Normal bloods (FBC, U&Es, inflammatory markers, TFTs)
A certain level of investigation can sometimes reassure the patient, but try not to over-do as this tends to heighten anxiety
Management of fibromyalgia
Patient education
It is very important to take this seriously and have an initial positive conversation.
Conditions involving chronic pain have a huge impact on quality of life so it is important to acknowledge this: it is a real and debilitating condition.
Emphasise the positives: there is nothing wrong with the patient’s joints or muscles, it is an issue with the perception of pain and patients can teach their bodies to deal with this through exercise and behavioural techniques.
Exercise programmes: graded return to activity
Cognitive behavioural therapy (CBT)
Tricyclics can improve sleep and pain
Start with amitriptyline 10mg ON and increase as tolerated
