Fibromyalgia

Fibromyalgia

Fibromyalgia is caused by your central nervous system becoming hypersensitive. What triggers this hypersensitivity is not always clear. The result is that all the systems in your body eg immune, sympathetic, endocrine and motor starat to over react to seemingly innocuous stimuli. This hypersensitivity is your body’s way of protecting itself. Unfortunately, once our brain is in the habit of overprotecting us, changes occur within our tissues and central nervous system and it becomes difficult to break this cycle without help. However, by following a treatment plan which looks at different options eg medication, gentle movement, exercise, stress reduction this hypersensitivity can be reduced and our body can start to react ‘normally’ again.

Fibromyalgia is a disorder characterised by chronic, widespread pain and muscle tenderness. Even the slightest touch can be sensitive and some people experience severe stiffness. Fatigue, depression, headaches and cognitive impairment eg forgetfulness and inattentiveness are often also present.

It affects 2- 5% of the population and occurs four times more commonly in woman than men.

Management

Exercise and physiotherapy is considered first line eg Stretching, aquatic exercise, balneotherapy, biofeedback therapy.

Psychology

CBT, guided imagery and relaxation have been proven to be effective.

Medication

Medication should be used when symptoms are uncontrolled and should be discontinued when possible eg amytriptilene, duloxetine, yelate. Tramadol is considered a 3rd line treatment.

Dietary supplements

Probiotics might be effective.

Complications

Extreme hypersensitvity with high levels of distress

Opioid or alcohol dependence

Marked impairment in functioning

Severe depression and anxiety

Obesity and physical deconditioning

Metabolic syndrome