What is Fibromyalgia

Fibromyalgia affects approximately 10.6 million people in the U.S. and 220 million worldwide.

Fibromyalgia (FM) is a complex, chronic pain disorder affecting people physically, emotionally, and socially. It's a syndrome (set of symptoms) characterized by widespread muscle pain, and increased tenderness in specific areas of the body (see illustration). These painful areas called "tender points" are very tender when pressure is applied.

Other symptoms often include chronic fatigue, sleep disturbances, difficulty concentrating or finding words, depression, anxiety, and many more.

Researchers believe fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals. They also believe that people with fibromyalgia have more cells that carry pain signals than normal. This means your pain volume is always turned up, like music blasting on a radio. The result is that minor bumps and bruises hurt more and longer than they should. And you may feel pain from things that shouldn't hurt at all.


How is Fibromyalgia diagnosed?

Fibromyalgia has been fraught with ambiguity in diagnosis. The criteria for diagnosis were updated in 2010 to allow for a more practical approach to the 1990 American College of Rheumatology diagnosis. Instead of diagnosing the disorder based on the history and location of the pain, the current guidelines instruct physicians to evaluate three key criteria:

  1. How widespread the pain is and how you experience symptoms
  2. Whether the symptoms have persisted at this level for at least three months
  3. Whether there are no other explanations for the symptoms

The new diagnostic criteria keep the requirement that other causes must be ruled out and that symptoms have to have persisted for at least 3 months. They also include two new methods of assessment, the widespread pain index (WPI) and the symptom severity (SS) scale score. The WPI lists 19 areas of the body where you've had pain in the last week. You get one point for each area, so the score will be 0-19.

For the SS scale score, the patient ranks specific symptoms on a scale of 0-3. These symptoms include:

  • Fatigue
  • Waking unrefreshed
  • Cognitive symptoms
  • Somatic (physical) symptoms in general (such as headache, weakness, bowel problems, nausea, dizziness, numbness/tingling, and hair loss).

The numbers assigned to each are added up, for a total of 0-12.


Instead of looking for a hard score on each, there's some flexibility built in, which recognizes that fibromyalgia affects everyone differently, and that symptoms can fluctuate from day to day in the same person.


For a diagnosis you need either:

  1. WPI of at least 7 and SS scale score of at least 5,
  2. WPI of 3-6 and SS scale score of at least 9.

This allows for people with fewer painful areas but more severe symptoms to be properly diagnosed.


What Causes Fibromyalgia?

Conventional medicine has yet to uncover any specific cause of fibromyalgia. Functional medicine, on the other hand, looks for the root causes of fibromyalgia, treating problems at the root level to restore patients to health.

Possible causes or triggers may include:

  • Gluten intolerance
  • Candida overgrowth
  • Thyroid disorders
  • Vitamin deficiencies
  • Small Intestine Bacterial Overgrowth (SIBO) and Leaky gut
  • Mycotoxins
  • Mercury toxicity
  • Adrenal fatigue
  • MTHFR mutations
  • Glutathione deficiency


Other Illnesses Often Associated with FM

Fibromyalgia is often associated with other illnesses, such as Chronic Fatigue Syndrome/ME, Post Traumatic Stress Disorder, and Multiple Chemical Sensitivities. Other may include:

  • Carpel tunnel syndrome
  • Diabetes or hypoglycemia
  • Gulf War syndrome
  • Heavy metal toxicity
  • Food allergies
  • Hypothyroidism or Hyperthyroidism
  • Irritable bladder or Irritable bowel syndrome
  • Lyme disease
  • Menstrual cramps and PMS
  • Mouth lesions/Canker sores
  • Multiple Sclerosis
  • Myofascial Pain Syndrome
  • Osteoarthritis or rheumatoid arthritis
  • Raynaud's phenomenon
  • Seasonal affective disorder
  • Systemic lupus
  • Temperomandibular jaw pain (TMJ)
  • Yeast, parasites and/or bowel infections


Who is at Risk for Fibromyalgia?

Although symptoms are more likely to appear between 25-50 years of age, fibromyalgia is seen in all age groups from young children to the elderly. It affects more women than men. Approximately a third of the people who contact the FCI are men.

Join FCI and get monthly newsletters, access to our private Facebook group, plus other updates and research news via email.




NOTE: This information is for educational purposes only and should not be interpreted as a substitute for appropriate medical advice or treatment. FCI offers support as an adjunct to, not a substitute for, professional health care. Any attempt to diagnose or treat illness should come under the direction of a healthcare professional.