe both!

The Warning icon cautions you against something that’s potentially harmful. Be sure to read and heed these icons.

When I get a bit technical on you, I use this icon. You can safely skip any paragraphs marked by the Technical Stuff icon — of course, if you read them, you’re sure to discover something interesting.

Beyond the Book

I pack a lot of information into this book, which may be overwhelming. That’s why we have the Cheat Sheet, which provides a quick reference for over-the-counter medications for fibromyalgia, a list of alternative remedies, and even treatments for depression or anxiety. To access this informative Cheat Sheet, go to www.dummies.com and type “Fibromyalgia For Dummies” in the search box.

Where to Go from Here

Fibromyalgia For Dummies, 3rd Edition, is divided into seven convenient parts, starting with what fibromyalgia is, moving to who’s most likely to have it, and zeroing in on many ways to deal with the pain, fatigue, and other common symptoms fibromyalgia sufferers share. If you’re not sure where to start, this list can help guide you to where you need to go:

If you’re new to the world of fibromyalgia, you can take a self-test in

Chapter 1

, get more details on symptoms in

Chapter 2

, and check out possible causes in

Chapter 3

. Then head to

Chapter 4

to get the lowdown on fibromyalgia pain, or check out more information on who gets fibromyalgia in

Chapter 5

.

If you’re curious about medical problems often confused with fibromyalgia, check out

Chapter 6

. Then walk through working with your primary-care doctor, and, if needed, finding a new physician in

Chapters 7

and

8

.

You can find out how to treat fibromyalgia, whether you’re curious about OTC drugs (

Chapter 9

) or prescription drugs (

Chapter 10

), or want to know more about hands-on therapy (

Chapter 11

) or alternative remedies and treatments (

Chapter 12

).

If you want to make some nonmedical lifestyle changes to ease your pain, in

Chapters 13

and

14

, I tell you how you can control stress and provide details on how to get a good night’s sleep. But if you need more info on dietary changes and exercise, go to

Chapter 15

.

If you’re looking for details on dealing with the emotional fallout of FMS, and, if you need a therapist, I offer advice on finding a good one in

Chapter 16

.

In

Chapters 17

and

18

, I discuss how you can help your family, friends, co-workers, and even your boss to help you, but if you want to help a friend or family member who’s hurting,

Chapter 19

is for you. If that person is your child, head to

Chapter 20

.

You can read about ten pieces of advice on remedies related to fibromyalgia in

Chapter 21

and

ten

mistakes to avoid when you have FMS in

Chapter 22

. I also have ten ways to beat brain malaise

(fibro fog)

in

Chapter 23

, and I debunk ten myths about FMS in

Chapter 24

.

I’ve included three appendices, one with a glossary of commonly used terms related to fibromyalgia (Appendix A), one listing important information about over-the-counter (OTC) drugs and prescribed medications useful to many patients with FMS (Appendix B), and one offering an Internet resource guide.

After you’ve read this book and started using my suggestions to begin your journey to less pain and better health, I hope that you’ll experience the considerable improvement that many others have felt. In particular, I hope you maintain your personal commitment to managing your own health. I also hope you’ll be well armored against attacks from people out there who somehow still (and wrongly!) think fibromyalgia is fake. Fibromyalgia is a real medical problem, not something in your head. And it’s also a real medical problem you can successfully or at least better control.

Part 1

The What, When, and Why of Fibromyalgia

IN THIS PART …

Get reassured that fibromyalgia is a real medical problem — no matter what you may have heard from other people (including some doctors!).

Understand exactly what fibromyalgia is and what the major symptoms are.

Discover intriguing theories on why you and others may have developed fibromyalgia.

Dig into the details about pain to gain insight into what’s actually going on with your poor, aching body.

