Fibromyalgia: A Real Disease of Pain Processing
Multimodal treatment outperforms any single therapy.
Dr. Inès Da Costa
Rheumatologist
In simple terms
Fibromyalgia is recognised as a central pain syndrome, not 'in the head'. Comprehensive care brings real relief.
What you need to remember
- Treatment — Education and pacing strategies
- What does NOT help — Strong opioids worsen long-term outcomes; chronic NSAIDs offer limited benefit.
Widespread pain >3 months, severe fatigue, non-restorative sleep, cognitive 'fog', and often coexisting irritable bowel and migraines.
Diagnosis
Clinical; no specific test. Rule out hypothyroidism, vitamin D deficiency, inflammatory arthritis.
Treatment
- Education and pacing strategies
- Graded aerobic exercise (the most consistent evidence)
- Sleep hygiene
- Cognitive behavioural therapy
- Selected medications: duloxetine, pregabalin, amitriptyline
What does NOT help
Strong opioids worsen long-term outcomes; chronic NSAIDs offer limited benefit.
Pacing, not pushing through, prevents the boom-and-bust cycle typical of fibromyalgia.
The words explained
Medical terms used above, in everyday language.
- Chronic
- A problem that lasts a long time, usually more than three months, and often comes back.
- Inflammation
- The body's reaction to injury or irritation: redness, swelling, heat or pain.
- Diagnosis
- The moment a doctor identifies which illness is causing your symptoms.
- Prevention
- Steps taken before a problem starts, to make it less likely.
- Cognitive
- Related to thinking: memory, attention, learning and decision-making.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Fibromyalgia: A Real Disease of Pain Processing?
- Fibromyalgia is recognised as a central pain syndrome, not 'in the head'. Comprehensive care brings real relief.
- What are the main symptoms or signs of Fibromyalgia: A Real Disease of Pain Processing?
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Fibromyalgia: A Real Disease of Pain Processing?
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
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