What is Fibromyalgia?

Fibromyalgia is a long-term condition that causes widespread pain and tenderness throughout the body. It affects the way the brain and spinal cord process pain signals, amplifying the perception of pain. This condition can also lead to fatigue, sleep disturbances, cognitive difficulties (often referred to as (fibro fog), and mood issues. Fibromyalgia can significantly impact daily life and is more common in women than men.

Common Symptoms

  • Persistent, widespread muscle and joint pain
  • Low back pain (is often the main pain site in most FM patients)
  • Fatigue, even after a full night's sleep
  • Sleep disturbances or non-restorative sleep
  • Brain fog
  • Headaches or migraines
  • Temporo-mandibular joint Pain (Jaw pain)
  • Bruxism
  • Sensitivity to bright lights, sounds and odour
  • Irritable bowel symptoms

Common Symptoms

  • Irritable bladder
  • Mood disorders such as anxiety or depression
  • Restless legs
  • Dizziness or vertigo
  • Tinnitus
  • POTS
  • Rash
  • Mixed anxiety and depression
  • Inability to ‘switch off’ the brain
  • Winter flares

Management of Fibromyalgia:

Managing fibromyalgia requires a multidisciplinary approach. There is no single cure, but symptoms can be controlled with the right combination of therapies.

Medications

  • NSAIDs and muscle relaxants to reduce inflammation and tension
  • Neuropathic agents for nerve-related pain

Medications

  • Amitriptyline, Duloxetine, Fluoxetine are commonly used.
  • Medications help improve sleep and reduce pain by 30% in 1/4 th patients.

Lifestyle and Self-Care:

  • Regular low-impact exercise (e.g., walking, swimming, yoga) can reduce pain
    and improve function.
  • Sleep hygiene – maintaining consistent sleep habits is essential.
  • Stress reduction techniques such as mindfulness, meditation, or cognitive
    behavioural therapy (CBT) and ACT based pain management program.

Injection Therapies

  • Facet joint injections or nerve root blocks for targeted relief
  • Epidural steroid injections for nerve compression or disc-related pain
  • Sacroiliac joint injections if the SI joint is the pain source
  • Diagnostic Nerve block for Facet Joints or SI Joint

Physical and Occupational Therapy:

  • Helps improve movement and reduce strain during daily activities.
  • Tailored exercise plans to enhance mobility and strength.

Complementary Therapies:

  • Acupuncture, light massage therapy, and hydrotherapy may provide additional
    relief.
  • Nutritional support and supplements, where appropriate, under professional
    guidance.

Advanced Interventions (if diagnostic nerve block is positive)

  • Radiofrequency ablation (RFA) for well localised, one sided facet joint pain
  •  Radiofrequency ablation (RFA) for one sided Sacro-iliac Joint pain
  • Pulsed RF of nerve root for sciatica in a single nerve

Trigger Point Injections,

  • Trigger Point Injections, Occipital Nerve Blocks or Lidocaine Infusions could help some patients achieve a pain holiday (though they are not endorsed by UK guidelines)

Possible Causes and Triggers:

While the exact cause is unknown, fibromyalgia is believed to involve a mix of:

  • Genetics – it may run in families
  • Trauma or infection – physical injury, RTA or illnesses can sometimes trigger it
  • Stress – emotional or psychological stress is a known aggravator
  • Adverse Childhood Experiences – these are present a significant number of fibromyalgia sufferers
  • Adverse Childhood Experiences – these are present a significant number of fibromyalgia sufferers

When to Seek Help:

If you experience persistent, unexplained pain or fatigue that interferes with daily life, it’s important to consult your GP in the first instance. If they are unsure of the diagnosis, we can offer a thorough evaluation, leading to an accurate diagnosis and a safe and effective management plan.

How Can We Help?

At PainClinicNI, we offer a comprehensive, evidence-based approach to low back pain. Our services include:
  • Comprehensive pain assessments
  • Help you understand this disorder
  • Medication optimisation
  • Guidance on individualised long term strategy (exercise, lifestyle changes, and emotional wellbeing)
  • Trigger point injections for specific triggers in the neck or lower back
  • Occipital Nerve Block if pain is mostly in the scalp muscles
“Our goal is to help you regain control, reduce pain, and improve your quality of life.”