10 Myths — and the Facts — About Fibromyalgia

There’s still a lot that isn’t known about fibromyalgia, which may be why myths about the condition persist.

Fibromyalgia is a chronic condition that causes pain throughout the body, as well as fatigue. Research suggests that fibromyalgia happens when the body's central and peripheral nervous systems don't process pain properly.

While it's often grouped with rheumatic diseases, it's not considered to be a disease of inflammation, or a joint or muscle disorder. And it's also not an autoimmune disorder, in which the body's immune system mistakenly attacks healthy tissues.

Everyone who has fibromyalgia experiences it differently, which is one reason why misunderstandings and myths often surround this condition. Even healthcare professionals may be misinformed about it.

Knowing the facts about fibromyalgia — and being able to separate them from myths — is essential to making the best choices to control the condition.

"The more informed and active the patient is, the better off they are in conditions like this," says Don L. Goldenberg, MD, a rheumatologist and professor emeritus of medicine at Tufts University School of Medicine in Boston. "They really need to get solid medical information."

In that spirit, here are 10 widely held misconceptions about fibromyalgia, as well as what we know to be true.

Myth 1: It Isn't a Real Disorder

Fact: Fibromyalgia was officially recognized as a disease by the World Health Organization in 1994.

And for people who experience the pain and other symptoms associated with fibromyalgia, the disorder is all too real, says Dr. Goldenberg.

The condition causes "chronic, widespread muscle pain," he notes. "By the time people see doctors, it's usually many months or years" since symptoms began.

But many doctors, Goldenberg laments, still don't understand the condition.

"Most doctors think that if your elbow hurts, or your knee hurts, or your shoulder hurts, the pathology is directly in those areas," he says. "In fibromyalgia, that doesn't work. The pain is actually coming from the brain."

This misunderstanding of the origins of the pain, says Goldenberg, is "one of the reasons it's very controversial, and was for a long time kind of pooh-poohed as, 'it's all in your head.'"

Myth 2: Fibromyalgia Is a 'Catchall' Diagnosis

Fact: Fibromyalgia has specific diagnostic criteria, developed and updated by the American College of Rheumatology (ACR).

Many people are under the impression that fibromyalgia is a "catchall" or "fallback" diagnosis because there isn't any single test or obvious symptom used to diagnose it.

"There's very little to see on a physical exam," Goldenberg says. "Laboratory tests to look for causes of pain are unremarkable."

According to the ACR, fibromyalgia is diagnosed based on the following factors:

Multiple painful areas of the body (on both sides, above and below the waist)
Additional symptoms, like fatigue, poor sleep, and difficulty thinking or concentrating
Symptoms that last for at least three months
No other apparent cause of these symptoms

Myth 3: Fibromyalgia Only Affects Women

Fact: Between 75 and 90 percent of people diagnosed with the disorder are women, according to the National Fibromyalgia Association (NFA).

Fibromyalgia affects an estimated 10 million adults in the United States, the NFA says, which means that between 1 million and 2.5 million men in the United States have been diagnosed with fibromyalgia.

But Goldenberg says that the actual incidence among men may be even higher, since gender-based bias may play a role in how doctors diagnose fibromyalgia.

Fibromyalgia can also occur in children and teens.

Myth 4: Fibromyalgia and Arthritis Are the Same Condition

Fact: Fibromyalgia and arthritis have little in common, other than sensations of pain and fatigue.

Unlike arthritis, fibromyalgia "doesn't primarily affect joints. It affects muscles and soft tissue," says Goldenberg.

And unlike arthritis and other rheumatic (arthritis-like) disorders, fibromyalgia isn't a disease characterized by inflammation. In fact, markers of inflammation tend to be normal.

Instead of the pain coming from an inflamed area of the body, in fibromyalgia, "The pain is actually coming from the brain, from the central nervous system," says Goldenberg.

Myth 5: A Special Fibromyalgia Diet Is Needed

Fact: There's no specific diet recommended for people with fibromyalgia, but certain foods can worsen symptoms while others may improve them.

Researchers have found that dietary fiber from fruits, whole grains, vegetables, and other plant products may ease fibromyalgia symptoms by altering the gut microbiota and that supplementing with probiotics may improve cognitive function. Evidence also suggests that an anti-inflammatory and gluten-free diet may have beneficial effects.

Focus on following a healthy, balanced diet that includes whole grains, lean protein sources, low-fat dairy products, fruits and vegetables, and plenty of water.

It's also a good idea to limit your consumption of caffeine, refined sugars, fried foods, red meat, processed foods, and alcohol.

Myth 6: Complementary Treatments Are Pointless

Fact: Meditative movement therapies — such as tai chi, yoga, and qigong — appear to improve fibromyalgia symptoms, according to research.

Acupuncture has also been found to reduce pain and improve quality of life.

And connective tissue massage was found to help with pain, fatigue, and sleep disruption in women with fibromyalgia.

Myth 7: You Should Avoid Exercise

Fact: Exercise is the single most effective treatment for fibromyalgia, according to the American College of Rheumatology.

Aerobic exercise, in particular, has been shown to be helpful in reducing fibromyalgia symptoms.

This includes activities like walking, biking, swimming, and water aerobics.

Goldenberg believes that stretching and strength training are also helpful for many people. Strength training can mean using weights, exercise machines, exercise bands, or your own body weight for resistance.

While exercise may be painful or difficult at first if you have fibromyalgia, regular physical activity can help improve your symptoms and make exercising easier.

Myth 8: You're Just Tired

Fact: Fatigue in fibromyalgia goes far beyond just being tired. As Goldenberg notes, the condition causes "a tremendous amount of fatigue. People are very exhausted."

While fatigue is a common symptom of fibromyalgia, research has found that it doesn't occur in isolation.

Instead, fatigue in fibromyalgia is interwoven with other symptoms — including pain, sleep disruption, and mood disturbances — and all of these symptoms can influence one another.

Myth 9: You Can Take a Pill to Make Fibromyalgia Symptoms Disappear

Fact: Drug treatments don't work very well for many people with fibromyalgia.

"The truth is, we don't have very good medications," says Goldenberg. "They work well in maybe one out of three or four patients."

While you may see some benefit from taking a drug approved to treat fibromyalgia, your symptoms will probably just diminish, not disappear.

You'll probably also still need to incorporate lifestyle measures, like exercise, stress reduction, good sleep habits, and possibly cognitive behavioral therapy (CBT), into your treatment plan.

Myth 10: There's Nothing You Can Do

Fact: While there's no cure for fibromyalgia — and medication doesn't work for everyone — there's still a wide range of options available for treatment.

"Nonpharmacological approaches actually work as well, or maybe even better," than drugs for many people with fibromyalgia, Goldenberg notes.

If your current treatment isn't giving you the relief you need, work with your doctor to try something new, whether it's exercise, prescription drugs, over-the-counter (OTC) pain relievers, or alternative treatments, like massage or meditative movement.

The Takeaway

Misconceptions about fibromyalgia persist, despite specific diagnostic criteria and the fact that it affects approximately 10 million adults in the United States.
Talk with your healthcare providers to explore both medical and lifestyle interventions, as medication alone might not fully relieve symptoms.
While there is no cure for fibromyalgia, treatments such as aerobic exercise, stretching, strength training, and complementary therapies like tai chi and acupuncture can help manage symptoms.
Diet plays a supportive role in managing fibromyalgia. A balanced diet rich in whole grains, lean proteins, fruits, and vegetables, and with few refined sugars or processed foods, may alleviate symptoms for some.

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