Chapter 1

Fibromyalgia Is Real

IN THIS CHAPTER

Considering symptoms, causes, and the pain aspect

Knowing who gets fibromyalgia and sorting through connected medical problems

Finding a good doctor and exploring medications and remedies

Considering how fibromyalgia affects work and family

Improving sleep, decreasing stress, and dealing with emotional effects

Knowing fibromyalgia syndrome (FMS) is a real medical problem needing to be dealt with is an important first step toward mastering your fibromyalgia symptoms — and moving toward where you can start to feel like you’re making progress. Sure, you can try to ignore the problem. But mostly, it won’t let you.

Fibromyalgia has many aspects to consider. In this chapter, I line up the major issues for you and refer you to chapters later in this book where I discuss how fibromyalgia affects you individually and what treatments and medications may work best for you.

Dumping Your Doubts on Whether FMS Is Real

Many people spend months or years questioning their fibromyalgia symptoms, sometimes wondering if they’re imagining how bad the symptoms are. After all, if you feel terrible one day and then significantly better or almost normal the next day, you may start to think that maybe you were exaggerating the pain and fatigue of the previous day.

The thing is, most people can’t remember pain well. They remember they had pain but can’t remember what it actually felt like. (This is generally a good thing!) As a result, people experiencing the ups and downs of pain and other symptoms accompanying fibromyalgia worry sometimes that perhaps the problem isn’t that big of a deal and could even be all in their heads. Consequently, they may try to ignore the problem and hope it’ll go far, far away — preferably today.

But if you have fibromyalgia (and I recommend you take my self-test later in this chapter to see whether you could be a possible candidate), simply ignoring the problem doesn’t work. The sooner you acknowledge fibromyalgia is a real and long-term problem, the sooner you can work toward and succeed at reclaiming your life.

You can gain enormous control over symptoms stemming from your fibromyalgia, but only rarely can you eradicate them altogether. Most people have plenty of room for improvement, however.

Examining Symptoms, Causes, and Pain of Fibromyalgia

Fibromyalgia isn’t a one-size-fits-all kind of medical problem, but I can make some descriptive generalizations about it regarding symptoms, causes, and pain.

Sizing up the symptoms

Many people with fibromyalgia report the following statements are true about their fibromyalgia symptoms. In fact, most people with fibromyalgia say they have at least several, if not all, of these symptoms (which I cover in much more detail in Chapter 2):

Flu-like pain that can be severe

A constant feeling of extreme fatigue

Several tender body areas that hurt

Overall body aches

Depression and/or anger

Feeling very anxious

Muscle stiffness and pain

Chronic back pain

Insomnia

Worsening of pain after physical activity

Mental malaise and confusion, often referred to as

fibro fog

Many people with FMS have other pain-based medical problems as well, which I cover in more depth in Chapter 2. Some examples of the array of medical conditions people with fibromyalgia may experience, on top of the fibromyalgia they already have (as if FMS isn’t enough), include

Restless legs

Irritable bowel syndrome

Interstitial cystitis (a chronic, painful bladder condition that may feel like a constant bladder infection)

Tension headaches or migraine headaches

Joint hypermobility syndrome (JHS; an often painful form of hereditary joint hyperextension)

Attention-deficit/hyperactivity disorder (ADHD)

Chronic fatigue syndrome

Considering causes

No one knows for sure what causes fibromyalgia, but physicians and other experts have many fascinating theories to explain what may induce the onset of FMS. The cause could be hormones or an autoimmune problem or biochemicals gone awry, chronic stress, or it may be related to a previous trauma, such as an injury you incurred in a car crash or another serious accident. Individuals abused as children or adults are more likely to develop fibromyalgia than others.

The cause could also be a combination of different factors coming together at just the right time (or wrong time, when you think about it) for you to develop FMS. For example, maybe you got the flu and then were in a serious accident. Or some other awful combination occurred.

As researchers (like me) continue to study this medical problem, they move closer to the truth. Speculating about causes can be fascinating, and Chapter 3 offers common theories for what causes fibromyalgia.

