Fibromyalgia: what it is and how we help

Fibromyalgia at a glance

Fibromyalgia is a long-term condition that causes widespread pain, fatigue, poor sleep and problems with memory and concentration, often called fibro fog. It is thought to involve changes in how the nervous system processes pain signals, which makes the body more sensitive. It is real, it is common, and although there is no cure, the right combination of care can make a meaningful difference.

Symptoms of fibromyalgia

• Widespread pain and tenderness lasting more than three months
• Extreme tiredness and unrefreshing sleep
• Stiffness, especially in the morning
• Difficulty concentrating and remembering
• Headaches, irritable bowel symptoms and sensitivity to temperature or noise
• Anxiety or low mood, often linked to living with pain

What causes fibromyalgia?

The exact cause is not known. It often starts after physical or emotional stress, such as an injury, illness or a difficult life event, and is more common in women. It is diagnosed from symptoms after other conditions have been ruled out, often with blood tests.

How is fibromyalgia treated?

NICE guidance for chronic primary pain (NG193) recommends exercise programmes, psychological therapies and, as an option, a single course of acupuncture. Some antidepressants may be offered by a doctor. Many common painkillers are not recommended for this type of pain.

How we help with fibromyalgia in Chiswick

• Acupuncture: one of the treatments NICE says can be considered for chronic primary pain.
• Physiotherapy: very gradual, paced exercise that avoids boom-and-bust flares.
• Tai chi and yoga: gentle movement with trial evidence for reduced pain and better sleep in fibromyalgia.
• Manual lymphatic drainage: a very gentle hands-on therapy many people with sensitive tissues tolerate well.
• Psychological support: with Prof (Dr) Diwakar Sukul, Chartered Clinical Psychologist.

What does the evidence say?

Exercise has the most consistent evidence. A well-known trial found tai chi improved fibromyalgia symptoms as much as or more than aerobic exercise. Acupuncture shows modest benefit in reviews.

How is fibromyalgia diagnosed?

There is no scan or blood test that shows fibromyalgia. A GP or rheumatologist makes the diagnosis from your history and an examination, usually when pain has been widespread for at least three months and comes with fatigue, unrefreshing sleep or memory problems. Blood tests are used to rule out conditions that can look similar, such as an underactive thyroid, low vitamin D, anaemia, rheumatoid arthritis, lupus and polymyalgia rheumatica. Many people wait years for a diagnosis, so it helps to bring a symptom diary to your appointment.

Is fibromyalgia an autoimmune disease?

No. In autoimmune diseases such as rheumatoid arthritis or lupus, the immune system attacks the body's own tissues and causes inflammation and damage. Fibromyalgia does not damage joints, muscles or organs, and inflammation markers are usually normal. Current research points to central sensitisation, where the brain and spinal cord amplify pain signals. Fibromyalgia can, however, occur alongside autoimmune conditions, so new joint swelling, rashes or fever should always be checked by a doctor.

What helps a fibromyalgia flare?

• Drop back to a lower, manageable level of activity rather than stopping completely
• Use warmth, such as a bath or heat pad, for stiffness and aching
• Protect your sleep routine, even if nights are broken
• Use relaxation or slow breathing to calm the nervous system
• Note what came before the flare, such as overdoing it, stress or illness, to spot patterns

What to expect at Omnia

Your first appointment is a longer conversation about where you hurt, how you sleep, your energy across the week and what you would most like to get back to. We check which tests you have already had and suggest any gaps to raise with your GP. You then receive a paced plan, often starting with acupuncture or gentle tai chi and a very small home programme, reviewed every few weeks. We never push through pain, and we adjust the plan on bad days rather than abandoning it.

What you can do at home

• Pace activity: plan rest before you need it
• Build activity very slowly, by small steps each week
• Keep a regular sleep and wake time
• Use warmth, such as a bath, to ease stiffness

Read more in our guides to how fibromyalgia is diagnosed and whether fibromyalgia is an autoimmune disease.

Omnia Lifestyle is at 8 to 9 Bedford Corner, Chiswick W4, two minutes from Turnham Green station. Book online or call 020 4515 0000.