Fibromyalgia pain in hands

Fibromyalgia: The Misunderstood Disease

After more than a year, she was finally diagnosed with fibromyalgia, a chronic and debilitating condition that causes severe pain throughout the body. Ongoing research at the University of Michigan is demonstrating that fibromyalgia may affect millions of Americans, and research using sophisticated imaging techniques is helping the medical community better understand this disease.

“Fibromyalgia is a condition that’s characterized by widespread pain involving the muscles, the joints, and in fact, any area of the body,” explains Daniel Clauw, M.D., director of the U-M Chronic Pain and Fatigue Research Center. “In addition to pain, individuals with fibromyalgia often experience sleep fatigue, difficulties with sleep, and difficulties with memory and concentration, among other symptoms.”

Josephine’s symptoms included extreme fatigue, recurring headaches, chest pains, stomach and intestinal problems, muscle fatigue and weakness, restricted mobility, and anxiety. At her worst point, Josephine was bed-ridden and medicated to the point that she wasn’t functioning due to the pain.

However, there is hope. “Fibromyalgia is gaining respect in both the scientific and the lay community because of all the research that’s been conducted – first, showing that it’s a real disease, and second, showing that there are drugs that specifically work to treat fibromyalgia,” Clauw says. “Our group and others at the University of Michigan have been very involved in looking at the underlying mechanisms of fibromyalgia.”

Clauw and his colleagues use a technique called functional imaging, which allows scientists to look at how different areas of the brain function when people are given painful stimuli. What they have found is that for the same amount of damage or inflammation in the peripheral tissues, a fibromyalgia patient would


feel significantly more pain than the average person. Patients with fibromyalgia can also experience pain throughout their entire body even without any damage or inflammation of the peripheral tissues.

“We think that one of the primary abnormalities in fibromyalgia is an imbalance between the levels of neurotransmitters in the brain that affect pain sensitivity,” Clauw says. With this knowledge, new treatments are being developed to combat the condition’s symptoms. “Although right now there are no drugs approved to treat fibromyalgia, within three years it its likely that there will be three, if not four, drugs specifically approved to treat the condition,” he says.

These drugs fall into two general classes. One class raises the levels of neurotransmitters that normally stop the spread of pain, while another class lowers the levels of neurotransmitters that normally increase the spread of pain.

The American College of Rheumatology estimates that about 3 percent of Americans suffer from fibromyalgia, but Clauw notes that this may not accurately reflect the number of people with this condition. “It’s widely agreed that their definition is very restrictive. In fact, it’s probably more like 5 or 6 percent of Americans,” he says.

There are other misunderstandings about fibromyalgia. Some physicians believe that its symptoms are all psychological. “The doctors say, ‘Well it’s all in your head, you just need to get some extra rest and you’ll be fine, toughen up,’” Josephine remembers. Another misconception about the disease is that it is caused by inflammation in the muscles. Doctors now know that neither of these theories is true. “This is not an inflammatory disorder and this is not a primary psychological condition,” Clauw clarifies. “Pain is always a subjective matter, but everything that we can measure about the pain in fibromyalgia shows that it is real.”

Unfortunately, patients are often misdiagnosed as having disorders such as rheumatoid arthritis, chronic fatigue syndrome, or irritable bowel syndrome. Fibromyalgia has no definitive diagnosis, so doctors must rely on a patient’s medical history and symptoms when diagnosing the illness, excluding conditions that might cause similar amounts of widespread pain.


The condition’s cause is still unknown, although it is probably a combination of genetics and environment. “A person is about eight times more likely to develop fibromyalgia if one of their relatives has it,” says Clauw. “But there are also certain environmental triggers. For example, people develop fibromyalgia after motor vehicle accidents, or after certain types of infections or biological stress,” he continues. Although the disease is more common in women, there are no real demographic factors that can predict its development.

Clauw recommends that anyone who experiences pain or fatigue that is severe enough to inhibit day to day functioning seek medical attention, even if the symptoms have only lasted a couple of days. “It’s better to get medical attention and appropriate treatment early for this condition,” he says.

