Fibromyalgia

Fibromyalgia is a long-term condition of widespread pain, unrefreshing sleep, fatigue and difficulty concentrating. It is real and recognised, and it results from the way the nervous system processes pain rather than from damage in the muscles or joints.

It does not harm organs or shorten life, and scans and blood tests are normal. There is no cure and no single tablet that fixes it. Most people improve with a combination of graded activity, better sleep, psychological approaches and carefully chosen medicines.

Symptoms

• Pain on both sides of the body, above and below the waist, for more than three months
• Marked fatigue not relieved by rest
• Waking unrefreshed
• Poor concentration and memory (often called fibro fog)
• Sensitivity to touch, noise, light or cold
• Headaches, irritable bowel and bladder symptoms
• Tingling without nerve damage, low mood and anxiety

Causes and risk factors

The central nervous system becomes sensitised and amplifies pain signals, a process seen on research brain imaging. It often begins after a trigger such as an infection, injury, surgery, childbirth or a period of severe stress, though sometimes there is none. It is more common in women, runs in families and frequently accompanies rheumatoid arthritis, lupus, osteoarthritis and hypermobility. It is not an autoimmune or inflammatory disease and does not cause joint damage.

How it is diagnosed

• Clinical criteria: Diagnosis is based on the widespread pain index and symptom severity scale. Counting tender points is no longer required.
• Examination: Looks for joint swelling, weakness or neurological signs that would point elsewhere.
• Limited blood tests: Blood count, CRP, thyroid function, vitamin D and sometimes CK to exclude mimics. Extensive antibody panels cause false alarms.
• Sleep assessment: Sleep apnoea and restless legs worsen symptoms and are treatable.

Treatment options

• Education: Understanding the condition reduces fear and unnecessary tests.
• Graded aerobic exercise: The treatment with the strongest evidence, started low and increased slowly. Warm water exercise, tai chi and yoga are well tolerated.
• Cognitive behavioural therapy and pacing: Help with flare management, sleep and mood.
• Medicines: Low-dose amitriptyline, duloxetine or pregabalin help some people modestly. Strong opioids and long-term steroids are not recommended.
• Treating associated conditions: Addressing sleep disorders, depression and any coexisting arthritis.

When it is urgent

Fibromyalgia does not cause emergencies. Chest pain, new weakness, swollen hot joints, unexplained weight loss or fever are not part of it and need ordinary medical assessment. Thoughts of self-harm need immediate local help.

Travelling to Türkiye for treatment

Long-term improvement comes from routines built into daily life at home, so travel cannot deliver the main treatment. A visit can reasonably provide a thorough rheumatology assessment to confirm the diagnosis and exclude inflammatory disease, a sleep study, and a structured start to a rehabilitation programme. Be sceptical of infusion courses, ozone, stem cells or detox packages marketed for fibromyalgia, as none has reliable evidence.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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