Managing Fibromyalgia

• May 8, 2020
• Dr Peter Landsberg

Last updated on June 27, 2023

Hello. My name is Dr Peter Landsberg. I’m a rheumatologist with the team at ArthritisCARE in Brisbane.

I just want to talk briefly about a condition called Fibromyalgia.

Fibromyalgia is often thought to be a form of arthritis but in fact it is actually a pain disorder. It’s a condition when a person under great duress or great stress starts feeling sore from head to toe with no visible signs of swelling or inflammation.

Often all blood tests and x-rays are normal and it is really a condition where the body’s pain system becomes flared up by stress reactions. Patients can literally hurt to comb their hair, touch their skin or move. 

It is often referred to as a painful form of post-traumatic stress disorder. Many patients with Fybromyalgia have been through awful experiences in life, such as assault, violence, car crashes, and even warfare. Maybe suffer an injury and from that time on, pain and distress seemed to be linked together for them. And these poor folk will just hurt everywhere.

These patients will also have increased episodes of pain during stressful times in their life, particularly if they are not sleeping very well. Or if they receive some bad news for the family, receive a bill for a major expense or have another accident. 

But it is not an immune disorder so it simply doesn’t respond to drugs like Prednisone or anti-inflammatories or arthritis medication. 

Probably the biggest role we have as a rheumatologist is to reassure people that they don’t have an auto-immune disease. We also confirm that the patient is really in pain, but that the pain is tied into their stress reaction and not due to anything physically damaging their actual tissues.

The treatments for Fibromyalgia are problematic but we really encourage gentle exercise and counselling. Activities like Tai Chi, Yoga and Pilates are wonderful. Many natural supplements, massage, and anything which breaks that pain cycle and helps a person feel more relaxed are recommended too.

Also just dealing with the stress helps. Often many patients with Fibromyalgia will have a long history of significant emotional and psychological issues which need to be addressed. So a good pain psychologist, and a good GP and therapist are very, very helpful. 

But it’s not an immune disorder and often we see patients who have been prescribed the wrong medication for management of the condition. Even things like cortisone and immune drugs are prescribed, but these will be completely useless and the wrong treatment for Fibromyalgia.

So we really encourage people with Fibromyalgia to have a good close assessment. But to be aware that it is a disease that is linked in to stress, sleep and even things like PTSD and to know that the pain is being driven by those emotional fires and not due to anything physical in the blood etc.