Symptoms of fibromyalgia vary from patient to patient as well as in their severity. The condition can affect memory and concentration, as well as causing pain in different areas of the body. We invited highly respected consultant in pain medicine Dr Yasser Mehrez to give expert insight on the condition’s impact on everyday life. He also details how patients can take control of their symptoms through education and self-management and the importance of a multidisciplinary approach to care.
What is fibromyalgia?
Fibromyalgia is a chronic condition which has been found to affect more and more people in recent years. The main complaint reported by patients is long term pain, lasting for more than a few months. The pain tends to affect various parts of the body simultaneously but can also be experienced in different areas on separate occasions. Over time, the pain may be aggravated or may settle down to some extent.
Additionally, patients report symptoms of tiredness, fatigue, a lack of sleep and also non-refreshing sleep. This may be accompanied by muscle stiffness, headaches and various other physical and cognitive consequences. We find many patients may also suffer from depression and anxiety. Some patients report abdominal and pelvic pain and others report painful and heavier periods.
As well as the unpleasant experience of pain, these symptoms can have a detrimental effect on quality of life and wellbeing. The exact presentation of fibromyalgia can vary from one person to another. Women are most affected, particularly those between thirty and fifty years old but younger patients and those over sixty can also develop the condition.
How does fibromyalgia affect quality of life and mental health?
Due to the variety of symptoms patients can report, the impact on quality of life can differ. Some patients have more problems with the level of pain itself while others may find the anxiety and sleep disturbance most troublesome. Some patients complain that severe headaches seriously limit their ability to perform certain functions and go about their daily tasks. Cognitive impairment, affecting memory and speech, can also impact on day-to-day functioning and is sometimes referred to as fibro-fog.
The impact of fibromyalgia on quality of life can vary depending on an individual's symptoms. It is clear, however, that overall, patients with fibromyalgia tend to be less able to perform physical exercises and that sleep disturbance has a serious impact their functional performance. As a pain specialist, my priority is improving the patient’s quality of life by helping them to manage their pain and maximise their performance.
Is there a cure for fibromyalgia?
Fibromyalgia is best described a manageable condition. Our main aim as pain specialists is to see what the individual patient requires and establish which are their principal concerns. As I have mentioned, there are many implications of fibromyalgia and its impact on a person's day to day performance. Through a thorough discussion with the patient, we assess their individual need and establish the best treatment plan, with the input of other members of the multidisciplinary team. A combined approach of pain management, physical therapy and psychological input can offer patients the best outcomes.
When used in the right way, there are various types of medication which can help to manage pain, improve muscle stiffness and reduce disturbance to sleep. We have also seen patients responding very well to courses of anti-depressants. While not necessarily used to treat depression, they have been found work as a pain killer as well as an aid to improving sleep.
While these medications can help the patient, they can also bring on side effects. A key point in our discussion with patients is the risk versus benefit of this type of treatment.
Low-impact exercise, such as swimming and walking can also improve symptoms so we do encourage patients to be active. This form of self-management can really benefit patients so we give detailed advice on how to take advantage of this.
Acupuncture has also been found to improve sleep quality and reduce muscle stiffness for some patients. Massage and topical heat application can also be helpful, as well as hydrotherapy. Use of a TENS machine may also reduce long term pain. However, the best approach I would recommend for patients is to have a consultation with a pain clinician who can address the individual need and tailor a personalised treatment plan.
What can people do at home to help relieve symptoms of fibromyalgia?
We encourage patients with fibromyalgia to exercise regularly but it is important to pace their activities and to slowly increase their level of activity. We recommend that they perform low impact exercise, such as gentle aerobic activities, walking or swimming. Some patients may also benefit from muscle strengthening as advised by a physiotherapist.
Psychological intervention can allow patients to make significant progress in managing their condition. Learning about relaxation techniques, coping strategies and realistic goal setting can help to reduce the condition’s impact on quality of life. If implemented successfully, these techniques can reduce pain and improve cognitive and physical ability thus potentially allowing the patient to reduce their intake of medication.
Does treatment for fibromyalgia have a significant impact on patients’ quality of life?
A number of my patients have benefited very significantly from a multidisciplinary approach under my care. Becoming aware of the nature of fibromyalgia is key for the patient and therefore I would urge people suffering from the condition to ask their clinician about the disease process, the symptoms and why they occur. A sound understanding of the condition helps patients to better self-manage their symptoms and can additionally ease elements of depression and anxiety brought on by their experience.
Many patients under my care were able to significantly increase their level of exercise and therefore lose weight and improve their overall health as well as their symptoms. As a consequence, they reduced or completely stopped taking pain killers as there was a drastic improvement in their condition and quality of life. A combination of good quality, multi-disciplinary care and education for patients can be really effective in controlling fibromyalgia, helping patients to achieve their goals and improve their condition.
If you are seeking high quality, impactful treatment for fibromyalgia, you can book a consultation with Dr Mehrez by visiting his Top Doctors profile.