Or just how common is fibromyalgia- and do lifestyle changes help?
What is Fibromyalgia (FM)?
Fibromyalgia is a chronic pain condition that affects mainly women aged 30-50.
It can occur at younger ages, and in men- but the biggest number of people diagnosed with this condition or women. Other symptoms include fatigue, cognitive problems and sleep disturbance. Some people also complain of stiffness, headaches, IBS, depression and anxiety.
Is it a real diagnosis?
Fibromyalgia is becoming a much more frequently-diagnosed condition, with around 1:20 people, or 5%, being affected in the UK.
What we don’t know is this- is it becoming more common simply because more people are presenting with symptoms and being given this diagnosis? Or is it becoming more common because of the change in our lifestyles- more processed food, more additives, more sedentary, more stress?
I would like to suggest that both of these are true- more people are diagnosed, and the increase in diagnoses is driven by our changing lifestyles. In particular, poor diet and more sitting
Can Fibromyalgia be cured?
This is a difficult question. While the is no ‘cure’- as there is no ‘cure’ for diabetes, hypertension or heart disease- there are ways of managing it so that wellbeing is improved.
Most individuals with fibromyalgia experience poorly managed symptoms and increased health service use. Most of the trials of medication are short term (6-12 weeks) whilst one of the major features of Fibromyalgia is its chronic nature. It is often misunderstood. It varies in its severity and has an impact on daily life- yet it is often an ‘invisible’ condition.
There is a variety of medications that can be tried, some of them are effective in some people- analgesics, antidepressants, pregabalin/ gabapentin. But there is no cure, and no medication that works for everyone.
And the narrative that people often hear from their health professional is that they have ‘an incurable illness’.
Many people start their fibromyalgia-journey with seeds of despair already sown. With little hope offered by their HCP. It’s a lonely journey, often with increasing inactivity and weight gain.
Yet look again at the symptoms of fibromyalgia- and think about the lifestyle drivers of inflammation. As fibromyalgia is a ‘diagnosis of exclusion’- the person does NOT have a recognised autoimmune disease, or a particular pattern in blood tests, there is no test that conclusively says that someone has fibromyalgia- it can lead to both the patient and the clinician feeling disempowered.
As clinicians, we are trained to ‘treat people with labels’- diagnose the condition first, then apply the treatment. On the other side of the desk, patients want to know what is wrong with them, what their ‘label’ is- because then it can be fixed.
As fibromyalgia has neither a diagnostic test nor a cure, we as clinicians or helpers can struggle to help our patients make sense of their situation.
As Lifestyle Medicine practitioners, we recognise that systemic chronic inflammation (or SCI) is a major driver for many of the long-term chronic conditions that we see had manage every day.
Maybe it’s time to add Fibromyalgia to the Long Term Conditions that we are learning to manage by Lifestyle change. And dare to suggest that the major driving factors of its increase in prevalence is disordered lifestyle- too sedentary, too much ultra-processed food, overweight, stress, inadequate sleep.
Obesity (32-50%) and overweight (around 25%) are more common in people with fibromyalgia than in the wider population. This is likely to be complex, related to chronic pain and physical inactivity, sleep disturbances, medications, metabolic changes, emotional eating and inflammation.
Addressing these factors, together with early consideration of weight-loss drugs, could provide hope.
There are no definitive published studies (Nov 24) that look specifically at GLP1 agonists (Wegovy, Mounjaro) together with behaviour change (increased movement, improved sleep)
The challenge for us as HCPs is to recognise that Fibromyalgia is a chronic disabling condition- in fact, a LTC- and that there are no quick fixes. I could find few ‘long term studies’ about the outcome for people with Fibromyalgia. But maybe we need to be as proactive in its management as we are in the management of diabetes. And see where it leads.
In Summary:
Lifestyle interventions can have considerable benefit in helping to manage fibromyalgia. So if you're thinking of setting up group sessions for a defined LTC- why not consider inviting people with fibromyalgia/
· A holistic, comprehensive management strategy works best, including regular exercise, balanced diet and stress management. This allows the root causes of the problem to be managed, rather than just masking the pain.
· Improved quality of life comes from better sleep, improved mood and reduced stress.
· The long-term benefits of lifestyle interventions are sustainable results without the side-effects associated with many of the medications that are prescribed.
· People feel more empowered, more in control of their condition, when the benefits are a result of their own actions.
· We all need to find our tribe! Working in a group can provide peer support.
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