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New Interventions for Fibromyalgia Treatment and Diagnosis

by Dr Mouzayan Ginzarly , Physician
March 24, 2024

Fibromyalgia (FM) is a multi-symptom syndrome characterized by chronic widespread pain, fatigue, and poor sleep quality.

Chances are, someone you know suffers from this condition that causes debilitating chronic, widespread pain. Navigating its challenges requires not only an understanding of the medical aspects but also merits identifying a supportive and empowering approach to fibromyalgia treatment amid day-to-day difficulties.

Fortunately, there is hope for those living with fibromyalgia, as practitioners and patients continue to demystify and discover key strategies to manage this complex condition. 

What Does Fibromyalgia Feel Like?


Those who suffer from fibromyalgia know all too well the undeniable reality of their condition. In addition to pain and stiffness all over the body, fibromyalgia patients can also experience:

  • Fatigue
  • Sleep problems
  • Headaches
  • Emotional distress
  • Cognitive difficulties, sometimes referred to as “fibro fog”

People with fibromyalgia usually suffer from extreme sensitivity to painful stimuli. Those who live with the condition can attest to their often severe day-to-day experience. 

Fibromyalgia Awareness in the Medical Field

Given the severity of symptoms associated with fibromyalgia, it’s understandable why some sectors of the medical community might overlook it. There are several potential reasons for this oversight. Firstly, fibromyalgia is a relatively recent diagnosis, and its underlying mechanisms remain incompletely understood. Secondly, diagnosing fibromyalgia presents challenges as many other conditions can manifest similar symptoms. Moreover, since there are no definitive blood tests or imaging techniques to confirm fibromyalgia, symptomatology becomes the primary basis for assessment.

Individuals grappling with fibromyalgia often encounter uncertainty regarding where to seek assistance and which medical professionals consider fibromyalgia a legitimate condition.

What Causes Fibromyalgia?


Unfortunately, the causes of fibromyalgia can also be mysterious. A combination of genetic, environmental, and psychological factors likely influences it. 

Many researchers believe that fibromyalgia adversely affects pain receptors in the brain and spinal cord, although how exactly these pain receptors are triggered is unknown. The condition is often believed to be prompted by an event that causes severe physical or psychological stress, but sometimes it develops without an obvious cause.

It is known that “anyone can get fibromyalgia, but more women get it than men.” In addition to gender, some of the potential factors that may contribute to the development of fibromyalgia include: 

  • Age: Though fibromyalgia can occur in people of all ages, it typically manifests in middle-aged adults. 
  • Genetics and Family History: The disorder tends to run in families, which suggests a genetic component that may increase susceptibility to fibromyalgia. 
  • Physical Illness or Infection: Some illnesses or viral infections, including rheumatoid arthritis, lupus, osteoarthritis, or irritable bowel syndrome, can be associated with fibromyalgia
  • Psychological or Mood Disorders: Conditions such as depression or anxiety may contribute to the development or exacerbation of fibromyalgia.
  • Physical or Emotional Trauma: Injuries (i.e. traumatic brain injuries) or emotional trauma, such as accidents or post traumatic stress disorder (PTSD), may trigger the development of the condition in some cases. 

One prominent theory suggests that fibromyalgia is associated with abnormalities in the central nervous system’s processing of pain signals (central sensitization). This phenomenon, known as central sensitization, leads to an amplification of pain perception, where individuals with fibromyalgia experience pain more intensely than those without the condition. It involves changes in neurotransmitters, such as serotonin, dopamine, and substance P, as well as alterations in the function of certain brain regions involved in pain processing, such as the thalamus and amygdala.

Is Fibromyalgia a Disability? 


Also much debated is the classification of fibromyalgia as a disability. While fibromyalgia itself is not explicitly listed as a disability in many frameworks, people living with the condition experience symptoms that impact their ability to engage in their daily lives. 