Pondering pain

Thinking about pain is certainly no fun, and yet pain is part of what makes us alive and human. But when pain runs rampant in our bodies, extracting particular pain in certain parts of it, it becomes a major problem, and fibromyalgia pain can be very intense. I talk about the purpose of pain and how and why it needs to be managed in Chapter 4. It may sound like a chapter to avoid, but hold on! You need to read it because it includes some important and useful ideas.

And by the way, I’m not just saying I believe the pain and symptoms of fibromyalgia are real because I’m a nice guy who doesn’t want to hurt your delicate feelings. I am here to help you, but even more importantly, I’m a physician who’s a clinical researcher, and I’ve proven in many studies on the pain of people with fibromyalgia that their pain (and yours) is real.

My studies, as well as the studies performed by other researchers, have shown the pain sensations experienced by people with fibromyalgia (especially women) are actually more intense, and the pain lasts longer than does the pain of people who don’t have fibromyalgia. Read Chapter 4 for further information on the ins and outs of fibromyalgia pain.

Considering Who Gets Fibromyalgia

Just about anyone of any age can develop fibromyalgia, but most research indicates the majority of people with FMS are females, partly because women may be more sensitive to pain than men. This is a time where a little equal opportunity of pain would be preferable (if you’re a woman). But who gets fibromyalgia isn’t about fairness.

Although women are the primary sufferers of fibromyalgia, many men have been diagnosed with FMS, too, and some men with fibromyalgia go undiagnosed for years. For more information about some major patterns that have been identified so far among people who develop fibromyalgia, which you may share with these fellow sufferers, be sure to read Chapter 5.

What about children and adolescents? Do they ever have fibromyalgia? Sadly, yes. If your child or teenager has FMS, they may have a difficult time because most physicians, as well as the general public, don’t realize kids can experience chronic pain from FMS. Instead, they think kids are faking it when they say they’re too sick to go to school. Maybe they are, but then again, maybe not. Skip ahead to Chapter 20 for more information.

Looking at Related Medical Problems

Sometimes, people strongly suspect (or are sure) they have fibromyalgia. Instead, however, they may have arthritis, Lyme disease, lupus, thyroid dysfunction, or a variety of other common and not-so-common medical problems. And sometimes people have both fibromyalgia and other serious medical problems. Having fibromyalgia doesn’t exempt you from getting sick with other illnesses (even though it seems like it would be only fair that it should).

With the existing array of possible medical problems and their often-overlapping symptoms, even doctors can become confused sometimes about which is which when they’re working on a diagnosis. A good doctor is up to this task, of course, as long as you don’t expect instant results on your first visit.

For example, suppose one of your primary symptoms is extreme fatigue, possibly to the point of total exhaustion — even though you haven’t been doing anything more strenuous than playing a game on your phone. This action may use one calorie or less, but afterwards, you feel like you’ve climbed Mount Everest. Maybe your problem is fibromyalgia, but maybe not.

Extreme tiredness is a possible symptom of many medical problems, including hypothyroidism, anemia, chronic fatigue syndrome, Lyme disease, arthritis, and — oh, yes — fibromyalgia, too. No wonder sorting it all out can be so hard sometimes! To find out more about illnesses often confused with FMS, and how doctors sort them out, read Chapter 6.

Taking a Self-Test for Fibromyalgia

Only your physician can diagnose you with fibromyalgia and then treat you. Reading this book is a very good idea, but it still doesn’t really cut it when it comes to making an actual diagnosis in your own individual case. What I can give you is a simple self-test to use to help you determine if you may have fibromyalgia syndrome.

Grab a scratch piece of paper and jot down your answers to the following “yes” or “no” questions. Then, read my analysis at the end of the list. If you think that you may be a possible candidate for fibromyalgia, make an appointment with your physician and find out for sure.

Do you have a lot of pain in certain specific areas of your body? If so, do these areas lack any obvious damage (such as bruising or swelling)?

Is your overall body pain sometimes severe?

Do you have trouble sleeping on three or more nights per week?

Do you feel exhausted about half the time or more?

Do people often say you don’t look well?

