Fibromyalgia syndrome is a chronic debilitating condition characterised by pain, fatigue, sleep disturbance and cognitive problems.
It is commonly encountered in general practice and affects between 2-8% of the population.
The diagnosis of Fibromyalgia is complex, but is based on the diagnostic criteria, symptom score, severity and pain index.
It is important to see your GP or specialist to exclude other diseases or diagnosis of fibromyalgia. These include inflammatory arthritis, cancers, neurological disease and systemic infections. Your doctor will need to investigate your symptoms appropriately. This may include blood tests and imaging (x-rays and CT).
There is no one single treatment for Fibromyalgia. Effective management requires a multimodal and holistic approach, considering an individual patient’s symptom profile, treatment profiles and reversible factors. It often involves treatment by multiple medical specialties. This will usually be coordinated by your GP.
Multidisciplinary management is the corner stone of treatment. This includes input from medical specialists such as rheumatologists/pain specialists, and allied health practitioners such as physiotherapists and psychologists.
Education, graded exercise and psychological strategies form the basis of fibromyalgia management.
Pharmacological treatments are a useful adjunct and include newer antidepressants such as SNRI’s, tricyclic anti-depressants, anti-epileptic drugs and non-opioid pain medications such as tramadol and tapentadol.
There has been significant public interest in the role of cannabinoids in chronic pain has recently emerged, however currently there is insufficient evidence to recommend these in routine practice.
Many people are interested in complementary medicines and treatment modalities. Please be aware that studies in these areas are limited and therefor recommendations are hard to make.
There are however two exceptions being tai chi and acupuncture which show a moderate improvement in pain when added to standard therapy.