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Fibromyalgia

Fibromyalgia · Fibromyalgie

What it is

Central pain amplification — the volume knob on pain is turned up.

Symptoms & signs

  • Widespread pain over 3 months
  • unrefreshing sleep
  • fatigue
  • brain fog
  • tender points
  • IBS overlap

🚩 Get help if…

  • call 112 / 911 now Thoughts of ending your life
  • see a doctor soon Fever, night sweats or weight loss you can't explain
  • see a doctor soon Swollen joints or a new rash
  • see a doctor soon Real muscle weakness, not just tiredness

Where it strikes

  • Muscles
  • Brain
  • Nervous system

Medical treatment

  • Graded aerobic exercise
  • duloxetine, amitriptyline, pregabalin
  • CBT
  • multidisciplinary pain programmes

Natural & lifestyle

  • Graded exercise and tai chi (strong evidence)
  • sleep repair
  • pacing
  • heat
  • mindfulness
  • CBT
  • avoid deconditioning

Emerging & experimental

  • Low-dose naltrexone — small early trials positive, a larger later trial negative mixed evidence
  • TMS and tDCS
  • cannabinoid trials
  • vagus stimulation

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Acupuncture — trials disagree mixed evidence
  • Cannabis — small trials show pain and sleep benefit mixed evidence
  • Spa and warm-water therapy — trials show benefit mixed evidence
  • Hyperbaric oxygen — small trials early / small studies
  • Magnesium with malic acid — small studies early / small studies

ICD codes