Do you turn down social invitations rather than going out due to feeling achy and tired?

Do you find yourself wondering whether your aches and pains will

ever

go away or if you’ll feel like this forever?

Are you always losing things and forgetting things? Do you have so much mental confusion you sometimes wonder if it could be an early onset of Alzheimer’s disease?

Are you having trouble finding any real pattern to your pain — because some days it’s bad and some days it’s not?

Have you started to feel “down” about your pain and fatigue? Are you wondering whether depression could be the underlying problem?

If you answered “yes” to three or more of these questions, you may have fibromyalgia, although every person’s case is different. But if you only answered “yes” to one or two of the questions, but still think you may have fibromyalgia, a consultation with your physician is a good idea.

Now, here’s some explanation of what may be happening to you, depending on your answers to Questions 1 through 10. Keep in mind, though, only your doctor can actually diagnose you with fibromyalgia.

Question 1:

If you’re experiencing pain in specific parts of your body, but you’re not seeing bruises or any apparent evidence of tissue damage (and neither is your doctor), these painful areas may be muscle pains characteristic of fibromyalgia. Read

Chapter 8

for more information on tender points.

Question 2:

If you said your pain is sometimes very severe, this is another indicator you may have fibromyalgia. Be sure to consult a physician to find out.

Question 3: If you have trouble sleeping three or more nights per week, this is serious. The problem may or may not be connected with fibromyalgia (although nearly everyone with FMS has sleep problems), but it’s important to resolve your serious sleep deficit. If you’re a walking zombie because you’re not getting enough sleep, you can’t perform well at work or home, nor will you be a happy person.

Also, if you’re prone to developing fibromyalgia, this continuing bad pattern of insufficient nightly sleep will make your other symptoms, such as your pain and fatigue, much worse.

Question 4:

Severe fatigue is a chronic problem among nearly everyone with fibromyalgia. Often, it’s linked to a lack of sleep. But it may itself be an element of FMS as a medical problem. You may also have chronic fatigue syndrome or thyroid disease, and your doctor will need to help you sort it out.

Question 5: If you agree that those you care about, or maybe even strangers around you, are commenting you look sick, something about you probably doesn’t look right. You may be displaying your chronic pain and associated depression on your face without realizing it.

On the other hand, other people may tell individuals with fibromyalgia they look “fine” and “great,” and the pain and symptoms are not reflected in the face or body language of the fibro sufferer. If this has happened to you, you’re definitely not alone.

Question 6:

If you’re turning down invitations you would have accepted in the past, have a serious talk with yourself to find out why. Is it because of pain and fatigue? Or could you be having a problem with depression or anxiety — both very common problems for people with and without fibromyalgia?

Question 7:

When your pain is constant and chronic, asking yourself if it’s ever going to end is only natural. But you need to consult with a physician. You may have fibromyalgia or another problem altogether. Don’t wait for the pain to magically disappear. Take action.

Question 8: If you constantly lose or forget things, you may have the “fibro fog” that often stems from fibromyalgia. You may also have ADHD. Another possibility is you may have neither of these but you’re simply trying to do too many things at once, and you need to take some things off your plate.

How do you know which it is? You make a stab at analyzing what you’re forgetting and when. If you can’t even begin to do that, and you’re also experiencing chronic pain, fatigue, and sleep problems, you may have fibromyalgia. But see your doctor to find out for sure.

Question 9: If your pain is severe some days and then far less of a problem other days and you think there doesn’t seem to be any pattern to it at all, you may be experiencing the chronic ups and downs of fibromyalgia.

Pain that can appear in one part of your body one day and migrate elsewhere on another day is a common symptom of FMS, as are days when you feel really bad and other days when you feel only mildly bad.

Question 10: If you don’t seem to enjoy anything anymore and feel overwhelmed by so many aches and pains, you may have depression. Many people with fibromyalgia have depression and FMS. You could also have a problem with an anxiety disorder, such as generalized anxiety disorder (GAD), where you are overwhelmed with extreme worry.

