Fibromyalgia and Chronic Pain Management
Fibromyalgia Management provides specialist rheumatology care combining patient education, CBT, graded exercise, and targeted medications to improve function, reduce pain, and enhance quality of life in patients with fibromyalgia and central sensitisation syndrome.
Overview
Key Benefits
Discover the advantages of choosing our fibromyalgia and chronic pain management services.
Pain neuroscience education transforms patient understanding reducing catastrophising
Graded exercise is the most evidence-based single intervention available for fibromyalgia
Improved sleep quality directly reduces daytime pain sensitivity and fatigue
Duloxetine reduces pain severity and improves function in 30 to 40% of patients
CBT addresses the psychological amplifiers of pain and disability providing lasting improvement
Clinical Features
The technology, techniques and clinical approach behind our fibromyalgia and chronic pain management.
ACR diagnostic criteria applied before treatment is initiated
Pain neuroscience education provided as first-step intervention independently reducing symptoms
Graded exercise programme prescribed with progressive pacing rather than sudden intensity increases
Sleep quality assessed and treated -- normalising sleep reduces fibromyalgia pain significantly
Opioids specifically not recommended -- evidence confirms no benefit and significant harm
Preparation Instructions
Engage fully with exercise -- even though it initially causes discomfort in fibromyalgia, consistent graded aerobic exercise is the most powerful treatment and must be pursued persistently. Attend all CBT sessions and practise techniques between sessions. Prioritise sleep hygiene consistently. Contact your rheumatology team if depression or anxiety worsens significantly as these are important treatable comorbidities.
The Procedure
Step-by-step guide to what you can expect during your fibromyalgia and chronic pain management procedure.
Fibromyalgia Diagnostic Assessment
ACR 2016 fibromyalgia criteria are applied -- widespread pain index and symptom severity score are calculated. Inflammatory markers confirm the absence of inflammatory arthritis distinguishing fibromyalgia from RA or SpA.
Pain Science Education
Pain neuroscience education explains how the central nervous system becomes sensitised in fibromyalgia -- why all pain signals are amplified and why the pain is real despite normal investigations. This independently reduces pain catastrophising.
Graded Exercise Programme
A supervised graded aerobic exercise programme is the most evidence-based single intervention for fibromyalgia. Low-impact exercise is started at comfortable intensity and increased progressively over weeks in a paced fashion.
Sleep Assessment and Management
Non-restorative sleep is present in 90% of fibromyalgia patients and directly amplifies pain. Sleep hygiene education and low-dose amitriptyline improve sleep quality which in turn reduces daytime pain and fatigue.
Medication Review and Optimisation
Duloxetine or pregabalin are initiated if pain remains significantly impaired after adequate exercise and sleep management. Opioids are specifically not recommended -- they provide no benefit and cause harm in fibromyalgia.
CBT and Psychological Support
CBT addressing pain catastrophising fear-avoidance beliefs and pacing strategies significantly reduces disability. Referral to a pain psychologist is arranged for patients with significant psychological distress.
What to Expect
Your rheumatologist performs a thorough assessment using ACR fibromyalgia criteria, reviews blood tests confirming absence of inflammatory disease, and explains central sensitisation in accessible terms. A multi-component management plan emphasising exercise, psychological strategies, and patient empowerment is collaboratively developed alongside carefully selected medication.
Frequently Asked Questions
Common questions about fibromyalgia and chronic pain management.
Related Services
Explore other services in our Rheumatology department.
Rheumatoid Arthritis Management
Osteoporosis Assessment and Treatment
Gout and Crystal Arthropathy
Ready to Get Started?
Schedule your consultation today and take the first step towards better health.