Fibromyalgia

It can be difficult to diagnose as many of the symptoms can belong to a number of conditions or may be mild and put down to expected aches and pains in life.

The cause of fibromyalgia is not clearly understood. It is more common in women, can occur at any age, and in some people it may relate to significant stressful events such as physical injuries or the death of a loved one, but there is evidence that genetics also play a part. One current theory is that fibromyalgia is actually a pain problem, caused by the central nervous system having excessive levels of pain stimulators in it. These respond to muscle triggers – in the absence of any injury – by causing excessive pain in that area. Studies have also shown that people with fibromyalgia have changes to their pain messaging system between the brain, spinal cord and nerves from the spine to the limbs, trunk and head.

It might be worth keeping a diary so you can identify trigger factors that make symptoms worse and avoiding where possible, or doing more of what can help. This includes treating body and mind – exercising improves mobility and reduces pain, and it releases endorphins in the body to make you feel better mentally. Investing time in rest and relaxation can also help.

Some people report certain foods and stress as triggers, others find it hard to pinpoint a pattern.

Pain and stiffness associated with inflammation around muscles, ligaments, and soft tissues can be alleviated to some extent by over-the-counter pain relievers and anti-inflammatories such as ibuprofen or aspirin.

A warm bath or hot compresses can also be soothing on hot spots of pain or inflammation.

For more debilitating pain, very short courses of opioid-based pain relievers containing codeine such as Co-Codamol may also be helpful. For more severe pain, your doctor may be able to prescribe alternatives on prescription. In 2021, the National Institute for Health and Care Excellence (NICE) published guidance on chronic pain - which is one of the key symptoms in fibromyalgia – and stressed the risk of addiction with the long-term use of strong opioid painkillers. (If you’re taking these, don’t suddenly stop them but speak with your doctor first). NICE now recommend the use of antidepressants in the treatment of chronic pain rather than the prolonged use of painkillers (which remain appropriate in the treatment of acute pain).

You may be fit for work depending on your occupation and the severity of your symptoms.

If you have bothersome symptoms of pain, tiredness, difficulty sleeping or bowel symptoms, you should discuss this with your doctor in a routine appointment. The diagnosis of fibromyalgia is usually made from the history and examination as there’s no specific test for the condition.

The doctor will ask about your symptoms and, if you are comfortable, examine you. Depending on the possible diagnosis, blood tests, urine tests, or imaging (ultrasound, X-ray, CT scan) could be carried out, or you may be referred to a specialist department. The doctor may also prescribe some medication to help with your symptoms.