Fibromyalgia is a complex, chronic, and disabling disorder. It causes widespread pain and stiffness in the muscles, tendons, and ligaments, along with poor sleep and fatigue.

The exact cause is unknown.

The following conditions are commonly associated with fibromyalgia:

• Depression and anxiety
• Muscle pain
• Chronic headache, such as tension headaches (frequently beginning with neck discomfort)
• Numbness and tingling
• Sensation of swollen hands and edema (swelling usually in the feet, ankles, and legs)
• Nocturnal myoclonus (moving legs involuntarily during sleep)
• Irritable bowel syndrome
• Complex regional pain syndrome
• Substance abuse
• Premenstrual syndrome
• Female urethral syndrome (irritable bladder)
• Raynaud's disease

A risk factor is something that increases your chance of getting fibromyalgia. Risk factors include:

• Sex: female
• Age: 20-60 years old
• Physical or mental stress
• Physical trauma (eg, accident, injury, or severe illness)

Common symptoms include:

• Generalized fatigue or tiredness
• Reduced physical endurance
• Generalized aches and pains of muscles, tendons, and ligaments
• Muscle tightening or spasms
• Pain in specific areas of the body, especially:
  • Neck
  • Shoulders
  • Chest
  • Back (upper and lower)
  • Hips and thighs
• Insomnia or poor sleep
• Sensations of numbness or swelling (although swelling is not actually present)
• Chronic headaches, including migraines
• Morning stiffness, worst on first arising

Factors that may trigger or worsen symptoms include:

• Weather changes, especially cold, damp weather
• Stress or anxiety
• Overexertion
• Medical illness
• Surgery

The doctor will ask about your symptoms and medical history, and perform a thorough physical exam. There are no specific tests for this condition.

The doctor will look for the following signs:

• Widespread pain lasting three months or longer
• Tenderness (on physical exam) in at least 11 of 18 specific areas of the body

The goal of treatment is to relieve or control the symptoms. Treatments include:

• Physical therapy (gradual aerobic exercise and stretching regimen)
• Heated pool treatments—Aquatic training in warm water (eg, strength, aerobic, and relaxation exercises) may help improve symptoms.
• Application of heat to painful areas
• Alternative treatments, such as massage , acupuncture , relaxation training , trigger point therapy, biofeedback
• Cognitive behavioral therapy

• Eating a healthful diet
• Learning to cope with physical and mental stress
• Doing regular, moderate, low-impact exercise with your doctor's approval
  • Try gentle exercise that does not strain painful areas, such as:
    • Walking
    • Biking
    • Swimming, preferably in warmer water
• Doing regular stretching exercises
• Maintaining a regular sleep schedule

These medications may help to improve symptoms:

• Weak opioids (eg, tramadol , paracetamol)
• Antidepressants (eg, amitriptyline , fluoxetine , duloxetine , milnacipran, moclobemide , pirlindole)
• Pain relievers (eg, tropisetron, pramipexole , pregabalin )
• Sodium oxybate (eg, Xyrem), a central nervous system depressant