Fibromyalgia is a chronic condition of disrupted pain processing. It is poorly understood, and although we know a few of its hallmarks, it is unclear exactly why it develops.
Onset often follows a stressful or emotionally traumatic period. It seems to affect women more than men, with the first symptoms usually appearing between the ages of 30 and 50. It can also start before or after this window.
Symptoms include pain and increased sensitivity to touch: things that should only be slightly painful are excruciating, and things that shouldn’t be painful at all are. Fibromyalgia has a wide-reaching collection of symptoms beyond the pain, such as:
- Joint and muscle stiffness
- Fatigue, poor sleep, and cognitive difficulties
- Irritable bowel syndrome (IBS)
Pain often leads to muscle tightness. If this affects the shoulders and neck it can lead to headaches.
Fibromyalgia used to be diagnosed using a system of specific tender points. This method of diagnosis has fallen out of favour. More clinicians are moving towards viewing the condition as a spectrum, rather than a “yes/no” diagnosis. One method of diagnosis is a questionnaire. We can go through this with you in your appointment if you would like, although ultimately you will want to complete it with your GP or consultant as well.
Fibromyalgia often exists alongside other conditions, such as rheumatoid arthritis. So although diagnosis does not depend on ruling them out, it is still helpful to investigate them. This may require imaging or blood tests organised through your GP.
One of the most effective methods for managing symptoms is aerobic exercise. This is something that you need to build up slowly; we can help advise you with this. There is also some evidence to support manual therapy itself.
As with any pain processing condition, understanding a bit about how it works can be really effective in reducing symptoms. One key point to understand about pain is that it’s dependent on context. For example, it’s relatively easy to ignore a pain in your arm if you know it’s from an injection you had that day. That same pain with no explanation might worry you and cause your brain to amplify the pain: it could be a sign of danger. So understanding that the pain of fibromyalgia is not made up or dangerous, just an error of processing, can help to control symptoms.
Depression is a common secondary symptom that can exacerbate other symptoms. CBT has been shown to have quite long term benefits in managing pain levels in fibromyalgia.
Painkillers typically used for epilepsy or depression can be effective, as all of these conditions affect the nervous system. Being prescribed anti-depressants does not necessarily mean you have depression. Evidence also supports the use of some NSAIDs and opioids. However, not all drugs in these families seem to be effective.
Fibromyalgia Action UK are a group who aim to improve the lives of people with fibromyalgia by increasing awareness of the condition throughout the UK and elsewhere, and improve the awareness of, and access to treatments for fibromyalgia.
Do these symptoms resonate with you, or do you already have a diagnosis of fibromyalgia? Book in and see how we can help.