Fibromyalgia is a disorder that has been subject of much controversy over the last 5-10 years. There are those physicians who embrace the diagnosis and there are those who doubt its "existence" as a distinct diagnostic entity.

For those of us who work with patients, it almost becomes irrelevant whether there is ongoing academic debate about it or not. We simply know that there are patients who suffer from a combination of the following symptoms:

• pain in different parts of the body, sometimes in joints and other times in muscle tissue;
• pain usually gets worse with stress and cold weather;
• it is associated with tiredness, lethargy and fatigues;
• it is often accompanied by headaches, difficulty concentrating and "brain fog".

These are the patients we try to help.

What is Fibromyalgia

Fibromyalgia is a chronic illness that is characterized by "aching all over". It is generally thought that patients who suffer from fibromyalgia have increased sensitivity to pain. Up to 5% of the population is affected and women appear to be affected more often than men.

The cause of the disorder is poorly understood but there is agreement among the medical professionals that best treatment approach includes a combination of strategies.

In Australia, fibromyalgia tends to be diagnosed and managed by rheumatologists. MediBrain Centre works closely with the Lewis Institute in developing and implementing best treatment programs as well as ongoing research and education.

Symptoms of Fibromyalgia

The symptoms of fibromyalgia include pain throughout the body, low energy levels, sleep problems, concentration and mood problems. There are also often associated symptoms of irritable bowel syndrome, migraines, depression, sexual difficulties, and impact on work, family and relationships. Many patients have to "readjust" their lives because they are unable to continue to function at the same level of capacity is it to continue to work full-time, or do the same work e.g. at the computer, or doing the same leisure activities such as sport or knitting.

There are no diagnostic tests, and diagnosis of fibromyalgia largely depends on identification of core symptoms and tender points through the body as well as exclusion of other disorders such as arthritis.

Patients with fibromyalgia often feel that their complaints - and they themselves - are not taken seriously, that they are being dismissed or that they are told that "it's all in my head". We feel that the distinction of symptoms being "in the head" or "in the body" is generally unhelpful and inaccurate. For all intents and purposes, everything is "in the head" because everything is processed in the brain - every thought, every emotion, every pain. It is far more important for us to make patients feel believed and understood, because without this trust treatment is bound to be unsuccessful.

Treatment of Fibromyalgia

The best approach to fibromyalgia treatment is by a team of qualified experienced professionals from different disciplines. At MMBC we work closely with physiotherapists, yoga and meditation practitioners, dietitian, naturopaths as well as psychologists.

Treatment generally consists of a combination of pharmacological and non-pharmacological therapies. It is often a challenge to find the correct combination, as patients with fibromyalgia seem to be particularly prone to side effects of medications, and the patient-doctor alliance becomes crucial for success.

How We Can Help With Treating Fibromyalgia

At MMBC we have developed a specific day treatment program for patients with fibromyalgia. It consists of group sessions conducted by therapists from various relevant disciplines, as well as use of Alpha-Stim and memory training programs.

To find out more please call 9504 8283 and one of our staff will be able to answer your Fibromyalgia queries and how Medicare and Private Health Insurance Rebates apply.

European Group Issues Fibromyalgia Guidelines

The recommendations were formulated by a European working group that included specialists from various fields, including rheumatology, pain medicine, and neurology, who reviewed all the available information from published trials.

Among the general recommendations were the concept that fibromyalgia requires a comprehensive assessment of pain, function and psychosocial context, and that treatment should be multi-disciplinary, combining various modalities tailored to pain intensity, function and associated features such as depression and fatigue.

Cognitive behavioural therapy was a useful adjunct to treatment for some patients, along with antidepressants for stabilization of mood and as modifiers of pain perception.