What is fibromyalgia?
Fibromyalgia is a syndrome comprising a group of symptoms marked by generalised pain and muscle stiffness which can be felt in all different areas of the body. It does not cause inflammation or damage to the painful areas, but may be due to an overactive pain system. It is more common in females than males and is estimated to affect 2% of the population.
The exact cause of fibromyalgia is not known. It is more common in people who have inflammatory arthritis(e.g. rheumatoid arthritis), pain pursuant to injury or trauma, and those with emotional distress or depression. It may also follow on from a viral illness although no specific viruses have been identified as specifically being a trigger.
In most people there is no precipitating factor or reason for it to start. Some research points to the body being extra sensitive in how it signals pain in people who have fibromyalgia.
There are numerous symptoms which people with fibromyalgia may experience. Not everyone will have all of them. The commonest symptom is widespread pain in the muscles. Others include, fatigue and impaired sleep, stiffness, problems with memory and concentration, irritable bowel symptoms, sensitivity to heat and cold, nausea, dizziness, and anxiety symptoms. Severity can vary from mild to severe. This is both in different people and in the same person at different times.
Diagnosis and complications
Fibromyalgia can be difficult to diagnose and is a diagnosis of exclusion where other causes of the symptoms have been ruled out. There are no blood tests, x-rays or scans that can diagnose fibromyalgia. Aside tenderness in the muscles there may be no abnormal findings on physical examination.
The American College of Rheumatology has established three criteria for diagnosis.
- Pain and symptoms in the previous week out of 19 identified body parts together with fatigue, poor sleep or cognitive problems
- Symptoms have been present for at least three months
- That no other condition is the cause of the symptoms
Fibromyalgia does not lead to any other medical condition so, whilst it causes many symptoms and can impact quality of life,there are no direct medical complications from it.
There is no specific cure or treatment for fibromyalgia. The focus is on lifestyle management and medications to alleviate symptoms. Eating a health diet and doing regular exercise are important. Managing stress via relaxation or meditation can be helpful as is optimising sleep as best you can. Some people find acupuncture or massage helpful. Counselling may assist with psychological symptoms. Medication for sleep and pain or psychological symptoms may have a role. Anti-inflammatory medications are not generally used.
Treatment with medicinal cannabis
Medicinal cannabis has been shown to assist with symptoms of fibromyalgia. It is not a cure or treatment for the condition itself. Cannabidiol (CBD) can help with pain, sleep, and anxiety. Tetrahydrocannabinol (THC) can help with sleep and pain. It can be prescribed by a doctor when other treatments have failed or have caused unacceptable side effects. Studies suggest that formulations with both THC and CBD may be the most useful. However, pure CBD may also be beneficial.