A clear understanding of fibromyalgia

Written in association with: Dr Rajesh Menon
Published:
Edited by: Kate Forristal

Fibromyalgia syndrome is a condition characterised by chronic widespread musculoskeletal pain, fatigue, sleep disturbances and cognitive disorders, associated with varied additional symptoms such as irritable bowel syndrome, dry mouth , dry eyes, temporomandibular dysfunction and many others. Despite being a common ailment, it often goes misunderstood and undiagnosed due to its complex nature.

 

In his latest online article, consultant in anaesthetics and pain management Dr Rajesh Menon aims to provide a clear understanding of fibromyalgia, its symptoms, causes, and management strategies to help those affected navigate their condition more effectively.

 

 

Symptoms of fibromyalgia

 

Fibromyalgia manifests through a variety of symptoms, making it challenging to identify. The primary symptom is widespread pain, often described as a constant, dull ache lasting for at least three months. This pain occurs on both sides of the body and above and below the waist.

 

In addition to pain, many individuals experience fatigue, even after sleeping for long periods. This fatigue can disrupt normal daily activities and is often accompanied by sleep disturbances. Patients may also report cognitive difficulties, commonly referred to as "fibro fog," which includes problems with concentration, memory, and mental clarity.

 

Prevalence - 2-4% worldwide, female to male ratio - 9:1

 

Other common symptoms include:

 

Causes and risk factors

 

The precise cause of fibromyalgia is still unknown, but it is thought to result from a combination of genetic, environmental, and psychological factors. Abnormal levels of certain chemicals in the brain and changes in the way the central nervous system processes pain signals might contribute to the development of the condition.

 

Risk factors for fibromyalgia include:

  • Genetics: A family history of fibromyalgia may increase susceptibility.
  • Infections: Certain illnesses or infections may trigger or exacerbate symptoms.
  • Trauma: Physical or emotional trauma has been linked to the onset of fibromyalgia.
  • Gender: Women have a higher likelihood of developing fibromyalgia compared to men. Ratio 9:1

 

Diagnosis and treatment

 

Diagnosing fibromyalgia can be difficult because there are no specific laboratory tests available for confirmation. Physicians typically rely on patient history, physical examination, and ruling out other conditions with similar symptoms. The American College of Rheumatology’s criteria include widespread pain lasting at least three months and the presence of additional symptoms such as fatigue, waking unrefreshed, and cognitive issues.

 

In the NHS, fibromyalgia patients are primarily treated by general practitioners (GPs), with no referral to secondary care. This limitation often affects the variety and depth of available treatment options. Most medications used to manage fibromyalgia symptoms are unlicensed for this specific condition, meaning they are not officially approved but can still be prescribed off-label by doctors.

 

Treatment for fibromyalgia is multifaceted and focuses on managing symptoms rather than curing the condition. Common approaches include:

  • Medications: Pain relievers, antidepressants, and anti-seizure drugs can help reduce pain and improve sleep. However, the effectiveness of these medications may vary, and options are limited within the NHS framework. Non-licences drugs like Cannabis, low-dose Naltrexone, melatonin and low-dose intravenous immunoglobin are tried with variable benefits.
  • Therapy: Cognitive behavioural therapy (CBT) can assist in coping with pain and addressing any mental health concerns.
  • Exercise: Regular physical activity, particularly low-impact exercises like swimming and walking, can alleviate symptoms and improve overall wellbeing.
  • Lifestyle changes: Stress management techniques, adequate sleep, weight loss and a balanced diet are crucial in managing fibromyalgia.

 

 

Dr Rajesh Menon is an esteemed pain management specialist. You can schedule an appointment with Dr Menon on his Top Doctors profile.

By Dr Rajesh Menon
Pain medicine

Dr Rajesh Menon is a highly experienced and skilled consultant in anaesthetics and pain management, based in Elland, Huddersfield, Yorkshire. He specialises in pain management, focusing on chronic regional pain syndrome, low back pain and chronic abdominal pain.

He possesses a wealth of knowledge and expertise in the medical field, initially graduating from the University of Calicut with Bachelor of Medicine, before pursuing a doctorate of medicine and a diploma in anaesthesia from the Mahatma Gandhi University, receiving a first class honours in both. He is currently working at the Spire Elland Hospital as a consultant in anaesthetia and pain medicine, as well as part of the NHS Calderdale and Huddersfield NHS Foundation Trust.

Alongisde his experience in chronic pain, he also holds experience working in palliative care, neurosurgery, gynaecology, surgery, orthopaedics and as part of a musculoskeletal team in managing patients with chronic pain.

Dr Menon is a firm believer in a holistic approach to pain management, concentrating on the functional and emotional well-being of patients, as well as pain relief. He considers patient empowerment to be of utmost importance, with a focus on honesty, communication and collaboration between doctor and patient. 

As part of his role as surgical division representative in the medical mangement committee of the Calderdale and Huddersfield NHS Foundation Trust, Dr Menon has developed guidelines for primary and secondary care, in keeping with the latest developments in the field of neuropathic pain management, opioids in pain management and opioids tapering guidelines.

Dr Menon is a fellow of the College of Anaesthetics, part of the Royal College of Surgeons in Ireland (RCSI) and the Fellowship of the Faculty of Pain Medicine, part of  The Royal College of Anaesthetics (FFPMRCA).

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