But You Don’t Look Sick

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People with Fibromyalgia don’t look sick. Although they appear to be healthy, they are in constant pain. There are things going on with them that you don’t see.

What is Fibromyalgia and what causes it? It’s a chronic condition that causes pain, stiffness and tenderness of the joints, muscles and tendons. The painful tissues are not inflamed, so there isn’t any body damage or deformity. It doesn’t cause any damage to internal organs. It is characterized by restless sleep, feeling tired all the time, chronic fatigue, anxiety and depression. It can also cause irritable bowel syndrome. The actual cause of fibromyalgia is not known. It seems that the people affected experience pain in response to stimuli that isn’t normally painful. Researchers have found elevated levels of a nerve chemical signal called substance P. in sufferers. Serotonin levels are also found to be lower in fibro patients.

What are the symptoms of fibromyalgia? The key symptoms are the following:

1. Pain all over: The muscles feel as if they have been overworked and sometimes twitch and cramp. It’s usually widespread on both sides of the body. It tends to affect the neck, buttocks, shoulders, arms and upper back and chest. There are “tender points” that are tender to light touch. The tender points are found on the elbows, shoulders, knees, hips, back of the head and the sides of the breastbone.

2.Fatigue: Sufferers have an overwhelming feeling of fatigue. Even when getting enough sleep, they never feel rested. People with fibro lack the level of sleep called “non-rapid eye movement”. They often don’t reach the level of sleep needed to feel rested and refreshed.

3. Brain fog: Poor concentration, forgetfulness and irritability are symptoms of “brain fog”. The person never quite feels as if they’re “all there”.

4. Headaches: Constant headaches which can include migraine and tension headaches.

5. Irritable bowel syndrome: This causes abdominal pain and discomfort and other bowel disturbances without detectable inflammation of the stomach and intestines. It can also cause painful and frequent bladder infections.

6.Multiple sensitivities: People have increased sensitivity to many different sensory stimuli and can have a low pain threshold. Body pain can be aggravated by noise, weather changes and emotional stress.

Who’s affected? Fibromyalgia affects mostly women between the ages of 35 and 55. Less often it can affect men, children and the elderly. It can show up independently or with another disease such as lupus.

How is it diagnosed? There aren’t any blood test or X-rays that can confirm a diagnosis. There are tests to exclude other diseases and diagnoses. In patients with chronic widespread body pain, there are identifying point tenderness areas that can point to fibromyalgia, patients may have 11 out of 18 tender points. By excluding other medical conditions that can mimic Fibromyalgia, it leaves the doctor with the diagnosis.

What are the treatments? The person can receive injections of cortisone medicines into the tender point area to try to relieve pain. The pain reliever Ultram and Ultracet may be helpful. The muscle relaxant Flexeril has been used for improving sleep and reducing pain. Anti-depressants, such as, Elavil, Sinequan, Prozac, and Ativan have been used to help treat patients. Biofeedback has been used with some success as well as acupuncture and massage therapy. Also education about the disease, stress reduction and exercise is helpful. Avoiding alcohol and caffeine before bedtime can promote better sleep.

A lot of diseases you can’t see but that doesn’t mean the person isn’t sick or “faking” it. Educate yourself on the “unseen” diseases and then you can be supportive of a person or loved one that has one.

By Linda Lee Ruzicka





Linda Lee Ruzicka lives in the mountains of Western PA , happily married and with her 8 cats and three dogs. She has been published in Twilight Times, Dark Krypt, Fables, Writing Village, June Cotner anthology, The Grit, Reminisce , the book, Haunted Encounters: Friends and Family. She also does freelances work for Beyond and. You can read Healthcarejobsite more of her blogs on Healthcarejobsite blog.


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