Risk factors
The known risk factors include a family history of fibromyalgia, an existing autoimmune condition such as rheumatoid arthritis, another chronic pain condition, ongoing sleep problems, and migraine. Fibromyalgia frequently coexists with these rather than replacing them, which is part of what makes it difficult to identify.
How fibromyalgia is diagnosed
There is no single test that can diagnose fibromyalgia. Diagnosis is made on the pattern of symptoms, and requires that they have been present for at least three months.
Blood tests and imaging are still used, but for a different purpose: ruling out other conditions that produce similar symptoms, including thyroid disease, inflammatory arthritis and vitamin deficiencies. People are often frustrated by rounds of normal test results, though those results are doing necessary work.
Because diagnosis rests on the pattern rather than on a marker, a clear personal account matters more here than in most conditions. A symptom diary covering pain, sleep, fatigue and what preceded a flare is genuinely useful to whoever assesses you.
How fibromyalgia is usually managed in Australia
There is no cure for fibromyalgia, and Australian practice manages it across several approaches at once:
- Graded physical activity, introduced gradually, which has the strongest evidence behind it
- Work on sleep, since poor sleep and pain reinforce each other
- Psychological therapies, particularly cognitive behavioural therapy
- Pacing, so activity is spread rather than concentrated into good days
- Medicines, which may include antidepressant medicines and medicines used for nerve pain
Most people end up with a combination rather than a single intervention, and plans are usually revised over time as circumstances change.
