| What We Treat
Fibromyalgia
Fibromyalgia is a real condition with a recognised mechanism. Graded activity helps, and the way it is introduced matters more than what is chosen.
Overview
What It Is
Fibromyalgia involves a change in how the nervous system processes pain signals, so that ordinary input is amplified. It produces widespread pain, unrefreshing sleep, fatigue and difficulty concentrating. Scans and blood tests are normal, which is often taken to mean nothing is wrong. That is a misreading: the problem is in signal processing, not tissue damage.
Amplified Signal Processing
The nervous system amplifies signals that would not normally register as painful. Normal imaging rules out tissue damage, not pain.
Symptoms
How It Tends to Feel
These are the features that point towards this diagnosis rather than another:
Widespread Pain
Present for more than three months, above and below the waist and on both sides.
Unrefreshing Sleep
Waking as tired as on going to bed. Near-universal in fibromyalgia.
Fatigue
Often as limiting as the pain itself.
Cognitive Difficulty
Word-finding and concentration problems, commonly called fibro fog.
Sensitivity
To touch, light, sound, cold and stress.
Fluctuation
Good and bad periods with no obvious explanation, which is characteristic.
Causes & Risk Factors
What Drives It
The usual contributors, in rough order of how often they turn out to matter:
Central Sensitisation
The nervous system amplifies signals that would not normally register as painful.
Sleep Disturbance
Both a symptom and a driver. Poor sleep lowers pain thresholds measurably.
Stress and Trauma
Frequently precede onset, though they are not the whole story.
Genetic Predisposition
Clustering in families is well recognised.
How We Can Help You
Treatment & Management
Treatment is built around what the assessment finds, but generally follows this shape:
When to Seek Help
Red Flags — Don’t Ignore These
Most presentations are straightforward. These features are the exceptions, and warrant prompt assessment:
⚠ Seek Medical Advice If You Notice
- New localised pain, swelling or joint redness — fibromyalgia does not cause these and another diagnosis needs excluding
- Unexplained weight loss, fever or night sweats
- Progressive weakness or numbness
- New severe headache or visual change
If any of these apply, contact your GP or seek urgent medical care rather than waiting for a physiotherapy appointment.
Common Questions
Frequently Asked Questions
Is it real, if scans are normal?
Yes. The mechanism is in how the nervous system processes signals, which scans do not show. Normal imaging rules out tissue damage, not pain.
Won’t exercise flare it up?
It will if it starts too high, which is why most people have had a bad experience. Starting genuinely low and progressing slowly is the whole skill, and done that way it is the most effective treatment available.
Will it go away?
Many people improve substantially and some become symptom-free. Most importantly, function usually improves well ahead of pain, which is what makes daily life liveable again.
Not Sure If This Is What You Have?
An assessment will tell you what is actually going on and what to do about it. I see everyone myself, and you will leave with a plan rather than a leaflet.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.