As for Josephine, maintaining a positive attitude and acknowledging and accepting the disease has helped her live a more normal life. “I know that I will always have this disease, but now I see myself as a survivor,” she says.

* Not her real name

Chronic Fatigue Syndrome and Myofascial Pain Syndrome vs. Fibromyalgia

There are many similarities in the symptoms of chronic fatigue syndrome, myofascial pain syndrome, and fibromyalgia, increasing the risk of a misdiagnosis.

See How to Get a Fibromyalgia Diagnosis

Chronic Fatigue Syndrome

Chronic fatigue syndrome and fibromyalgia are so similar that some doctors believe they are the same condition. Others consider the two conditions related. The syndrome is well named; the exhaustion associated with the condition can be debilitating and may last for years.

See Characteristic Symptoms of Fibromyalgia

Chronic fatigue syndrome can develop in children and teens, but is most likely in people between the ages 40 and 60. It is estimated that more than 1 million people in the United States have chronic fatigue syndrome, and the condition is four times more common in women than men.1


The severe exhaustion, combined with multiple other conditions, forces many people with chronic fatigue syndrome to significantly reduce their activities, and some are unable to continue working.

How it is similar to fibromyalgia. Fatigue, sleep difficulties, stiffness, anxiety, depression, frequent headaches, sensitivity to light, and cognitive issues are common. Other similarities include symptoms of irritable bowel syndrome, symptoms that come and go, and pain in the joints without swelling. There is no single drug that alleviates all the symptoms. The diagnosis is made by ruling out other possible causes.

How it is different from fibromyalgia. Fatigue is the crucial symptom of chronic fatigue syndrome, while pain is the dominant feature with fibromyalgia. The body may also appear to be fighting off an infection, and sore throats may be frequent. Fibromyalgia often appears to stem from a traumatic event, such as a car accident. There is speculation that chronic fatigue syndrome is related to a virus.

In This Article:

  • Fibromyalgia or Not? 6 Conditions to Know
  • Celiac Disease and Low Thyroid vs. Fibromyalgia
  • Lyme Disease and Rheumatoid Arthritis (RA) vs. Fibromyalgia
  • Chronic Fatigue Syndrome and Myofascial Pain Syndrome vs. Fibromyalgia

Myofascial Pain Syndrome

The weblike connective tissue that covers the muscles throughout the body is known as the fascia, or myofascia. When it is functioning well, the fascia is supple and flexible. If something restricts the movement of the fascia, however, it can cause intense pressure and tension, leading to muscle pain.

Everyone has muscle pain from time to time, but myofascial pain syndrome is more serious. Rather than gradually easing, the pain gets worse and does not go away. Examples of myofascial pain syndrome include acute backache, tension headaches, tennis elbow, and pelvic floor pain, among other conditions.

Watch: Myofascial Pain Syndrome Video

An individual with myofascial pain syndrome may notice knots, or “trigger points,” that are painful if pressure is applied. Muscle pain is felt deep inside the muscles. Tightness can be severe enough to restrict movement.


Controversy about the criteria for a diagnosis makes it difficult to know how many people have myofascial pain syndrome. One estimate places the total at about 44 million Americans.2 It is not certain what causes myofascial pain syndrome, but hormonal issues, overuse, injuries, and stress are believed to play a role.

How it is different from fibromyalgia: The pain is generally confined to the small knots called trigger points in myofascial syndrome, while pain is widespread and in areas known as tender points in fibromyalgia. Pain does not follow a symmetrical pattern.

How it is similar to fibromyalgia: Muscle pain and tenderness, stiffness, fatigue, sleep problems, headaches, back pain, and depression are common. Trigger point pain may occur in various parts of the body. Lab tests, MRIs, and X-rays usually are not helpful in diagnosing myofascial syndrome. Treatment is multifaceted; no single medication eliminates symptoms.

See Multi-Specialty Fibromyalgia Treatment

For years, fibromyalgia was a mystery illness. No one knew what caused it, how to diagnose it or how best to treat it. Some people, including doctors, even questioned its existence. In the last few years, however, researchers have cleared up some of the mystery. Although much about fibromyalgia still isn’t understood completely, two things are clear: It’s very real, and it affects a disproportionate number of people with rheumatoid arthritis (RA).

