What is Fibromyalgia?
Fibromyalgia is a common condition affecting up to 4% of the population. Patients with fibromyalgia typically complain of symptoms of widespread body pain and stiffness that affects their function, fatigue and sleep. There may be multiple tender points on the body and the pain is present for greater than 3 months. There is no specific test for it, the patient’s story and examination will give the most clues for a diagnosis to be made.
However, there should not be evidence of fever, muscle wasting or weight loss, swelling or redness of joints – the presence of these complaints may herald underlying disease such as arthritis / systemic autoimmune conditions whose symptoms can overlap with fibromyalgia. In this case there may be the need for some simple tests to be undertaken – usually by a General Practitioner.
Despite the fact that the cause of fibromyalgia is not yet clear it is important to recognise that for the patients the symptoms and impact on their daily lives is very real and just recognising this is often the first step on the road to recovery. For many people symptoms can be longstanding and developing strategies to cope with the condition may be more beneficial than aiming for a ‘cure’.
How to Improve the Symptoms of Fibromyalgia
There has been good evidence from research in recent years that education about the condition and exercise are effective, drug free strategies to help.
Exercise has had proven benefit for symptoms of fibromyalgia in many studies. Moderate intensity aerobic exercise (e.g. walking, cycling, swimming) for 12 weeks improved overall well-being and physical function. Strength training results in a reduction in tender points, pain and depression. This exercise is best done in a supervised fashion and slowly increased in intensity.
There is some evidence also that Tai Chi has benefits in treating fibromyalgia over and above simple stretching exercises.
A Combination of Treatment
For some psychological support is very important, symptoms of poor sleep and fatigue can be particularly difficult to live with. Studies have shown that Cognitive Behavioural Therapy (CBT) a talking therapy undertaken usually with a psychologist can have good results in improving symptoms and quality of life in fibromyalgia patients. Patient education has shown similar benefits.
Some types of anti-depressants, when used in low doses have benefits in treating conditions other than anxiety and depression. Fibromyalgia has been shown to be treated successfully in many studies with improvements in pain, fatigue, mood and sleep greater than those taking placebo. They must be prescribed by your doctor and may be a good option for some people.
In some cases, medication is used to treat pain. NSAIDS (non-steroidal anti-inflammatory) like ibuprofen and diclofenac have no proven benefit and should not usually be prescribed. Strong painkillers, while maybe useful in the short term, often have long term side effects and difficulties associated with their regular use including addiction and so exercise and psychological support is felt to be the better option. Research supports this.
In summary fibromyalgia is a common condition which can be both difficult to live with and to treat but there is much help available and with a focus in particular on understanding the condition and making positive lifestyle changes many people can improve their day to day function and quality of life significantly. If you have any concerns, please talk to your medical professional