Perhaps you notice that an employee seems to be extremely tired. Or they tell you that they are constantly sore. Maybe their memory doesn’t seem as sharp as it used to be. Fibromyalgia might be the cause. It's an illness that's often hidden, but it's one with serious repercussions. Here's what employers need to know.

What is Fibromyalgia?

With its vague symptoms, an employee with fibromyalgia may seem to be complaining or even trying to avoid work. Taking time to learn about fibromyalgia will help you understand more about what happens to an employee with the diagnosis, as well as what to expect as they struggle with the condition.

Fibromyalgia is a common disorder that causes widespread pain and tenderness throughout the body. It is a chronic disease, meaning that it can last a long time. One of the challenges of dealing with fibromyalgia is that although it is considered to be in the arthritis family, it doesn’t act the same as arthritis. Unlike arthritis, fibromyalgia doesn’t destroy the joints or soft tissues. In fact, there is no visible damage to the areas. But both conditions cause pain and fatigue, as well as interfere with the ability to perform and enjoy daily activities.

Who gets Fibromyalgia?

Of the 5 million people with the diagnosis, about 80-90 percent of those affected are women. Most people begin to develop symptoms between ages 30 and 55; by age 70, about 8 percent of Americans will be affected.

Fibromyalgia Symptoms

The main symptom of fibromyalgia is pain. The pain is widespread and ongoing. People describe it as an intense muscular ache or soreness. They may also say that it is burning or throbbing. Some people complain of numbness, tingling, or unpleasant “crawling” sensations over their bodies. The pain never fully goes away, but can increase with situations, such as stress, fatigue, overexertion, or being out in the cold or damp.

In the early stages, the pain often starts in the neck and shoulders. Over time, it extends to the middle and lower back, arms and legs, and chest. Even a touch or small amount of pressure can cause pain. People may complain that their joints hurt, although there is none of the redness or inflammation that would be seen with arthritis.

How Fibromyalgia Affects Work

The pain of fibromyalgia can be overwhelming, causing a person to be less active or withdrawn. An employee may still come to work, but be less productive. This is called “presenteeism.”

Other symptoms of fibromyalgia, which can affect an employee’s performance, include:

• Fatigue. Over 90 percent of people suffer from persistent fatigue from poor sleep. They may have trouble falling asleep, staying asleep, or sleeping very lightly. They may also have sleep apnea, when they stop breathing for up to a minute.
• Anxiety and depression. Anxiety occurs in about 60 percent of people with fibromyalgia, and depression is reported in almost three-quarters after their diagnosis.
• Other sources of pain. The connection is not understood, but many people also suffer from other conditions, such as migraine headaches, irritable bowel syndrome, bladder problems, menstrual disorders, or temporomandibular joint (TMJ) syndrome.

The good news? Fibromyalgia is not a progressive or life-threatening disease. It doesn’t get worse. Nor does it cause deformities. The other news? It’s difficult to diagnose and treat. And there is no quick cure.

Finding and Treating Fibromyalgia

There is a new test (FM/a) to diagnose fibromyalgia that identifies markers that are seen in the disease. However, more research is needed to prove that it is accurate. Some insurance plans do not cover the test. People often visit many physicians before they learn they have fibromyalgia, because the pain and fatigue symptoms are similar to other disorders. Doctors can also decide the pain isn’t real or as bad as the person describes, or they may prescribe a pain medication that simply isn’t effective for fibromyalgia.

Treatment is also a challenge. It’s important to find a physician who understands fibromyalgia. There are several approved medications, but it may take time and patience to determine which is best. Pain control specialists can play a role. Physical therapy can be useful. There is no set treatment regime; each person requires an individualized plan.

Costs to Employers of Fibromyalgia

According to the Centers for Disease Control (CDC), here’s what to expect with a worker who has fibromyalgia:

• The direct and indirect cost per person is about $6,000 per year.
• Employees may be absent for physician office visits, procedures, tests, hospitalizations, or other symptoms related to fibromyalgia.
• People with fibromyalgia average 1 hospitalization every 3 years.
• Fibromyalgia occurs 25 to 65 percent of the time with other serious conditions such as rheumatoid arthritis or systemic lupus erythematosus.

Helping Your Employees Stay Productive with Fibromyalgia

Most people with fibromyalgia continue to work, despite their symptoms. Research shows that symptoms do not change over time (although stress can cause flare ups). Their jobs are important to people with fibromyalgia, not only for income and benefits, but for their self-esteem and their social supports at work.

Even with good medical management, employees with fibromyalgia will have flare ups or days when they have extra pain, stiffness, or fatigue. Your employee may ask you to:

• Allow extra rest periods (Learn more in Breaks During Work Are Necessary for Employee Well-Being and Work Performance)
• Let them work from home
• Leave early and them them come in on the weekend

Those with severe symptoms may refer to the list of job modification suggestions from the U.S. Department of Labor’s Job Accommodation Network. Depending on the person’s symptoms and limitations, some of the accommodations for symptoms may include:

• Concentration: Reduce stress; Prioritize job assignments; Allow flexible hours and self-pacing; Provide calendars and organizers; Minimize distractions
• Anxiety and Depression: Provide written instructions; Remind about deadlines and meetings; Allow time for counseling; Train co-workers to be sensitive; Permit calls and texts to doctors and support system
• Fatigue: Reduce workplace stress and physical activity; Schedule breaks; Allow flexible work schedule; Permit work from home; Design an ergonomic work station

Fibromyalgia and Disability

Fibromyalgia may or may not be a disability under the American Disabilities Act (ADA). The ADA does not list specific medical conditions or diagnoses. Rather, it provides a general definition (2011) that a person must meet to qualify as disabled. The ADA Amendments Act states, “A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having such an impairment.”

In 2012, Social Security issued a ruling on criteria for fibromyalgia to be considered a disability. Although the ruling is helpful, most people with fibromyalgia are still considered as non-qualifying.

As an employer, you will likely encounter workers who have a fibromyalgia diagnosis. Encourage them to talk about their specific symptoms and what helps them feel better. Find a way to support them and they will do their very best for you.