Fibromyalgia is a long-term condition causing generalised pain which is predominantly musculoskeletal. This is associated with extreme fatigue, sleep disturbance, reduced memory and low mood. Fibromyalgia affects females more than males and is increasingly associated with background history of endometriosis, irritable bowel syndrome, depression and major illness.
Medications:
- Tab. Brufen 400 (Ibuprofen 400 mg) 1 tablet thrice a day for flare ups (maximum for 7 days in one course).
- Tab. Xykaa BD (Paracetamol 1000 mg) 1 tablet twice a day for 3 days.
- Tab. Meganeuron NT 75 (Pregabalin 75 mg, Nortriptyline 10 mg) 1 tablet at night.
- Cognitive behavioural therapy.
General advice:
- Brisk exercise for 30 minutes
- Alternate hot and cold compressions
- Mindfulness activities
- Maintain nutritious diet which is low in carbohydrates and fats
- Optimise weight management
Investigations:
- Complete blood count – to rule out anaemia
- Serum electrolytes – to rule out low potassium for cause muscle fatigue
- Lipid profile – to optimize lipid levels
- Fasting and post lunch blood glucose level – to rule out diabetes
- Serum creatinine – to rule out renal impairment
- Thyroid function test – to rule out hypothyroidism
- Vitamin D levels – Low levels of vitamin D can lead to similar symptoms
Referrals:
Consider referral to physiotherapy to improve exercise and mobility. Consider referral to psychologist in case of evidence of depression.