At a glance
What it is
Chronic widespread pain in muscle and fascia, with altered pain processing in the brain.
Typical signs
Deep aching pain, poor sleep, general fatigue, referred pain away from its source.
How we treat it
Multimodal care: trigger point injection, nerve blocks, physiotherapy, sleep and stress management.
What fibromyalgia is
Fibromyalgia is a complex condition characterised by widespread muscle pain. Some researchers believe it increases the body's pain sensations by affecting the way the brain processes pain signals — the pain receptors remember the signal, and eventually overreact to it.
Muscle makes up most of the human body and plays an active role in movement, balance and coordination. Myofascial pain results from stress or damage to a muscle or its fascia, and is often overlooked despite being a major cause of pain and dysfunction.
Muscle and fascia are among the parts of the body most exposed to wear and damage. Yet clinicians tend to focus on bones, discs and nerves. That bias needs to change.
In practice this means a patient can carry pain for years while imaging is repeatedly reported as normal. The diagnosis is made by history and physical examination of the muscles, not by the scanner.
Trigger points
A myofascial trigger point is a small area of irritation in a muscle or its fascia that produces pain. Every trigger point is either active or latent, and the distinction changes how the patient experiences it.
Type A
Active trigger point
- Produces pain at rest, and again on any movement that stretches the muscle.
- Always tender; felt as a taut band between muscle fibres.
- Often refers pain to a distant site — the source is not where the pain is felt.
Type B
Latent trigger point
- Silent at rest; only produces pain when pressed or overloaded.
- Still restricts range of motion and reduces muscle strength.
- Can become active under stress, fatigue, or a minor injury.
What we see in clinic
66%
Cases missed on first specialist visit before referral here
80%
Improve substantially with injection + physiotherapy
85%
Diagnosis reachable by history and examination alone
Key facts
How it is treated
Care is multimodal — no single intervention resolves fibromyalgia on its own. The clinic combines interventions from all four groups below, weighted to the individual patient's presentation.
Injection therapy
Direct treatment of trigger points
- Trigger point injection (local anaesthetic ± steroid)
- Botulinum toxin for refractory muscle spasm
- Sympathetic nerve blocks
- Peripheral nerve blocks
Physiotherapy
Manual and movement therapy
- Myofascial release
- Stretching and postural work
- Graded exercise therapy
- Dry needling
Medication
Systemic support, not first line
- Low-dose tricyclic antidepressants for sleep and pain modulation
- SNRIs for centralised pain
- Anticonvulsants where nerve pain dominates
Lifestyle
Non-negotiable adjuncts
- Sleep hygiene review
- Stress reduction (CBT, mindfulness)
- Aerobic conditioning built up gradually
- Weight management where relevant
The actual regime varies from patient to patient. Selection is discussed at the first consultation after the muscle examination and imaging review.
Related reading
Back pain
Most back pain is mechanical and settles in weeks. The first visit identifies the few cases that need imaging, injections or surgery, without over-treating.
Acoustic neuroma
A slow-growing, non-cancerous tumour of the hearing and balance nerve. Treatment ranges from monitoring to microsurgery, depending on its size and effects.
Book a consultation
The secretary schedules first appointments during clinic hours; please have prior imaging, operative notes and a current medication list available at the time of the call.
This page provides general information about fibromyalgia and myofascial pain and is not a substitute for individual medical assessment. If your symptoms are severe or worsening, contact a clinician promptly.