Fibromyalgia

The pain may feel as though it affects your whole body, or it may be particularly bad in just a few areas. People with fibromyalgia often say that the tiredness (fatigue) is the worst aspect of the condition.

Less frequent fibromyalgia symptoms include:

• poor circulation – tingling, numbness or swelling of the hands and feet
• headache
• irritability, or feeling a bit down
• forgetfulness or poor concentration
• feeling an urgent need to urinate
• irritable or uncomfortable bowels (diarrhoea or constipation and abdominal pain).

Research has also shown that people with fibromyalgia are more sensitive to physical pressure – this means that what would be a relatively minor knock for many people could be extremely painful for someone with fibromyalgia. While this increased sensitivity is not fully understood, we think this could be related to chemical changes in the nervous system. It's also thought that sleep disturbance contributes to this increased sensitivity. 

• Learn about fibromyalgia. Understanding the condition can help to lessen any fear and anxiety about it
• Find out if there's a support group in your area. Talking about your experiences with people who understand may help
• Encourage your family and friends to find out more and discuss your condition with you.
• Try the medication your doctor has to offer and discuss which ones are helpful.
• Find more effective ways of communicating feelings such as anger. Counselling or cognitive behavioural therapy may be helpful – your GP will be able to refer you.
• Unhappiness at home or work can make fibromyalgia pain feel worse. Addressing the causes of this unhappiness could help.

The presence of specific tender points in certain areas of the body can help the doctor to make the diagnosis. These areas can be tender even when pressed very gently.

While tenderness can occur at individual sites in other conditions such as tennis elbow, in fibromyalgia there is tenderness at many sites – usually more than ten.

Fibromyalgia drugs

Several drugs may help with the symptoms of fibromyalgia.

• Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain.
• Sleeping tablets may be used in the short-term if your sleep is disrupted.
• Drugs such as amitriptyline and dothiepin, which are often used for depression, can also reduce muscle pain and improve sleep patterns in fibromyalgia.
• Antidepressants, such as fluoxetine or paroxetine, may be prescribed if depression is a particular problem for you.
• Newer drugs such as pregabalin, gabapentin and duloxetine may help to reduce pain by altering levels of chemicals within the brain and nervous system. It's not yet clear how long pain relief will last, but clinical trials will help to decide whether these drugs will be used more widely for fibromyalgia.
• Steroid injections are not usually recommended for fibromyalgia because they have short-lasting effects and can cause damage to flesh or muscle if repeated too frequently. They are sometimes given if one or two places are much more painful than the others.

Physical therapies

Your doctor may refer you to a physiotherapist or an occupational therapist for further treatment and advice.

Physiotherapy

Physiotherapy can help you to improve your posture, stretch and relax your muscles, and gradually become more active. Physiotherapists can also advise you about relaxation techniques.

Occupational therapy

Occupational therapy can help you to manage your everyday jobs without increasing your pain or wearing yourself out – by pacing yourself, changing the way you work or using labour-saving gadgets.

Exercise

If you have fibromyalgia your muscles will often be tense making them more prone to sprains and strains, so it's important to reduce muscle tension by stretching regularly. A physiotherapist will be able to advise on the stretching exercises that will be best for you.

Aerobic exercise improves fitness, reduces pain and fatigue, and helps to reduce excess weight. It should also improve your sleep. Aerobic simply means increasing the circulation of oxygen through the blood, so any exercise that gets you breathing heavily and your heart beating faster is aerobic. Swimming is particularly recommended for people with fibromyalgia.

Build up your exercise at a rate you can cope with. Increasing your exercise little by little will improve your fitness, flexibility and stamina.

Diet and nutrition

No particular diet has been proven to help fibromyalgia but we recommend keeping your weight within a healthy range by eating a balanced diet with plenty of fruit and vegetables.

Read more general advice on diet, nutrition and nutritional supplements.

Complementary therapies

Massage, acupuncture, or manipulation by a chiropractor or osteopath are all noted for easing pain and discomfort. You may need repeat treatments to get any lasting benefit, but the treatments may help to boost your morale.

Research into complementary and alternative therapies is continuing all the time. Arthritis Research UK has published a detailed authoritative report on these therapies for rheumatoid arthritis, osteoarthritis and fibromyalgia. This report contains detailed information about a number of complementary and alternative medicines that are taken by mouth or applied to the skin.

Sleep

Poor sleep and developing specific painful points on the body are key features of fibromyalgia. Brain-wave studies have revealed that people with fibromyalgia often lose deep sleep. In a subsequent experiment, healthy people who were repeatedly woken from deep sleep started to develop the typical symptoms and tender points of fibromyalgia.

So getting enough proper sleep appears to be important in the development and treatment of fibromyalgia. The severe tiredness that often goes with fibromyalgia is also due to this poor sleep pattern.

Several things can disrupt deep sleep, for example:

• pain or stiffness in the neck
• pain and stress from an injury or another illness
• anxiety or depression brought on by events or relationships at home or at work.

Dealing with sleep disturbance may also help with the physical symptoms:

• Avoid alcohol, tea or coffee late at night, as these may disturb your sleep.
• Sleeping in a soft collar can help, particularly if your neck is painful, but we don’t recommend wearing it during the day.
• Relaxation and gentle exercise can improve your sleep and can also reduce muscle tension.

Find out more about the most common sleep problems that affect people with arthritis and what can be done to help.