Compiled by our Masters trained Physiotherapist Chris Smith. To book an appointment with Chris, or read his Meet the Team profile CLICK HERE.
Fibromyalgia is a condition characterised by widespread pain in the muscles and connective tissues for 3 months or more. It is defined as a syndrome due to the collection of symptoms rather than a disease, as there is currently no identifiable cause within the medical field.
It often runs in families and people with Rheumatoid arthritis, lupus and Ankylosing spondylitis are more likely to develop it. However, it is not a condition of the joints or an inflammatory condition. There are many hypotheses for why it may develop, although none of these have been proven and accepted yet. For example psychological trauma or prolonged stress may affect how the body's pain signals react, potentially leading to a sensitised pain system. Another suggestion is a widespread and chronic raised inflammatory response in the body.
As many as 1 in 50 people may develop fibromyalgia at some stage in their life and it is most common between ages 25-55. It affects 9 women for every 1 man, but it can also affect children.
- Widespread pain and stiffness: heightened sensitivity to touch/pressure, common trigger points include neck, shoulders, chest, hips, & knees.
- Fatigue, insomnia and poor sleep.
- Difficulty with concentration (Fibro fog)
- Changes in mood, anxiety and depression.
- Gastrointestinal problems.
How is it diagnosed?
There is no gold standard for fibromyalgia diagnosis. Various criteria have been suggested over the years since 1990, however the most recent were updated in 2016. These include:
- (1) Generalized pain, defined as pain in at least 4 of 5 body regions, is present.
- (2) Symptoms have been present at a similar level for at least 3 months.
- (3) Widespread pain index and symptom severity scales. These are outcome tools that clinicians used to measure pain location and severity.
What are the management options?
There is no cure for fibromyalgia. Management should be aimed at relieving symptoms and improving function. Everyone's symptoms will be different, therefore treatment approaches will need to be individualised. However, they are likely to include both medical and self-care approaches.
Medication may be useful, but active approaches to relieving stress including mindfulness, meditation, yoga and psychological support may be helpful. Reducing stress triggers in your life may also be beneficial, rather than merely managing stress when it occurs. Graded exposure to exercise is also recommended. In addition to this, looking at lifestyle and sleep hygiene may be important as one of the major symptoms is sleep disturbance and fatigue. A recent study from 2017 demonstrated that the agreed treatments between international expert groups on the topic were exercise, cognitive behavioural therapy, and certain antidepressant drugs such as amitriptyline.
As physiotherapists with expertise in persistent pain, we are well placed to support and educate fibromyalgia patients about their condition in addition to producing an individualized exercise and rehab program that may be beneficial. Our training also provides us with a good knowledge of the impact your psychological system can have on any pain condition. If we feel you need more expert talking therapies as part of your management we can signpost to the correct psychology services.
So if you think or know of anyone with fibromyalgia come in and see one of us to see how we may be able to help you.