What Is Fibromyalgia?

Fibromyalgia is a syndrome marked by widespread pain, fatigue, poor sleep and memory problems. It’s often associated with other symptoms, too, including headache, irritable bowel syndrome and increased sensitivity to temperature changes, light and sound. In some respects, it can resemble RA, which is why patients with both RA and fibromyalgia sometimes go years without the fibromyalgia being diagnosed.

Unlike arthritis, however, fibromyalgia doesn’t affect or damage joints or other tissues. “Fibromyalgia pain tends to occur where arthritis pain doesn’t, such as the trunk, back and muscles in the thighs and arms,” explains Daniel Clauw, MD, a professor at the University of Michigan and noted fibromyalgia researcher. “Qualitatively, it’s a different kind of pain, too, more diffuse and migratory — not as constant from day to day as, say, rheumatoid arthritis in a finger joint.”

The cause of fibromyalgia pain is also different. Instead of resulting from inflammation, it’s thought to result from changes in the way the brain and spinal cord process and transmit pain signals.

Robert Bennett, MD, professor emeritus at Oregon Health & Science University in Portland, Oregon, and executive director of the Fibromyalgia Information Foundation, explains that in fibromyalgia, pain impulses are intensified, as if the volume on a radio has been turned up full blast.

Dr. Clauw and colleagues first demonstrated an association between fibromyalgia and a heightened pain response in 2002. In their study, people with fibromyalgia had measurable responses to gentle finger pressure in pain-processing areas of the brain. It took twice as much pressure to create similar responses in controls.

These findings have since been corroborated by other research, including a 2013 Harvard study published in Arthritis & Rheumatism suggesting that the brains of people with fibromyalgia are less able to guard against pain signals. This hypersensitivity to pain is known as central sensitization.

Double Trouble

Having inflammatory forms of arthritis increases the risk of fibromyalgia. This may be due, at least in part, to chronic pain itself, which causes the brain to become highly sensitized not only to things that hurt but also to things that normally aren’t painful. The hypersensitivity makes arthritis pain worse and can create widespread pain and other symptoms, such as fatigue, even when arthritis is well controlled.

Ann Vincent, MD, a physician-investigator specializing in fibromyalgia at the Mayo Clinic in Rochester, Minnesota, points out, “People with fibromyalgia have pain receptors firing all the time. And in fighting that pain, people become fatigued, have unrefreshing sleep and cognitive problems. It’s important to recognize that chronic pain kicks the symptom burden much higher.”

It’s not clear how many people with RA have fibromyalgia. Researchers used to think it was around 20–30%, but that number may be too low. The current thinking, based on a 2013 study in Arthritis Care & Research, is that fibromyalgia is a spectrum disorder, with symptoms ranging from mild to severe. That means more people are likely to fall under the fibromyalgia umbrella.

“Once patients are diagnosed with RA or lupus, rheumatologists tend to attribute all pain and fatigue to the autoimmune disease. What can end up happening is that the RA is over-treated with disease-modifying drugs or biologics because symptoms such as fatigue and memory problems persist even after joint swelling and inflammation are reduced. Persistence of symptoms should be a blinking neon light to look for central sensitization,” Dr. Clauw says.

How Is Fibromyalgia Treated?

Dr. Clauw says one of the most common misconceptions is that there are no effective therapies for fibromyalgia.

“Fibromyalgia requires both pharmacological and nonpharmacological therapies,” he explains. “Pharmacological therapies address pain processing, and nonpharmacological therapies address the functional consequences of pain. So, for instance, we know activity is extremely important. Research has repeatedly shown that regular activity is one of the most effective treatments for pain syndromes, just as it is one of the most effective treatments for arthritis. I tell people to take it slowly because if they try to do too much at first, they get frustrated.”

