For years, fibromyalgia and its diagnosis remained misunderstood, overlooked. Many health professionals denied its existence and patients — particularly women — continued to suffer.
In recent times, greater awareness of this disabling condition has been reached. However, it still takes, on average, 2.3 years from first presentation and 3.7 physicians to get diagnosed.
In this article we aim to help you understand if you might have this condition. And if so, what treatment options are available to ease your struggle and potentially, hopefully, welcome remission.
First, let’s look at how pervasive fibromyalgia is.
In the United States, estimates suggest that between 2% to 8% of the population is affected; that’s around 5–10 million adults. If you have this condition, you are sadly in good company. If you are female, your risk jumps exponentially.
Is Fibromyalgia a Woman's Disease?
The whispers suggest that fibromyalgia in women is more common. But is this true? Is fibromyalgia a woman’s disease?
The noncommittal answer is, yes and no. This condition certainly can effect men. Saying that, the research suggests that up to 90% of sufferers are indeed women.
To make matters worse, women are more likely to experience:
- fatigue, including morning fatigue
- more widespread pain
- a great number of tender points
- a higher number of total symptoms, and
- irritable bowel syndrome (IBS)
But as the article, The role of gender in fibromyalgia syndrome, noted, the severity of pain, the impact on physical function, and levels of anxiety, depression, and stress don’t vary between the sexes.
This raises an important question. Why are fibromyalgia symptoms in females more numerous, or more to the point, why are women at greater risk of this potentially incapacitating condition?
That’s a question we don’t fully know the answer to yet. But there are important clues. Fibromyalgia is a complex condition — which may be why it takes so long to diagnose — and there are a range of postulated causative factors.
These include:
1. Central sensitization — a state where the central nervous system becomes overly sensitive — can trigger fibro-related pain. This process changes the way sensations are experienced in both the musculoskeletal system and the body’s organs. Non-painful stimuli, for example, mild to moderate pressure, are felt as painful. Just like the painful tender points in fibromyalgia.
2. Dysautonomia — a state where the autonomic nervous system (ANS), the subconscious part of the nervous system that looks after involuntary processes like breathing, heart rate, and digestion — goes, for the want of a better term, haywire. (“dys” means bad, difficult; autonomia refers to the ANS).
This could explain why pain occurs without any stimuli; why tender points twang, why digestion hurts, why heads ache. It also explains the other typical symptoms of fibromyalgia like anxiousness, tiredness, and non-restorative sleep.
3. Trauma — It’s here we wish to insert a trigger warning. There are significant correlations between trauma and sexual abuse in fibromyalgia. But, as far as a definitive cause for the link, doctors and scientists are stumped. The research that follows provides insight, but should not be taken as hard fact.
Certain regions of the brain are involved in the genesis of fibromyalgia. As Professor Efrati from the Sackler School of Medicine said, “We… now know that fibromyalgia takes root in the part of the brain responsible for pain interpretation.”
But, pain is not a simple process. All kinds of inputs are required before we experience pain: actual or potential tissue damage, up or down regulation of the nervous system, the focus of attention, environmental cues, emotional state. The list goes on. The crux is that physical and psychological pain aren’t separated in the brain; there is overlap. The same parts of the brain are active in both scenarios.
So, it’s not overly surprising that Efrati’s research noted that grave psychological distress, for example, the type triggered by sexual abuse, can cause long-term brain injury and subsequent related issues. He believes that unrelenting physical and psychological wounds could account for a number of persistent, long-term conditions, including fibromyalgia.
Other research has shown that patients diagnosed with fibromyalgia were significantly more likely to also have a psychiatric diagnosis including
- anxiety
- bipolar disorder
- depression
- post-traumatic stress disorder (PTSD)
- or borderline personality disorder.
Each of these conditions are more common in women, and each can be a consequence of trauma. This matches as the evidence counsels that women experience trauma-related symptoms more often than men, with greater re-experiencing of an event, greater anxiety, and a greater level of dysphoric arousal (a profound state of unease).
Regions in the brain physically change following trauma in a way that appears to promote the risk of fibromyalgia, especially in women.
Note: Make no mistake, fibromyalgia is a very real, physical condition. As with all pain conditions, there are psychological components. Mind and matter merge, always. If anyone ever says, “It’s all in your head,” walk away. The speaker is ill informed.
