Fybromyalgia

Fybromyalgia is a condition characterised by widespread pain in the soft tissues of the body including muscles, ligaments and fascia. It can affect anyone at any time but is more likely to occur in women aged 35-60. Patients are in pain most of the time and suffer with fatigue, weakness and are very sensitive to pressure.

Fybromyalgia is difficult to diagnose, as there are no laboratory tests or scans that reveal any abnormalities. Patients are often diagnosed with Fybromyalgia when all other diseases have been ruled out.

Fybromyalgia means ‘fibrous tissue pain’ but the true anatomy of the condition is poorly understood. It does not involve any problems with the joints. Patients have specific points of pain on their body when pressure is applied and these must have been present for three months before Fybromyalgia is considered a possible diagnosis.

Allodynia is a condition where people feel extreme pain with the lightest of pressure and this is often found in Fybromyalgia sufferers. Allodynia is thought to be as a result of abnormalities within the Central Nervous System (CNS) and this therefore has lead to studies to find potential links between Fybromyalgia and abnormalities of the CNS, either with the nerves themselves or chemicals influencing them.

There is no known specific cause for Fybromyalgia but there are several factors that are though may contribute to people suffering with the disorder.

  • Stress and depression. These are often seen in Fybromyalgia patients and a severe episode may trigger the onset in susceptible individuals.
  • Genetics. There is a slight correlation between the condition and associated conditions such as IBS and Chronic Fatigue Syndrome, which may run in families.
  • Central Nervous System. Recent theories have discovered that some Fybromyalgia patients may have altered pain signals within their CNS.

The symptoms of Fybromyalgia are numerous and affect everyone differently. People may suffer with all or some of the problems below

  • Pain in the muscles around the neck, back, shoulders, arms, legs, hips and feet.
  • Fatigue
  • Bladder disturbances
  • Bowel disturbances
  • Hands and feet feel swollen and tingly
  • Sleep problems

  • Loss of concentration
  • Headaches/ migraines

There is no one treatment for people with Fybromyalgia and it depends on the number and severity of the symptoms. It is best approached with a multidisciplinary team and patients may need help from different practitioners.

  • Physiotherapy. Physiotherapists are well placed to offer treatment and advice on several modalities that have evidence of helping Fybromyalgia patients. Graded exercise programmes are essential to maintain muscle flexibility and strength and can help to prevent further pain. Acupuncture can ease the pain of widespread body pain and also treat specific muscle trigger points, which are common. Specific soft tissue and fascia release can also improve muscle flexibility and reduce pain. Heat can also be useful when applied correctly as can general massage.
  • Psychological support. This can be helpful in patients with depression and also help patients with coping strategies.
  • Occupational Therapy. Patients who struggle with activities of daily living may benefit from advice on aids and appliances to maintain independence
  • Medication. A combination of painkillers, antidepressants and painkillers for nerve pain can help control symptoms.