But before rushing off to the nearest psychiatrist to ask for the latest antidepressant or anti-anxiety medication approved by the Food and Drug Administration (FDA), instead, consider talking to your regular doctor or a pain specialist. Why? Your primary problem may actually be fibromyalgia, and if your medical problem is treated and your symptoms subsequently improve, so may your sad mood. Many doctors prescribe antidepressant medications to treat pain and FMS. Get more details on this in Chapter 10.

This test is just a starting point. If you’re really concerned that you may have FMS and/or another chronic illness, make an appointment with your doctor.

Finding a Knowledgeable FMS Doctor

Although I believe that most well-educated physicians are at least aware of the existence of fibromyalgia and its basic symptoms and also know it’s a valid problem that needs to be treated, I also know there are some doctors out there who still haven’t gotten the word yet. If your doctor isn’t helping you with your FMS symptoms, you need to help them understand it. Taking this book to your appointment and showing them what you’re reading is a good start.

A good doctor will consider your symptoms as valid, take a complete medical history, and perform a physical examination. Read Chapters 7 and 8 for more details.

Sometimes, no matter what you do, a particular physician isn’t working out for you. Maybe the two of you have a personality conflict, or maybe they think you should just tough out your fibromyalgia. Or maybe the problem stems from something else altogether. Whatever it is, sometimes, you just need to find a new doctor. (I’ve devoted a significant part of Chapter 7 to helping you find a new doc, if that’s what you need to do.)

After you find a good doctor interested in working with you, they can formulate a plan for you to follow — one that’s doable in your life. Usually, such a plan involves medications to take (over-the-counter and/or prescribed drugs and, sometimes, supplements or alternative remedies, too), as well as advice on basic lifestyle changes you can make to improve your health. Some of these lifestyle changes may involve foods to eat or avoid (for example, foods high in caffeine may make you feel worse), exercises to perform, and other therapies that may improve your symptoms.

Treating the Problem

When you have fibromyalgia, at least some of the time you may want to take some medications, whether they’re over-the-counter drugs; prescribed medications, such as muscle relaxants or painkillers; or other medications such as prescribed or over-the-counter topical ointments that can help to ease your pain and symptoms. I cover these topics thoroughly in Chapters 9 and 10. You can also often gain benefit from hands-on therapy, including heat, ice, and massage therapy, all covered in Chapter 11.

And don’t forget about the promise of alternative remedies! People with fibromyalgia have some very intriguing choices to consider, including acupuncture, acupressure, biofeedback, and herbal remedies. Read more details about all these different choices in Chapter 12.

Making Lifestyle Changes: Pulling Yourself into a Non-Fibro World

As you work to pull yourself back into the non-fibromyalgia world, you may sometimes feel like a person loaded down with 50 pounds of extra supplies, slogging your way through the swamp. During your struggle you see others on dry land with no heavy packs dart by you, maybe waving and telling you they’ll see you later.

If you want to improve your quality of life and be able to reduce your backpack of troublesome symptoms, consider the following basic ideas:

De-stress yourself.

Stress is a normal part of life, but if you have fibromyalgia on top of the usual daily stresses, or maybe with some extra stress thrown in once in a while, you’re in a bad situation. Stress can greatly worsen the chronic pain, fatigue, and other symptoms of the person with fibromyalgia. Be sure to read

Chapter 13

for my suggestions on relaxation therapy, meditation, and other methods to “destress” yourself. They work!

Improve your sleep to decrease your pain.

Don’t kid yourself. Five or even six hours of sleep every night aren’t enough. So, if insufficient sleep is a problem for you, as it is for many people with fibromyalgia, face it. You may need medication (such as a sleep aid, an antidepressant or anti-anxiety medicine), an alternative remedy (such as valerian or melatonin), or another form of treatment to solve this no- or low-sleep problem you’re going through. Read

Chapter 14

for ideas on resolving sleep problems and helping yourself feel better.

