Understanding fibromyalgia: A comprehensive guide to pain management

Written by: Dr Rajiv Malhotra
Published: | Updated: 15/11/2023
Edited by: Sophie Kennedy

Fibromyalgia is a complex and often misunderstood condition characterised by widespread pain and tenderness in the muscles, ligaments, and tendons. For those who suffer from fibromyalgia, the daily battle with pain can be overwhelming. Fortunately, there are a number of effective pain management strategies which can help patients who suffer from fibromyalgia to regain control of their lives. To learn more, we invited revered consultant in pain management and anaesthesia Dr Rajiv Malhotra to shed light on the most troublesome symptoms of fibromyalgia and the range of management strategies available to help.

What is fibromyalgia?

Fibromyalgia is a chronic condition that affects the central nervous system, causing heightened pain sensitivity. It is not an inflammatory or degenerative condition like arthritis but rather a disorder of pain processing. This means that the way your brain perceives pain is altered, leading to widespread and persistent discomfort.


Recognising the symptoms of fibromyalgia

Fibromyalgia is known for its wide array of symptoms, with pain being the most prominent. Common signs include:


Widespread pain

Patients often describe aching, burning, or stabbing pain throughout their bodies, which persists for at least three months.


Fatigue

Overwhelming fatigue, often unrelieved by sleep, is a hallmark of fibromyalgia.


Sleep disturbances

Difficulty falling asleep and staying asleep can worsen pain and fatigue.


Cognitive difficulties

Referred to as "fibro fog", this includes memory problems, difficulty concentrating, and mental clarity issues.


Tender points

Specific points on the body, such as the neck, shoulders, chest, hips, and knees, may be tender to touch.


Irritable bowel syndrome (IBS) and other symptoms

Some patients may experience digestive issues, headaches, and mood disturbances.


What types of pain management strategies can help relieve symptoms of fibromyalgia?

Managing fibromyalgia pain can be challenging, but there are strategies to improve your quality of life. Your pain specialist may prescribe medications to help manage pain, improve sleep, and alleviate symptoms. These may include analgesics, antidepressants, and anticonvulsants.

In addition, a tailored exercise program can help improve strength, flexibility, and overall physical function. Physical therapists can also teach relaxation techniques to manage stress. Incorporating a balanced diet, regular exercise, and stress-reduction techniques can also make a significant difference in pain management. Avoiding caffeine and alcohol close to bedtime may help improve your sleep.

Some patients find that cognitive behavioural therapy helps them to develop coping strategies, manage stress, and improve their overall mental wellbeing. In addition, connecting with others who share your condition can provide emotional support and practical advice for managing fibromyalgia.

There are also alternative therapies to consider. Some individuals find relief through acupuncture, massage therapy, or chiropractic care. Overall, avoiding overexertion and pacing yourself is key. Learning to manage your energy levels is crucial, so don't be afraid to say no when needed.


When should I seeking professional help?

If you suspect you have fibromyalgia or have already received a diagnosis, it's essential to work closely with a specialist who is experienced in treating the condition. With this expertise, your doctor can help create a tailored pain management plan that suits your individual needs.




If you are struggling with the symptoms of fibromyalgia and would like to schedule a consultation with Dr Malhotra, you can do so by visiting his Top Doctors profile.

By Dr Rajiv Malhotra
Pain medicine

Dr Rajiv Malhotra is a highly respected Consultant in Pain Medicine and Anaesthesia based in Liverpool. He is renowned for his expertise in the management of long-term pain conditions and acute exacerbations of pain conditions, including back painneck pain and osteoarthritis. He also specialises in sciaticadegenerative diseases and epidural/nerve injections.

Dr Malhotra qualified in medicine from the University of Liverpool, as well as obtaining a Bachelor’s  degree with honours in pharmacology before going on to qualify in medicine from the University of Liverpool in 2006. He achieved the Fellowship of the Royal College of Anaesthetists in 2011, winning the Macintosh Prize for his exceptional academic achievement. Dr Malhotra then went on to complete an advanced fellowship in pain medicine at the Royal Liverpool and Broadgreen University Hospital NHS Trust, where he currently serves as a Consultant in Pain Medicine and Anaesthesia . In 2016, he was appointed as a fellow of the Royal College of Anaesthetists’ Faculty of Pain Medicine, and was once again recognised with an award for his top scores in the examinations. With extensive clinical expertise in a wide range of pain conditions, Dr Malhotra is dedicated to improving patients' quality of life through his comprehensive approach to pain management. He sees private patients at Spire Liverpool Hospital.

Throughout his esteemed career, Dr Malhotra has held a number of senior positions, and currently serves as the Regional Advisor in pain medicine (Mersey) for the Faculty of Pain Medicine of the Royal College of Anaesthetists. He is also a member of the British Pain Society’s Patient Education Group and acts as chair for the Vascular Anaesthesia Society’s research and auditing group.

Dr Malhotra's dedication to pain management goes far beyond clinical practice. He actively contributes to the field through his research and publications, having published numerous papers which appear in peer reviewed journals. He is also a leading name in education, having completed a Masters in Medical Education in 2015. He supervises trainee doctors and serves as lead consultant on a number of training courses. Dr Malhotra also holds several key roles with Health Education North West, acting as an Educational Supervisor and as a Consultant representative for the Mersey Pain Medicine Training Group. In addition, he regularly speaks at key conferences of fellow specialists on topics related to pain medicine.

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