What is Fibromyalgia?
Fibromyalgia, is a complex rheumatoid condition that can be characterized by widespread regions of pain, and is often accompanied by fatigue, memory problems, and sleep disturbances.
There is no known cause of Fibromyalgia but clinically, increased nervous system sensitivity and lowered sensation tolerances to normal stimulus, go some way to explain the symptoms experienced by people with fibromyalgia.
What we do know is that approximately 2 % of the population has fibromyalgia with women being more affected than men at a ratio of 6:1.
What are the symptoms?
The most common symptoms of fibromyalgia include:
- Multiple regions of pain or increased sensitivity
- Difficulties with memory alertness or concentration
- Trouble sleeping
- Sleeping for long periods of time without feeling rested (nonrestorative sleep)
- Pain or a dull ache in the lower belly
- Dry eyes
- Bladder problems, such as interstitial cystitis
If you suspect that you have Fibromyalgia, you should consult with your doctor ASAP to discuss you symptoms, organise relevant tests and guide your management.
How is it diagnosed?
The diagnosis of fibromyalgia is usually given when no other diagnosable medical condition can be found, to explain the widespread pain, fatigue and symptoms you experience.
The clinical diagnosis of fibromyalgia is given when the following criteria are met
Pain is felt in 4 out of 5 of the following areas
- tops of the shoulders
- upper chest
- outer elbows
** previously clinicians used 11/18 painful trigger points, or sensitive areas when pressed **
- Onset of symptoms follows a significant life event/ trauma/ illness
- Feelings of ‘Fogginess’ – difficulties with concentration, memory and alertness cognitive challenges
- Disproportional or unexplained fatigue and tiredness based on your level of activity
- Any potential underlying rheumatoid condition is ruled out with suitable tests
Blood tests may be used by your GP or Rheumatologist to rule out any short and long term inflammatory causes for your pains. There is no blood test that confirms you have fibromyalgia.
X-rays may be used to rule out any specific injuries you may have sustained, or look at the condition of your joints to see if there are any signs of inflammation and joint damage.
Depending on the results of your investigations, your doctor should discuss with you whether or not you would benefit from taking medication, see a Rheumatology specialist or both.
A Rheumatologist is a specialist doctor that investigates your symptoms further, requests specific tests (if required), guides the medical management you require, prescribes specialist medication (if required) and provides you with resources to understand your condition.
Rheumatologist do not routinely see people with fibromyalgia on an on-going basis, as Fibromyalgia does not require the medications or expertise of a Rheumatologist to manage their health problems.
The most common medications your Doctor or Rheumatologist may prescribe somebody with Fibromyalgia are:
- Pain killers/ analgesics
- Cortico Steroids medications or injections
- Anti-depressant – for the purpose of easing the pain and sensitivity in your body
What can I do about it (5 tips)?
Know ‘pain’ and what it is
Pain in many different forms, is the most common symptom that comes with Fibromyalgia. However, despite many people living with, and experiencing pain, it is very common for the same people to have little understanding of what “Pain” actually is (or in other words, what research and science can currently tell us about pain).
This concept may seem confusing initially, seeing as you know what you and your body are feeling. However, spending time learning about “pain” can provide valuable insight and understanding to what you are experiencing, and provide you with powerful tools to help reduce the impact of pain on your life.
Have a clear Understanding of how your diagnosis and symptoms influence, or affect you.
Every individual with Fibromyalgia is affected in many different ways. Identifying, understanding and addressing which symptoms of the fibromyalgia diagnosis relate to you can keep you focused and objective as you live with the condition.
