Fibromyalgia (FM) is a persistent widespread pain disorder and is second only to osteoarthritis and spinal pain as the most common condition seen in pain management and rheumatology clinics.
It affects quality of life by impairing a patient’s ability to function and participate in everyday activities, affecting relationships with family and friends.
Research would suggest that fibromyalgia is a disorder of the central nervous system. There are multiple factors though the exact cause is less known. MRI scans show changes in the brain and central nervous system, which may result in patients’ low pain threshold. There may be environmental, genetic, gender, hormonal, sleep disturbance or dietary factors that can affect the nervous system of some individuals, making them susceptible.
Like other chronic conditions like diabetes, asthma, thyroid problems and hypertension, it cannot be cured, but its symptoms can be managed to a great extent. A number of symptoms can be controlled very well.
Fibromyalgia is becoming increasingly common. Recent studies suggest up to 5% of the population is likely to suffer from the condition. Onset typically occurs in middle age, but it can be diagnosed in people of any age. It is more common in women than in men.
Typically, patients will have widespread pain in most parts of the body including multiple tender points, concentration and memory issues known as “fibrofog”, chronic fatigue and sleep disturbances.
Along with this, they can have other symptoms such as migraine, facial pain, Irritable Bowel Syndrome, low mood, intolerance to cold, chronic fatigue, chest pain, widespread numbness and pins and needles and feelings of fatigue. All of these are referred jointly as fibromyalgia syndrome.
Fibromyalgia pain can often be unrelenting and debilitating. It is experienced as generalised, head-to-toe aching or sometimes a burning sensation. It can fluctuate at different times and can be experienced in different areas of the body.
Three factors are needed for diagnosis of fibromyalgia:
- Pain present in both sides of the body and widespread across different locations in the body
- Symptoms and pain present for at least 3 months
- No other explanation of the pain is possible
Diagnosis should be accompanied by a thorough explanation of the condition that acknowledges the pain is real, not imagined. Patients are most satisfied by explanations that remove blame, take into account psychological and biological factors, and suggest concrete ideas for management.
No single treatment addresses every symptom. A variety of medications can be given and physiotherapy in the form of graded exercise therapy, psychological therapy (Cognitive Behavioural Therapy, Acceptance and Commitment etc) and complementary therapies can be used.
With the right combination of therapies, pain becomes less intense and is more manageable, enabling patients to have better function and quality of life.
At Circle Rehabilitation, a personalised approach including any or all of the above options can be provided after initial consultation.
It can take up to 3 to 6 months for most fibromyalgia patients to be seen by an NHS specialist. In the private healthcare sector, there are group-based programmes available for such patients.
Circle Fibro Clinic is part of Circle Rehabilitation. For those seeking an individually-focused rehabilitation approach, it offers the chance to step on to a bespoke fibromyalgia rehabilitation programme just a week to 10 days after the first consultation. Fibromyalgia is often associated with fatigue, and disturbed or fragmented sleep can amplify patients’ pain: at Circle Rehabilitation, sleep hygiene and managing sleep will be addressed and appropriate advice given.
Circle Reading Hospital, where Circle Rehabilitation is based, has a set of state-of-the-art therapeutic and exercise equipment unique in the UK outside specialist facilities for armed forces personnel, police officers and professional sportsmen and women. Machines which may be particularly beneficial for fibromyalgia patients include the Hydro Physio, an aquatic treadmill allowing patients to exercise their muscles and joints supported and their pain eased by the water around them.