Fibromyalgia

Overview

Fibromyalgia is a chronic condition characterised by widespread musculoskeletal pain, fatigue, sleep disturbance, and cognitive difficulties. It is thought to involve abnormal processing of pain signals in the brain, making the nervous system amplify normal sensations into significant pain.

How common is it?

Fibromyalgia appears to be relatively common, but its exact frequency is uncertain because diagnosis can be difficult. It is more common in women and often begins between ages 25 and 55, although it can occur at any age.

Causes and risk factors

The exact cause is unknown, but fibromyalgia involves central sensitisation, where the nervous system becomes hypersensitive to pain signals. Stressful physical or emotional events often precede onset.

Common risk factors

• Viral infection as a trigger in some people
• Physical or emotional trauma
• Female sex
• Family history of fibromyalgia
• Anxiety, depression, or post-traumatic stress
• Other rheumatic conditions (rheumatoid arthritis, lupus)
• Sleep disorders

Symptoms

• Widespread musculoskeletal pain in multiple body areas
• Fatigue despite sleeping, unrefreshing sleep
• Cognitive difficulties ('fibro fog'): poor memory, difficulty concentrating
• Headaches
• Irritable bowel symptoms
• Sensitivity to heat, cold, light, and noise
• Anxiety and depression

When to see a doctor

See a GP for persistent widespread pain, fatigue or sleep problems. Do not wait 3 months before seeking help. The clinician will assess other treatable causes and whether fibromyalgia is likely.

Diagnosis

Diagnosis is based on persistent widespread pain and associated symptoms. There is no single diagnostic test. A clinician may use blood tests to look for other causes, such as thyroid disease or inflammatory illness; fibromyalgia can coexist with other conditions.

Treatments

Self-care and lifestyle

• Prioritise sleep hygiene: regular bed times, cool dark quiet room, avoid screens
• Use pacing strategies to avoid boom-bust cycles of overactivity followed by flare
• Warm baths or hydrotherapy can reduce pain temporarily
• Build a support network and connect with fibromyalgia peer support groups

Prevention

There is no established way to prevent fibromyalgia. Sleep support, paced activity and stress management may help people manage symptoms, but are not proven to prevent the condition.