4. The great unknown — There are a myriad of other possible causative or exacerbating reasons why fibromyalgia in women is more common. Genetics, hormonal and immune differences, gender discrimination, and yet to be determined triggers included.
Fibromyalgia in Young Females
We often think of severe pain as coming on with age. But fibromyalgia in young females is not uncommon. In fact, the prevalence is the same as the general estimate. Research suggests that 2.4% of young women suffer from fibro, too.
This condition can even begin in childhood. Called juvenile-onset fibromyalgia, it often extends from early life into adulthood.
Fibromyalgia Symptoms in Females
The symptoms of fibromyalgia can appear vague. On top of this, many health professionals aren’t in possession of the latest (or even past) diagnostic criteria. So, it’s important to know the signs and symptoms so you can advocate for yourself, understand your condition, and find relief.
The review article, Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment, provides some helpful guidance.
They note:
- There are three chief symptoms: fatigue, pain, and sleep disturbance
- The pain is usually diffuse (widespread), multifocal (located in more than one spot), deep, burning, or gnawing (IBS)
- The pain ebbs and flows, can migrate from one site to another, and occurs on both sides of the body
- That sufferers often report an irritable bowel, cognitive problems (like “fibro fog”), and headache
Then there are the well-known painful spots…
Fibromyalgia Tender Points in Females
There are 18 tender points in total; made up of nine pairs. They are located at:
- Lower front neck
- Upper center breasts
- The arms near the outer part of the elbows (thumb side)
- Inner knees
- Upper neck at the base of the skull
- Near the top of the shoulders
- Over the shoulder blades
- Upper outer buttocks
- Over the hip bones
To determine whether a sore spot fits the diagnosis of a tender point, 4 kg of pressure should be applied. That’s akin to pushing down with your thumb until the thumbnail begins to blanch.
Fibromyalgia tender points occur in female and male patients. And they hurt. They feel painful, not merely irritating or slightly tender.
Which raises the query; why do these points hurt?
That’s the burning question!
There are a number of theories. It seems that tender points may be a combination of:
- Hypersensitivity (nerves that are too excited)
- Lowered inhibition (nervous system dampeners fail to send the message that, “Hey, this is okay, it doesn’t hurt”).
- Faulty protective mechanisms in the brain.
In short, watch this space.
Female Fibromyalgia Treatment Options
The good news is that there is hope; there are evidence-based treatments available. Fibromyalgia symptoms in females and males can be calmed. Relief is possible.
Positive lifestyle choices like low-impact aerobic exercise and resistance training, mind-body approaches like Tai Chi and mindfulness meditation, acupuncture, massage therapy, and stress reduction have all proven to offer respite. The last option is particularly important: stress reduction.
The links between stress and chronic pain — including fibromyalgia — are well known. If you suffer from fibromyalgia you’ve likely already experienced this. Mental strain and physical pain are often inseparable. But even on your bad days, when the idea of a walk or (gently) hitting the gym are unfathomable, you can work on calming your mind and nervous system.
Research has shown that the brain can be rewired to increase the creation of happy chemicals like anandamide, dopamine, oxytocin, and serotonin. The process of neural rewiring — known as neuroplasticity — reorganizes synaptic connections, functions, and the literal physical structure of the brain.
This may provide relief, even possible remission, from pain, anxiety, depression, trauma, and fibromyalgia directly.
How can you rewire your brain?
There are a range of ways to build a better brain…
Methods include hyperbaric oxygen therapy and transcranial direct current stimulation (brain stimulation), but these require specialized equipment and come at considerable cost.
Approaches such as learning, exercise, and mindfulness and meditation.
At XRHealth, we combine the knowledge and expertise of a licensed therapist with cutting-edge virtual reality (VR) technology to retrain your brain. This can be very effective for chronic pain treatment.
We incorporate:
- VR technology
- Video calls and in-app messaging with a dedicated XRHealth therapist
- A personalized care plan, which is consistently updated based on your progress
We’ve helped many patients achieve respite from chronic pain, including fibromyalgia. To find out if you are a good candidate for VR therapy or to get started, book an introductory call now.
The Fibromyalgia Takeaway
Fibromyalgia in women, particularly, is a complex and potentially disabling condition that is often overlooked and poorly managed, learning to burdened lives and unrelenting pain.
But, with the right steps — including aerobic exercise, resistance training, mindfulness, meditation, mind-body approaches, stress reduction, and evidence-based treatments like VR therapy — relief is possible.
You can once again enjoy a life filled with ease!