For some, the constant battle against pain, fatigue, brain fog, and other sources of physical and emotional distress can often define their day-to-day life. 

How Is Fibromyalgia Disabling? 

People grappling with fibromyalgia often face perplexing symptoms, but, like many other invisible illnesses, the outward signs may not always align with conventional expectations of disability. 

However, the severity of many symptoms for some patients is undoubtedly disabling, even if they’re not apparent on the surface. For people with fibromyalgia, self-care is more than a luxury—it’s crucial to functioning on a daily basis. 

Understanding how these symptoms impact people on an individual basis is crucial for a more empathetic discourse: 

  • Chronic Pain: Fibromyalgia is characterized by widespread pain that affects multiple areas of the body. For many people, this makes it challenging to engage in simple, routine activities such as walking, standing, or even sitting for long periods of time. 
  • Trigger Points: The chronic pain associated with the condition often manifests in specific trigger points across the body. When pressed, these trigger points can elicit intense discomfort. 
  • Reduced Mobility: Pain and discomfort can lead to a reduced range of motion, making it difficult to perform commonplace tasks such as bending, reaching, or other maneuvers that require basic flexibility.
  • Frequent Fatigue: It’s not uncommon for patients with fibromyalgia to experience persistent fatigue and weakness. Discomfort leads to unrefreshing rest due to sleep disturbances, further exacerbating pain and fatigue and contributing to a seemingly never-ending cycle of exhaustion. 
  • Cognitive Difficulties: Also termed “fibro fog,” cognitive challenges such as memory lapses, trouble concentrating, and confusion can interfere with tasks that require focus and attention. 
  • Emotional Distress: Living with fibromyalgia takes a toll on a patient’s mental health. Anxiety and depression are common, and the emotional impact further contributes to a dip in motivation, mood, and overall well-being. 

One of the perplexing aspects of fibromyalgia is the variability in symptom presentation, which can differ significantly from patient to patient. This makes it even more challenging for some to recognize fibromyalgia as a disability. That doesn’t mean the complex interplay of its symptoms doesn’t impact an individual’s ability to lead the life they want for themselves. It simply means a comprehensive understanding is even more essential. 

How Is Fibromyalgia Diagnosed?


There is no specific test to definitively confirm the presence of fibromyalgia; diagnosis requires a comprehensive, careful evaluation by a fibromyalgia specialist. The diagnostic process involves multiple components, each contributing to understanding the patient’s experience. 

  • Physical ExaminationPractitioners assess various aspects of a patient’s symptoms, including the presence of tender points, muscle stiffness, and joint mobility.
  • Medical History – A detailed medical history helps practitioners understand the context of a patient’s symptoms. Individuals may be asked about the duration, intensity, characteristics, and family history of these symptoms.
  • Widespread Pain Index (WPI) and Symptom Severity (SS) ScoreThe Widespread Pain Index (WPI) and Symptom Severity (SS) Score are quantitative diagnostic tools. The WPI identifies tender points, while the SS score evaluates the severity of associated symptoms.
  • Exclusion of Other ConditionsBecause fibromyalgia shares symptoms with various other conditions, practitioners conduct tests to exclude alternative explanations.
  • Consult a healthcare provider – Given the complexity of the condition and the necessity of a nuanced evaluation, it’s crucial to consult a healthcare provider such as a rheumatologist, neurologist, or primary care physician with experience in fibromyalgia. These professionals can guide individuals through the diagnostic process. 

Can Fibromyalgia Be Permanently Cured?

There is no known cure for fibromyalgia, and effective treatment options can be elusive. Only three medications are approved by the Food and Drug Administration (FDA) to treat the condition, although many physicians prescribe pain relievers, antidepressants, or anti-seizure medications to alleviate symptoms. A laser-based therapy, or photoceutical device, has also been approved, but its effectiveness has only been tested over the course of three weeks. 

