Fibromyalgia Know-How

Fibromyalgia is a systemic disorder affecting 2-6% of the adult population. The most common complaint is “hurting all over”, yet there is no obvious origins for this pain.

Fibromyalgia is considered a chronic pain syndrome, with widespread pain and tenderness in muscles and soft tissue. It is not a disease or psychological disorder. The good news? This painful disorder will not permanently damage affected joints and muscles. The bad news? The mechanisms for these symptoms are not well understood. Studies suggest there may be an over-sensitivity in the nerve cells; or an imbalance of chemicals in the brain; or an inability of the brain or spinal cord to ease pain signals; or, perhaps it can be caused by severe depression or anxiety.

Fibromyalgia sufferers frequently experience fatigue interfering with activities of daily living; ultra-sensitivity of the skin with “pins-and-needles” reaction to touch; and sleep problems, such as getting to sleep or staying asleep in addition to unexplained pain all over. Less common are complaints of headaches, constipation or diarrhea, morning stiffness, memory and concentration difficulties and numbness and tingling in hands.

Symptoms can be triggered by overexertion, lack of exercise, stress, anxiety, depression, poor quality of sleep, trauma, extremes in temperature or humidity, infectious diseases such as lymes disease and possibly rheumatic diseases, such as rheumatoid arthritis.


Pain syndromes of unknown origin lasting more than three months characterized by muscular ache, plus abnormal tenderness of eighteen different points on the body is a string indication of fibromyalgia.

Tender Points

There are 9 pairs of tender points, one on each side of the body – 18 in all.
1-2. Just behind the ear, where the neck muscles attach to the base of the skull, right along the ridge.
3-4. Half way between the base of the neck and the tip of the shoulder.
5-6. Just below #2, where the back muscles attach to the shoulder blade.
7-8. Just above and out to the sides of the buttocks.
9-10. Outer, upper leg behind the bony part of hip.
11-12. Front of the neck above the collar bone
13-14. Just right and left of the breastbone, 2 inches below the collar bone.
15-16. Just below and outside of each elbow crease.
17-18. On the inside of the knee.


Treatment protocols focus on management of symptoms, such as pain, fatigue and depression. Occasionally, your physician may prescribe medications to assist in sleep, severe pain or severe depression, but the number one way to combat fibromyalgia? Exercise!

A regular exercise routine can help combat fatigue and muscular aches while strengthening can decrease risks of injuries from deconditioning.

Keys to a successful exercise routine:
1. Stretching. Start out and end each session with stretching. Stretching decreases the chance of injury by lengthening the muscles for optimal use.

2. Start out slowly. Over exertion can cause a flare up, so go at a slower pace, gradually working your way up to a more vigorous routine. When flare-ups occur, slow down activities, but stick with it. Often inactivity causes muscle soreness.

3. Low impact aerobics. Things like walking and swimming are excellent ways to shape up without unnecessary strain on your body.

4. Strengthening. Strengthening your muscles will decrease the possibility of injuries. Exercises as simple as leg lifting and bicep curls without weights are good places to start. Avoid overtaxing muscles with weights in the beginning.

Other treatment suggestions:

Physical Therapy. PT can provide pain relieving modalities and stretching/strengthening education to increase overall function.

Cognitive Behavior Therapy. CBT is a form of counseling which focuses on modifying certain thoughts and behaviors to control symptoms.

Massage Therapy. Massage can reduce stress levels and provide a decrease in pain symptoms by increasing circulation and relaxing muscle tightness. It also may provide a desensitization of the skin.

Where there is no cure for fibromyalgia, there is hope. By learning to manage your symptoms and your daily activities, you still can enjoy an active, healthy life!

For more information, check out the National Fibromyalgia Research Association at and
the Fibromyalgia Network at

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