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What is Fibromyalgia?

Fibromyalgia is a medical disorder that is very commonly known as a “chronic widespread pain condition” in rheumatology. In the US, Fibromyalgia is considered an “arthritis condition,” which, according to the National Institute of Health, means it’s a medical condition that impairs the joints and soft tissues and causes chronic widespread pain. However, fibromyalgia is much more complex than a single symptom, as it often presents with a multitude of overlapping symptoms, including significant fatigue and heightened sensitivity to pain. Each individual’s experience with fibromyalgia can be quite different, which makes accurate diagnosis and effective treatment challenging. Notably, fibromyalgia frequently co-occurs with other conditions such as irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), anxiety, and depression. While the exact reason for these comorbidities is not fully understood, some researchers suggest that the body’s vulnerability from managing one chronic condition may make it more susceptible to developing another.

 

What is Fibromyalgia?

Fibromyalgia is a medical disorder that is very commonly known as a “chronic widespread pain condition” in rheumatology. In the US, Fibromyalgia is considered an “arthritis condition,” which, according to the National Institute of Health, means it’s a medical condition that impairs the joints and soft tissues and causes chronic widespread pain. However, fibromyalgia is much more complex than a single symptom, as it often presents with a multitude of overlapping symptoms, including significant fatigue and heightened sensitivity to pain. Each individual’s experience with fibromyalgia can be quite different, which makes accurate diagnosis and effective treatment challenging. Notably, fibromyalgia frequently co-occurs with other conditions such as irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), anxiety, and depression. While the exact reason for these comorbidities is not fully understood, some researchers suggest that the body’s vulnerability from managing one chronic condition may make it more susceptible to developing another. This complexity means that observable symptoms alone are not a reliable way to confirm or rule out fibromyalgia. The precise cause of fibromyalgia remains unknown, but it can develop after physical trauma, infections, significant emotional stress, or in association with other medical conditions like lupus or rheumatoid arthritis. Risk factors include middle age, obesity, repetitive joint injuries, and certain viral infections, though in many cases, fibromyalgia can occur without a clearly identifiable trigger.

Causes of Fibromyalgia

While some indications point to possible causes for fibromyalgia, there is no consensus on what causes fibromyalgia to develop in certain individuals. In fact, it was only in 1990 that fibromyalgia was first thought of as its own medical condition rather than simply pain symptoms of other disorders. Fibromyalgia often co-occurs with other chronic disorders, with which it shares similar symptoms, and so it’s not uncommon for there to be mix-ups and misdiagnoses, likely part of the reason why it took so long to figure out that this was a unique medical condition, and why medical researchers today still cannot isolate a root cause.

What We Know About Fibromyalgia

While there’s much we do not know about this condition, it does not mean science has learned nothing about fibromyalgia; hundreds of thousands of Canadians live with this disorder every day. We know that most cases – up to 80-90 percent, in fact – occur in women, with over 50% of cases in women between 45 to 64 years of age. It’s unclear why it disproportionately affects women, but there is some indication that the impact of hormones may play a role in the development of FM (as in the case of other chronic pain conditions and autoimmune disorders like rheumatoid arthritis). There’s also a fairly clear indication that genetics plays a major role in predetermining who stands a better than average chance of developing FM during their lifetime; individuals with family members who have had FM in the past are several times more likely to develop FM themselves. That being said, an individual with a history of fibromyalgia may not necessarily develop FM. Studies seem to indicate that there needs to be a triggering event, on top of genetic history that makes an individual more likely to develop FM, that happens around the time symptoms for FM begin to show. It’s unclear how the trigger interacts with the genetic preconditions for fibromyalgia, but there are a number of situations that are commonly thought to be part of the formula that leads to the development of fibromyalgia in an individual:

• Physical trauma: the physical pain, state of shock and emotional distress of traumatic situations seem to set the conditions that cause an individual to develop FM.
• Stress: similar to trauma, it’s suspected that chronic, elevated levels of stress provide the right impetus for the pain patterns associated with FM to begin showing. Common situations that lead to high levels of stress before the onset of FM include divorce, the death of a loved one and job loss.
• Infections: it’s not uncommon for individuals to develop FM after suffering from an infection. There are a number of possible explanations for this, including that the infection itself may have caused damage to the nervous system, or that the infection may have been accompanied by a high fever, which is known to be linked with the development of FM.
• Certain medications: some prescription drugs are thought to lead to FM, including interferon alpha and beta, lithium and some types of antidepressants.
• Strong emotions: both positive and negative emotions have been shown to exacerbate FM symptoms in patients, though it’s unclear why. It’s suspected that emotions may affect the autonomic nervous system, which in turn impacts the pain processing areas of the brain.
• Poor quality of sleep over extended periods: although difficulty sleeping is usually attributed to someone’s pain experience, recently, medical researchers are considering the possibility that someone’s insomnia or difficulty sleeping might be causing their fibromyalgia.
• Post-traumatic stress disorder (PTDS): individuals with PTSD are at a higher risk of developing FM, likely because of the complex combination of chronic pain, anxiety, and sleep disorders that are all symptomatic of PTSD. Statistically, individuals with PTSD are anywhere from 2.5 to 6 times more likely to develop FM than individuals who have not experienced trauma.
• Other conditions like rheumatoid arthritis or lupus: in some cases, it’s even been shown that FM will develop alongside RA or lupus in some individuals. These comorbidities, which means diseases and disorders that occur at the same time, often present in very similar ways.

