What is Fibromyalgia?
Fibromyalgia is a condition that occurs in up to 5% of the adult population in the UK. It is a disorder characterized by widespread musculoskeletal pain accompanied by a number of other symptoms, including fatigue, poor sleep, memory and mood issues and irritable bowel syndrome. It is thought that in fibromyalgia, the brain processes pain signals abnormally so that ‘normal’ painful sensations are amplified, making relatively minor pain sensations much more intense.
Fibromyalgia often develops after a physical trauma, surgery, infection or significant and prolonged psychological stress. In other cases, symptoms gradually accumulate over time without any obvious triggering cause.
Fibromyalgia is encountered much more frequently in women. The condition is associated with a variety of other conditions, including tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.
What are the Symptoms of Fibromyalgia?
Fibromyalgia pain is usually described as a dull ache in the muscles of the body. The muscles feel sensitive and sufferers feel pain more easily. Patients with fibromyalgia tend to have tender points (trigger points) which are especially sensitive. These points are mainly in the shoulders, neck, upper chest, elbows, hips, and knees.
As well as pain, individuals with fibromyalgia experience tiredness, poor sleep and restless legs. This constant fatigue and sleep disturbance tends to aggravate the pain symptoms and can also affect mood. Other frequently occurring symptoms include depression, anxiety, frequent headaches, memory issues, TMJ pain and irritable bowel.
How is Fibromyalgia diagnosed?
The American College of Rheumatology (ACR) revised its diagnostic criteria in 2010. Fibromyalgia is a diagnosis of exclusion. This means that all other rheumatoid conditions have to be excluded before this diagnosis can be made.
What Treatments Can be offered for Fibromyalgia?
Your pain management specialist will take a full medical history and make a thorough assessment of your pain and tailor a treatment plan to your individual needs.
Treatment options will include:
- A full explanation of fibromyalgia – from a specialist who is familiar with this condition and the impact that it has on the individual
- Pharmacotherapy – Anti neuropathic drugs have been shown to be effective in management of pain as well as sleep in fibromyalgia. These drugs include tricyclics and the gabapentinoid antiepileptic drugs
- Psycho-therapy / Cognito-Behavioural Therapies - Cognito-behavioural therapy and relaxation techniques, as a part of multidisciplinary approach, can help in managing the pain, with less dependence on drugs and health care professionals.
- Injections. These are rarely a viable long term solution for fibromyalgia but can be considered in the short-term to give ‘a window of opportunity’ to begin mobilising and improve muscle tone.
Options for injections include trigger point injections with either cortisone or botulinum toxin. Trochanteric bursa injections with cortisone are also offered to reduce hip pain and improve mobility and sleep.
While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.