Causes

• Using brain scans on patients with fibromyalgia, researchers have discovered an abnormal increase in blood flow (called "brain perfusion") in an area of the brain that discriminates the intensity of pain, and a decrease in blood flow in areas thought to be involved in the emotional response to pain. These abnormalities were unrelated to the patients' depression and anxiety levels, reinforcing the idea that fibromyalgia is a real disorder, rather than a result of depression.
• Patients with fibromyalgia seem to be more sensitive to sounds than those without the condition. This increased sensitivity may be due to an abnormality in sensory processing by the central nervous system.

Prognosis

• People with fibromyalgia experience greater psychological distress and a greater impact on quality of life than those with other conditions, such as chronic low back pain.

Treatment

• The U.S. Food and Drug Administration (FDA) has approved the drug duloxetine (Cymbalta) for treating fibromyalgia. In studies, duloxetine reduced fibromyalgia pain by more than 30%.

Lifestyle

• Exercising in a warm swimming pool is a cost-effective therapy that improves quality of life in women with fibromyalgia.

• Waon therapy -- a type of treatment in which patients first sit in a dry sauna and then are placed in a warm room and wrapped in blankets -- may help reduce pain in fibromyalgia patients, according to one small study.

Medications

• The anti-epileptic drug pregabalin is effective at improving pain and sleep in three different doses (300 mg, 450 mg, and 600 mg), and the drug is well tolerated by fibromyalgia patients.
• A synthetic drug derived from marijuana may prove an effective addition to fibromyalgia treatment. In one study, nabilone (Cesamet), which is typically used to treat severe nausea and vomiting in chemotherapy patients, significantly relieved fibromyalgia pain compared to placebo.