Types of Fibromyalgia

To date, due to the relatively little confirmed information available about FM, there is little information about other types of fibromyalgia. It’s even unclear whether other disorders and conditions that share certain symptoms with FM, like rheumatoid arthritis, have anything in common with the disorder. What is known, however, is that certain types of FM have been observed in patients:

• Primary Fibromyalgia: In Canada, the most common type of fibromyalgia is primary FM, with approximately 80-90% of all diagnoses falling into this category. This type of FM has no discernible cause and occurs seemingly out of nowhere. It’s the most common type of fibromyalgia and is characterized by a long history of symptoms, with little to no improvement over time.
• Secondary Fibromyalgia: Secondary fibromyalgia is caused by another condition or set of conditions. A shorter history of symptoms characterizes it and usually improves when the root cause is properly treated.
• Childhood Fibromyalgia: This type of FM is diagnosed in children and adolescents, and is characterized by a similar set of symptoms to adult FM. However, the pain experienced by children tends to be more focused in areas like the back, neck, and abdomen as opposed to being widespread.

Symptoms of Fibromyalgia

As mentioned, pain is a predominant symptom that almost always underlies fibromyalgia. For a person with fibromyalgia, pain flare-ups are often severe, sharp and long-lasting and are generally brought on by some instigating factor, or aggravator, which amplifies the pain and/or other symptoms to acute levels. When the flare-up subsides, a person will almost always still have pain — it almost never goes away because fibromyalgia is a chronic condition. Despite pain being the most common symptom of fibromyalgia, it is only part of a constellation of symptoms that a person with the condition will suffer. Oftentimes, people with fibromyalgia will suffer all-consuming fatigue, numbness and tingling sensations throughout their extremities, IBS, restless leg syndrome, dizziness, allergic reaction-type symptoms like runny nose and burning eyes, nausea, dizziness, headaches, etc. A more detailed outlook of fibromyalgia symptoms is as follows:

• Knotted or Tightened Muscles: many people with fibromyalgia experience the feeling of knotted or tight muscles. Muscles often hurt to the touch, and pain radiates to other body areas when pushed on certain muscles. This increased sensitivity is often known as “trigger points,” –  which doctors use to diagnose a fibromyalgia condition by pushing on certain areas of the body and noting how many of the trigger points are painful to the person. Oftentimes, people with fibromyalgia will turn to massage therapy to assist with the feeling of knotted or tight muscles, cramping and weakness.
• Digestive Disorders: people with fibromyalgia often experience digestive disorders such as heartburn, constipation, diarrhea and indigestion. Other symptoms include abdominal cramping that is triggered by certain foods.
• Widespread body pain: this is the core symptom of fibromyalgia that often prevents people from working. Typically, the pain with fibromyalgia is a dull, aching pain sensation in the muscles and/or joints that lasts for at least three months or more. In order to meet the criteria for widespread pain, the individual must experience pain in at least four out of these five areas: left upper body, right upper body, left lower body, right lower body, and/or the axial region (neck, chest, or back). People with fibromyalgia have often described widespread body pain as feeling like one has the flu, which is exacerbated by any kind of movement.
• Fatigue: fatigue is a common symptom for all people with fibromyalgia is a total lack of deep, restful, restorative, stage four sleep. This is the period of sleep where the body repairs and replenishes and heals itself. Persons with fibromyalgia often suffer from severely interrupted sleep and often wake exhausted – with fatigue persisting through the day.
• Brain fog and Cognitive Issues: sometimes referred to as “fibro fog” can impact a person’s ability to focus, their memory, attention span, and concentration. People with fibromyalgia often complain that they cannot focus or concentrate and have word-finding difficulties. Tasks that require quick or frequent changes in thought may also be more difficult. Memory difficulties and confusion are very prevalent in people who suffer from fibromyalgia.
• Morning Stiffness: it’s often been written by experts that the pain and stiffness that a person with fibromyalgia suffers is often much worse in the morning when they first get out.
• Headaches, Migraines and Balance Difficulties: headaches and migraines can be a daily occurrence for someone suffering from fibromyalgia. Pain medication might not be strong enough, thus requiring prescription pain relievers. Balance difficulties are often common, often due to brain fog, headaches, and muscle wasting. It’s not uncommon for someone with fibromyalgia to have difficulties riding a bike or walking long distances.

