Fibromyalgia, a chronic disorder characterized by widespread musculoskeletal pain and fatigue, affects more than 3 million Americans. It often comes with sleep problems, which then contribute to the already existing symptoms of pain, fatigue and muscle stiffness.
People who have fibromyalgia experience increased tenderness throughout their body, with the neck, lower back, hips, legs, and shoulders being commonly involved. These so called tender points are usually symmetrical-- meaning if you have pain in your right shoulder then you will likely experience pain in your left shoulder as well.
Fibromyalgia is a chronic medical condition. There are no diagnostic tests that have been shown to make a definitive diagnosis. It can be very difficult to treat, but medications, therapy, self care and lifestyle changes can help to manage symptoms and improve quality of life.
Fibromyalgia Causes
Exactly what causes fibromyalgia isn't entirely understood, but we believe it may involve a combination of genetic, environmental and psychological factors.
In addition, certain factors tend to trigger or exacerbate fibromyalgia symptoms which include:
Physical or emotional trauma
Repetitive injuries
Certain medications, foods and other substances may trigger fibromyalgia symptoms in people who are susceptible to the disorder
Stressful or traumatic events
Symptoms tend to be worse during times of increased stress, illness, injury or menstruation.
Conditions that cause pain like rheumatoid arthritis, irritable bowel syndrome (IBS) , chronic fatigue syndrome (CFS), chronic migraines or depression can also lead to a greater risk of developing fibromyalgia or having multiple diagnoses. These are often connected.
At Virios Therapeutics, we believe that when a patient experiences a stressor in life that is significant, either physical stressors or emotional stressors, those stresses can have a negative impact on the patient’s immune system. For patients with underlying risk factors, this immune compromise can in turn allow an already resident herpes virus to reactivate. Herpes viruses, including Herpes simplex 1 and 2, are viruses that tend to be latent in the body, and under weakened immune conditions they can reactivate and cause symptoms.
It is the overall cyclical process of virus reactivation with lytic infection of HSV-1 that may perpetuates the symptoms of fibromyalgia in these patients. Research suggests that fibromyalgia patients who also have a chronic gastrointestinal disorder exhibit activated herpes virus when biopsied.
Because so many factors can trigger symptoms, it can be very difficult for doctors to determine the best course of treatment.
Fibromyalgia often first appears in early adulthood, affecting mostly women. It is thought to be caused by many factors including genetics, environment, and how certain processes of the body work together.
People who have a family history of fibromyalgia, or other medical conditions such as depression, anxiety, and irritable bowel syndrome are thought to have a higher risk of developing the disorder. Symptoms may also be triggered by certain medications or infections. There are some studies and research that indicates fibromyalgia may run in families and those with family history have a higher chance to develop fibromyalgia.
Fibromyalgia Symptoms
Fibromyalgia is classified as a disorder of the central nervous system that causes widespread pain in muscles and joints. Common symptoms of fibromyalgia may include:
Chronic Pain ( > 3 months)
Fatigue, Severe Continued Tiredness, Lack of Energy
Sleep Problems (including insomnia, restless sleep, and waking up frequently)
Depression and Anxiety
Brain related issues such as memory problems and trouble concentrating (sometimes called Fibro Fog)
Chronic Headaches (15+ per month)
Body Tenderness, pain and stiffness
Muscle pain, Twitches or Cramps
Painful Menstrual Periods
Numbness or Tingling in Hands and Feet
One doctor diagnosed himself with fibromyalgia said it this way, "Fibromyalgia is the most painful thing I've ever experienced, that's all I know."
People who have fibromyalgia may experience sleep disturbances including insomnia or frequent waking during the night. This makes it extremely difficult to get enough restorative sleep for improved health and healing of body systems.
Fibromyalgia patients experience a lot of pain, but their pain is all over their body instead of just one location. The pain can be so bad that it makes daily activities difficult.
For example:
Lifting a grocery bag can cause fibromyalgia pain in the back, shoulders, arms
Walking around the house can cause pain in hips, legs, feet
Even something as simple as changing clothes can be hard because it requires movement which causes pain.
Fibromyalgia Diagnosis
Because there is no specific lab test for fibromyalgia, doctors rely on patient history, physical examination and exclusion of other disorders to diagnose fibromyalgia. A health care provider must rule out other conditions before a diagnosis of fibromyalgia is made as there are many conditions such as musculoskeletal and skin diseases that cause pain and tenderness in the body.
To meet the criteria and have your fibromyalgia diagnosed your doctor must determine that you have pain in multiple regions of the body and at multiple locations. The physician will ask about related symptoms such as fatigue and sleep disruption. The combination of the number of painful areas on the body (the widespread pain index) and the severity of the associated symptoms (symptom severity) allows a determination of whether you meet the criteria for fibromyalgia.
Your doctor will ask you to describe your pain and its characteristics. He or she may also use one or more of the following exams:
Symptoms checklist
Neurological exam
Other diagnostic tests as needed, depending on other possible conditions.
Fibromyalgia Treatment
Treatment of fibromyalgia is limited currently as there are few options available for people with fibromyalgia. The more severe the pain, the more likely it is that your doctor will prescribe medications to manage pain and sleep problems. You may also be referred to another health care provider for relaxation techniques or physical therapy to treat fibromyalgia.
Fibromyalgia treatment is often effective at relieving many of the symptoms of the disorder, but complete relief of all symptoms is unlikely. Most therapies focus on helping a person cope with the disorder and its symptoms rather than curing it completely.
The goal of fibromyalgia treatment is to help you manage your condition and improve your quality of life. Although there is no cure for fibromyalgia, proper treatment can make living with the disorder much easier and help you overcome many daily challenges.
Modern therapies have been focused on treating the symptoms of fibromyalgia (eg, pain), but these treatments do not address the underlying cause of the disease. While any progress is welcomed, there is still significant room for improvement in expanding fibromyalgia treatment options.
Virios is committed to improving the treatment standards for the millions of fibromyalgia patients across the globe and hopes to one day bring to market an antiviral treatment approach that targets a root cause of fibromyalgia.
This article was written and medically reviewed for accuracy by Virios Therapeutics Chief Medical Officer R. Michael Gendreau, M.D., Ph.D.
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