Fibromyalgia
Fibromyalgia: treated in primary care
Fibromyalgia is an abnormality of the pain processing systems.
Pain signals to the brain are amplified and the pain control
mechanism compromised because of an imbalance in chemicals and
hormones.
This results in widespread pain, profound fatigue and tiredness,
difficulty with thinking clearly or remembering things (brain fog).
Learning to manage the condition is the most successful way of
dealing with fibromyalgia. It is a long term condition, so patient
education, pacing of activities, slowly increasing exercise and
psychological support is all important.
General practitioners diagnose and treat patients with
fibromyalgia in primary care. It is not necessary to have the
diagnosis confirmed by a rheumatologist. Specialist support
services (such as specialist physiotherapy or psychological
services) for people with fibromyalgia is not available in the
rheumatology department. Patients would only be seen in
rheumatology if there is a real concern that there could be an
alternative diagnosis of an inflammatory rheumatic disease.
In Bristol, patients with fibromyalgia should usually therefore
be referred to exercise on prescription and Improving Access to
Psychological Services (IAPT) by their GPs as first line
treatments. Referral to a pain team is reserved for people who have
completed these courses.
Information for patients:
https://www.nhs.uk/conditions/fibromyalgia/
https://www.versusarthritis.org/about-arthritis/conditions/fibromyalgia/?gclid=EAIaIQobChMIn4_QnYWe5QIVUOR3Ch1G-QeCEAAYASAAEgKm4_D_BwE
Information for GPs:
Advice on local referral policy in Bristol:
https://remedy.bnssgccg.nhs.uk/adults/pain-management-and-cfs/fibromyalgia/
EULAR guidelines for management of
Fibromyalgia:
https://ard.bmj.com/content/76/2/318
