How Do You Know If You're Having a Fibromyalgia Attack?

Fibromyalgia is a chronic (long-term) condition that causes muscle and joint pain throughout your body. An attack is a worsening of typical fibromyaligia symptoms such as widespread pain, hypersensitivity, stiffness, fatigue, trouble sleeping, muscle weakness, and memory or concentration issues lasting days or weeks.

A fibromyalgia attack is a temporary worsening of fibromyalgia symptoms. 

Fibromyalgia is a chronic (long-term) condition that causes muscle and joint pain throughout your body along with other symptoms, like fatigue, difficulty sleeping, or problems with memory.

Fibromyalgia is not a progressive disease, meaning that it will not get worse over time or cause damage to organs such as muscle or bone {Cedars Sinai: “Fibromyalgia.”}. However, during a fibromyalgia attack, symptoms become more severe and more frequent for a period of time.

Fibromyalgia symptoms tend to come and go, so a few hours or a day when you feel worse is not considered a fibromyalgia attack. The term “flare” or “attack” is used to describe a long period of several days or weeks when your symptoms are significantly worse than usual.

People experience fibromyalgia flares differently. One person may find that their back pain gets much more severe, while another person may have more intense headaches.

Symptoms of fibromyalgia include:

Widespread pain

The pain of fibromyalgia may be described as aching, burning, gnawing, stabbing, or throbbing. 

Some of the more common forms of fibromyalgia pain include:

• Lower back pain, sometimes with shooting leg pains
• Muscle cramps, especially in the legs
• Migraines or severe tension headaches
• Temporomandibular joint disorder (TMD) (pain in the jaw joints and the muscles that control the jaw)
• Other joint pain, especially in the neck, shoulders, and hips
• Dysesthesia (an uncomfortable sensation of numbness, prickling, or tingling, often in the hands or feet)

Hypersensitivity

In addition to chronic pain, people with fibromyalgia often experience allodynia and hyperalgesia. 

Allodynia is a lowered pain threshold that causes you to experience pain from something that would not normally hurt, such as a light touch. Hyperalgesia is an unusually intense pain response to something that would normally hurt. The pain may also last much longer than expected. 

People with fibromyalgia are also often exceptionally sensitive to noise, lights, smells, temperature changes, and/or vibration. This can quickly lead to sensory overload, which can make other fibromyalgia symptoms even worse. 

Stiffness

About 80% of people with fibromyalgia feel stiff for at least 15 minutes upon waking in the morning. For many, this continues for hours afterward, and they must allow for extra time in their morning routine because their movement is so limited. The same stiffness may return later in the day if they’ve been sitting still for a while and then get up.

Fatigue

People with fibromyalgia typically feel exhausted much of the time, even after sleeping or resting. Their stamina (strength for a lengthy physical or mental task) is often significantly reduced. After a physical effort such as work or exercise, the person often experiences a worsening of symptoms, including extreme fatigue, muscle exhaustion, and increased pain. 

Difficulty sleeping

Researchers have found that over 90% of people with fibromyalgia have trouble sleeping. 

Sleep disorders common in people with fibromyalgia include:

• Insomnia — problems falling asleep or staying asleep
• Restless leg syndrome — an uncomfortable urge to move your legs
• Periodic limb movement disorder — your legs or arms move repetitively during sleep
• Sleep apnea — you experience pauses in your breathing during sleep

Muscle weakness and tightness

Muscle weakness means a loss of muscle strength. Fibromyalgia can cause generalized weakness, affecting all your muscles at once, or weakness in a particular muscle. Your muscles may be easily exhausted and respond by trembling or twitching.

In fibromyalgia, your muscles may be tight or tense much of the time, leading to soreness and pain. Tight muscles may result in a decrease in your strength and range of motion.

Problems with memory and concentration

“Fibro fog” is a common description of the forgetfulness, confusion, and trouble focusing often experienced in fibromyalgia. Communication may become more difficult during a flare, as it may take even longer than usual for you to process information and respond.

Triggers that tend to bring on a fibromyalgia flare include:

Stress

Whether caused by issues at work, in your finances, or in your personal relationships, stress of all types can cause your fibromyalgia to flare. Stressful events such as the death of a loved one can have the same effect. Physical stressors such as injury or illness can also cause your fibromyalgia to flare.

Schedule changes

Moving, a new job (especially if you switch to a different shift), or even a new relationship can significantly change your day-to-day routine and trigger a flare. Even events that create temporary schedule changes, such as traveling or a school break, can lead to an increase in symptoms.

Hormones

The menstrual cycle, pregnancy, and menopause all cause drops and/or jumps in the levels of hormones in a woman’s body. These dramatic shifts in hormone levels can trigger fibromyalgia attacks.

Changes in weather

Some people find that their fibromyalgia symptoms increase with large swings in barometric pressure, humidity, or temperature, such as when a cold front moves through.  

Sleep deprivation

Studies have shown that lack of quality sleep worsens pain and other symptoms in people with fibromyalgia.

To diagnose fibromyalgia, your doctor will ask you questions about how long you have had pain and which body parts have been hurting.

You may receive a diagnosis of fibromyalgia if you have experienced widespread pain for more than three months and have other fibromyalgia symptoms, such as fatigue or problems with memory.

There are many ways to reduce the frequency and severity of fibromyalgia attacks. Some of the options your doctor might suggest include:

Lifestyle changes

• Gentle exercise
• Stress management techniques, such as mindfulness or deep breathing

Treating sleep problems

At home, you can try:

• Going to bed and getting up at the same time every day
• Creating a bedtime routine, such as turning down the lights and listening to relaxing music
• Limiting caffeine and daytime naps

If you are still having trouble sleeping or feel tired even after getting enough sleep, your doctor may order a sleep study. In a sleep study, you are monitored overnight to see if you have a sleep disorder that can be treated.

Therapy

Physical therapy can improve strength and stamina. Occupational therapy can help you make changes at home and work so that your daily tasks are less stressful on your body. Counseling can teach you strategies that help you cope with stress and pain.

Medications

Over-the-counter pain medications, like acetaminophen (Tylenol) or naproxen (Aleve), may help. 

Your doctor may also prescribe: 

• Amitriptyline or cyclobenzaprine to help you sleep
• Duloxetine (Cymbalta) or milnacipran (Savella) to reduce pain and fatigue
• Gabapentin (Neurontin) or pregabalin (Lyrica) to ease certain kinds of pain