What Is Fibromyalgia?
Fibromyalgia is a long-term (chronic) condition characterized by widespread pain and chronic fatigue – the source of which is subjective, and cannot be determined by tests. Because the source of the chronic pain cannot be pinpointed, diagnosis and treatment are also fairly subjective.
Physicians don’t currently have a clear understanding of fibromyalgia’s root causes, and therefore treat the condition based on several working theories. One theory is that fibromyalgia pain is a type of neuropathic (nerve) pain.
“Fibromyalgia affects between 1% and 5% of the world’s population.”
- Chronic, Widespread Pain (Particularly in “Tender Points”)
- Chronic Fatigue, Lack of Energy and Constant Feeling of Being Tired
- Sleep Problems (Insomnia, Hypersomnia, Inability to Fall or Stay Asleep)
- Concentration Problems and Cognitive Impairment (Sometimes Referred to as “Fibro Fog”)
- Anxiety, Depression and/or Panic Attacks
- Stiffness in Joints and Muscles (Particularly in the Morning)
- Numbness in Hands, Feet and Extremities (Tingling, Sharp Pain and “Pins and Needle” Pain)
- Headaches and Migraines
- Irritable Bowel Syndrome
- Problems with Urination
- Increase in Menstrual Pain and Cramps
- Manic or Rapidly Changing Moods
What Is Neuropathic Pain and Neuropathy?
Neuropathic pain emanates from the central nervous system itself, due to damage or dysfunctional nerve tissues.
In non-neuropathic pain, the nerve cells and tissues are working properly, and report damage or injury to surrounding muscles and tissues to the brain as pain signals.
With neuropathic pain, the injury or damage affects the nerve tissues themselves, or there is no damage at all, yet still the nerve tissue reports pain signals to the brain.
What Causes Fibromyalgia?
Without being able to pinpoint the causes and mechanisms of neuropathy and fibromyalgia pain, it is difficult to say that any one or multiple factors can cause fibromyalgia. However, physicians have pinpointed seven factors that can increase your risk and/or predisposition for fibromyalgia. Those factors include:
Genetic Predisposition to Fibromyalgia and Neuropathy
Children of fibromyalgia and neuropathy sufferers are more likely to develop symptoms themselves – suggesting that genes and genetics commonly play a role in the development of fibromyalgia.
Particularly, genetic polymorphisms (variations) in the systems regulating serotonin, dopamine, and in the catecholaminergic system are suggested risk factors, according to a study* on “Genetic Susceptibility to Fibromyalgia.”
*Park D-J, Kang J-H, Yim Y-R, et al. Exploring Genetic Susceptibility to Fibromyalgia. Chonnam Medical Journal. 2015;51(2):58-65. doi:10.4068/cmj.2015.51.2.58.
Comorbidities and Illnesses Can Increase Your Risk of Fibromyalgia
Those suffering from fibromyalgia often have one more more co-occurring conditions affecting their health – both physical and mental health conditions. Neuropathic pain is more common in those that have had traumatic physical injuries, or who have lived through traumatic events.
Diseases that are commonly seen in fibromyalgia sufferers include:
- Irritable Bowel Syndrome (IBS)
- Chronic Fatigue Syndrome
- Chronic Headache/Migraines
- Tension Headache and Stress-Related Headaches
- Depression, Anxiety and Panic Disorders
- Rheumatoid Arthritis
- Restless Leg Syndrome
According to a Mayo Clinic study**, the following comorbidity rates were seen in fibromyalgia sufferers:
- Chronic Joint Pain and Degenerative Arthritis was present in 88.7% of fibromyalgia sufferers.
- Migraines and chronic headaches were present in 62.4% of fibromyalgia sufferers.
- Hyperlipidemia (High Cholesterol) was present in 51.3% of fibromyalgia sufferers.
- Obesity was present in 48% of fibromyalgia sufferers.
- Hypertension was present in 43.2% of fibromyalgia sufferers.
- Type 2 Diabetes was present in 17.9% of fibromyalgia sufferers.
- Irritable Bowel Syndrome (IBS) was present in 32.5% of fibromyalgia sufferers.
- Plantar Fasciitis was present in 24.8% of fibromyalgia sufferers.
- Temporomandibular Joint Disorders (TMJ & TMD) were present in 17.4% of fibromyalgia sufferers.
