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Fibromyalgia

Fibromyalgia

This is a condition we often get asked about in clinic as people may know somebody who has been diagnosed or they may have been recently told they have this condition. It is thought that 1 in every 25 people suffer from Fibromylagia (FM), this is more common in women than men.

It is important to note that Fibromyalgia is described as a syndrome as it is a clinical picture of a collection of symptoms which include:

  • Widespread pain
  • Tiredness or lack of energy
  • Sleep disorders
  • Headaches
  • Changes in mood; Irritability, increased stress, feeling low in mood
  • Irritable or uncomfortable bowels
  • Forgetfulness or poor concentration (this is sometimes characterised as “Brain Fog”)

Despite the prevalence of this condition and it’s disabling nature. To date, there is no definitive physical or psychological cause for fibromyalgia. However; anxiety, depression, emotional distress and poor sleep can exacerbate symptoms. Pain is a common pre dominant symptom of FM, though it is important to note that this pain is not caused by any injury or damage to any tissue, this does not make it any less real or disabling. The discomfort people feel is due to a problem in how the brain and the nervous system process pain in certain regions. This malfunction in the pain processing system means that there is also increased sensitivity and tenderness to pressure, even with minor bumps or knocks.

Blood tests can rule out other conditions presenting similarly e.g. Rheumatoid arthritis, Hypothyroidism, and Vitamin D deficiency, though there are no formal tests or investigations to confirm the diagnosis of FM. Instead, a Doctor or Trained Chartered Physiotherapist will make the diagnosis based on assessment findings. Historically, a Fibromyalgia diagnosis was made by the presence of specific set of tender points throughout the body, however, since 2010, guidelines have dismissed this method. A diagnosis is now considered by the presence of three common signs;

  • Widespread pain for more than 3 months
  • Fatigue or feeling unrefreshed from sleep.
  • Changes in the thought processes including memory and understanding.

What can be done?

Fibromyalgia is a chronic long term condition with no cure. However there are a number of therapies and medications that can help manage the symptoms including;

Medication

  • Low dose anti-depressants such as Amitriptyline can help pain, sleep and improve mood.
  • Gabapentin and Pregabalin are used to help nerve pain and have been used to treat fibromyalgia with some success.
  • Paracetomol can be used to help ease pain. Cocodamol and Codrydamol ( a combined paracetamol and codeine) provide stronger analgesia but can cause side effects constipation and this may cause further discomfort.
  • Opioids are pain killers used to treat moderate to severe pain. There is limited evidence opioids can help fibromyalgia. They are advised for short term use to help ‘flare up’ episodes of pain as they can have effects if taken long term and can create dependency.
  • Non steroidal anti-inflammatories gels or capsaicin gels have been useful for some people with fibromyalgyia, although there is little evidence to support their use.

(Do not take medication without discussing with your GP or pharmacist to make sure they are suitable for you.)

Mangement Strategies

  • Meditation and relaxation can help improve sleep and reduce anxiety and stress.
  • Physiotherapy can help muscle tension, provide pain relief, improve posture and provide a bespoke exercise programme tailored to your needs.
  • Exercise can help stretch and strengthen muscles and well as improve your mood.
  • Acupuncture  can provide pain relief and reduce myofascial trigger point pain and spasm.
  • Psychological therapies including CBT ( Cognitive Behavioural Therapy) can help with depression, anxiety and stress. They can also help form strategies for coping mechanisms.
  • Support groups to talk and share experiences are helpful for some people.

Here at Great Northern Physiotherapy we offer a variety of treatment options to help with chronic pain and long term conditions including Fibromyalgia. Don’t suffer, get in touch for further information on how we can help.