Deep, restorative sleep is also essential for reducing chronic pain, but for many people with fibromyalgia, that’s easier said than done. Pain interferes with normal sleep, and lack of sleep makes pain worse. Conversely, a good night’s rest can significantly improve fibromyalgia symptoms.

Relaxation techniques, meditation, massage, deep breathing and cognitive behavioral therapy — a type of therapy that can help change certain thought and behavior patterns — are also helpful for relieving pain and fatigue.

Nonpharmacologic approaches are particularly important because the three drugs approved to treat fibromyalgia — pregabalin (Lyrica), duloxetine (Cymbalta) and milnacipran (Savella) — are only moderately effective. Dr. Clauw emphasizes that most patients find relief with a combination of treatments.

He also recommends that people with RA who have ongoing pain and other symptoms ask their doctor about fibromyalgia.

“That question may cause your physician to have an ah-ha moment,” he says.

Linda Rath for the Arthritis Foundation

Treatment For Fibromyalgia Knee Pain

Fibromyalgia knee pain can be a result of many things and not all are directly attributed to fibromyalgia, but with tender and trigger points compounding this area, it is very common to have fibro related knee pain.

Two of the eighteen fibromyalgia tender points are located around the knee area, on both sides. Various activities can exacerbate fibromyalgia knee pain. Tight muscles, tendons and ligaments within close proximity can also increase pain in this vulnerable area.

Although a fibromyalgia diagnosis includes much more than eighteen tender points, there are still some areas like the knees that tend to affect more of the surrounding areas; this is likely due to the weight bearing nature and any associated joint issues.
Also the SS (symptom severity) evaluation test can be helpful in a decision to treat these more vulnerable areas of the fibro body.

Fibromyalgia Knee Pain

As well, the trigger points that we often refer to can also cause radiating pain around the knee, up and down the leg and into the hip flexors and lower back.

(NOTE : Related article links are at the bottom of this article )

Fibromyalgia knee pain can cause increased symptoms when standing, especially for prolonged periods of time, and more in the latter part of the day for those with any kind of standing job.

Also, even excessive sitting at a desk and/or lack of regular range of motion within this area can cause painful symptoms.
This may be attributed to a strain or tightness within the quadrant around the sartorius muscle and perpetual tightness in the hamstrings which also ‘pull’ on the knee and can contribute to TRP’s or trigger points around the knee, radiating upward into the groin and hip flexors and also downward into the shins and ankles.

Do you have fibromyalgia knee pain?

Do you experience pain in your knees upon standing from a sitting position? Do your knees often feel like they are buckling under you while standing in one place or while walking? This could be due to active or latent trigger points around the leg muscles.
Do you find it especially hard or nearly impossible to engage in certain activities of daily living like cleaning a bathtub or a floor where kneeling or bending is required?
These are all common within the fibro body, especially due to the weight bearing nature of these tender and trigger point areas.

Like other joints, this area of the fibro body is also sensitive to weather and temperature changes and may cause a feeling of extreme weakness and increased pain around the joint and soft tissue surrounding the knee.

How do we mitigate fibromyalgia knee pain
to increase range of motion and agility
within the fibro body?

With fibromyalgia knee pain, we are best to keep the blood flowing around these tender areas and work on staying conditioned with non-invasive remedies and strength applications where possible. Compression is a great way to naturally increase circulation.

Compression wear is a non invasive remedy for knee pain that gently hugs and supports the joint, trigger points and soft tissue around the knee. Some compression garments include infra-red technology for even great benefit.

Knee compression garments like this one shown (the healing tree) can be worn any time of day. However, not all compression garments are appropriate for those with fibromyalgia due the differing degrees of ‘tightness’.
Experiment to find what rate of compression works best. This one shown exerts a smaller degree of compression but also includes the infra-red technology which in itself will increase circulation and oxygen flow around tender and trigger points of the body.

Using light ankle weights and performing leg lifts to increase leg strength is also essential. It does not have to be a great deal of weight, just enough to start activating muscle and increasing strength slowly.

