Fibromyalgia

New research suggests an increased ‘connectivity’ between sensory, pain, attention and mood networks in the brain.

Sadly, fibromyalgia does not respond to medication very well. Often, there is only a 1 in 10 chance of improvement in symptoms.

It means few patients respond well to medication and patients with fibromyalgia are often more prone to side effects.

With that in mind, if strong medications (such as tramadol, amitriptyline, fluoxetine and pregabalin) are used, it is important to be realistic about their possible benefits, and withdraw them if there are no significant improvements.

Many patients still describe their pain score as 10/10, despite being on four medications for pain, and in addition experience a lot of detrimental side effects.

One of the best approaches is trying to get fit again – this is termed as a ‘graded aerobic exercise programme’ - and there are simple changes that can start this off, such as short walks, using stairs more and gentle exercise in a swimming pool.

An exercise programme using the principles of Tai Chi can also be helpful.

We don’t normally see patients with an established diagnosis of fibromyalgia in the rheumatology department because there are no specialist treatments available.

Sometimes patients with other conditions such as rheumatoid arthritis develop fibromyalgia and we may discuss some of the medications above or direct them to the online resources below.