Fibromyalgia is a poorly understood condition characterised by widespread chronic pain, cognitive difficulties, and gastric disturbance.
Diagnosing Fibromyalgia
Fibromyalgia cannot be diagnosed with any single test as it is a functional condition. This means that imaging and blood tests cannot pick it up. However, they can still be useful to rule out other conditions. Chronic joint and muscle pain can be a sign of autoimmune or rheumatological conditions. Osteopaths are qualified to make some musculoskeletal diagnoses, but we will usually refer you back to your GP to make sure these other possible diagnoses can be disregarded. This process can usually be ongoing while you continue with your osteopathic treatment plan.
We currently work from the 2010 diagnostic criteria for diagnosing fibromyalgia. This requires three criteria to be met:
pain affecting at least 3 areas at a >9/10 pain level, or 7 areas at >5/10
consistent symptoms lasting 3 months or more
no other explanation for the symptoms
Beyond the pain, there may also be an increase in headaches and IBS-type symptoms. Sleep may become less refreshing, and energy and concentration may be reduced.
Who is Affected?
The condition tends to affect women more than men, at an estimated rate of 7 to 1. Onset most commonly begins between the ages of 30 and 50, but it is not too unusual for it to occur outside this bracket. Similarly to some rheumatological conditions, the onset often follows some sort of trauma. This may be an emotional trauma or a physical one. Bereavement and break ups can initiate it, as can injuries, surgeries, or giving birth.
Current Theories
Research on fibromyalgia is frustratingly inconclusive in general. There are a number of theories but none are well supported. Ideas of toxin build up have led to an offering of a range of therapies that may or may not have any benefit. PainScience.org has collated a lot of the current thinking, including the similarities with trigger points and myofascial pain syndrome. Unfortunately, this is another poorly understood condition, meaning treatment options can become a trial and error situation while an individual discovers what best suits them.
Managing Fibromyalgia
Osteopathy is recognised as a therapy that may be able to help an individual with their fibromyalgia. The approach that research highlights as most effective is a gradual increase in exercise. Of course, when you’re in pain and exhausted, it feels like useless advice, but we can help devise an achievable plan. As your capacity for exercise grows, we can adjust accordingly.
Some people find that gentle work to the muscles provides some relief. If the discomfort causes you to hold yourself in an awkward position, working on these secondary effects may be useful too.
The NHS recognises that many treatments can ease symptoms, but expects that some pain will still remain. It is important to have realistic expectations, and you may find that a combination of therapies is the best solution for you. Medication and talking therapies are also recommended- speak to your GP about these avenues.
