Fibromyalgia can impact upon every aspect of a person’s life, with people experiencing guilt, loneliness, self-doubt and isolation. Evidence has shown the effect on employers in terms of absence and loss of productivity costs.
What Causes Fibromyalgia (FMS)?
The causes are unclear and may differ from person to person.
It may run in families. There is a likely genetic factor, however, genes alone do not cause FMS, but they may make people more prone to getting it.
Evidence suggests involvement of the nervous system, specifically the central nervous system (brain and spinal cord). There is a change in the way the body “talks” with the spinal cord and brain, due to the volume of pain sensation in the brain being turned up too high.
Certain ‘triggering factors’ can set off FMS, such as:
- injury
- spinal conditions
- physical stress
- underlying rheumatic conditions
Who Does Fibromyalgia Affect?
Fibromyalgia Symptoms
A wide range of symptoms are common in FMS as a result of an increased pain response. The effect on the individual can not only be to experience pain in the muscles, bones or joints, but in other areas of the body too, such as:
- headaches
- tingling
- chest
- bowel
- bladder
Additional symptoms of fatigue, sleep dysregulation, and cognitive impairment/brain fog- termed “Fibro Fog” may also be experienced.
How is Fibromyalgia Diagnosed?
It can be difficult to diagnose as symptoms can vary from person to person.
There is no specific laboratory test, x-ray or scan – a diagnosis is based on a person’s medical history and symptoms, and by ruling out other diseases with similar symptoms.
Fibromyalgia used to be diagnosed by a specialist in secondary care (Rheumatologist), but can now be made by a GP.
The Royal College of Physicians 2023 guidance advises, that specialist referral is only needed if there is uncertainty.
Overlap in Symptoms of ME and Fibromyalgia – Impact on Diagnosis
There is an overlap in symptoms of ME/CFS and FMS, and there are those diagnosed with a combination of both, or with other similar conditions such as: underactive thyroid gland, osteoarthritis, rheumatoid arthritis, or anaemia.
In addition, a recommended treatment using exercise for fibromyalgia, could cause potential harm to patients with a diagnosis of ME/CFS, in the form of Post Exertional Malaise (PEM).
It is vitally important to get an accurate diagnosis of Fibromyalgia, so that other conditions are appropriately and promptly treated, and so that PEM in ME/CFS is not mistaken for a ‘fibro-flare’.
- FMS cannot be cured, but symptoms and flare-ups can be reduced by treatments, therapies and self-management techniques, that can improve quality of life.
- There is no one treatment that works for all symptoms, or people, or that is available Therefore, a combined approach is more beneficial. This does not always include medication.
- It is important for individuals to find a healthy balance between fitness and mental health, whilst managing pain and sleep disturbances, and preventing ‘fibro-flares’ that can feel both physically and emotionally exhausting.
How is the diagnosis made?
The diagnosis is made using the American College of Rheumatologists (ACR) 2016 criteria. All three of the criteria must be met to make the diagnosis:
- Widespread pain index (WPI) score of 7 or more and symptom severity scale (SSS) score of 5 or more
OR WPI of between 4–6 and SSS score of 9 or more.
- Generalised pain, defined as pain in at least 4 of the 5 body regions, is present.
- Symptoms have been present at a similar level for at least 3 months.
Links to Additional Resources and Support on Fibromyalgia
Charity and Support Group Information
Fibromyalgia Action UK https://www.fmauk.org/
Versus Arthritis NI
Tel: 028 9078 2940
Email: [email protected]
Educational Resources
NHS Health A-Z – Fibromyalgia
Bateman Horne Centre Educational Webpage
BUPA Information on Fibromyalgia
Patient Information online – Fibromyalgia