Fibromyalgia overview and Definition

        It includes pain occurring in the muscle, soft tissue and skeletal tissues. It is characterized  with sharp pain, deep steady pain. The fibromyalgia is caused by the injuries, infection other health diseases.


: It affects 2-4% of the population. Women are more prone for fibromyalgia when compared to men


the  pathogenesis of fibromyalgia is recognized as the malfunctioning of the central nervous system characterized by central sensitization which is a high levelof pain perception accompanied by ineffective pain inhibition or modulation. This increased response to the peripheral stimuli causes hyperalgesia, allodynia and referred pain across multiple spinal segments resulting in chronic pain that spread very rapidly and decreased tolerance to sensory input of the musculoskeletal system.

Fibromyalgia might result in dysregulation of neurologic, immunologic, endocrinologic and enteric organ systems.

Autonomic nervous system:

The autonomic system is responsible for regulating the sympathetic such as fight or flight response and parasympathetic such as rest and digest responses. The patient with fibromyalgia show lesser threshold for pain in autonomic nervous system when compared to the parasympathetic system. Continuous overactivation of the sympathetic activation results in increased heart rate, excessive gastric secretions and contractions, abnormalities of the smooth muscle contraction throughout digestive tract, rapid and shallow respiration and vasoconstriction.  Prolong inhibition of the parasympathetic nervous system alters the neuroimmunoedocrine systems, directly growth hormone secretion by the pituitary gland. This can result in non restorative sleep, pain, fatigue and congnitive or mood symptoms.

Immune system:

The immune response to infection, inflammation and trauma is a release of cytokines for local healing which trigger the CNS to release glial cells within the brain and spinal cord for healing support and pain response. With fibromyalgia this autoimmune response is high causing an excess of glial cells in the body which creates an exaggerated state of pain.


Clinical signs & symptoms

muscle stiffness

joint stiffness

depression and anxiety

sleep problems

problems with the thinking, memory and concentration

headaches including migraines

Other symptoms may include:

Tingling or numbness in hands and feet

Pain in the face or jaw, including disorders of the jaw known as temporomandibular joint syndrome (also known as TMJ)

Digestive problems such as abdominal pain, bloating, constipation an also irritable bowel syndrome

Numbness and tingling in the hands and feet

Sensitivity to bright lights or loud noises


muscle cramps


feeling of weigtedness in the hands 

soreness and inflammmations

the associated symptoms include rheumatoid arthritis and systemic lupus erythematosus.


Differential Diagnosis

  • Blood tests:

They can show if your body has an infection or another condition not related to cancer that can cause muscle aches.

  • Computed tomography (CT or CAT) scan:

Makes a 3-dimensional image of the inside of the body.

  • Magnetic resonance imaging (MRI):

 Uses magnetic fields to create detailed images of the body.

  • Bone scan:

Sometimes it is hard to distinguish between bone pain and muscle pain. If the doctor suspects bone-related issues, a bone scan may be done.


Fibromyalgia may now be diagnosed in adults when all of the following criteria are met:

  • Widespread pain index (WPI) ≥7 and symptom severity scale (SSS) score ≥5 OR WPI 4–6 and SSS score ≥9.
  • Generalized pain, defined as pain in at least 4 of 5 regions, is present.
  • Symptoms have been present at a similar level for at least 3 months.
  • A diagnosis of fibromyalgia is valid irrespective of other diagnoses. A diagnosis of fibromyalgia does not exclude the presence of other clinically important illnesses.


Practising exercises

avoid stress and depression

Doing stretching execises before starting vigorous exercises

Warm up during exercise

Avoid lifting heavy objects

Always be hydrated

Have healthy food diet.