Exercise. Unless you’re an exercise-aholic, you probably don’t like the idea of exercising (most people don’t), and the mere thought of it may be nearly migraine-inducing for some readers. But the fact is, aerobic exercise will usually help you limber up and lose weight, making you more mobile and also helping you feel better. So consider “getting physical.” Read Chapter 15 to find out more about benefits of exercises and some specific, FMS-friendly exercises you can try.

Exercise shouldn’t hurt a lot, nor should it be something to dread. If you hate swimming or bicycling, don’t choose those activities. Maybe walking would suit you better, or possibly dancing or some other form of aerobic exercise with your partner or a friend. Chair yoga, anyone? You can exercise many different ways: Be creative and find the best ways for you.

Pay attention to your emotions.

Stress isn’t the only problem people with fibromyalgia often face. Depression and anxiety are also very common, and may be problems you face. These problems are treatable and, in

Chapter 16

, I talk about how to know if you may have a problem, and how to identify a good therapist to help you, if you need one.

Coping with FMS at Home and Work

Unfortunately, fibromyalgia doesn’t end at 6 p.m. or whenever you arrive home from work, nor does it go away when you wake up in the morning, struggling to get ready for another day. When you have FMS, it’s always there on the sidelines, waiting to jump on you yet again with its aggravating symptoms.

You also need to keep in mind that other people you interact with on a daily basis (your partner, children, friends, co-workers, and other family members) are directly affected by your fibromyalgia, even if they don’t have FMS themselves.

Virtually anyone you interact with on a regular basis needs some understanding of what you need from them, whether you tell them that you have fibromyalgia or not. (Some people with fibromyalgia tell everyone that they have “arthritis” because they think that it sounds better.)

Even as you become more aware of your symptoms and how best to resolve them, you still have to deal with the “non-fibro” world, comprised of your family members who don’t have fibromyalgia, your fellow workers, and many others you interact with. You need to develop workable strategies to cope with these varying situations and come up with a winning game plan for your life. I cover these topics in Chapters 17 and 18.

Be prepared to hear comments that range from uninformed to downright hurtful, and use this book to equip yourself with simple, factual replies. Rather than trying to clap back, keeping responses short, neutral, and factual helps educate others without draining your energy.

Working with fibromyalgia at work

Many people with fibromyalgia continue to work full-time or part-time, despite their pain and fatigue. They struggle with what to do when their symptoms make it hard to continue to work.

Often people worry about whether they should tell others at work about their FMS, whom they should tell, what they should say, and so much more. In Chapter 17, I provide a thorough overview of these issues and how they’ve affected real people.

Handling FMS with family and friends

Even the most loving family members and friends usually don’t really understand fibromyalgia if they don’t have it themselves. And even if they do have FMS, too, their symptoms may be very different from what you experience, and the intensity of their symptoms may be better or worse than the way your symptoms grab hold of you.

The reality is fibromyalgia isn’t a quickie one-time explanation. For people to understand what your problem is, especially the people with whom you share your home and your life, helping them get a clue about what you’re going through and what you need takes a lot of work.

You have to be candid, and you also need to know how to respond to the dumb things people often say to people who have fibromyalgia. Read Chapter 18 for more information on how (and also how not) to explain fibromyalgia to your children of all ages, your partner, and others, so they can better understand what’s really going on here.

Sorting it out if someone else has FMS

Maybe you don’t have fibromyalgia, but live with someone who does, and really want to understand the problem and help as much as possible. But where do you begin? Not to worry, I’ve provided a chapter just for you — Chapter 19.

This chapter describes techniques to assist you in helping your friend or loved one deal with FMS, and it also tells you some things you should not do or say because they drive most people with fibromyalgia wild. (People who do have fibromyalgia may enjoy reading Chapter 19, too, and sharing it with their friends and family members who don’t have FMS.)

