Understanding Fibromyalgia

What is it?
Fibromyalgia is a chronic condition characterised by widespread pain throughout the body along with fatigue, memory problems, sleep and mood disorders. Sufferers of fibromyalgia often spend years trying to find a diagnosis that fits their symptoms and fluctuate between periods of having high energy and ‘crashes’ of fatigue and pain. In severe cases, fibromyalgia can cause significant lifestyle disruptions, including reduced activity, unemployment and depression.
 
The underlying mechanism that creates the symptoms of fibromyalgia has been shown to be increased pain amplification by the central nervous system and reduced activation of the sympathetic nervous system. Essentially this means that small pain signals in the body are processed as large pain signals by the central nervous system.

What causes it?
Fibromyalgia is a complicated condition that is poorly understood. This can be very frustrating for sufferers, who often find themselves being shuffled between health practitioners looking for answers and long term relief. While the pain generally feels muscular, usually little to no muscular damage or injury can be found on physical assessment or investigations. The symptoms can also mimic those of an infectious illness or other chronic diseases. Often a diagnosis of fibromyalgia is reached after other diseases and causes have been ruled out.
 
The cause of fibromyalgia is as yet unknown. It was initially thought that the depression and reduced activity that are often associated with fibromyalgia could be causative, however it has been shown that these are symptoms of fibromyalgia rather than causes. Other significant signs are a lack of REM (good quality) sleep in sufferers and a positive result of more than 11 out of 18 muscular trigger points.
 
What is the treatment?
Following a diagnosis of fibromyalgia, the primary strategy is to understand and manage your symptoms. This can involve pacing activities and exercise so as to reduce ‘crashes’ and pain cycles that lead to frustration. Identifying activity, employment and a routine that doesn’t exacerbate symptoms can have a significant impact on quality of life for someone with fibromyalgia. Having psychological support can also be very important to help deal with the emotional distress of a complex chronic condition that has no outward physical signs.

Treatments that have been shown to help reduce symptoms are TENS (electrical stimulation) which produces an endorphin response and can reduce pain; certain medications may be helpful when prescribed by a doctor; and education and understanding of this condition, helping to manage and maintain some control over your symptoms. Physiotherapists can have a large role in education and helping patients find a routine and activity level that helps them manage their condition as best as possible, as well as providing symptomatic relief during pain cycles with manual therapy, stretching and massage techniques.

It is always best to see a medical professional for advice on your individual injury or condition.