Do you seem to be tired all the time, even after you’ve had a full night’s sleep? Do you feel stiff every morning? Do you ache all over? Do you get frequent headaches?

These symptoms could be the result of stress. However, if you experience these feelings over a long period of time, it could indicate that you have a condition called fibromyalgia.

Because the symptoms are so common, many people go undiagnosed for years with this increasingly prevalent chronic pain disorder. Next to osteoarthritis, fibromyalgia is the most common rheumatic disease. It affects approximately 2% of the population and it is estimated that up to 20% of patients that see a rheumatologist (a doctor specializing in arthritis) are suffering from fibromyalgia.

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This condition is sometimes referred to as fibrositis or fibromyositis. It usually affects women between the ages of 20 and 50. It’s a syndrome that causes chronic, sometimes debilitating muscle pain. The pain usually occurs where muscles attach to bone and is similar to the pain of arthritis. The good news is that the joints themselves are not affected. The joints do not deteriorate or become deformed as they do in some types of arthritis.

Pain is the most prominent symptom. It usually occurs in the neck, shoulders and back. People with fibromyalgia describe the pain in many ways. Some people report a stiff, aching feeling. Others describe a burning, stabbing, gnawing or radiating pain.

Pain isn’t the only symptom. (See the symptom chart on the next page.) Many people also experience generalized stiffness. Remaining in one position for extended periods of time, for example sitting for a long car ride, can increase the stiffness. For this reason, it seems to be worse first thing in the morning.

Fatigue is another almost universal symptom. About 90% of sufferers report moderate to severe fatigue. They feel a lack of energy, less endurance with exercise, or the kind of exhaustion associated with the flu or lack of sleep. This can interfere with concentration. Even simple mental tasks can seem extremely difficult.

Other common symptoms include swelling, tender points, headaches, insomnia, depression and neurological problems like numbness and tingling in the limbs.

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Fibromyalgia is very difficult to diagnose because the symptoms mimic those of stress and other diseases. To add to the problem, there is no definitive laboratory test that can be done to confirm that you have the condition.

Because the diagnosis is made primarily on the basis of the reported symptoms, people with fibromyalgia are often led to believe that it’s all in their heads and that nothing is wrong.

It’s a mystery

Nobody seems to know what causes fibromyalgia. Originally it was thought to be some type of arthritis, but no signs of arthritis or inflammation have been found. A number of theories have been developed to explain these mysterious symptoms.

Some researchers hypothesize that muscles undergo microtrauma during everyday activities but are repaired during restorative sleep. People with fibromyalgia seem to have a particular sleep disturbance so that the restorative sleep stage does not occur properly. Others believe that the nervous system causes problems with normal circulation and as a result there is a deficiency of oxygen reaching the body tissues. This lack of oxygen, hypoxia as it is often called, has been linked to tenderness, fatigue and post-exercise soreness.

There is also some evidence that the symptoms may be the result of a deficiency of certain growth hormones or hormones produced by the adrenal glands. Other theories about the cause of fibromyalgia involve some unidentified virus and physical or emotional trauma, such as a car accident or physical or emotional abuse. The one thing that most experts do agree on is that it is not psychological. Fibromyalgia is a real disease with a definite, although undiscovered, physical cause.


Treatment of fibromyalgia requires a comprehensive approach. Physicians typically prescribe low doses of antidepressant medications to improve sleep, elevate mood and relax muscles. For whatever reason, anti-inflammatory medications like aspirin, Advil, Voltaren, and Naprosyn don’t seem to work very well. About 75% of all fibromyalgia sufferers seek some form of alternative healthcare and massage is a popular choice.

Massage can be an extremely useful tool for helping you get relief from symptoms. One study conducted by the Touch Research Institute at the University of Miami found that 30-minute massages two times per week had a long-term effect on symptoms. In addition to being more relaxed, the subjects of the study had less pain and stiffness, reduced depression and fatigue and more comfortable sleep.

Because of the widespread tenderness, your massage therapist will likely need to adjust the pressure to make the massage comfortable. A typical one-hour session may sometimes seem too intense therefore the massage time may need to be shortened. Although the techniques used may vary, the massage treatment will largely focus on relaxation and stress reduction.

The relief provided by massage may last anywhere from a few hours to many weeks. You’ll need to determine with your therapist how frequently you’ll need to come in to maintain a significant level of relief. A once weekly treatment that is typically used for relaxation massage may be helpful. However, it may be more beneficial to have a massage several times a week, gradually reducing the number of sessions, making sure that you return before the effect of the last treatment has subsided.

You may also find some relief with the application of heat. Hot baths or showers, a hot water bottle or a heating pad may all be helpful in managing the symptoms. During a treatment, the therapist may put some type of heat pack on the areas that are most tender.

Research has also shown that moderate aerobic exercises like walking and swimming can help alleviate painful symptoms. Start off slowly. Monitor your response to exercise before increasing the duration and intensity. Ask your therapist for suggestions.