What is fibromyalgia?

Fibromyalgia is a complex chronic pain condition that is characterised by widespread, diffuse musculoskeletal pain that lasts for longer than three months. However, it is important to note that pain is often not the only symptoms, with many patients with fibromyalgia also experiencing fatigue, brain fog, sleep disturbances and mental health concerns such as anxiety and depression. Fibromyalgia is often a diagnosis of exclusion as it can often mimic other conditions, and not everyone with chronic pain will have fibromyalgia. Fibromyalgia is a condition of central sensitisation where there are alterations to the central nervous system, meaning there is often an amplified pain response. You can see differences in activity of pain sensitive areas of the brain in those with fibromyalgia.

Who is affected by fibromyalgia?

Fibromyalgia mostly affects women between 20-55 years of age, with women twice as likely to have it than men. It is also more common in those with existing rheumatic disease. However it can affect children and adolescents, but will often be referred to as juvenile primary fibromyalgia syndrome. A single cause of fibromyalgia has not been identified, but it is believed physical and emotional stressors can worsen symptoms, which is why it is important to have a multi-disciplinary whole-person approach to treating and managing fibromyalgia.

What to do when you have fibromyalgia?

Addressing the major symptoms that a person is struggling with is important. This may involve;

• Manual therapy to aid in reducing musculoskeletal pain and tension.
• Sleep:
  • Ensuring that there is a good routine in place. Some tips include sleeping in a dark, cool environment, setting a good schedule where you go to bed and get up at the same time, avoid caffeine after lunchtime, avoid alcohol and large meals close to bedtime and avoiding strenuous exercise for the two hours prior to bedtime. Implementing some of these can aid in a more restful sleep to help with the associated fatigue.
  • Sleep is also important in the management of pain, as poor sleep can lead to increase in pain, which in turn can lead to poor sleep.
• Pain education
  • Reassuring and validating the person that their pain is a part of a real condition, while explaining heightened pain sensitivity
  • Educating on how whilst there is no cure, symptoms can be managed but there will often be fluctuations, especially with pain and fatigue
• Physical exercise
  • Physical exercise needs to be tailored to the individual and what they can tolerate. Exercise that is commonly well tolerated in patients with fibromyalgia includes; walking, biking, swimming, water aerobics and tai chi. These are all low impact exercises. It is important to gradually increase exercise to minimise the initial increase in pain and fatigue.
• Stress management
  • Using techniques to help reduce stress such as meditation, relaxation or therapy can help reduce pain, improve sleep and decrease symptoms of depression and anxiety