Fibromyalgia is characterised by widespread pain, tender muscle trigger points in the shoulder, neck, back and hips, joint stiffness, debilitating fatigue and sleep disturbance. Fibromyalgia is estimated to affect 2-4% of the population. The cause is not fully understood. There is evidence to suggest stress, a genetic predisposition and chemical abnormalities including central dopamine or serotomin dysfunction have a role. Additionally, there is evidence that depression is associated with fibromyalgia, although the nature of the association is controversial.
The diagnosis is with history, examination and investigations such as blood tests or MRI scans to exclude other causes.
There is no recognized cure for fibromyalgia, but some treatments have been demonstrated in clinical trials to be effective in reducing symptoms. Such treatments are often undertaken through a multimodal approach and may include specialist medication including amitriptyline, duloxetine and pregabalin, acupuncture, exercise and lifestyle changes, trigger injections, intravenous lignocaine infusions and psychological therapies.
