A guide to Fibromyalgia

Fibromyalgia is the name for a group of conditions that causes generalised pain and muscle stiffness in many parts of the body. Other common symptoms are extreme tiredness and sleeping poorly.

Some people also feel vague and confused at times. Fibromyalgia is common and affects around 2-5% of the population, mainly young to middle-aged women.

What are the symptoms of fibromyalgia?

The most common symptoms of fibromyalgia are:

  • pain in many different muscles and bones
  • tenderness or stiffness in the muscles or bones, lasting for at least 3 months
  • extreme tiredness
  • difficulties in sleeping

Other symptoms and related conditions may include:

  • problems with concentration and memory
  • anxiety, depression or emotional distress
  • irritable bowel syndrome
  • headaches
  • numbness and tingling in the arms and legs

People with fibromyalgia often find their symptoms change over time. The symptoms may be worse during times of psychological, social or physical stress.

What causes fibromyalgia?

The cause of fibromyalgia is not completely understood, but it seems that fibromyalgia is a problem with the brain, rather than the muscles and bones. For some reason, the brain of someone with fibromyalgia is very sensitive to certain things. It feels them as pain, where other people would not. This does not mean that the pain is not real — simply that the pain originates in the brain, not the muscle and bone.

Fibromyalgia is thought to be related to other ‘sensitivity syndromes’, such as chronic fatigue syndrome, multiple chemical sensitivities and irritable bowel syndrome.

How is fibromyalgia diagnosed?

Fibromyalgia can be difficult to diagnose since there is no single test or examination for it.

People suspected of having fibromyalgia may have blood tests and x-rays to look for other possible causes of the muscle and bone pain.

A doctor may diagnose fibromyalgia when they think that the pattern of pain and tiredness fits the condition and doesn’t fit other conditions.

How is fibromyalgia treated?

There is no cure for fibromyalgia but most people find they are able to ease some of the pain and tenderness with the right approach. It’s important to learn about fibromyalgia and play an active role in your treatment.

Regular exercise reduces pain and tiredness, and improves sleep in people with fibromyalgia. Exercise should be introduced slowly and gradually — water-based exercise (hydrotherapy) may be a good place to start. A physiotherapist can help you design the right exercise program. Tai chi and yoga may also help.

Getting enough sleep is important. Setting aside plenty of time for sleep, reducing tea and coffee after lunch, relaxing before bed and getting up at around the same time each day can all help.

Psychological approaches can also help. These include learning how to manage stress, learning how to plan and pace your life, and therapies such as mindfulness and cognitive behaviour therapy, or CBT.

Common pain relievers such as paracetamol and anti-inflammatory drugs are usually not helpful in fibromyalgia. Some people with fibromyalgia may find that their pain or other symptoms can be controlled with medicines that are sometimes used to treat epilepsy or depression.

Some medicines originally developed to treat epilepsy, such as pregabalin and gabapentin, have been shown to help reducing pain. Pregabalin is not on the PBS so is not subsidised in Australia and can be expensive. Many fibromyalgia patients get referrals to pain clinics or hospital outpatient services where it may be possible to buy pregabalin at the PBS rate.

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