Fibromyalgia- fact or fiction?
There used to be a lot of debate and denial about Fibromyalgia- but now there’s wide agreement that it’s a very real syndrome. It’s common, affecting around 2% of people, and it can make life pretty miserable. The truth is that doctors may feel uneasy dealing with it for a few reasons- there’s no simple test for it, symptoms vary from person to person, and there’s no one-size-fits-all way of treating it. Sometimes this means that getting a diagnosis takes longer than it should- in some cases involving several frustrating years of going back and forth to GPs and specialists. However, early diagnosis is important and very helpful, as it lets people take the steps they need to manage it, and avoid repeated and unnecessary investigations.
Symptoms of Fibromyalgia
If you have symptoms of Fibromyalgia, your GP will often be to diagnose it without any need for you to see a specialist. Though symptoms may come and go, you may be experiencing some or all of the following from time to time:
- Widespread aches and pains for over 3 months- this pain often has a burning quality, and is not limited to any specific part of the body- it can move around. In the past, doctors used to check for certain “tender points” on the body- but it’s now known that this is not a very accurate way of diagnosing Fibromyalgia.
- Fatigue and sleep disturbances
- Trouble with thinking, concentration and memory
- Changes in mood
- Various other physical symptoms including headaches, restless legs syndrome, dizziness, feeling too hot or cold, irritable bowel syndrome or numbness and tingling in the arms and legs.
It’s still not understood what leads to these symptoms.
What else could it be?
This depends on your symptoms. Fibromyalgia can mimic many different conditions. Depending on the type of symptoms you have, your doctor will ask certain questions and may recommend tests to rule out issues such as an underactive thyroid, depression, anxiety, M.S, or inflammatory conditions like lupus or rheumatoid arthritis.
Of course, it’s possible to have more than one thing going on- for example, some people may have an underactive thyroid AND Fibromyalgia, or be suffering from depression too.
Do I need tests?
The tests you need will depend on what symptoms you have- and may include a blood count, liver and kidney function tests, thyroid function tests, calcium levels, B12, folate, and other tests to check for inflammatory conditions such as rheumatoid arthritis and lupus. If you have prominent bowel related symptoms, a colonoscopy may be recommended. If you have a lot of nerve related symptoms such as pins and needles or numbness, this may require scans or a neurology opinion. But in most cases, the history itself will give the diagnosis, and blood tests are all that’s needed to ensure there’s nothing else going on.
Treatment for Fibromyalgia
It’s very helpful if fibromyalgia is diagnosed early, and the patient is given the information they need to deal with it. Often a gradual increase in physical activity and fitness can be effective- you may need some expert guidance from an exercise physiologist or personal trainer. It may require patience- taking it at a pace that gives benefit without triggering pain.
Most standard painkillers tend not to work very well for Fibromyalgia, but if pain is bad, Tramadol, Pregabalin (Lyrica) or Duloxetine (Cymbalta) are sometimes used to good effect.
If low mood, anxiety or difficulty coping are prominent symptoms, seeing a psychologist for CBT (cognitive behavioural therapy) may help. Occasionally antidepressant medication may be useful too. Other medications can help with sleep problems- Pregabalin (Lyrica) or low dose Amitriptyline (Endep) may be considered.
It’s a good idea to team up with your doctor to look at all these options, and create a tailor-made combination of the above treatments, that suit your symptoms, personal circumstances and lifestyle.
If you have more questions, speak to your GP.