New guidance on the diagnosis of fibromyalgia

New guidelines aiming to support clinicians in the diagnosis of fibromyalgia syndrome (FMS) have been published by the Royal College of Physicians (RCP).

FMS, although common, is often challenging to diagnose and as a result, patients may receive the wrong diagnosis and only receive the correct one after years of delay. The new guidance aims to correct this, by supporting patient-facing clinicians to consider a diagnosis of FMS.

Symptoms of FMS vary, are commonly multiple and can fluctuate. It can often be difficult for patients to articulate an array of symptoms, and for both patients and healthcare professionals to fully make sense of the complexities of the condition. Some of the core symptoms include widespread pain, hypersensitivities to pressure, touch, temperature, noise, and light, fatigue and poor sleep, as well as cognitive symptoms relating to short term memory or difficulty finding a word – often called ‘fibro fog’.

Helen Robinson describes her symptoms as debilitating: “My experience of fibromyalgia is when I wake up in the morning, it doesn’t matter whether I’ve had an hour’s sleep or 6 hours’ sleep, I feel totally, totally exhausted. On flare-up days I struggle to get out of bed. I struggle to get washed or dressed and feel as if every ounce of energy has been drained out of me.”

Marcia Glanvill has experienced burning skin, pain and cystitis among her symptoms. She said: “I think the hardest thing is when people don’t believe you. Not just your clinicians, but your family and friends.”

Dr Andreas Goebel, a specialist in pain medicine who led the work on the new guidelines, said: “Understanding about symptom-based disorders without tissue destruction is still in its beginnings, and fibromyalgia syndrome (FMS) is amongst the most common of these conditions. I anticipate that this new guidance can empower healthcare professionals to make the FMS diagnosis confidently and accurately.”

Dr Chris Barker, a GP and pain specialist who co-chaired the Guideline Development Group, said: “Anyone who is close to fibromyalgia knows how hard it can be to live with. My hope is that these guidelines can help reduce the suffering endured particularly because of misunderstanding and difficulty recognising it.”

Dr Cathryn Edwards, RCP registrar, added: “We’re delighted to have published these guidelines, which aim to increase understanding of fibromyalgia and support the diagnosis of the condition. We very much hope that they will help to raise awareness and lead to improved lives and outcomes for patients.”

To download the guidelines, click here.

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