Fibromyalgia Awareness Day – 12 May 2025

By Dr Parul Shrestha, Consultant Rheumatologist

What is Fibromyalgia?

Fibromyalgia is a long-term, complex condition that causes widespread musculoskeletal pain, persistent fatigue, sleep disturbances, and cognitive difficulties often referred to as “fibro fog.” It is believed to result from abnormal processing of pain signals in the brain and nervous system, leading to an amplified perception of pain. The condition can significantly impact quality of life and daily functioning.

How Common is It?

Fibromyalgia affects between 2% and 4% of the global population. Women are disproportionately affected, with a diagnosis rate seven to nine times higher than men. While it most commonly presents between the ages of 40 and 60, fibromyalgia can occur at any age, including in children and adolescents. In the UK alone, up to 3 million people live with the condition.

Recognising the Symptoms

The core symptom of fibromyalgia is chronic, widespread pain, but the condition is associated with a broad range of symptoms, including:

Persistent fatigue that is not relieved by rest
Non-restorative sleep or insomnia
Cognitive impairment (often described as “fibro fog”)
Headaches or migraines
Irritable bowel syndrome (IBS)
Mood disturbances such as anxiety or depression

These symptoms often vary in intensity and may be triggered or worsened by physical or emotional stress.

Diagnosis: Why It’s Not Always Straightforward

Fibromyalgia is diagnosed clinically—there is no single test or scan that can confirm the condition. Diagnosis is based on a history of widespread pain for more than three months, alongside other characteristic symptoms such as fatigue and cognitive issues. Clinicians also use a widespread pain index and symptom severity scale to support the diagnosis.

Due to the overlap with many other conditions, diagnosis can be delayed. On average, it may take up to five years for a person to receive a correct diagnosis. This delay is often due to the complexity of symptoms, lack of awareness, and the absence of objective diagnostic markers.

Management and Treatment

There is no cure for fibromyalgia, but effective management can significantly improve quality of life. Medication can help alleviate specific symptoms, particularly pain, mood disturbances, and sleep difficulties. These may include:

Simple analgesics (e.g., paracetamol)
Certain antidepressants that also reduce pain sensitivity
Neuropathic agents such as gabapentin or pregabalin

However, medication alone is rarely sufficient.

A Holistic, Patient-Centered Approach

I strongly advocate for a holistic and multi-disciplinary approach that empowers patients to take an active role in managing their condition. Key components of this approach include:

Pacing: Learning to balance activity and rest to avoid symptom flare-ups
Graded exercise: Low-impact activities like walking, swimming, and yoga
Psychological support: Cognitive behavioural therapy (CBT) and counselling when needed
Pain management programmes
Education: Understanding the condition is fundamental to managing it
Self-management strategies: Equipping patients with tools to regain control of their health

The Importance of Self-Management

Self-management is vital in fibromyalgia care. Simple lifestyle changes can have a significant impact:

Engage in regular, gentle physical activity
Practise mindfulness, meditation, or deep breathing techniques
Establish consistent sleep hygiene habits
Break tasks into smaller, manageable steps and avoid overexertion
Maintain a balanced diet and healthy lifestyle

These strategies can reduce symptom severity and help patients feel more in control of their condition.

My Role in Supporting You

As a Consultant Rheumatologist, I provide comprehensive, personalised care tailored to each individual’s needs. My approach involves:

Identifying potential triggers—whether related to physical illness, stress, trauma, or family history
Supporting patients through the emotional journey of diagnosis
Encouraging acceptance and understanding of the condition
Helping patients develop practical, sustainable self-management techniques

I believe in having open and honest conversations to help individuals feel empowered rather than overwhelmed.

Tips for Managing Fibromyalgia

To help those living with fibromyalgia, I often recommend the following:

Begin with low-impact exercise and increase gradually
Prioritise sleep and maintain a consistent routine
Incorporate daily stress-reduction practices
Break down large tasks and pace yourself throughout the day
Seek support—both professionally and through community or peer groups

Raising Awareness

Fibromyalgia remains a misunderstood and, at times, stigmatised condition. Awareness is key—not just for early diagnosis and appropriate treatment, but also for fostering empathy and support from family, friends, employers, and the wider community.

If you or someone you know is struggling with ongoing pain, fatigue, or other unexplained symptoms, don’t hesitate to seek medical advice. Help is available, and with the right support, it is possible to live well with fibromyalgia.