Fibromyalgia is a common health problem that leads to long-lasting (chronic) pain. More than 500,000 Canadians have fibromyalgia. This is about 2% of the population in Canada. There may be even more people living with fibromyalgia since some have it but don’t have a diagnosis of the disease.

Fibromyalgia is much more common in women, but men can also have it. Eighty to 90% of people with fibromyalgia are women. Fibromyalgia affects all age groups.

What are the symptoms of fibromyalgia?

Fibromyalgia is a medical syndrome, which means you can have many symptoms at the same time. Symptoms of fibromyalgia include:

• pain all over the body
• feeling very tired (fatigue), including when you wake up
• trouble sleeping (insomnia)
• having trouble concentrating
• trouble passing stool (constipation) or having loose stool (diarrhea)

Not everyone with fibromyalgia has the same symptoms or is affected the same way. Fibromyalgia doesn’t damage organs and is never life threatening. But it can lessen your quality of life if it’s not managed well.

It’s important to know that you can more than one health problem at a time. This means you can have fibromyalgia and another health problem like osteoarthritis, lupus, or rheumatoid arthritis at the same time.

What causes fibromyalgia?

Some research shows that fibromyalgia may be caused by a mix-up of signals in the nervous system. It’s not clear how or why this happens, but when it does, you feel pain more easily.

How is fibromyalgia diagnosed?

Your healthcare provider makes a diagnosis of fibromyalgia by gathering information about you and doing tests. This includes:

• getting your medical history
• asking you about your symptoms and how long you’ve had them
• doing a physical exam

Pain and other fibromyalgia symptoms need to last at least 3 months and at the same level before your healthcare provider will make a diagnosis of fibromyalgia.

The diagnosis of fibromyalgia includes checking for other health conditions, like chronic fatigue syndrome, myofascial pain syndrome, polymyalgia rheumatica, and multiple sclerosis. Some of these conditions have the same symptoms as fibromyalgia.

How is fibromyalgia managed?

There is no cure for fibromyalgia but there are ways to manage it. This includes managing the worse symptoms with medicines and healthy lifestyle habits.

Medicines
The following medicines are approved by Health Canada to manage fibromyalgia. Talk to your doctor or pharmacist if you want more information about medicines.

Duloxetine
Duloxetine (Cymbalta) is an antidepressant medicine that is sometimes used to manage fibromyalgia. If your healthcare provider prescribes it for you, it doesn’t mean you’re depressed. Duloxetine can help give you more energy.

Common side effects of duloxetine includes:

• feeling sick to your stomach (nausea)
• bloating
• headaches

These side effects usually don’t last long. Talk to your healthcare provider to see if duloxetine is right for you.

Find out more about duloxetine.

Pregabalin
Pregabalin may be used to manage fibromyalgia. It can help lessen pain and improve sleep. Common side effects of pregabalin includes:

• feeling dizzy
• feeling very tired
• holding onto extra fluid
• weight gain

Your healthcare provider will start you on a low dose of this medicine at night and slowly raise the dose. Once your body gets used to the medicine, you might take it 1 or 2 times each day.

This medicine doesn’t start to work right away. When you’re taking a low dose, you likely won’t feel any different.

Talk to your healthcare provider to let them know if you think the medicine isn’t working or if you have any side effects. They can adjust the dose to find the right one that works best for you.

Find out more about pregabalin.

Exercise and activity
Exercise can help manage fibromyalgia. Slowly add exercise and activity into your day.

You may notice that you feel very tired after exercising, so it’s important to pace yourself. Take time to write down the activities you’re able to do for 2 weeks before you start adding exercise. You can then use that as a guide to slowly add more activity to your day.

Start by walking short distances, even for just 10 minutes. Then you can build up to walking for longer amounts of time. It’s also important to do chores around the house slowly and one at a time, rather than all at once.

Doing too much activity too quickly can cause more pain and make you feel even more tired.

Find out more about getting and staying active.

Diet
Having a balanced diet and a healthy weight is important for your overall health and quality of life.

Find out more about healthy eating.

Complementary and alternative medicine
Many people with fibromyalgia are interested in complementary and alternative medicine (also called CAM). Some types of CAM that might help manage fibromyalgia are:

• tai chi
• yoga
• acupuncture
• hydrotherapy (uses water to treat health conditions)
• massage
• meditation and mindfulness practices
• magnesium citrate

Research shows that magnesium citrate can help lessen pain from fibromyalgia and let you sleep better. If you have irritable bowel syndrome along with fibromyalgia, it can cause loose bowel movements (diarrhea). If you're thinking about trying a CAM or taking a supplement, like magnesium citrate, talk to your healthcare provider.

It’s important to know that not all CAMs are covered by healthcare or private insurance benefits.

Find out more about complementary medicine.

Living with Pain

Living with constant pain can affect your mood. If you have fibromyalgia, it’s a good idea to think about seeing a psychologist who specializes in pain. They can help you learn ways to cope with sudden pain flare-ups and how it affects your relationships and goals. This may include:

• deep breathing and relaxation exercises
• marriage counselling
• goal setting

A psychologist can help you manage your pain whether you’re depressed or not. Making lifestyle changes and taking medicine can help you feel better. But you may still have some bad days.

Knowing ways to cope with your pain and feelings can help you manage better on bad days. Having good support and a plan to manage your pain will make it easier for you to keep working and add quality to your life.