Fibromyalgia typically involves chronic widespread pain that has occurred for at least a period of several months. Many times, it becomes a diagnosis of exclusion when blood tests, imaging and electromyogram (EMG) tests do not show a traditional pain generator. It can be very limiting and negatively impact daily life by causing both pain and fatigue.
There is typically no direct causative event that precipitates this condition. Fibromyalgia can be linked to genetics, a sensitization of central/peripheral nerves and/or environmental factors. Symptoms can be exacerbated by physical and psychological stressors and sleep disturbances. It is important to identify these underlying agents in order to select appropriate treatments.
It can also be associated with and exacerbated by anxiety, depression, cognitive dysfunction, difficulty with sleep, headaches and irritable bowel diseas.
Typically, opioid medications do not provide long-term benefit.