The adjacent picture also shows a simple way to lightly ‘compress’ the area around the knees by using a small exercise ball and just squeezing in between the knees. Compress just enough against the ‘tender’ tendons and soft tissue..
Simply squeeze the ball… hold… and release. Use 8-10 repetitions for 1-2 sets.

Remember that healthy muscle protects bone and healthy bone/joints protects muscle.

What about ice and heat for fibromyalgia
knee pain?

Alternating ice and heat is always a good idea. 20 minutes cold/20 minutes warm. However, after exercise or strenuous activity, I find that ice or cold to decrease any soreness is best if tolerated. If you don’t tolerate the extreme cold of an ice pack, wrap the pack in a towel and work up to tolerance.
For those who are a little more adventurous, how about a hot/cold shower? This is simply alternating hot and cold water for about 20-30 seconds at a time. Focusing on a particular body part like the knees or lower back will increase circulation without undue stress to the entire fibro body.
I use the same wraps for my knees that I use for around my head during intense migraines. However, with a headache, the cold part only goes around the back of the head, for knees, it wraps around the entire knee. Check out the migraine article if you like for the cold wrap. Very easy to use on the knees as there is no need to hold it on them.

Be careful with blood pressure or other issues that may not respond well to extreme temperature variance.

Additional Therapies

It is also important to note that chronic lower back pain and tight hamstring muscles (back of legs) can also exacerbate knee pain. If your lower back is ‘out’ or you are over compensating in any way, often the knees can take on the added strain. SI joint pain (in the dimples of the lower back) is also connected to knee pain, so regular care for the spine and lower back can improve pain in the lower extremities and knees as well.
Knee pain can also be exacerbated by tight fascia. Please visit the article on Myofascial Release by using the Sitemap and/or related links below. Also, join me on my facebook page FibroFitPeople1.
Bowen therapy and/or Myotherapy can be helpful for fibromyalgia. This can be effective for related symptoms that affect both muscle and fibro tender areas. Check for a qualifed Bowen therapist in your area. Also refer to related links below.
Another effective and less invasive procedure than something like cortisone for knee pain and arthritis involves cartilage injections. I have personally used these injections for my knees over the last three years. Check in your area for a holistic joint doctor. Our bodies naturally lose cartilage as we age, so it is something we need anyway. Often pain for by insurance.
Prolozone therapy is another option for knees. This therapy utilizes oxygen, and may be injected with a natural anti-inflammatory into the surrounding areas of the knee joint. Not always paid by insurance.

Links to other related articles:

  • Fibromyalgia-Leg-Pain
  • Joint-Health
  • Fibromyalgia-Exercise-Muscle-Conditioning
  • Myofascial Release

Before you leave, my sitemap can provide you with a “God’s-eye” view of this website laid out in “outline format”. It shows the titles of the major sections as well as subpages in an easy to understand manner AND each entry is a link to the respective page. Click on this link, sitemap, and read one more page before you go.

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Fibromyalgia Pain Relief

Fibromyalgia is a syndrome that has as its primary symptoms a combination of widespread pain with fatigue, sleep trouble and difficulties with mood and memory. Sometimes these symptoms can occur after surgery, infection, physical trauma, or a stressful event. However, at times these symptoms can develop over time with no particular trigger.

What does the pain of fibromyalgia feel like? The pain of fibromyalgia is often described as a dull ache that occurs on both sides of the body above and below the waist. This pain usually includes leg pain. Fibromyalgia leg pain can be described as sharp, dull, numbing or burning. Leg pain related to fibromyalgia can occur in the ligaments, tendons, or muscles surround the joints. The leg pain of fibromyalgia becomes amplified in the central nervous system (brain and spinal cord) because of problems in pain processing, the ‘wind up’ phenomenon. Some people with fibromyalgia can have leg or burning feet pain that may be related to a related condition called small-fiber-polyneuropathy (SFPN). The tenderpoints associated with fibromyalgia leg pain are located the hip region and inside portion of the knee.

The Difference Between Fibromyalgia and Arthritis

Fibromyalgia is a medical condition that is often misdiagnosed, misunderstood, and confused with other conditions because of its symptoms.1,2

Joint pain and fatigue could be attributed to fibromyalgia, but these could also be symptoms of arthritis or another chronic condition instead. Other confusing fibromyalgia symptoms include changes in a person’s sleep, mood, and memory.

