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Fibromyalgia


Expert reviewer, Dr Sundeept Bhalara, Consultant Rheumatologist and General Physician
Next review due August 2022

Fibromyalgia is a long-term (chronic) condition that causes pain in different places in your body. It can also disturb your sleep, make you feel tired and cause problems with your memory.

Doctors don’t fully understand what causes fibromyalgia, although it does run in families. There’s no cure for fibromyalgia, but there are treatments which can help ease your symptoms. These include medicines, exercise and psychological therapies.

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What is fibromyalgia?

Fibromyalgia is quite common. It affects up to one in 20 people, and is much more common in women than in men. Most people with fibromyalgia start to get symptoms between the ages of 20 and 60. You’re more likely to get fibromyalgia as you get older, but children can get it too. Some people who are diagnosed with fibromyalgia as adults are found to have had it since childhood.

You may have heard the terms fibrositis and muscular rheumatism, which were once used to describe the condition of fibromyalgia. These terms imply that there’s inflammation or wear and tear in your muscles and joints, but doctors now know that this isn’t the case in fibromyalgia. It isn’t due to tissue damage – it’s to do with the way your body processes pain. For more information on this, see our section: Causes of fibromyalgia below.

Symptoms of fibromyalgia

The main symptoms of fibromyalgia include:

  • widespread pain in your body – this may be joint pain, muscle pain or both; it often affects your neck and shoulders, or lower back
  • oversensitivity to touch, light, sounds or smells – even a slight touch may seem painful
  • feeling stiff, especially when you wake up – it may get worse when you move
  • feeling very tired and lacking energy
  • sleeping badly and waking up unrefreshed
  • problems with your memory or thinking clearly (sometimes called ‘fibro fog’)
  • changes in your mood

These symptoms may get worse in cold weather or if you’re feeling stressed. If you’ve had these symptoms for at least three months, contact your GP.

Other symptoms and health conditions can be associated with fibromyalgia. These include:


Diagnosis of fibromyalgia

Your GP will ask about your symptoms. They may also ask about your general health, any illnesses you’ve had and your family's medical history.

Your GP will examine you to see if you have areas of tenderness in your muscles and joints. If you have lots of 'trigger points' without symptoms of any other joint or muscle disease, you're more likely to have fibromyalgia.

There are no blood tests, X-rays or scans that can diagnose fibromyalgia. But your GP may do some blood tests to rule out other conditions with similar symptoms to fibromyalgia.

Your GP may refer you to see specialists for further tests and treatment. These specialists might include:


  • a pain specialist, who may be working in a pain clinic
  • a musculoskeletal (MSK) specialist such as a physiotherapist or MSK physician (health professionals who specialise in treating conditions that affect muscles and joints)
  • a rheumatologist (a doctor who specialises in identifying and treating conditions that affect the muscles and joints)
  • a psychologist (a doctor who specialises in mental health and psychological treatments)

Self-help for fibromylagia

If you have fibromyalgia, there’s a lot you can do to help yourself.

  • Learn about fibromyalgia and the ways you can manage it. It may help to share this information with your family and friends so they can support you.
  • Pace yourself. Work within your limits and break up tasks into smaller sections if that helps. Catch up with some activities on good days so that you can rest when you feel less able to be active.
  • Do some exercise every day if you can, even if it’s just a little. See our treatment section below for more information about exercise for fibromyalgia.
  • Try to get into a good sleep routine to help ease your tiredness.
  • Learning some relaxation techniques may help. Try to do something you find relaxing each day, especially before bedtime.
  • Having a hot bath or applying heat with a hot water bottle may help ease pain and stiffness.
  • Practising mindfulness may help.
  • Keep up your social activities and try to stay connected with friends and family. Having long-term pain can make you feel isolated and lower your mood, so try to keep up things you enjoy.
  • Consider joining a support group. Ask your GP practice if they know any local to you, or check the organisations listed below under ‘Other helpful websites’.

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Treatment of fibromyalgia

There isn’t a cure for fibromyalgia, but there are treatments to help ease your symptoms. A key part of treating fibromyalgia is to educate yourself about the condition and to work with your doctors and therapists to find treatments that help you. Often, you’ll need to use a combination of treatments to ease your symptoms.

Many people with fibromyalgia who get treatment can manage their symptoms and live a full life.

Exercise

Doing some exercise every day is really important if you have fibromyalgia. It can help relieve pain and stiffness, increase your strength and improve how easily you move around. You’ll get an increased sense of wellbeing too.

