It took four different doctors to determine her sister had fibromyalgia when she was diagnosed 25 years ago, says nail tech, author and co-founder of the Nailcare Academy Janet McCormick. Her sister’s first few doctors seemed to think she was just a complainer and that her symptoms were all in her head, McCormick recalls.
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It took four different doctors to determine her sister had fibromyalgia when she was diagnosed 25 years ago, says nail tech, author and co-founder of the Nailcare Academy Janet McCormick. Her sister’s first few doctors seemed to think she was just a complainer and that her symptoms were all in her head, McCormick recalls.
Although doctors are more familiar with the condition today, fibromyalgia still is not well understood, even though it affects millions of Americans. Formerly referred to as “rheumatism,” the term for this syndrome of overall chronic body pain and fatigue was not coined until the mid-1970s. As recently as February 2021, the Harvard University Medical School published a blog titled, “Is fibromyalgia real?” As the author of that blog post noted, fibromyalgia is a real, and complex, health problem. Although there is no cure for it, fibromyalgia is treatable and manageable, even for people in physical careers such as nail technicians.
As McCormick’s sister found, fibromyalgia’s complexity makes diagnosing it difficult, doctors acknowledge. So, it is important to familiarize yourself with its signs so you can advocate for yourself. Here is what you need to know about this syndrome.
Fibromyalgia Defined
Fibromyalgia causes pain all over the body, in muscles, ligaments and tendons. People with this syndrome also experience fatigue (extreme tiredness), trouble sleeping and often tenderness to touch. The pain can wax and wane and travel throughout the body; it might be described as throbbing, aching pain and can feel unbearable at times. It is also commonly associated with symptoms of depression and problems with thinking or concentration, or what might be termed “brain fog,” explains board-certified internist and integrative doctor Jacob Teitelbaum, M.D., author of From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. People with fibromyalgia might also have digestive problems such as irritable bowel syndrome (IBS), Teitelbaum says.
The syndrome might accompany other chronic health problems such as endometriosis and cystitis, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. People who get migraines also might have fibromyalgia.
Estimates differ regarding how many Americans have the syndrome: It affects roughly 3 million people in the United States, according to the Centers for Disease Control, but the National Fibromyalgia & Chronic Pain Association (NFCPA) puts the figure at closer to 10 million. Fibromyalgia is more common in women and typically strikes between the ages of 25 and 55, although kids can get it.
While the syndrome can strike at any age, it is more common during middle age, which is one reason its symptoms might be dismissed or misdiagnosed, as pain and tiredness generally increase as people get older. It can come on slowly over time for some people, but others might go from active and healthy to feeling debilitated by fibromyalgia quickly, Teitelbaum says.
Suspected Causes
Experts continue to debate whether fibromyalgia symptoms stem from abnormal functioning of the nervous system or the immune system. A study published over the summer raised the suspicion that fibromyalgia might relate to an autoimmune issue rather than one related to the brain, according to researchers at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London, the University of Liverpool and the Karolinska Institute. The authors suspect that antibodies spur activity among pain-sensing nerves in the body.
It is also unknown whether fibromyalgia might be genetic. But, doctors do tend to agree that fibromyalgia appears to cause abnormal pain-signal functioning in the brain, telling the body it is experiencing pain—even though there is nothing happening that should cause pain.
Fibromyalgia seems more common in people that have other sources of pain as well, including autoimmune arthritis conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and lupus, notes Siddharth Tambar, M.D., a board-certified rheumatologist with Chicago Arthritis and Regenerative Medicine.
“The severity of pain will vary from person to person,” Tambar says. “In general, symptoms are progressive, meaning they worsen over time if treatment is not pursued.”
Diagnosis
Because its causes are not yet known, and the symptoms are so broad, fibromyalgia can be difficult for health care providers to identify. Fibromyalgia is very similar to chronic fatigue syndrome, which causes tiredness that can be overwhelming, Teitelbaum states. Fibromyalgia essentially adds pain to the mix.
What helps in diagnosing the syndrome is asking patients whether they are able to get a good night’s sleep, Teitelbaum continues. The paradox of extreme fatigue and inability to sleep can signal fibromyalgia, particularly when combined with widespread pain and brain fog.
“That means the circuit breakers that control sleep are off,” Teitelbaum says. “It is like a trip in a circuit breaker; that trip triggers an energy crisis.”
Put another way, fibromyalgia causes the body to spend more energy than it makes, he says; its pain receptors are working overtime, and it is unable to get the rest it needs to recharge.
In addition to a physical examination and an assessment of your health history, your health care provider might run lab tests, such as blood work or X-rays, to rule out lupus, rheumatoid arthritis or a thyroid condition.
Treatment
There are several medications that can help with muscle and nerve-related pain, Tambar notes. Acupuncture, massage and chiropractic treatments might also help, he adds.
Medication that improves deep sleep also is important in treating fibromyalgia, Tambar says. But, people with fibromyalgia should make good sleep habits a priority as well.
“Improving sleep habits at night is important to optimize your sleep pattern,” he explains. “Fatigue can also improve with regular aerobic exercise and should be incorporated for people living with fibromyalgia. If movement and exercise is limited by pain, physical therapy to improve movement patterns can be very helpful.”
Tambar says nail techs can “absolutely” continue to work if they are diagnosed with fibromyalgia but notes it will require some work and effort to maintain their health and quality of life. Part of that effort means effectively managing stress.
“Let us face it, being a nail tech is very stressful,” McCormick says. “Hour to hour, it is very stressful; unless you have control over your skills, you are under time stress all the time.”
McCormick encourages nail techs who suspect fibromyalgia should consult a doctor as soon as possible. Because doing nails can exacerbate chronic upper back and shoulder pain from fibromyalgia, it is important that they work with a good ergonomic setup, she urges.
“If your table is too high or too low and your shoulders are hunched, that will stimulate [fibromyalgia],” she continues.
Electric-filing is also better than hand-filing nails, she notes. “E-filing helps because you are not waving your arms back and forth. Hand-filing can bother shoulders, too.”
McCormick’s sister found relief with a prescription medication for fibromyalgia. Teitelbaum recommends certain supplements to help lessen fibromyalgia symptoms as well (Note: Nutritional supplements are regulated as food, not drugs, by the U.S. Food and Drug Administration and are therefore not approved by the FDA to treat or prevent diseases).
People with chronic pain are more likely to be depressed no matter what the cause, Teitelbaum notes. So, it is not surprising that depression is one of the symptoms of fibromyalgia. The CDC recommends cognitive behavioral therapy in addition to establishing good sleep habits and exercise, including yoga and meditation, to help manage fibromyalgia. There are also numerous formal and informal organizations you can join for support, such as Facebook groups and communities at SupportFibromyalgia.org, LivingWithFibro.org and the American Chronic Pain Association (TheACPA.org).
Sources: National Fibromyalgia & Chronic Pain Association, FibroAndPain.org; Mayo Clinic, MayoClinic.com; National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIAMS.nih.gov; Harvard Health Publishing, Health.Harvard.edu; The Food and Drug Administration, FDA.gov
About the Author
Virginia Pelley is a freelance writer and editor based in Tampa, Florida.
FIBROMYALGIA FACTS*
- Fibromyalgia affects between 3 million and 10 million Americans.
- 80% of people with fibromyalgia are women.
- The first drug to treat fibromyalgia was not approved for use in the U.S. until 2007.
- Fibromyalgia costs people in the U.S. between $12 and $14 billion a year.
- Fibromyalgia accounts for an annual loss in productivity in the U.S. of 1-2%.
*Source: The National Fibromyalgia & Chronic Pain Association
