Since I am a nurse-midwife, my practice focuses on the essentially normal pregnancy so my experience with fibromyalgia is limited. Fibromyalgia is one of many rheumatologic disorders that occur in women. Symptoms may include localized muscle pain in the paraspinous regions of the upper and middle back, neck, shoulders, arms, and legs. Pain is worse after even minimal activity and may include generalized sypmtoms such as diffuse myalgia, fatigue, a low-grade fever, muscle tension, headache, and skin sensitivity. Sleep disturbance is common. As with most rheumatologic disorders in pregnancy, there is no definite predictable course. Some will improve, some will exacerbate, and some will remain the same.

Treatment in pregnancy will vary based on the treatment's effect on the fetus vs. the severity of mother's symptoms. Use of nonsteroidal antiinflammatories may be limited after the 28th week of pregnancy because of their potential effects on the fetus. Medication to promote sleep may be changed to one with minimal effects on the fetus. Regular exercise with adequate warm-up, cool-down and stretching may be helpful. Soft tissue injections with anesthetic agents may be used.

Considering this is your first pregnancy with the diagnosis of fibromyalgia and I do not know what treatments you have used for this disorder while not pregnant, I would recommend that you consider consulting with a perinatologist at least once during this pregnancy to become more informed.

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