The purpose of this article is to describe the most common fibromyalgia symptoms and provide information about the difference between fibromyalgia and arthritis. It will also address the issue of experiencing fibromyalgia and arthritis together as comorbidities and how to manage this type of pain and discomfort.

What is Fibromyalgia?

For anyone wondering exactly what is fibromyalgia, this is a musculoskeletal disorder in which pain sensations are amplified due to how pain signals are processed in the brain.3,4 It can develop slowly over time or be triggered by stress, an infection, or surgery. Women are more likely to develop fibromyalgia than men,5 but there is still a great need for fibromyalgia research to undercover the disease’s causes and any potential cures.

Common fibromyalgia symptoms include dull aching pain that lasts for several months or longer.3,4 It is typically felt all over the body in various parts. In addition to bodily pain, individuals with fibromyalgia may also experience fatigue and a mental fog. People with fibromyalgia often suffer from other coexisting conditions at the same time, such as irritable bowel syndrome, painful menstrual cramps, anxiety, and depression.4,5,7

Difference between Fibromyalgia and Arthritis

People who have both osteoarthritis and rheumatoid arthritis can be more likely to develop fibromyalgia.6,7 These arthritis conditions are risk factors of fibromyalgia, but the causes and symptoms of these conditions are significantly different.

For example, rheumatoid arthritis is caused by an autoimmune disorder that makes the immune system attack the joints.9 RA and fibromyalgia progress very differently as disorders as well. While fibromyalgia usually involves constant pain,8 RA flares up periodically and involves inflammation issues.9 Fibromyalgia isn’t an inflammatory condition, but rather one of the central nervous system that causes abnormal sensory processing.

Also, osteoarthritis is a degenerative joint disease that affects the cartilage in a person’s joints.10 When someone has osteoarthritis, this lack of cartilage can make the joints rub together and result in pain, stiffness, and reduced range of motion.11 This distinguishes osteoarthrosis from fibromyalgia, which doesn’t typically involve progressive joint deterioration.

Finally, psoriatic arthritis differs from fibromyalgia in that its pain is typically accompanied by scaly patches on the skin, swollen toes or fingers, and a family history of psoriasis.12

Experiencing Fibromyalgia and Arthritis Together

Although fibromyalgia and arthritis are very different medical conditions, they can still occur in the body at the same time.6 This coexistence can make the symptoms of each condition worse, especially joint pain on both sides of the body, fatigue, and depression. Over-the-counter pain relievers, pain relief creams like JointFlex, non-steroidal anti-inflammatory medications, and COX-2 inhibitors may be used to treat patients with fibromyalgia and arthritis together. Meanwhile, reducing daily stress, getting an adequate amount of quality sleep, and exercising a little every day goes a long way in managing symptoms of fibromyalgia and arthritis together.



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Women with fibromyalgia have impaired hand function and strength, which is associated with increased pain and greater disease severity, according to a new study. The study, “Assessment of hand function and disability in fibromyalgia,” appeared in the journal Zeitschrift für Rheumatologie. Reduced muscle strength is common in fibromyalgia patients, limiting their ability to do daily activities and increasing the risk for disability. However, according to the authors, little attention has been focused on the impact of fibromyalgia on hand function and how it subsequently affects quality of life in patients. To address this, a research team from Turkey compared pain threshold, handgrip strength, and pinch strength in 40 women with fibromyalgia and 30 individuals used as controls. In both groups, the mean age was 40 years old. Pain level was assessed with a Visual Analogue Scale, from zero to 10, at rest. Handgrip strength of the dominant hand was measured three times at one-minute intervals in each patient, using a hand-held device called a dynamometer. A similar protocol was followed to determine pinch strength through a manual pinch meter. Functional status was assessed with the Fibromyalgia Impact Questionnaire (FIQ). This test specifically measures 10 different properties — physical disability, feeling good, feeling Subscribe or log in to access all post and page content.

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