- Chronic Pelvic Pain issues were reported by 15.3% of fibromyalgia sufferers.
- Depression was present in 75.1% of fibromyalgia sufferers.
- Anxiety was present in 56.5% of fibromyalgia sufferers.
- Insomnia was present in 50.6% of fibromyalgia sufferers.
- Restless Leg Syndrome was present in 20.3% of fibromyalgia sufferers.
“50.5% of fibromyalgia sufferers also met the criteria for a metabolic syndrome – like diabetes.”
**Vincent A, Whipple MO, McAllister SJ, et al. A cross-sectional assessment of the prevalence of multiple chronic conditions and medication use in a sample of community-dwelling adults with fibromyalgia in Olmsted County, Minnesota. BMJ. Open 2015;5:e006681. doi: 10.1136/bmjopen-2014-006681
Emotional and Physical Abuse Leading to Fibromyalgia and Neuropathic Pain
A connection between emotional, physical and sexual abuse and fibromyalgia has long been suspected, but a 2011 study on “Emotional, physical, and sexual abuse in fibromyalgia syndrome: a systematic review with meta-analysis” found significant associations between abuse and the incidence of fibromyalgia.
Scientists theorize that past trauma – physical, mental or emotional – can actually change the way the way the brain utilizes pain signals. Some studies suggest that the body and brain create false pain signals in reaction to stressors such as disease, mental health conditions and feelings/emotions that are causing stress.
Post-Traumatic Stress Disorder (PTSD) and Fibromyalgia
Numerous studies in recent years link PTSD to fibromyalgia and chronic neuropathic pain. These studies found that not only could fibromyalgia pain be directly related to the presence of a trauma-related disorder, but also that fibromyalgia symptoms were much more severe in individuals who showed more severe symptoms of PTSD.
One study dealt specifically with the topic of “Fibromyalgia in Men Suffering From PTSD,” concluding that while there was a strong association between PTSD and the tender points for neuropathic pain, sufficient exercise could decrease the pain.
Lack of Exercise and Fibromyalgia
Lack of exercise is also directly related to increased neuropathic pain. Studies have shown that fibromyalgia sufferers are more likely to not exercise regularly. Also, fibromyalgia sufferers who don’t get enough exercise report more painful symptoms.
Fibromyalgia Is Most Commonly Diagnosed in Women
An astounding 91 percent of fibromyalgia diagnoses are of women. Physicians agree that women are more likely to suffer from neuropathic pain and fibromyalgia. However, they also agree that fibromyalgia in men is widely underdiagnosed.
Doctors worry that this underdiagnosis of men with fibromyalgia is indicative of misdiagnosis, meaning many men with the symptoms of fibromyalgia may have incorrect diagnoses. Studies show that neuropathic pain in men is much less severe than in women; this means that women feel the pain more intensely than men do.
If this is true, it could mean that men diagnosed with depression, anxiety, PTSD and other mental and physical disorders could be living with undiagnosed fibromyalgia.
Untreated Anxiety and Depression Can Lead to Fibromyalgia
One of the biggest concerns among mental health experts and substance abuse counselors is the theory that untreated anxiety and depression can lead to the development of fibromyalgia.
Fibromyalgia and neuropathy rates are much higher in populations that have at least one mental health condition. Medical professionals warn that if patients don’t receive adequate treatment for these mental health conditions, the resulting stress and effects will transcend from mental symptoms to physical symptoms – in the form of neuropathic pain.
Under this theory, if an individual does not adequately treat and deal with his or her mental health issues, the brain begins to scream for help by igniting pain signals all throughout the body. Essentially, this is the brain giving them a “zap” to try to get some relief from the symptoms of the comorbidities. This may involve underlying physical illnesses and mental health issues such as depression, anxiety or trauma.
“It is hypothesized that individuals suffering from fibromyalgia are getting the pain signals from the nervous system, but – without any visible injury or obvious reason for the pain – don’t understand how to prevent or stop the pain signals.
“Without a valid way to stop the pain, most individuals are forced to self-medicate in an attempt to numb the symptoms and chronic pain.”
Alcohol and Fibromyalgia: Why Do Fibromyalgia Sufferers Abuse Alcohol?
