Fibromyalgia is a long-term condition that causes pain and tenderness all over your body.
It is thought to be caused by confusion in your nervous system so that it is not able to control or process pain signals from other parts of your body. This pain may be particularly bad in certain areas and may be affected by changes in temperature. It is common for the symptoms of Fibromyalgia to ebb and flow with periodic “flare-ups” occurring that make you feel worse.
Common symptoms include:
- Forgetfulness or poor concentration (brain fog)
- Anxiety and/or Depression
- Tingling/numbness/swelling of your hands and feet
- Headaches
- Restless legs syndrome – a tingling, uncomfortable feeling in your legs, especially at night
- Painful menstrual periods
- Diarrhoea, constipation and stomach pain – sometimes separately diagnosed as irritable bowel syndrome (IBS)
- Increased sensitivity to temperature, sound and physical touchTtender or sensitive joints and muscles.
Who is affected and what causes it?
It’s estimated that between 1.8 million and 2.9 million people in the UK have fibromyalgia. (https://www.versusarthritis.org)
It most commonly develops between the ages of 25 and 55 and it seems that more women are affected by fibromyalgia than men.
At the moment, we don’t know the exact reason why people get fibromyalgia. But there does seem to be a link with other illnesses, a traumatic event, and your mental well-being. I have had clients who were diagnosed after recovering from a viral illness and after receiving Chemotherapy treatment. Symptoms often seem to start at a time of emotional or physical stress.
Fibromyalgia isn’t caused by damage or an injury to the body. There is no inflammation, but it does increase the sensitivity of your nerve endings. Research has shown that the parts of the brain that register pain react differently if you have fibromyalgia. Sleep disturbance is common and we know that a lack of deep sleep can make pain feel worse and affect your mental health. This doesn’t mean the symptoms of fibromyalgia are unreal or ‘all in your mind’. However, anxiety, trauma, and sleep disturbance are all thought to play a part in the condition.
How is it diagnosed?
Fibromyalgia can sometimes be difficult to diagnose, as the symptoms vary from person to person. There are some common symptoms your doctor will look for to help diagnose fibromyalgia. These include:
Long term pain with no obvious, physical cause
Disturbed sleep
Fatigue
Poor concentration or brain fog
It may help your doctor understand the problems you’re having if you make a list of any physical or psychological symptoms you’ve experienced. They will probably then carry out a physical examination. There aren’t any specific blood tests, x-rays or scans to confirm a diagnosis of fibromyalgia. But you might have blood tests to check for other conditions.
Many symptoms of Fibromyalgia are similar to those of other conditions, like Rheumatoid arthritis, IBS or an under active Thyroid, so these will need to be ruled out before a diagnosis can be given. It is possible to have Fibromyalgia as well as another condition.
Your doctor may also suggest a referral to a:
- Rheumatologist – a doctor who specialises in conditions affecting the bones, joints and muscles. They may confirm your diagnosis.
- Physiotherapist – who can suggest exercises and relaxation techniques
- Community or hospital-based specialist pain clinic, or chronic fatigue service – who can help you manage your symptoms.
Treatment
Because fibromyalgia’s symptoms vary from person to person, it’s difficult to predict how long you will have the condition and the impact it will have on your life.
Although there’s currently no cure, there are treatments, therapies and self-management techniques that can improve your quality of life.
There are a number of ways that your symptoms can be managed:
Physical therapies
A Physiotherapist will be able to help you to develop an exercise plan that can strengthen your muscles and enable you to become more active. Regular exercise can improve your mental well being as well as making you stronger and healthier. It has been shown to improve fatigue and your ability to control pain.
An Occupational therapist may be needed if you require any adaptations to your home or workplace in order for you to manage your everyday activities.
Acupuncture has been shown to relieve pain in patients with Fibromyalgia. Usually, results are short – term but this may help to get you kick started on other, longer term treatment plans.
Massage can also be helpful in the short – term reduction of painful symptoms. It can create a sense of well being and improve sleep quality/quantity. Be sure to discuss your case with the therapist so they can understand your symptoms and what you hope to achieve from the session.
Psychological therapies
Pain is a feeling, just like happiness or sorrow. It is created by the brain based on messages provided by the nervous system. We already know that Fibromyalgia is not caused by any physical damage to the body, it appears to be confusion in this signalling system. Therefore, Talking Therapies, Mindfulness and Relaxation are often part of the treatment plan.
Psychological approaches to pain management try to address the emotional effects of your pain and the things that can make your pain worse. They help you look at how your pain affects your thoughts and habits, and how your emotions can affect your pain.
Making small changes to the way you react to a situation or problem can often improve both your emotional and physical health.
Medication
Drugs can’t treat fibromyalgia, but they can help reduce your symptoms. Your doctor will only recommend drug treatment once you’ve tried the other options mentioned above.
Antidepressants are regularly used to treat sleep problems and pain, as well as depression. When they are used to treat pain, they’re usually prescribed at a lower dose than when they are used to treat depression. However, they can still help if your condition effects your mood.
Antidepressants are now recommended by the National Institute of Health and Care Excellence (NICE) as the first choice of drug treatment for unexplained long-term, widespread pain, such as fibromyalgia.
You might need to take them for a few months before you feel their full benefits. Your doctor will gradually increase the dose to a level that works for you.
Sleep
Poor sleep appears to be a significant cause of fibromyalgia, so getting enough good-quality sleep is an important part of your treatment. Not only will it help with tiredness and fatigue, it may also improve your pain.
Sleeping tablets are not normally recommended, as the body can become tolerant to them, which can lead to the effects wearing off and even addiction. But regular activity, particularly aerobic exercise, and cognitive behavioural therapy (CBT) have proven effective for people with disrupted sleep patterns.
It can also help to change your habits around bedtime. Here are some things that can be useful:
- Make sure your bedroom is dark, quiet and a comfortable temperature.
- Try a warm bath before bedtime to help ease pain and stiffness.
- Develop a regular routine, where you go to bed and get up at a similar time each day.
- You may like to try listening to some soothing music before going to bed.
- Some gentle exercises may help reduce muscle tension, but it’s probably best to avoid energetic exercise too close to bedtime.
- Keep a notepad by your bed – if you think of something you need to do the next day, write it down and then put it out of your mind.
- Avoid caffeine, alcohol, large meals and smoking close to bedtime.
- Try not to nap during the day.
- Avoid watching TV and using computers, tablets or smartphones in your bedroom.
What else can you do?
Because fibromyalgia varies from person to person, I suggest you try some of the following tips to find out what works for you:
- Learn about fibromyalgia, and encourage your family/friends to as well – understanding your condition can help reduce your fears and anxiety. It also means you’re fully aware of treatment and self-management approaches that can help you. It is important that those around you understand how your condition affects you, even when you “look” well. You can get more information from The Independent Voice of UK Fibromyalgia
- Find a support group in your area or an online forum for people with fibromyalgia. Talking about your experiences with other people who understand can help.
- Pick your best time of day to do anything needing concentration. Explain to others if fibromyalgia affects your memory. Learn to pace yourself by breaking tasks into smaller chunks, giving yourself time to rest in between.
- Working flexible hours, as well as adapting your desk, chair, computer and other working areas for comfort, can all help.
If you need any help or advice about how massage can be used to improve the lives of those with chronic illness, please get in touch