The main criteria for diagnosis and what you can do about them are as follows:
|Significant life event/ trauma/ illness||Identify and reflect on the time in your life prior to, or as the symptoms started to develop. Discuss this time with somebody. Look to gain acceptance on this event and move forward with a positive management plan|
|Pain and tender points||Understand what ‘Pain’ is and how the complex nature of pain relates to youLook to gain acceptance regarding your pain and aim to move forward with a positive management plan|
|Underlying rheumatoid condition||Discuss your symptoms, diagnosis and management with your GP and Rheumatologist, to ensure you, and them, are very clear on the condition you have.|
|Concentration, ‘Fogginess’ or cognitive challenges||Identifying what aspects of life that are most effected by your ‘fogginess” can be a starting point to find ways to manage this symptom betterAspects that of life that are most commonly effected by Fibromyalgia are socialising, physical activity, relationships, employment and emotions|
|Fatigue and tiredness||Analysing your sleeping patterns and sleep health can be a starting point to find ways to manage this symptom better Similar to fogginess, identifying what aspects of life that are most affected by your fatigue can be a starting point to find ways to manage this symptom better Aspects that of life that are commonly found to be fatiguing are socialising, physical activity, managing relationships, employment and dealing with emotions|
If you find managing your symptoms, or find it difficult to identify which diagnosis are most relevant to you, discussing your condition and situation with your family, friends, Doctor, Physiotherapist, Occupational Therapist or a counsellor may be beneficial.
Be consistent and balance life
By maintaining a consistent healthy balance in your life, will reduce your symptoms, make life much easier and less stressful on you. Whether it is at the initial stages or during flare ups of Fibromyalgia, being consistent with your activity levels, diet and lifestyle choices will help you monitor and manage your symptoms more effectively. Having poor or inconsistent habits with nutrition, smoking, drinking and inactivity can have a negative effect on the management of your condition.
Taking on major physical challenges (physical work commitments, fitness challenges, being more physical within family life) or psychological challenges ( new roles at work, family challenges, increased stresses) while trying to get your symptoms under control, can make the process of getting symptom relief more challenging and less effective.
By ignoring the signs symptoms of RA, doing little about your health, or trying to push through symptoms, you may actually be making the process of getting symptom relief harder for you and your medical team.
Applying techniques such as pacing/activity diaries, mindfulness, self awareness, or speaking to a health professional, can help make you more aware of the impact your lifestyle is having on your RA and provide strategies to help you.
Be active with your condition
When diagnosed with Fibromyalgia it is important to be pro-active and fully involved in the management of your condition. This means both physically pro-active and mentally pro active.
Physically Pro active – While it is understandable and common to feel that doing very little helps your pain, protect your joints and helps your condition, over time, inactivity and disuse with have a detrimental effect on your physical and mental wellbeing. Maintaining good joint mobility and muscle condition through exercise and activity will maintain your joint, and heart health for longer, and will have many more health benefits over inactivity.
There may be times when you may have to reduce the intensity at which you do your activities to a level that does not aggravate your symptoms. BUT keeping the joints moving through their range of movement, and maintaining good muscle condition (cardiac and body muscle) is essential for your health.
Being Mentally pro active – Structuring your days, having goals and being objective towards the management of your Fibromyalgia will provide you with good foundations from which to measure, monitor and manage your condition effectively.
Applying practices such as training diaries, pain diaries monitoring your successes and challenges, will help you plan your life around your condition effectively. Also, in doing this you can help your Doctor or health professionals identify changes in your condition. This will help implement effective management plans more effectively.
Be objective and set goals
The journey that you are going through with your condition, is exactly that. A journey. It has many highs and lows, during which, your pain, symptoms and emotions can vary greatly making the journey unclear at times. Being objective throughout your journey through the use of goal setting and measuring your success can provide you, and your health team, with a clear impression of your condition. From this you, and your team can monitor, manage and control your condition more effectively.
Setting short and long term goals with a condition, and symptoms that can vary greatly is difficult. Therefore setting simple and subtle goals that directly address your symptoms (see symptoms for a refresher) and identified problems, can help keep you on track and focused when symptoms vary or intensify.
Goals can be set for many different aspects of your life with fibromyalgia. Goals such as health goals, social goals, pain related goals, mental or emotional goals and sleep related goals are all commonly set by people with fibromyalgia.