Self-medication is extremely common in fibromyalgia sufferers. This is understandable when you consider that standard medical care practitioners still really don’t know what causes fibromyalgia, or how to even adequately diagnose the condition with 100 percent certainty. All fibromyalgia sufferers know is that the pain is immense, relentless and that they want to feel better.
Alcohol has the ability to numb pain, a property that has been known for thousands of years. However, alcohol is not a considered a suitable long-term method for dealing with pain. It is simply too addictive, and the drawbacks of persistent use greatly outweigh any perceived benefits.
Doctors know all too well the cycle of self-medication and addiction that alcohol brings. But for everyday pain sufferers, alcohol may feel like a cure for their pain – in the beginning. Alcohol doesn’t cure anything, unfortunately, and does an even worse job at managing pain in the long term. In the end, individuals who try to self-medicate underlying physical and mental health conditions with alcohol end up becoming dependent on the chemical.
Fibromyalgia Medications Carry the Risk of Addiction
Prescription medications for dealing with fibromyalgia and neuropathic pain can offer much needed relief to sufferers. However, without a known way to “cure” or reverse the symptoms of fibro, the only option is to preserve quality of life through medication.
Medications for fibromyalgia aim to treat the various symptoms that fibro causes, including pain, cramping, anxiety, depression, insomnia and concentration/cognitive problems. These medications would inherently need to be used long term – since the symptoms will likely not go away.
Long-term use of any medication carries the risk of dependency, abuse addiction, and possibly overdose. The medications that treat fibromyalgia symptoms are infamously addictive.
Common prescription medications for fibromyalgia:
- Sleep Aids – 33.3% of fibro patients
- SSRIs (Antidepressants) – 28.7% of patients
- Opioids – 22.4% of patients
- SNRIs (Antidepressants) – 21% of patients
- Alpha-2-Delta Ligands (Seizure and Pain Meds) – 19.4% of patients
- Benzodiazepines (Sedatives) – 18.5% of patients
- Tramadol (Opioid) – 15.7% of patients
Opioid painkillers are one of the riskiest types of medication that doctors commonly prescribe for the long-term management of fibromyalgia-related pain symptoms. Opioid painkillers for the management of chronic pain disorders carry a very large risk: the risk of addiction. The recent opioid epidemic has taught us the dangers of these drugs.
Benzodiazepines can treat anxiety and insomnia issues related to fibromyalgia. Though benzos were once thought to be non-addictive, widespread benzodiazepine prescribing since the 1960s has shown that not only are these drugs addictive, but also that benzodiazepine withdrawal symptoms can be as deadly and dangerous as alcohol withdrawal and delirium tremens (DTs).
Mixing alcohol with fibromyalgia medications is another grave concern, though a popular practice. Estimates show that up to 15 percent of fibromyalgia sufferers mix alcohol with their medications.
How Do You Treat Drug and Alcohol Addiction in Fibromyalgia Sufferers?
Fibromyalgia sufferers already have a lot stacked up against them. Doctors aren’t sure what causes fibromyalgia, nor how it causes the symptoms that it does. Up until recently, doctors weren’t even sure if fibromyalgia was a real condition, or if those claiming neuropathic pain were being truthful.
There are currently no medical tests that can say for sure you 100 percent have fibromyalgia. And, even if you do get diagnosed as likely suffering from fibromyalgia, the only treatment is addictive medications that could bring on more symptoms and underlying issues.
What happens when, on top of all of this, you feel like the medications you are taking are starting to cause more problems, and the benefits you once received from them are waning? How can you get off the medications and/or alcohol and still adequately manage your pain? Is it possible to live pain free without fibromyalgia medications?
Though you should make lifestyle changes, you can still control fibro symptoms and pain with lower-dose medications for pain management, and through holistic treatment therapies.
”Living with fibromyalgia is all about managing how healthy and well you feel throughout your mind and body.”
By making some small changes to your health and lifestyle, you can see reduced symptoms and decreased neuropathic pain. An unhealthy body and mind invites worsening symptoms of fibromyalgia. Through diet, exercise, management of mental health conditions, and pain-management techniques, you can achieve greater control of your fibro.
While Western medicine has not yet found a cure for fibromyalgia, we do know how to bring fibromyalgia under greater control. And, with this control, you can find a greater quality of life – one that is free from self-medicating with drugs and alcohol.