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No need to suffer, help is at hand to ease pain; Fibromyalgia became a topic for discussion in late 2017 when Lady Gaga's Netflix film, Five Foot Two, revealed the daily struggles she faces living with the condition. Here, doctors at St Joseph's Hospital in Newport describe what causes the condition and how it can be treated.

Fibromyalgia is an often misunderstood, long-term, chronic condition with no outwardly visible symptoms.

Widespread pain, fatigue and sleep disturbance are the main symptoms, but they vary from person to person, meaning there is no single treatment.

Around one in 25 people in the UK suffer with the condition and anyone can develop it, but around 70% of all cases are in women with the majority diagnosed between the ages of 30 and 50 years old.

| COMMON SYMPTOMS OF FIBROMYALGIA INCLUDE: | Widespread pain | Fatigue | Sleep disturbance | LESS FREQUENT SYMPTOMS MAY INCLUDE: | Headaches | Poor circulation - a tingling sensation, numbness or swelling of the hands and feet | Feeling miserable | Irritability | An urgent need to urinate, particularly at night | Irritable or uncomfortable bowels. This may present as diarrhoea, constipation or abdominal pain.

We spoke to members of the team at St Joseph's Hospital's Fibromyalgia Centre of Excellence to discuss the condition and provide advice for anyone who thinks they may be suffering with fibromyalgia.

Dr Sonia Wartan - pain consultant A pain consultant is usually the first person to see a patient with fibromyalgia after their GP.

Because symptoms vary so much, our job is to assess the individual's symptoms and location of their pain and recommend different treatments and combinations most suited to them.

Depending on symptoms I can refer patients to physiotherapy, including yoga and tai chi, and counselling, as well as carrying out pain management injections and prescribing medications when necessary. Although there is no cure for fibromyalgia, with appropriate treatment patients are usually able to manage their symptoms and lead near-normal lives.

I work with patients to identify clear, achievable goals to help improve not only their physical symptoms but also their mental wellbeing.

We find this "multi-modal" approach, combining both non-drug and drug treatments, is the best way to treat patients with fibromyalgia.

For anyone who thinks they may have fibromyalgia, my advice is to see your GP as soon as possible.

Early diagnosis can make a huge difference, but it's a process of elimination and can take time. For anyone living with the condition, remember just because your symptoms aren't visible it doesn't mean you don't have a valid and medically recognised syndrome.

Don't let anyone let you feel you're making it up or exaggerating your illness.

Sonia Mansfield - physiotherapist Patients with fibromyalgia are referred to our team of physiotherapists by their pain consultant. Our treatment plan depends on the patient's symptoms, their level of function and how much pain they are in.

Fibromyalgia symptoms vary widely from person to person so treatment and management plans are designed on an individual basis.

Within our purpose-built hydrotherapy centre, we offer hydrotherapy and "aqua-relax" therapy - a form of relaxation using floatation and gentle movements in warm water.

The buoyancy of the water helps support the body and allows patients to increase their movement, while the water resistance slowly improves muscle strength.

Acupuncture is also used for the treatment of various pain conditions.

Through stimulation of the body's spinal cord and brain pathways to release natural pain-relieving chemicals, acupuncture can promote reduction in pain, improved sleep and overall wellbeing.

In conjunction with these approaches, we recommend gentle graded exercises aimed at building general aerobic fitness and muscle strength to help improve day-to-day function.

We guide patients through an exercise plan and give specific advice on understanding your pain, pacing your activity and working to achievable specific goals.

As well as improving function, exercise releases endorphins and has a positive impact on mood, which is vital for helping to manage symptoms such as depression and anxiety.

Working together, treatment is tailored to improve physical function, activity tolerance and quality of life.

Dr Ivanova-Stoilova - pain consultant Although there is no cure, one positive for sufferers of fibromyalgia is it isn't likely to progress in terms of severity and it doesn't cause physical damage to the body.

As long as they receive appropriate treatment, patients will almost always see improvement in their symptoms.

The condition is often rooted in the patient's psychology, so it is important to consider that aspect when setting up the treatment plan.

Patients suffering with fibromyalgia benefit from learning to understand their condition, in particular that their perception of pain is sometimes distorted or even false.

I liken it to the "phantom limb" sensation experienced by amputees, which can also cause severe and debilitating pain but isn't caused by anything physically visible.

Understanding this can help fibromyalgia sufferers perceive their condition differently and feel more positive when approaching treatment. Learning to recognise and combat the "triggers" which set off attacks is also vital for patients - common triggers are stress, exercise and foods containing ingredients including caffeine, dairy or gluten.

From a psychological perspective, many sufferers develop mental health issues associated with chronic pain conditions such as depression, anxiety and agoraphobia so counselling, cognitive behavioural therapy, relaxation and mindfulness play an important role in treatment and self-management.

To any sufferers - you may have been told nobody understands your condition or knows what causes it.

While this may have been the case a few years ago, it is important for you to know that advances in understanding and treatment are being made all the time and we have a much better picture of the condition now than we ever had before.

If you've been diagnosed with fibromyalgia, or think you may have the condition, the Fibromyalgia Centre of Excellence at St Joseph's Hospital offers a one-stop approach to treatment, led by pain management consultants and supported by a full multi-disciplinary team, where patients can access all the treatment services they need in one place.

| For more information, visit or call 01633 820300.


Dr Sonia Wartan

Dr Ivanova-Stoilova

The hydrotherapy pool at St Joseph's Hospital
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Title Annotation:Features
Publication:South Wales Echo (Cardiff, Wales)
Date:Mar 14, 2018
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