  • aerobic exercise – activity that gets you breathing harder and faster
  • resistance (strengthening) exercise – to strengthen muscles and protect joints
  • stretching exercises – to increase flexibility

You can get advice from your doctor or see a physiotherapist to get tips on how to exercise safely and effectively. This may mean starting gently, then gradually building up the time you spend being active each day. Walking or water-based exercises are both good forms of exercise to start with. Be patient – you may find your pain and tiredness get worse at first but they should improve.

Other activities that combine exercise and relaxation, like yoga and t’ai chi, might also help with some of the symptoms of fibromyalgia, particularly difficulty sleeping.

See our ‘Related information’ and ‘Other helpful websites’ sections below for more tips and advice about exercise.

Talking therapies

A talking therapy called cognitive behavioural therapy (CBT) may help if you have fibromyalgia. It helps to challenge negative thoughts, feelings and behaviours, and how you manage pain. You can either see a CBT therapist or access the treatment online.

Medicines

Medicines can be very helpful for some people with fibromyalgia. But they don’t work for everybody, and some people can’t cope with the side-effects. Your GP will talk you through your options and what’s best for you.

Medicines which may be used to ease the symptoms of fibromyalgia include the following.

  • Painkillers. You may find over-the-counter painkillers such as paracetamol and ibuprofen help to relieve your pain, especially if you have arthritis as well. If they don’t work for you, your GP may refer you to a pain clinic or consider stronger medicines. You may be offered a stronger painkiller called tramadol, but only for a short time because it can become addictive for some people.
  • Antidepressants. These medicines can also help relieve pain and improve sleep for some people with fibromyalgia.
  • Anticonvulsants. Although they’re usually used to treat epilepsy, the anticonvulsant medicines pregabalin and garbapentin may also help in fibromyalgia. They can relieve pain and improve sleep for some people.

When doctors prescribe antidepressants or anticonvulsants for fibromyalgia, it’s called off-label use. This means the medicine is being used to treat a condition that it hasn’t been licensed for. Doctors can legally do this. But you won’t see anything about fibromyalgia in the patient information leaflet that comes with the medicine.

Remember to always carefully read the patient information leaflet that comes with your medicine. If you have any questions about taking your medicine, ask your pharmacist.

Complementary therapies

Some people try complementary therapies such as acupuncture or hydrotherapy to help ease pain, stiffness and tiredness, and improve their quality of life. There isn’t strong scientific evidence that these therapies work, but you might decide to give them a try.

Causes of fibromyalgia

Doctors don’t yet know the exact reasons why you may develop fibromyalgia.

Although you feel pain, there isn’t any damage to your muscles or other tissues. This doesn’t mean that the pain ‘is all in your head’. It is real. But because there aren’t any damaged tissues to be healed, it’s difficult to stop the pain you feel.

In fibromyalgia, there seems to be a problem with the way your brain and nervous system process pain. Experts have found altered connections and an imbalance of the chemicals that help to transmit pain signals within the brain. One theory is that in fibromyalgia, there may be a lower threshold or ‘volume control’ on your perception of pain.

Fibromyalgia may also be connected to a disturbance of deep sleep. Your body needs periods of deep sleep to produce many of the chemicals and hormones needed for health. So, if your periods of deep sleep are disturbed, this may contribute to the symptoms of fibromyalgia.

Fibromyalgia runs in families. You’re more likely to get fibromyalgia at some time in your life if one of your relatives has it. So, there may be a link to your genetic make-up.

It’s possible that experiencing a traumatic event such as a car crash or serious illness might trigger the start of fibromyalgia, although there isn’t strong evidence to confirm this yet.

Fibromyalgia and work

Work can be challenging for some people with fibromyalgia. If you need help at work to deal with the pain, have a chat with your employer to discuss what your options are. You may be able to keep working if you make some adaptations to your workplace. Or you may be able to work flexible hours or have additional rest breaks to cope with fatigue. An occupational health adviser can help you with this.

If your symptoms are really bad, you may feel that you have to stop working. But it’s important not to rush into this decision. Work can be a good thing for many reasons – keeping up your physical abilities, self-esteem, confidence and social relationships. Your awareness of the pain and tiredness may increase if you have fewer things to focus on. It’s a good idea to take a short period of sick leave first to see how you get on before you make your decision. Your GP or specialist doctor can help you make this decision.

If you do give up work, it’s a good idea to build other things into your life such as taking up a new hobby. These could be a distraction from the pain of your condition, and will keep you active and may even expand your social life. After all, your quality of life is key.

