Fibromyalgia is a chronic condition that causes widespread pain that is felt in the muscles and tissues, such as tendons and ligaments.
Patients will also experience tenderness in well-recognised tender point sites, which are found mainly in the upper chest and back, as well as neck, arms and legs.
In addition to pain and tenderness, fibromyalgia typically causes considerable distress and disability, impacting daily activities.
About 1 in 25 people will develop fibromyalgia during their life.
Chronic, widespread pain is the most common symptom experienced by patients. The pain often has certain qualities:
- Exacerbated by stress, cold or activity;
- Diffuse tenderness or muscles, ligaments and tendons;
- Back and neck are frequently the most painful sites of the body.
Most patients report fatigue and tiredness, which is unrelieved by rest. This is commonly exacerbated by poor sleep (insomnia).
In addition, patients are often affected by other symptoms/conditions including:
- Irritability and poor concentration;
- Pins and needles;
- Depression and/or anxiety;
- Irritable bowel syndrome;
- Chronic fatigue syndrome.
The exact cause of fibromyalgia is not currently known. The most common theory explains that in people with fibromyalgia their nervous system produces an exaggerated response to messages from muscles. Their nerves release an inappropriate amount of chemical messengers responsible for pain when muscles feel pressure or stretch. This causes patients to feel pain in the location of these muscles, ligaments and tendons.
Anyone can develop fibromyalgia, however it more common in women and between the ages of 30 and 50.
Fibromyalgia is diagnosed from speaking to a patient to understand their symptoms in full, and by performing a thorough clinical examination
There is no formal test to diagnose fibromyalgia, however other conditions may mimic the symptoms of fibromyalgia and further tests may be required to investigate these if suspected.
There is currently no cure for fibromyalgia and treatment focuses on improving symptoms and quality of life. As fibromyalgia affects individuals differently, patients often require tailored treatment plans.
Several patients report benefits in their symptoms with simple remedies such as exercise, physiotherapy, relaxation and self-help.
Psychological support is an important component of care. Cognitive behavioural therapy may improve symptoms in select patients.
Regular painkillers may provide some benefit in fibromyalgia. Recommended first line treatment however is with antidepressants (e.g. amitriptyline, cyclobenzaprine, duloxetine). Antiepileptic medications (e.g. pregabalin, gabapentin) also have proven benefit in fibromyalgia. Many patients will require a combination of 2 or 3 medications to achieve optimum symptom management.
Medical Cannabis can be considered when first line therapies have not achieved adequate symptom control.
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