With no available cure, many patients look to other approaches and solutions to find relief and improve their quality of life

Fibromyalgia Coping Strategies and Treatment Options


These strategies and therapeutic interventions are used to enhance the quality of life for individuals navigating the challenges of fibromyalgia.

Lifestyle Changes

Creating a balanced and supportive lifestyle forms the foundation for overall well-being, which is fundamental to managing fibromyalgia. 

This includes prioritizing sleep, establishing healthy routines, and engaging in relaxation techniques to mitigate the impact of stress on the body. Some individuals find relief by avoiding certain trigger foods and incorporating anti-inflammatory nutrients into their diets. 

Physical Therapy

Physical therapy can enhance muscle strength and alleviate pain. Tailored physical therapy programs can also improve flexibility and minimize pain. 

Stress Management

Addressing the emotional and psychological aspects of fibromyalgia is a powerful way to cope with pain and stress. Cognitive behavioral therapy (CBT) can help patients find a safe, supportive space to manage the emotional impact of the condition. 

Fibromyalgia self-care techniques can also include listening to your body, pacing activities, and practicing self-compassion to facilitate a positive mindset despite personal limitations. 

Hyperbaric Oxygen Therapy (HBOT)

Hyperbaric oxygen therapy is considered highly beneficial for fibromyalgia patients.

Brain Signaling: HBOT has been shown to influence brain activity and signaling pathways. Some studies suggest that HBOT may enhance cerebral blood flow, improve oxygenation in brain tissues, and modulate neurotransmitter levels, which could potentially lead to changes in brain signaling patterns.

Brain Sensitization: Fibromyalgia is associated with central sensitization, a process in which the central nervous system becomes hypersensitive to pain signals. While the exact mechanisms are unclear, some research suggests that HBOT may help modulate central sensitization by reducing inflammation, enhancing tissue repair, and improving neural plasticity.

HBOT for Fibromyalgia Relief


At Aviv Clinics Dubai by DP World, our founder, Dr. Shai Efrati, has long been passionate about finding better fibromyalgia treatment options. His mother suffered from fibromyalgia and was unable to hold her grandchildren when they were born due to her immense pain. He hypothesized that a specific hyperbaric oxygen therapy (HBOT) protocol could treat the areas of the brain that misinterpret pain signals.

“The problem is real. It is biological, not psychological like we used to think in the past,” Dr. Efrati explains. “The problem is in the brain, in the locations that are responsible for interpreting signals from the body. The signals are misinterpreted, and then we think there is a pain signal, even though there is no stimulus.”

Pioneering Research for HBOT and Fibromyalgia 


In 2015, Dr. Efrati and his research team conducted the first-ever published clinical trial on the efficacy of HBOT on people with fibromyalgia. This trial resulted in symptom improvement in every one of the 48 participants, and brain scans revealed positive changes in the pain-related areas of the brain. Powerfully, this study “provides evidence that HBOT can improve quality of life and wellbeing of many FMS patients.”

More recently, the research team compared the effectiveness of HBOT to that of pharmaceuticals. In this trial, which was published in March of this year, 64 patients who had traumatic brain injury-induced fibromyalgia received either fibromyalgia medication or HBOT treatment. 

“The hyperbaric oxygen therapy brought significant relief of all symptoms related to fibromyalgia,” says Dr. Efrati. “Not only the pain; everything was significantly better in the hyperbaric group as compared to the medication group. In fact, the improvement was so significant that two out of every five patients no longer met the criteria for fibromyalgia.”

This research, which discovered that “HBOT can improve pain symptoms, quality of life, emotional and social function,” brings optimism to people who suffer from this invisible illness and have not experienced relief from medications. Rather than simply treating the symptoms, the hyperbaric oxygen protocol offers the potential for true recovery.

Fibromyalgia Relief at Aviv Clinics – Watch Aysha’s Story:

Taking a multi-dimensional approach, the team at DP World’s Aviv Clinics Dubai can improve outcomes for people with fibromyalgia. We strive to make a significant difference in fibromyalgia symptoms so those living with the condition can experience relief and take charge of their quality of life.

