Specific areas may be tender when pressure is applied. Muscle tightness and spasms may occur. Although any fibrous tissue or muscle may be affected, those of the neck, shoulders, chest and rib cage, lower back, and thighs are especially likely to be painful. In the primary fibromyalgia syndrome, pain may occur throughout the body and is accompanied by more general symptoms, such as nonrestorative sleep, anxiety, depression, fatigue, and irritable bowel syndrome. The diagnosis of fibromyalgia syndromes is based on the pattern and location of the pain.
Nondrug treatments are usually the most helpful.
Reducing stress can alleviate some mild cases. Stretching and conditioning exercises, improvements in sleep, the application of heat, and gentle massage as well as keeping warm are usually beneficial. Aspirin or other nonsteroidal anti-inflammatory drugs generally aren't very helpful. Occasionally, local anesthetics, alone or with corticosteroids, are injected directly into a particularly tender area. Doctors may prescribe low doses of antidepressants at bedtime to help promote deeper sleep and relieve symptoms.