Understanding Four Pillars of Therapy

I’ll end this chapter describing a concept important to me and many doctors: the four pillars of therapy. The bulwarks of treating fibromyalgia (and other illnesses) include these key elements:

Patient education:

The more you understand your illness, the more likely you can and

will

follow your physician’s instructions.

Fitness:

Your doctor wants you as physically fit as you can be, given the constraints of your illness. The more you perform at least minimal exercise, the better you will feel over time.

Medications:

Medications are also important, both over-the-counter (OTC) drugs and prescribed medications, and I have several key chapters on these topics.

Psychotherapy, if needed:

Often an illness like fibromyalgia can lead to depressive or anxious symptoms, and you may need to consult a mental health professional. This does

not

mean you are severely mentally ill, but it could mean you may benefit from medications and/or therapy.

Chapter 2

Recognizing Key Fibromyalgia Symptoms

IN THIS CHAPTER

Analyzing the pain and stiffness

Sorting out the fatigue and fibro fog

Dealing with weather changes, sleep problems, and depression

Identifying related medical problems

Whether you have severe, widespread pain that overwhelms other symptoms like fatigue and muscle stiffness, or you’re constantly tired and confused, fibromyalgia symptoms can leave you feeling trapped, unable to accomplish what you want or need to. And to top it off, you may even have additional medical issues commonly associated with fibromyalgia, such as irritable bowel syndrome and chronic headaches.

I get it. It’s a lot to deal with and sort out. So in this chapter, I cover several key symptoms of fibromyalgia, including — first and foremost — the pain and stiffness nearly everyone complains about. I also cover syndromes and diseases often associated with fibromyalgia, for which many treatments are similar or the same as treatments recommended for fibromyalgia. This chapter helps you feel seen and identify what you know you’ve been experiencing all along, even if you’ve struggled to explain or prove it to others.

Describing Where It Hurts: Almost Everywhere!

Most people with fibromyalgia say the widespread pain drives them the most crazy. Sure, they don’t like fatigue or muscle aches, nor do they enjoy fibro fog. These symptoms are common for many people with FMS. But they may seem minor league compared to the hurting-all-over pain, which can sometimes escalate from mild or moderate to severe pain.

Eva has had FMS for years, she and says if you want to understand how FMS feels, imagine a giant truck ran over you — and backed up and ran over you again.

Feeling aches and body pains of your fibromyalgia — But unable to show proof

You probably find it hard to explain to people where you hurt. You can get pretty strange looks when you say you hurt almost everywhere. Not just in your back, legs, neck, or other sites of your body. All those places may hurt, and maybe other places, too. Nor do you have visible damage to point to. No broken bones, no gushing wounds, not one bruise to show someone, “Here is where it hurts me the most. Look at this.”

Laboratory tests can’t diagnose fibromyalgia — at least, not yet. Tests can only tell you don’t have other medical problems known to cause pain. You shouldn’t, therefore, be surprised if doctors can’t find anything except some tender points, where you wince when pressure is applied there. (Read more about the tender points of fibromyalgia in Chapter 8.)

So you have no hard evidence that you can present for your pain. And yet you continue to hurt and hurt and hurt and hurt.

As an FMS sufferer, you’re not alone regarding a lack of specific laboratory findings. People with chronic migraine headaches, tension headaches, and back pain have recurrent pain, and often doctors find no specific abnormalities. In fact, many chronic-pain conditions lack overt physical findings. But remember, you don’t have to prove to anyone — including your doctor — that you hurt. You know you have pain, and that should be good enough for your physician.

Focus on finding a knowledgeable doctor who can diagnose your illness. If you have FMS, you’ll also have classic symptoms, such as chronic widespread pain and tenderness as well as fatigue, insomnia, and distress. A doctor who takes a thorough medical history, performs screening tests for other possible diseases, and does a careful physical examination can diagnose most FMS sufferers. (See Chapter 7 for advice on finding a good fibromyalgia doctor.)

