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For more information, go to www.arthritisresearchuk.org

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:

  1. describe how pain is modulated in the nervous system
  2. integrate psychological and biological factors
  3. suggest specific ideas for management.

Action plan

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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Referral and further action

Lady having chat with doctor

Referral to secondary care may be required for diagnosis and/or treatment and may be appropriate even where a condition can normally be managed in primary care.

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