D1 • Fibromyalgia
Understanding Fibromyalgia
Chronic widespread pain, fatigue and cognitive symptoms — how to recognise it, discuss it, and support patients.
A summary of the condition
Clinical focus: Fibromyalgia is a chronic pain disorder characterised by widespread pain and tenderness. It often coexists with fatigue, sleep disturbance and "fibro fog". There is no cure yet, but an individualised plan improves quality of life.
Core features
- Widespread musculoskeletal pain and tender points
- Fatigue that doesn't improve with rest
- Sleep disturbances and unrefreshing sleep
- Brain fog — memory and concentration difficulties
- Diagnosis requires widespread pain > 3 months
Triggers & comorbidities
- Physical trauma, infections, emotional stress
- Stress and changes in weather can worsen symptoms
- Often coexists with arthritis, anxiety, depression
- Irritable bowel syndrome and other comorbid conditions
- Family history of chronic pain / fibromyalgia
Management strategies
- Education and support for patient and family
- Antidepressants and anticonvulsants when indicated
- Regular low-impact exercise, pacing
- Stress management and sleep hygiene
- Multimodal approach — no single curative treatment
Note: Consistent gentle activity, stress management techniques and good sleep habits can help alleviate flare-ups.
Disclaimer: This page is for educational purposes only and does not replace individual clinical advice. Always consult a qualified healthcare professional.
Watch: An overview of fibromyalgia
Patient consultation – sample dialogue
A fibromyalgia history explores widespread pain, fatigue, sleep, cognitive symptoms, triggers, family history and impact on daily life.
Osteopath: What brings you in today?
Patient: I've been experiencing widespread pain and fatigue.
Osteopath: How long have you had these symptoms?
Patient: It's been about a year, but it's gotten worse recently.
Osteopath: Can you describe the pain? Is it constant or does it come and go?
Patient: It's a constant dull ache that intensifies at times, especially in the evening.
Osteopath: Where do you feel the pain the most?
Patient: Mostly in my back, shoulders, and hips.
Osteopath: Does the pain affect your sleep?
Patient: Yes, I often wake up at night due to discomfort.
Osteopath: What other symptoms are you experiencing?
Patient: I also have fatigue and trouble concentrating, like a fog in my head.
Osteopath: Have you noticed any specific triggers for your pain?
Patient: Stress and changes in weather seem to make it worse.
Osteopath: Have you tried any treatments or medications?
Patient: I've taken over-the-counter pain relievers, but they only help a little.
Osteopath: Do you have any history of similar symptoms in your family?
Patient: Yes, my aunt had fibromyalgia, and my mother has chronic pain issues.
Osteopath: How does this pain interfere with your daily life?
Patient: It makes it hard to work and do daily activities; I often feel too tired.
Osteopath: Have you noticed any stiffness in the morning?
Patient: Yes, I feel stiff for about 30 minutes after waking up.
Osteopath: Any recent changes in your diet or exercise routine?
Patient: I've tried to exercise more, but it often leaves me feeling exhausted.
Osteopath: We'll discuss a comprehensive treatment plan to help manage your symptoms better.
Teaching points: Note open questions, validating language ("that makes sense"), and specific fibromyalgia cues: widespread pain >3 months, morning stiffness, fatigue, brain fog, stress/weather triggers, family history.
Words & phrases to remember
Click 🔊 to hear the term without leaving this page.
| Term | Definition | Pronunciation |
|---|---|---|
| Fibromyalgia | A condition characterised by musculoskeletal pain. | /ˌfaɪbroʊˈmaɪældʒiə/ |
| Chronic Pain | Persistent pain that comes and goes for months, or even years. | /ˈkrɒnɪk peɪn/ |
| Fatigue | Overwhelming tiredness that doesn't improve with rest. | /fəˈtiːɡ/ |
| Tender Points | Specific areas on the body that are particularly sensitive to pressure. | /ˈtendər pɔɪnts/ |
| Brain Fog | Cognitive difficulties, including memory problems and difficulty concentrating. | /ˈbreɪn fɒɡ/ |
| Sleep Disturbances | Problems falling asleep, staying asleep, etc. | /sliːp dɪsˈtɜːrbənsɪz/ |
| Myofascial Pain | Pain and discomfort in the muscles and connective tissue around them. | /ˌmaɪoʊˈfeɪʃəl peɪn/ |
| Central Sensitisation | Increased sensitivity to pain due to changes in the nervous system. | /ˈsentrəl ˌsensɪtaɪˈzeɪʃən/ |
| Flare-Up | When symptoms worsen significantly, often triggered by stress, illness, etc. | /ˈflɛər ʌp/ |
| Hyperalgesia | Increased sensitivity to pain, where even mild stimuli cause great discomfort. | /ˌhaɪpərælˈdʒiːziə/ |
| Allodynia | Pain caused by stimuli that don't normally provoke pain. | /ˌæloʊˈdɪniə/ |
| Stiffness | A common symptom, usually in the morning or after periods of inactivity. | /ˈstɪfnəs/ |
| Comorbid Conditions | Other issues associated with fibromyalgia, like irritable bowel syndrome. | /koʊˈmɔːrbɪd kənˈdɪʃənz/ |
| Trigger Points | Tight areas in muscles that cause pain elsewhere. | /ˈtrɪɡər pɔɪnts/ |
| Cognitive Dysfunction | Difficulty with thinking, memory, and concentration. | /ˈkɒɡnɪtɪv dɪsˈfʌŋkʃən/ |
| Joint Pain | Discomfort at or from any part of a joint. | /dʒɔɪnt peɪn/ |
| Treatment Plan | Structured approach to manage a patient's condition. | /ˈtriːtmənt plæn/ |
| Widespread Pain | Pain that affects multiple areas of the body, often found in fibromyalgia. | /ˈwaɪdspred peɪn/ |
| Anxiety | Feelings of worry, nervousness, unease, common in fibromyalgia patients. | /æŋˈzaɪəti/ |
| Fibrous Connective Tissue | Tissue that provides support and structure to muscles and organs. | /ˈfaɪbrəs kəˈnɛktɪv ˈtɪʃuː/ |
| Hypervigilance | A heightened state of awareness and sensitivity to stimuli. | /ˌhaɪpərˈvɪdʒɪləns/ |
| Emotional Blindness | Difficulty recognizing or processing emotions. | /ɪˈmoʊʃənl ˈblaɪndnəs/ |
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