Conditions that can Aggravate Fibromyalgia Symptoms

For those suffering from fibromyalgia, some conditions and activities can worsen the symptoms of this condition. This is particularly pertinent for working individuals, as many of these conditions are brought on or made worse by work-related stressors. While these conditions and activities may be considered no more than uncomfortable for someone without fibromyalgia, for those with FM, they can be quite debilitating:

• Sitting or standing in the same position for too long: Having to stay in the same position for an extended period of time, whether seated or standing, can cause pain to worsen and can make it difficult to move when the individual is finally able to.
• Lack of physical activity: While too much physical activity can also worsen pain, a lack thereof can have a similar effect. This is because not moving around enough can cause muscles to weaken and stiffen, leading to more pain.
• Poor posture: Maintaining poor posture for too long, whether at work or home, can put unnecessary strain on the spine and other joints, leading to increased pain. This can make FM a problem for those working in industries requiring them to sit or stand in the same position for long periods.
• Repetitive motions: Doing the same motions repeatedly, whether at work or during leisure activities, can lead to pain and stiffness in joints. This is why it’s important to take breaks often and to vary up the activities that are being done.
• Lifting heavy objects: Fibromyalgia patients often report increased pain after lifting something heavy, as this can put additional strain on the muscles and joints.
• Excessive stress: as with most chronic pain conditions, stress can exacerbate the symptoms of fibromyalgia. This is why it’s important to find ways to relax and de-stress, whether through yoga, meditation, or another activity. Fibromyalgia is considered a long-term condition, which means that symptoms can come and go, or vary in intensity. There are periods when symptoms might be barely noticeable, and others where they’re severe and have a major impact on day-to-day life.
• Suffering from overexertion: exercises that you might have been able to do previously may now be much more difficult and may exacerbate your fibromyalgia symptoms. If whatever exercise or activity you are doing makes your symptoms worse, it may be a good idea to lessen your physical activity.
• Weather: persons with fibromyalgia who spend an extraordinary amount of time in the sun may, unfortunately, feel an increase in burning and itching of their skin. Rapid changes in the weather, as well as cold weather, can really be hard on the person with fibromyalgia. Symptoms of depression, muscle aches and headaches often get worse with rapid weather changes or when the weather is snowy or rainy.

For some people, the symptoms might only last for a few weeks or months, while others might have them for years. Fibromyalgia can affect people of any age, but it’s most commonly diagnosed in adults aged 20 to 50. Women are also more likely to be diagnosed with fibromyalgia than men.

Fibromylagia Causes Pain

Since there’s no clear explanation for what causes FM, medical individuals will focus on how people with FM feel. Although the causes for FM are unclear, how it affects individuals is very apparent. Researchers suspect that the reason why individuals with fibromyalgia are constantly in a state of pain or discomfort is that the body’s system of nerves. The same nerves that send pain signals to act as a warning when we’ve been burned or cut overreact to stimuli that wouldn’t normally be painful. This overreaction causes individuals with fibromyalgia to hurt all over, even when nothing is causing them physical harm. The pain signals sent by these nerves can also cause other symptoms, such as fatigue, sleep problems, and difficulty concentrating. Instead of sending pain signals in response to what most individuals might consider a ‘normal’ threshold of pain – a knife slicing your finger, or falling off a tree – nerves in people with fibromyalgia are over-sensitive. They will trigger at even the slightest pressure such as wearing body-fitting clothing or belts, someone tapping them gently on the shoulder (or anywhere on their body), knocking on the door, a sudden stream of water from a showerhead and being bumped while walking on the street. While people without FM might not even think twice about these experiences, these events can be painful for people with fibromyalgia, pain that range from mild and simply irritating to debilitating.