Frequently asked questions

  • It can be challenging to continue working if you’re often in pain and tired from having fibromyalgia. If you feel your only option is to stop working, you may be able to apply for welfare benefits. You’ll need to meet certain criteria to be eligible, based on how much fibromyalgia affects your ability to work and take care of yourself.

    There are different types of benefits, and they all have different criteria to meet. These include:

    • personal independence payment
    • employment and support allowance
    • attendance allowance (if you're over the state pension age)

    For more information about welfare benefits, see the GOV.UK website, your local job centre or Citizens’ Advice Bureau.

  • Yes, you may find you feel depressed if you have fibromyalgia because these two conditions may be linked. Nearly one in three people who are diagnosed with fibromyalgia have symptoms of depression.

    Fibromyalgia has a range of symptoms, which can affect different aspects of your health and wellbeing. If you find it difficult to manage your symptoms and are in pain, or don't get much sleep, it’s understandable if you feel depressed. It’s also possible that whatever is causing your fibromyalgia also causes depression; for example, low levels of certain brain chemicals.

    It can be difficult to stay positive when you’re in pain and feeling tired. If you‘re concerned, contact your GP. You may also find help and support from local support groups or online forums. See our section below ‘Other helpful websites’ for contact details of organisations that can help.


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Related information

    • Fibromyalgia. Medscape. emedicine.medscape.com, updated November 2018
    • Fibromyalgia. BMJ Best practice. bestpractice.bmj.com, last reviewed June 2019
    • Fibromyalgia: what is it? Patient information from BMJ. BMJ Best practice, 2018. bestpractice.bmj.com
    • Living with fibromyalgia. Patient information from BMJ. BMJ Best practice, 2018. bestpractice.bmj.com
    • Fibromyalgia: what treatments work? Patient information from BMJ. BMJ Best practice, 2018. bestpractice.bmj.com
    • Fibromyalgia. Patient. patient.info/doctor, last edited November 2014
    • Fibromyalgia. The MSD Manuals. www.msdmanuals.com, last full review/revision November 2018
    • Rheumatology. Oxford handbook of clinical medicine (online). Oxford Medicine Online. oxfordmedicine.com, published September 2017
    • Deare JC, Zheng Z, Xue CCL, et al. Acupuncture for treating fibromyalgia. Cochrane Database of Systematic Reviews 2013, Issue 5. doi:10.1002/14651858.CD007070.pub2
    • Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis 2017; 76:318–28. doi:10.1136/annrheumdis-2016-209724
    • Fibromyalgia. Versus Arthritis. www.versusarthritis.org, accessed August 2019
    • Fibromyalgia. Patient Information Leaflet. Arthritis Care (Versus Arthritis). June 2017. www.arthritiscare.org.uk
    • Cognitive behavioural therapy. Royal College of Psychiatrists. www.rcpsych.ac.uk, accessed August 2019
    • Off-label or unlicensed use of medicines: prescribers’ responsibilities. GOV.UK. www.gov.uk, published December 2014
    • Opioid analgesics. NICE British National Formulary. www.evidence.nhs.uk/formulary/bnf/current, reviewed April 2017
    • Cooper TE, Derry S, Wiffen PJ, et al. Gabapentin for fibromyalgia pain in adults. Cochrane Database of Systematic Reviews 2017, Issue 1. doi: 10.1002/14651858.CD012188.pub2
    • Gabapentin and pregabalin. NICE British National Formulary. www.evidence.nhs.uk/formulary/bnf/current, reviewed February 2017
    • Off-label or unlicensed use of medicines: prescribers’ responsibilities. GOV.UK. www.gov.uk, published April 2009
    • Fibromyalgia. Fit for Work. fitforwork.org, updated March 2018
    • Benefits of working. Fit for Work. fitforwork.org, published December 2015
    • Personal independence payment (PIP). GOV.UK. www.gov.uk/pip, accessed August 2019
    • Employment and support allowance (ESA). GOV.UK. www.gov.uk, accessed August 2019
    • Attendance allowance. GOV.UK. www.gov.uk, accessed August 2019
    • Personal communication, Dr Sundeept Bhalara, Consultant Rheumatologist and General Physician, August 2019
  • Reviewed by Dr Kristina Routh, Freelance Health Editor, August 2019
    Expert reviewer, Dr Sundeept Bhalara, Consultant Rheumatologist and General Physician
    Next review due August 2022



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