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February 13, 2019

Fibromyalgia is a condition which causes widespread chronic (persistent) pain, and has associated sleep problems, depressed mood, fatigue and cognitive problems.

It effects about 2% of the population, is more common in females, and becomes more prevalent as you get older.

Our understanding of this condition is still developing, and unfortunately it was particularly common in the past that people suffering this condition would be told, “it’s all in your head” or “you’re making it up.” Unfortunately, it’s all too easy for health professionals to blame the patient when their understanding limits them in adequately explaining someone’s presentation. But this only increases confusion and frustration in patients, and can lead to many sufferers giving up on conventional medicine, or on treatment generally.

With advancements in our understanding of fibromyalgia (and chronic pain in general) we’ve learnt that it appears to be due to changes in the nervous system. These changes occur throughout the nervous system. Sensory nerves in the tissues may become more sensitive to stimulation and therefore send more nerve impulses. Nerves in the spinal cord change to become more receptive to input from nerves in the tissues which may be associated with pain. And finally, the sensory cortex in the brain undergoes changes to focus more on sensory input associated with pain, and to become less aware of the position and movement occurring in areas of the body which are experiencing pain.


Some of these changes in the nervous system are normal, and healthy when associated with a recent injury. When you sprain your ankle your nervous system changes so that you will feel pain in your ankle more easily, so you will know it’s injured and protect it in the early stages of healing. In this situation the nervous system changes are narrowly focused and temporary. Unfortunately in the case of fibromyalgia they are widespread and continuous.

So why does this happen?

Good question. It seems that there are features which increase your risk of developing fibromyalgia, but no definite cause. For example, as we mentioned, females are more likely to develop fibromyalgia than males. Psychological issues such as stress, mental health disorders and having experienced physical and/or sexual abuse are also significant risk factors. There also seems to be some familial link.

How do we treat it?

The various symptoms of fibromyalgia also create vicious cycles where they all impact negatively on each other. For example poor sleep leads to worsening pain, worsened pain makes sleep more difficult. As such, the management of fibromyalgia needs to be multifaceted to work to break these vicious cycles. Techniques such as massage, dry needling, heat packs, stretching etc may be useful to provide some temporary relief of pain, but a holistic management program for fibromyalgia needs to include a graduated exercise program to help relieve pain, fatigue and improve mood, as well as other treatments to address all symptoms, such as sleep hygiene training to improve sleep.


What are the takeaways?

That’s a lot of information, and a lot of big words to take in. So here are some bullet point takeaways

  • Fibromyalgia, and chronic pain generally, is not “all in your head.” You should never have been told this.
  • Our understanding of fibromyalgia, and chronic pain generally, has come on in leaps and bounds in recent years, and is still developing.
  • Pain relief techniques are helpful to temporarily manage symptoms
  • Sufferers benefit most from a holistic management program including pain relief techniques, a graduated exercise regime, and other tools to deal with all potential causes and symptoms.

Do you know someone who is experiencing fibromyalgia or some other type of persistent pain? Recommend they make an appointment to see our physiotherapist in Aubin Grove to begin a holistic management program to get them in control of their pain!

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