Fibromyalgia and Chronic Pain

Millions of people in the United States suffer from pain lasting for more than 6 months. The pain can range from mild, debilitating, episodic to continuous, and completely disrupt a person’s life. When people experience chronic pain, pain signals remain active in the nervous system for weeks, months, or even years. All this pain can take a dramatic toll on one’s health and well-being.

What causes chronic pain?

Chronic pain can be triggered by many factors such as nerve damage, chronic inflammation in the blood, poorly healed prior injuries, or wear-and-tear of bones, joints, and tissues from the natural aging process.

One of the most common forms of chronic pain is back, neck, or shoulder pain. It can stem from many different conditions including:

  • Years of poor posture and sedentary lifestyle

  • Inflammatory diet

  • Improper lifting and carrying of heavy objects

  • Being overweight (i.e., every 5 extra pounds places 20 additional pounds on the spine and joints)

  • Scoliosis

  • Traumatic injuries

  • Wearing high heels

What are the symptoms of chronic pain?

Chronic pain symptoms can vary from person to person. Some of the most common symptoms of chronic pain are:

  • Mild to severe persistent pain

  • Shooting, burning, aching, sore, stiff, or sharp pain in the affected area

  • Fatigue

  • Sleeplessness

  • Limited mobility

  • Mood shifts like depression, hopelessness, and fear

  • Weakened immune system

  • Disability


Chronic Fatigue Syndrome and Fibromyalgia

Chronic fatigue syndrome (CFS) and fibromyalgia cause extreme chronic pain and fatigue. Yet, the symptoms of these conditions are so indistinguishable that there is ongoing debate in the medical community whether they are just different manifestations of the same disorder. The prevailing opinion maintains that the two conditions are distinct disorders.

Fibromyalgia is the more common of the two conditions. Estimates from the Center for Disease Control and Prevention claim that about 4 million Americans suffer from fibromyalgia, compared to 863,000 to 2.5 million sufferers of chronic fatigue syndrome. 

Accurately differentiating the condition creates some measure of diagnostic ambiguity. In fact, the Arthritis Foundation, after evaluating diagnostic criteria in detail, suggests that anywhere from half to three quarters of fibromyalgia sufferers would also meet the criteria for chronic fatigue syndrome. 


How Do Fibromyalgia and Chronic Fatigue Syndrome Differ?

Part of the confusion in accurately diagnosing chronic fatigue syndrome and fibromyalgia stems from the way each condition is evaluated. Fibromyalgia tends to be studied by rheumatologists and arthritis experts, while chronic fatigue syndrome is more frequently diagnosed and treated by immunologists and virologists. Fibromyalgia is often considered a muscular disorder, while chronic fatigue syndrome is usually treated as a complication from a viral infection.

For example, if the same symptoms are shown to a neurologist and a virologist, one will see symptoms of a stroke and the other an infection. This may be a result of hyperspecialization. As such, the diagnostic criteria for chronic fatigue syndrome and fibromyalgia are more nuanced providing greater objectivity.

Fibromyalgia is characterized by wide-spread musculoskeletal pain, especially localized into 18 distinct tender points, and often accompanied by extreme fatigue, sleep disturbances, memory impairment, and mood disturbances such as depression and anxiety. 60% of these tender points must be identified as painful or tender to meet the diagnosis. While fatigue is a component of fibromyalgia, it tends to be secondary to the pain.

In contrast, chronic fatigue syndrome may include general aches and pains, but fatigue is the primary complaint. Chronic fatigue syndrome may cause fever, swollen glands, among other signs of an inflammatory or immune response, while fibromyalgia does not. 

In the United States, fibromyalgia is the most common cause of generalized musculoskeletal pain in women between 20 and 55 years. Despite ongoing research on fibromyalgia, the cause, diagnosis, and optimal treatment is still not clear. However, researchers believe that fibromyalgia sensitizes the way the brain processes pain signals, causing one to feel elevated levels of pain than normal. Other theories also suggest genetic causations, high levels of systemic inflammation combined with intra-cellular nutritional deficiencies.

Fibromyalgia is usually triggered after a stressful or traumatic event, such as an infection, injury, accident, an emotional trauma, or previous history of chronic pain. Its symptoms include:

  • Widespread pain

  • Fatigue

  • Cognitive difficulties

  • Migraines and headaches

  • Irritable bowel syndrome

  • TMJ (temporal mandibular junction pain)

  • Interstitial cystitis/painful bladder syndrome

What are the Commonalities Between Chronic Fatigue Syndrome and Fibromyalgia?

Both chronic fatigue syndrome and fibromyalgia are diagnosed at a higher rate among women than men, and are often detected in middle-age. Both conditions are characterized by pain and fatigue, often resulting in debilitation.

Insomnia and sleep disturbances, including an inability to achieve deep, restorative sleep, are also symptoms of these disorders. 

Even though there are no treatments or reliable cures for chronic fatigue syndrome and fibromyalgia, managing symptoms and supporting the body’s other systems may improve   the quality of life.

How Do the Treatments for Chronic Fatigue Syndrome and Fibromyalgia Work Synergistically? 

The treatments for chronic fatigue syndrome and fibromyalgia are not necessarily comparable. Fibromyalgia patients often respond well to increased exercise, while the symptoms of chronic fatigue syndrome can be exacerbated by increased activity.

Lifestyle habits, such as drinking and smoking, may affect both conditions by increasing the discomfort of fibromyalgia and seriously inhibiting quality sleep. Limited consumption of inflammatory foods, those high in sodium or refined sugar, processed foods, and meats, may also lessen symptoms. For more information about inflammation and diet, read our post on implementing a healthy diet. For example, consuming caffeine causes dehydration, lose of critical water-soluble vitamins, and sleep disturbances. Each of these effects alone can quickly lead to fatigue, physical pain, and mental disturbance. 

Fibromyalgia and chronic fatigue syndrome, both associated with pain and fatigue, are chronic conditions requiring ongoing treatment and management. Although these treatments differ, lifestyle alterations such as improving sleep quality, anti-inflammatory diets, and personalized movement/exercises are helpful in managing both.

Reducing stress through mindfulness practices, yoga, meditation, and psychological counseling can dramatically ease the symptoms of both fibromyalgia and chronic fatigue syndrome. For example, being still with one’s thoughts and focusing on one’s breath can regulate dopamine and serotonin levels leading to healthy sleep, decreased pain, and spike in energy.  Massage eases soreness and improves blood circulation. 

GUARANTEED RESULTS 

If you are suffering from fibromyalgia or chronic pain, work with the nation’s leading expert on integrative functional medicine. By caring for the whole person, rather than a series of isolated organ systems, Dr. Bhandari understands the root causes of diseases and provides personalized treatment plans which drive quick and effective results.