Medical Information

Explore detailed information about a range of joint problems and treatments, including medications, surgery, physiotherapy and rehabilitation. Reading this will help you understand more about your own condition. There is also a glossary with explanations of many medical terms used in orthopaedics. You can find out even more by following the links page to other related websites, journals or professional medical associations.

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This booklet explains how fibromyalgia affects people in different ways, and how doctors diagnose it. It explains what can be done to help with the symptoms, and offers advice on living with it more easily.

What is fibromyalgia?
Fibromyalgia is a name for widespread pain affecting the muscles but not the joints. It is a chronic condition, but it is not life-threatening or progressive and does not cause permanent damage to muscles, bones or joints. There are usually no outward signs of the condition and people with fibromyalgia often look well but feel awful. Because of this, other people may not appreciate the pain and tiredness you are suffering and this can cause additional distress. However, it is important to stress that the pain suffered by people with fibromyalgia is real and may be severe, even though it is usually not associated with visible swelling or deformities of muscles or joints.

Fibromyalgia is a common condition. A study from America found that up to 2% of people suffer from fibromyalgia, and it occurs more commonly in women than in men. The amount of pain varies from person to person and from day to day. The pain may be quite mild on many days but it is sometimes so severe that it affects your work and your personal and social life. Some people find that the pain feels worse in cold or damp weather. In fibromyalgia the tendons and ligaments, or fibrous tissues (fibro-), and the muscles (my) are affected by pain (-algia) and tenderness. It may feel as though the pain affects the whole body.

There are usually tender points in certain areas of the body. These tender points help the doctor to make the diagnosis. If enough pressure is applied to these points most people will find it uncomfortable, but in fibromyalgia many of these points can be extremely tender even when they are pressed quite gently. Tenderness at individual sites sometimes occurs and this can give rise to localized conditions such as tennis elbow. In fibromyalgia, however, there is tenderness at a number of points.

What are the symptoms of fibromyalgia?
Pain, tiredness and sleep disturbance are the main symptoms of fibromyalgia. Most people feel the pain of fibromyalgia as aching, stiffness and tiredness in the muscles around the joints. It may feel worse first thing in the morning, or as the day goes on, or with activity. It may be particularly bad in one part of the body or may be equally bad in several different areas such as the limbs, neck and back. Patients with fibromyalgia often feel that they have pain all over their bodies.
Sometimes tiredness (fatigue) can be the most severe aspect of fibromyalgia.

There may be overall tiredness and lack of energy, or muscular fatigue and loss of stamina. Either way, it can be difficult to climb the stairs, do the household chores, go shopping or go to work. Becoming less fit physically makes matters worse.
Waking in the morning feeling unrefreshed is common.
Other symptoms include:
poor circulation – tingling, numbness or swelling of the hands and feet
irritability or feeling low or weepy
forgetfulness or poor concentration
feeling an urgent need to pass water
irritable bowels (diarrhoea or constipation and abdominal pain).

Of course symptoms like these can have other causes, and your doctor can help decide whether any further tests or advice is required. There are no blood tests, x-rays or scans that can diagnose fibromyalgia as blood tests and x-rays are usually normal. When tests are carried out they are usually done to make sure that there is no other cause for the symptoms. The severity of the symptoms and the effects of fibromyalgia can vary considerably, and this range of severity can cause problems in diagnosing the condition and lead to varying medical opinions. Patients often find it helpful that their pattern of symptoms is taken seriously and recognized as being due to fibromyalgia – even though this may not always lead to any change in treatment.
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