Fahmida's action plan
For patients like Fahmida with a diagnosis of fibromyalgia, a skilful explanation of the condition can significantly improve outcomes and help avoid a fruitless cycle of investigation, referral and re-referral.
Explaining the condition
Explanations which imply that the condition is ‘all in the mind’ are likely to cause offence. Explanations which are less likely to offend:
describe how pain is modulated in the nervous system
integrate psychological and biological factors
suggest specific ideas for management.
A pharmacological approach alone is unlikely to be successful, though stronger analgesics and/or low-dose antidepressants such as amitriptyline may offer some pain relief. Other elements in the management plan might include:
signposting information (for patients and carers)
exercise therapy, especially regular aerobic exercise building up gradually to 20–30mins two or three times a week and strength training
heated pool therapy
psychological therapies e.g. cognitive behavioural therapy
advice around pacing activities, sleep hygiene and support to stay in work.
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