Ask the Rheumatologist: Fibromyalgia

30 July 2019

Approximately 1 in 20 people are affected by fibromyalgia in some degree, developing mostly in women between 30-50 years old, but also affecting men and children too. Diagnosis and treatment can vary from patient to patient, with different specialties used. We’ve already heard from our Physiotherapist manager, but now our Consultant Rheumatologist, Dr Naveen Bhadauria, discusses fibromyalgia from a Rheumatology point of view.

What is fibromyalgia?

Fibromyalgia is classed as a chronic condition that is mainly defined by pain throughout the entire body as well as extreme fatigue. The pain can often be described as burning or aching, and leaves patients feeling drained of all energy. Other common symptoms include poor sleep, short-term memory loss (“brain fog”) and concentration issues.

What causes fibromyalgia?
The exact cause of fibromyalgia is actually not clear. However, it is often related to underlying mental health issues such as depression or anxiety. Poor un-refreshed sleep is also a contributing factor, and in some cases traumatic events, such as road traffic accidents or bereavements, can lead to fibromyalgia. The theory is that the nerve endings become hyper-sensitive and the central processing of pain is altered, which means pain is felt at even the lightest of touch (allodynia).

Diagnosing fibromyalgia
A full history and examination by the rheumatologist will take place regarding all the symptoms that you are experiencing. As the symptoms can represent other conditions, these will need to be tested for and ruled out before a diagnosis of fibromyalgia can be made. On most occasions blood tests, and occasionally X-rays, will be carried out.

Treating fibromyalgia
There is no one specific treatment for fibromyalgia and the approach is of a multi-disciplinary nature. This involves several areas including physiotherapy, psychology and medication. The key is to be able to manage the symptoms to improve the quality of life and to allow for day to day function.

Exercise is one of the most important treatments. Although patients are in pain and lack energy, a graded-exercise programme via physiotherapy will help relieve symptoms and build up stamina. Other good forms of exercise include swimming and Tai-Chi.

Cognitive behavioural therapy (CBT), a form of counseling that helps to strengthen the mind to be able to cope with the symptoms that you are experiencing, has very good evidence of benefit in fibromyalgia.

Medications can also be prescribed, and will be tailored to each individual depending on their specific symptoms. Some of the most common medications prescribed include painkillers, antidepressants and neuroleptics such as pregabalin or amitriptyline.

If you’re suffering from fibromyalgia, or are experiencing symptoms, and would like to know more Mr Naveen Bhadauria is available to book at Spire London East Hospital. Contact our Private Patient Executives on 020 8709 7817 for his availability.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

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