You don’t have to suffer alone, feeling misunderstood and misdiagnosed. We can help you achieve real relief.



Will fibromyalgia put me in a wheelchair? 

While some individuals with fibromyalgia use mobility aids such as wheelchairs, not all fibromyalgia patients need them. 

We do encourage you to use a wheelchair or other aids if it will help you avoid pain flare-ups or save energy. Listen to your body, and speak with your physician if you believe your quality of life can improve with the help of a wheelchair.  

A medical professional can help you find a wheelchair that is: 

  • A good fit for your body
  • Comfortable for long-term use
  • An appropriate size based on your lifestyle needs 

Does fibromyalgia cause armpit pain? 

Swollen lymph nodes can occur in some individuals with fibromyalgia, but they are not considered a hallmark symptom of the condition. Swollen lymph nodes are more commonly associated with infections, autoimmune disorders, and other medical conditions unrelated to fibromyalgia.

What is the connection between fibromyalgia and bowel movements? 

Digestive issues, such as irritable bowel syndrome (IBS), are common among those with fibromyalgia. 

Studies report “up to 70% of patients with diagnosis of FM have symptoms of IBS.” Common IBS symptoms include abdominal pain, cramping, or bloating and increased gas or mucus in the stool. FM can disrupt normal muscle function, which impacts the digestive system. 

Does fibromyalgia make you immunocompromised? 

To date, there are no clear findings that fibromyalgia makes an individual immunocompromised. 

However, there is some research suggesting FM “is a disease of the immune system.” Further studies need to be done to confirm this, but if true, it could lead to additional FM treatment methods in the future.

What does the fibromyalgia map of tender points refer to? 

When someone with FM feels widespread pain, they will likely feel multiple tender points across their body. Pressing on these trigger spots can cause pain. 

A fibromyalgia map of tender points shows the locations of the typical tender points in this disorder. There are 18 tender points associated with fibromyalgia, consisting of nine symmetrical pairs—for example, the inside of the left and right knees. Typically, a diagnosis of fibromyalgia involves tenderness of at least 11 of these points.

Can fibromyalgia cause pain on one side of the body? 

Fibromyalgia is characterized by widespread pain that impacts multiple areas of the body. The pain can start in one part of your body and spread throughout the tender points. You generally have to have some pain on both sides of your body to be diagnosed with fibromyalgia.

How does fibromyalgia affect the nervous system? 

Fibromyalgia causes changes in the levels of neurotransmitters in the body. These changes cause “augmented central nervous system pain processing.” The neurotransmitters that trigger pain increase, while the ones that stop pain decrease. This makes the nervous system more sensitive to pain.

Does fibromyalgia cause dizziness? 

FM can cause dizziness. It can often feel like that “head rush” you get after standing up too quickly. 

FM impacts the autonomic nervous system (ANS), which is in charge of key tasks such as regulating your heart rate, blood pressure, body temperature, and digestion. 

A healthy ANS increases your blood pressure when you stand up from sitting or lying down. This prevents you from getting dizzy. In those with FM, the ANS does not function properly, and your blood pressure may drop instead, which can lead to dizziness. 

We encourage you to be careful if you experience dizziness, as it can increase your fall risk. A healthcare professional can suggest rehabilitation plans and/or fall prevention techniques. 

Is alcohol bad for fibromyalgia?

Light or moderate alcohol intake is not bad for fibromyalgia. Studies have even found “low and moderate drinkers of alcohol reported lower severity of symptoms.” Heavy alcohol intake can reverse this effect, though, increasing the severity of FM symptoms. Given the many negative health impacts of heavy drinking, it’s always a good idea to moderate your alcohol intake.

Restoring Hope with a Groundbreaking Fibromyalgia Treatment at DP World’s Aviv Clinics Dubai

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