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Fibromyalgia
and Widespread Pain
Overview
Fibromyalgia, sometimes referred to as Fibromyalgia Syndrome (FMS), is a long-term condition that can affect people in different ways and can relapse-remit over a person's lifetime.
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Fibromyalgia comes under the umbrella term "Chronic Primary Pain" which covers many pain conditions that
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Diagnosis is usually made through listening to the history and experience of the patient and aided by questionnaires and the ruling out of other medical pathologies that could explain the symptoms the person is experiencing.
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Ruling out other medical explanations for widespread pain and associated symptoms might look like blood tests, MRI scans and consultation with other specialties.
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Pain is one feature of Fibromyalgia and can be localised and constant, or widespread and changeable. Clinicians often use the Widespread Pain Index WPI designed by the American College of Rheumatology (Wolfe et al 2010) as a way of differentiating fibromyalgia from other generalised pain conditions.
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The WPI checklist that assesses the presence of pain or tenderness (within the prior seven days) in 19 specific areas of the body; each affected area receives one point. The regions on the WPI include the following:
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Right and left jaw
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Right and left shoulder girdle
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Right and left upper arm
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Right and left lower arm
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Right and left hip/buttock
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Right and left upper leg
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Right and left lower leg
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Upper and lower back
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Neck
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Chest
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Abdomen
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In addition to pain, the WPI also explores the common symptoms of Fatigue, refreshed wakefulness and cognitive impairment scored on a scale of 0 - 3 (3 = severe) and 'other somatic symptoms' as seen in the table above.
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Clinicians are more likely to give a diagnosis of Fibromyalgia when a person has >7 areas of pain with >5 somatic symptoms, OR has 4-6 areas of pain with >9 somatic symptoms.
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It's important to remember that this is just a guide, and a diagnosis of FMS is ultimately made by a clinician combined with your history and their experience of working with people with this condition.
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How can working with a specialised pain therapist help?
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Feel heard and involved in the process of curating and developing a therapeutic plan that is meaningful for you
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Have your questions answered and spend time on exploring the complex information and what it means for you in your unique case
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Get access to a seamlessly integrated whole-person approach incorporating physiotherapy and rehabilitation knowledge, pain science education, psychotherapeutic approaches and personal coaching.
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Have a safe and encouraging space to discuss how medical management (medications), interventional treatments (neuromodulation devices, surgeries, injections etc) and therapeutic approaches can work together or, advice on where these approaches may not be indicated for you.
Resources:
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Flippin' Pain: Fibromyalgia information days (UK only but lots of information about pain)
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American College of Rheumatology - Fibromyalgia information
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References:
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Wolfe, F., Clauw, D.J., Fitzcharles, M.A., Goldenberg, D.L., Katz, R.S., Mease, P., Russell, A.S., Russell, I.J., Winfield, J.B. and Yunus, M.B., 2010. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis care & research, 62(5), pp.600-610.
What is a Syndrome? What we call conditions in medicine and therapy is a decided by a globally-acknowledged coding system. Where possible, clinicans will try to use words that describe the location, severity and target mechanism. "Syndrome" comes from the greek words for 'run' (syn) and 'together' (drome) and is used to give a name to the series of symptoms experienced by a large group of people, but for which there is no medical diagnosis as yet. Medical diagnoses usually get their names either from the person who first described it, the recognised mechanism or the location and description of the experience. For example: Parkinson's was named after James Parkinson in 1817. Diabetes Melitus comes from the greek for "syphone" (Diabets) and Melitus (swettness) to describe the mechanism of excess sugars passed into the blood and urine. Low Back Pain is perhaps a more obvious one. It can be described as mild, moderate or severe and acute (short lasting or early phase) or chronic (lasting more than 3 months). So when we discuss a condition that is a syndrome, it is becuase the medical scienctific community have no known cause or targetable mechanism that best fits. Yet an observable and measurable pattern in the symptoms experienced by a large group of people exists. The term 'syndrome' was introduced to validate the experience of many people who live with long-term conditions, help clinicians share information and calibrate medical approaches, and to allow us to study the conditions in medical and therapeutic research.
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