Ask a Doctor: Fibromyalgia

Hand surgeon Reid W. Draeger, MD answers your questions about fibromyalgia and how it may relate to the numbness in your hands.

What is fibromyalgia?

Fibromyalgia is a disorder that causes aches, pains, and tenderness all over the body. It is a long-term disorder that lasts for years or may even be lifelong. It is associated with fatigue and sleep problems. Fibromyalgia affects 2-4% of people. Women are affected more often than men, and it is most often diagnosed in middle age.

What causes fibromyalgia?

There are a number of theories about the causes of fibromyalgia, but no one is completely sure about the answer to this question. Researchers believe that a problem with the central nervous system (brain and spinal cord) may be responsible for the condition. Fibromyalgia may run in families, but exact inheritance patterns are unclear. Though the pain experienced by people with fibromyalgia is real, it is not caused by an autoimmune, inflammation, muscle, or joint disorder.

Fibromyalgia may occur after a triggering event, such as the onset of arthritis, an injury, physical stress, or emotional stress. These triggers may change the way the brain and spinal cord process pain and increase the pain a person experiences.

How is fibromyalgia treated?

There is no known cure for fibromyalgia. There are two categories of treatment: non-drug treatment and medications. Surgery is not an effective treatment for fibromyalgia.

Non-drug treatment may include physical exercise, cognitive behavioral therapy, and meditation. Even though pain may make being active difficult and unappealing, low impact exercise can be helpful. Cognitive behavioral therapy is a type of psychotherapy aimed to help a patient understand how thoughts may affect the way a patient feels and manages pain. This therapy can be helpful. Mindfulness (a type of meditation) may also be helpful with symptoms.

Medication treatment of fibromyalgia falls into a couple of different categories. Treatment often includes drugs that modify brain chemicals (serotonin and norepinephrine) to change the way pain is experienced. This includes medicines that can also be used to treat depression.  Another type of medicine used to treat fibromyalgia blocks over-activity of nerve fibers involved in sending pain signals to the brain and spinal cord. Check with your primary care doctor or pain management team about these treatments. These medical professionals are often more familiar with dosing recommendations than your hand surgeon will be.

Are numb hands a symptom of fibromyalgia?

Numb hands are not a symptom of fibromyalgia, but people with fibromyalgia can have the same medical problems as people without fibromyalgia. Carpal tunnel syndrome and similar conditions can cause numb and painful hands. Carpal tunnel syndrome is caused by pinching of an important nerve (the median nerve) by a ligament at the wrist.

If you have a diagnosis of fibromyalgia and have numb and/or painful hands or symptoms that do not seem to fit with your diagnosis of fibromyalgia, you should be evaluated further. Evaluation by your doctor or by a hand surgeon can help to determine the cause of your hand numbness or pain. 

Dr. Draeger is a hand surgeon and Assistant Professor at the University of North Carolina Department of Orthopaedics.

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