Suffering from early morning muscle stiffness

Many people with fibromyalgia say the severe muscle stiffness and achiness is worst in the morning. You may wake up and feel as though you’ve already participated in a major marathon — or maybe like gremlins beat you all night long. The stiffness may diminish as you move about, but usually doesn’t go away completely. People with arthritis also often experience muscle stiffness, so maybe in the past, doctors told you your problem was arthritis.

You may have both arthritis and fibromyalgia. Unfortunately, having fibromyalgia doesn’t exempt you from other medical problems. If you suffer from chronic stiffness, turn to Chapter 15, which includes some good, easy stretching exercises to help you with this problem.

Singling out a source of your pain: You can’t

When you try to analyze where all this pain is coming from — the master generator of your agony — you most likely can’t figure it out. Nor can you deduce why you’re experiencing it. However, you may have found out stress makes almost all your symptoms worse. Your doctor may often be puzzled by these questions, too. (Read about possible causes of fibromyalgia in Chapter 3.)

Some experts believe extreme exercise or injuries from a car accident or a fall may induce FMS. But you probably haven’t been exercising like crazy because you’ve felt too bad to exercise a lot (or at all). You probably haven’t just fallen or had an accident or injury, either.

Chronically feeling your pain

Fibromyalgia pain is chronic, which means it’s sticking around. Sometimes, it’s better; sometimes, it’s worse. But it’s almost always there in the background, seemingly waiting to ambush you. As with many chronic illnesses, stress often aggravates fibromyalgia, causing pain to flare up at the worst times.

Are you suffering from oligoanalgesia? This word refers to the undertreatment, ineffectual treatment, or total nontreatment of pain — a problem many people with fibromyalgia relate to. Yet both nontreatment and inadequate treatment of pain can seriously weaken your immune system and impair your quality of life. Turn to Chapter 4 for more information on pain and its role in your life.

Migrating pain: The worst pain may move from place to place

Another truly maddening aspect of FMS is the worst pain can be in your lower back today, your neck tomorrow, and maybe in your upper back the next day. Or maybe your whole spinal column is okay now, but you’re having a serious problem with pain from irritable bowel syndrome or chronic headaches — both common conditions for people with fibromyalgia.

Pam says her fibromyalgia feels like a kind of radiating pain that pops up like a poltergeist (a ghost in German folklore) in new places all the time. She never knows when or where it’ll hit her next. It’s the kind of surprise she’d prefer to live without, so Pam is actively seeking treatment.

AS IF OTHER SYMPTOMS WEREN’T ENOUGH …

Some people with FMS suffer from an array of other symptoms beyond pain, fatigue, sleep difficulties, brain fog, and so forth. Here are some annoying, but more unusual, symptoms:

Restless legs: People with this symptom feel an achiness and irritability in their legs (sometimes at night when lying in bed) that makes them move about or shake their legs.Paresthesia: Also known as “pins and needles,” this symptom primarily affects the legs, hands, or feet of fibromyalgia sufferers.Tinnitus: A high-pitched ringing in the ears is a problem that some people with fibromyalgia experience.

Of course, these symptoms may be caused by other medical problems, so if you have them, be sure to let your doctor know.

Fibromyalgia isn’t the only chronic medical syndrome. Many medical problems are chronic. High blood pressure is a chronic problem for many people; diabetes is another. Many people suffer from chronic back pain. You’re not alone in experiencing a chronic disease.

Being Terribly Fatigued

Darla says sometimes she orders her feet to move, but they just don’t go, especially when she gets up in the morning. This extreme fatigue is common among people with fibromyalgia. Yet, despite such profound fatigue, few patients with FMS get a satisfactory night’s sleep. Although the pain is still the worst part for most people with fibromyalgia, the bone-numbing exhaustion is also terribly distressing for many people, who say this kind of fatigue goes far beyond simple tiredness.

Feeling exhausted

If you actually were exercising vigorously, you could understand this extreme pain and exhaustion. But if you’ve been in couch-potato mode, sitting or lying down all day (because it hurts to move), you can feel really frustrated when doing nothing seems to take all the energy you’ve got.