The Impact of Fibromyalgia on Work Ability

Fibromyalgia is a chronic condition that causes widespread pain, fatigue, and a variety of other symptoms, all of which can significantly impact a person’s ability to function at work. The unpredictable nature of symptom flare-ups can make maintaining regular work hours and consistent productivity especially challenging. Common ways fibromyalgia can affect work include:

• Chronic pain and stiffness: Persistent discomfort can make it difficult to sit, stand, or move for extended periods, limiting both physical and desk-based tasks.
• Fatigue: Many with fibromyalgia experience overwhelming tiredness that does not improve with rest, leading to difficulty focusing, reduced stamina, and lower work output.
• Cognitive issues (“fibro fog”): Problems with memory, concentration, and mental clarity can interfere with decision-making, following instructions, and multitasking.
• Sleep disturbances: Poor sleep quality can further worsen fatigue and cognitive function, creating a cycle that impairs daily performance.
• Emotional symptoms: Anxiety and depression, which often accompany fibromyalgia, can reduce motivation and affect interactions with colleagues.

Additional workplace challenges:

• Unpredictable flare-ups: Sudden increases in symptoms may require time off or adjustments in workload.
• Physical limitations: Some jobs that require manual labor or repetitive motion may become impossible to perform safely.
• Need for accommodations: Many individuals require flexible schedules, the option to work from home, or ergonomic adjustments to continue working.

Can I qualify for Long-Term Disability if I suffer from Fibromyalgia?

Fibromyalgia is a recognized medical condition that can cause significant pain and a range of symptoms, often severely limiting an individual’s ability to work. Despite this, many insurance carriers are reluctant to approve disability benefits for chronic pain conditions like fibromyalgia. This reluctance is often due to the invisible nature of fibromyalgia, the challenges in diagnosis, and persistent misconceptions about the condition. For many years, fibromyalgia has been surrounded by myths, including doubts about its legitimacy as a disease. However, it is officially recognized by the World Health Organization (WHO), the Canadian Rheumatology Association, the Canadian Pain Society, and the American College of Rheumatology. Eligibility for long-term disability benefits depends on meeting the definition of “Total Disability” as outlined in your group or individual disability insurance policy. While specific definitions may vary, most policies consider a person “Totally Disabled” if they are unable to perform the substantial duties of their own occupation. The responsibility to prove this disability rests with the claimant. Individuals suffering from fibromyalgia frequently encounter employment challenges due to unpredictable and debilitating symptoms, which can make sustained work difficult or impossible. If you have been diagnosed with fibromyalgia and are unable to work, you may qualify for long-term disability benefits. However, insurance companies often deny these claims for a variety of reasons, including:

• Severity of symptoms: Insurers may argue that your symptoms are not severe or consistent enough to justify benefits.
• Diagnosis by an “acceptable” physician: Due to the lack of a definitive test for fibromyalgia, insurers may dispute the qualifications of your diagnosing doctor or claim inadequate medical evidence.
• Treatment history: Claims may be denied if insurers believe you have not pursued all reasonable treatment options or that your efforts to manage symptoms are insufficient.
• Permanency of condition: Some insurers may contend that fibromyalgia is not a permanent disability or that there is insufficient evidence to support long-term impairment.
• Incomplete or inaccurate medical information: Missing or inconsistent information in your claim file can result in denial.
• Doubts about total disability: Insurers may seek evidence that you are not as impaired as claimed, including monitoring your activities online or through surveillance.

If your claim for long-term disability benefits has been denied, it is crucial to seek assistance from a qualified disability lawyer. The appeals process can be complex, and experienced legal representation can greatly improve your chances of securing the benefits you need.

Denied Long-Term Disability for Fibromyalgia? We Can Help.

Fibromyalgia is a complex medical condition that affects individuals in unique and unpredictable ways. Its symptoms—such as chronic widespread pain, fatigue, and cognitive difficulties—can vary significantly in severity and can profoundly disrupt a person’s daily life and ability to work. Unfortunately, the variable nature of fibromyalgia is not always fully understood or acknowledged by disability insurance companies, resulting in many deserving individuals being denied long-term disability benefits. At Lalande Personal Injury Lawyers, we recognize the serious impact fibromyalgia can have on your livelihood and well-being. Our legal team has extensive experience representing clients who have been denied disability benefits due to fibromyalgia and related conditions, including brain trauma. We understand the medical complexities involved and the challenges of proving disability in the face of skeptical insurers. If you or a loved one has been denied long-term disability insurance after a diagnosis of fibromyalgia, do not be discouraged. Our dedicated fibromyalgia disability lawyers are committed to fighting for your rights and securing the benefits you need and deserve. Since 2003, we have helped thousands of claimants at all stages of the disability process across Ontario. We offer compassionate support and a thorough understanding of both the medical and legal issues at play, ensuring your case is presented with the strongest possible evidence. Contact us to book a free consultation with our Hamilton disability lawyers at 905-333-8888 or by using our online contact form.