If goal setting is a challenge for you or you find you are ‘stuck’ with your fibromyalgia, using a therapist or counselor trained in goal setting can be beneficial. Commonly used techniques to help people with fibromyalgia are Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT).
What can other people do to help me?
There are many people and products out there to help with your Fibromyalgia. The hard part is finding the things that are effective in relieving your pain and symptoms consistently. The management and experience of Fibromyalgia can vary greatly between individuals which makes it challenging to manage at times. The following people are consistently used by individuals and health systems to manage the condition.
Initially, the most important thing you can do is discuss your symptoms and diagnosis with your doctor. They may prescribe medications that can help your symptoms immediately, order tests to confirm your diagnosis and refer you to a specialist (Rheumatologist).
Finding the right doctor for you is very important. For the long term outlook, it is important to find a Doctor you feel is approachable and effective in the management of your condition. You may have to call upon them at various times in your life, therefore having a positive relationship with them, and confidence in their management of you is important.
The most common medications your Doctor will manage are
- Pain killers/ analgesics
- Cortico Steroids medications or injections
Specialists / Consultant Rheumatologists
Once diagnosed with RA your doctor may refer you to a Specialist Rheumatologist to examine your symptoms and tests results in further detail. Generally, Rheumatology Specialists will see people with Fibromyalgia to rule out any other possible causes for multiple joint pains and treat them if required.
However, Rheumatologists do not routinely keep seeing people with Fibromyalgia as they do not require the medications or expertise of a Rheumatologist to manage their health problems
Based on the symptoms and issues you may be experiencing, your Specialist or GP may refer you to a variety of health professionals to help manage your condition. The most common Health professionals used by GPs and Rheumatologists, to help people with AS are:
|Physiotherapists||Help manage pain, rehabilitation from injury, improve movement, improve or maintain function and independence|
|Occupational Therapists||Help to manage day to day tasks and function. Provide equipment to maintain function and independence, wheelchair prescription, splints and supports for upper limbs, pressure area management and pacing strategies|
|Dietitians||Help to manage diet, nutrition, obesity, malnutrition and lifestyle choices related to nutrition|
|Podiatrists||Help manage foot pains, footwear, problems and mobility issues related to the foot|
|Exercise Physiologists||Help manage general fitness, functional strength and conditioning, cardiac health, body conditioning and lifestyle management.|
When choosing which therapist to see it is beneficial to discuss your plan with your GP, research the therapist you intend to see, and ensure the therapist applies some sort of evidence based practice to the treatments they are providing you. More importantly, please ensure you feel better after seeing any health advisor, have a clear plan on how your progress will be monitored, and the plan for long term self-management.
Remember, there is no cure for Fibromyalgia, so be cautious of anybody making unfounded claims to be able to cure your condition or resolve your symptoms completely.
Many people do try alternative approaches to help their fibromyalgia and its symptoms, often with mixed effect. It is not the intention of this website to dismiss any type of therapist or treatment, but as mentioned earlier, please ensure you feel better after your therapists intervention and that you have a clear plan on how your condition will be monitored and self-managed in time.
Family, Friends and Support Networks
The most important members of you Fibromyalgia team are your family, friends or support network. Attending events, remaining active and living life can be a challenge at times for all of us, however, for people with Fibromyalgia, the symptoms can flare up at times and can significantly impact your life. Therefore, having people to talk to and share your highs and lows with is very important in maintaining good physical, mental and spiritual health.
Many organisations and charities offer support, education and self-management courses for people with Fibromyalgia. These can help you connect with other people living with it, as well as build skills and confidence in managing your health and Fibromyalgia.
Participating in physical activity with others can provide you with an opportunity to keep your joints and body healthy, while sharing positive experiences with others. Activities such as walking, hydrotherapy, Tai chi, Pilates or mindfulness sessions are all low impact activities that can be enjoyed at all stages of Fibromyalgia.