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Originally Posted On: https://sloanestreetsurgery.co.uk/articles/fibromyalgia-symptoms-diagnosis-and-treatment/
What is fibromyalgia?
Fibromyalgia is a long-term condition that causes widespread pain throughout the body, along with fatigue, sleep disturbance and a variety of other physical and cognitive symptoms. It is classified as a chronic primary pain condition, meaning that the pain itself is the main problem rather than being caused by damage or inflammation in the tissues.
Fibromyalgia is estimated to affect around two to five per cent of people in the UK, which equates to roughly 1.8-2.9 million people, according to Arthritis UK.
It is a recognised medical condition, acknowledged by healthcare professionals worldwide, and although it is more common in women, men and younger people can also develop the condition.
What are the symptoms of fibromyalgia?
Fibromyalgia symptoms vary significantly between individuals and often fluctuate over time. Many people experience periods when symptoms worsen, known as flare-ups, which may be triggered by stress, illness, poor sleep or physical overexertion.
Widespread pain
- Pain affecting both sides of the body
- Often described as aching, burning or stabbing
- Pain lasting at least three months
Fatigue
- Persistent tiredness that does not improve with rest
- Feeling exhausted after minimal activity
Sleep problems
- Difficulty falling or staying asleep
- Waking feeling unrefreshed
Cognitive problems (“fibro-fog”)
- Poor concentration
- Memory problems
- Slower thinking
Heightened sensitivity
- Increased sensitivity to pain, touch, noise or light
- Pain from normally non-painful stimuli
Other associated symptoms
- Headaches or migraines
- Irritable bowel syndrome (IBS)
- Anxiety or depression
What causes fibromyalgia?
The exact cause of fibromyalgia is not fully understood, but current evidence suggests it is related to changes in how the central nervous system processes pain. This process, known as central sensitisation, means the brain and spinal cord amplify pain signals, making normal sensations feel painful.
Genetic factors may play a role, as fibromyalgia can run in families. Certain events appear to trigger the condition in some people, such as physical injury, surgery, infections or significant emotional stress. Poor sleep quality and hormonal factors may also contribute. Fibromyalgia commonly occurs alongside other conditions, including chronic fatigue syndrome (CFS/ME), IBS, anxiety or depression.
How is fibromyalgia diagnosed?
There is no single test that can diagnose fibromyalgia, and diagnosis is based on a careful clinical assessment.
A GP will usually take a detailed history of symptoms, and then a physical examination is carried out, with blood tests are often requested to rule out other conditions that can cause similar symptoms, such as thyroid disease, inflammatory arthritis, vitamin deficiencies or autoimmune conditions. Doctors may also use recognised diagnostic criteria, such as those developed by the American College of Rheumatology.
Diagnosis can sometimes take time because fibromyalgia symptoms overlap with many other conditions, and test results are often normal. While this can be frustrating, excluding other causes is an important step in reaching an accurate diagnosis and ensuring appropriate management.
Is fibromyalgia a progressive condition?
Fibromyalgia does not cause joint damage, muscle destruction or shorten life expectancy. However, symptoms can be long-lasting and may fluctuate over time. Many people experience periods of worsening symptoms followed by times of relative improvement. With appropriate treatment and self-management strategies, many individuals find that their symptoms become more manageable and their quality of life improves.
What treatments are available for fibromyalgia?
There is currently no cure for fibromyalgia, but treatment focuses on reducing symptoms and improving daily function. Treatment usually involves a combination of approaches rather than relying on a single therapy.
- Education and self-management
Understanding fibromyalgia is a key part of treatment.
Patients are encouraged to:
- Pace activities
- Avoid over-exertion followed by flare-ups
- Identify triggers
- Set realistic goals
- Exercise and physical activity
Regular, gentle exercise is one of the most effective treatments for fibromyalgia.
Recommended activities include:
- Walking
- Swimming or hydrotherapy
- Yoga or Pilates
- Physiotherapy-guided exercise
Exercise should be gradual and consistent, starting at a low level and increasing slowly.
- Psychological therapies
Talking therapies help manage pain perception and coping strategies.
These include:
- Cognitive Behavioural Therapy (CBT)
- Acceptance and Commitment Therapy (ACT)
- Medications used for fibromyalgia
Medication can help some patients, but is not suitable or effective for everyone.
- Amitriptyline (low dose) – for pain and sleep
- Duloxetine – for pain and mood
- Pregabalin or Gabapentin – used selectively
- Simple painkillers such as paracetamol
Strong opioid painkillers are not recommended, as they are usually ineffective and carry significant risks.
Are there new treatments for fibromyalgia?
Research into new treatments for fibromyalgia is ongoing. One area of interest is low-dose Naltrexone, which is being studied for its potential effects on pain signalling and inflammation. While some patients report benefit, it is not currently a standard treatment and is usually prescribed off-label by specialists.
How can fibromyalgia be managed day to day?
Living with fibromyalgia often requires a long-term, self-management approach. Many people find benefit from maintaining regular sleep routines, incorporating gentle daily movement, managing stress and prioritising mental wellbeing. Keeping a symptom diary can help identify triggers and patterns, while support groups and pain management programmes can provide education and reassurance.
When should I see a GP?
If you’re worried about yourself, another family member or a friend who may be living with ongoing pain, fatigue or other symptoms of fibromyalgia, please don’t delay seeking help. Fibromyalgia is a real and manageable condition, and early assessment and support can make a meaningful difference to symptoms and quality of life.
At Sloane Street Surgery, we understand how frustrating and overwhelming it can be to live with persistent pain and exhaustion, especially when symptoms are difficult to explain or have been present for a long time. Our experienced GPs can assess your symptoms carefully, help rule out other conditions, and work with you to develop an individual management plan. This may include advice on lifestyle changes, pain management strategies, appropriate medication, psychological support or referral to specialist services when needed.
You can book a confidential appointment online or call us on 0207 245 9333 to speak with one of our team.
You don’t have to manage fibromyalgia alone – understanding, support and effective treatment options are available.
About the author
Dr Christiana Lucas
MD MRCGP CILT
“Good medicine starts with listening — no patient should ever feel unseen or unheard.”
My background across different healthcare systems and clinical settings has shaped a broad experience and a flexible, holistic approach to care. At Sloane Street Surgery, I value the continuity that allows me to build long-term relationships with patients. I have a particular interest in preventive medicine and the positive impact it can have on long-term health and wellbeing.
