FM affects two to five per cent of the general population, with more women than men affected. It can affect both adults and children. Early diagnosis of FM is important—if you think you have FM, it’s important to see your GP. They will ask you about your pain and how it affects your function and general wellbeing. They may also refer you to another health professional for management of your symptoms. There are no specific laboratory tests for FM, so diagnosis can be difficult. Signs and symptoms of FM include widespread pain for three months or longer, memory or thought problems and disrupted sleep. Your GP will also rule out any other conditions that may be causing the symptoms.

There are many different musculoskeletal and other health conditions that can have similar features to FM. It is important to seek an opinion from your health professional to get an appropriate diagnosis. Other conditions with similar symptoms to FM include:

• rheumatoid arthritis
• osteoarthritis
• lupus
• hypothyroidism
• polymyalgia rheumatica
• multiple sclerosis
• depression or anxiety
• chronic fatigue syndrome
• irritable bowel syndrome (IBS)

Some of these conditions may co-exist with FM or be the underlying cause of the symptoms.

FM is not life threatening but it does negatively impact your wellbeing. This means that everyday living, work, study and family life can be challenging, but learning how to cope and manage your FM is helpful. This is especially important as it can affect your mood, sleep patterns, thinking and memory, and bowel and bladder functions. Not everyone is affected to the same degree, or experiences all of these symptoms, so it is important to have a skilled health professional help you work out a treatment plan that is relevant to your specific problems.

The best evidence at the moment indicates that the first line of treatment should be non-pharmacologic (not medicine/drugs based). The treatment that shows the strongest benefit is appropriately paced aerobic and strengthening exercises. This is something your physiotherapist can help you with as they can develop an exercise management program for your needs.

No one treatment is effective for FM. The most beneficial treatments are often a combination of treatments designed for you, including exercise, sleep management, nutrition, medicines and psychological treatments that focus on mood management and positive coping strategies. With exercise, you may initially notice an increase in symptoms, and it is very important to work closely with your physiotherapist to ‘pace your activity up’. Exercise is generally considered safe, especially when practised under supervision.

You need to be in charge of your FM management. Having a good team around you is the key. You will need a management plan that is developed for your needs. This usually relies on you being actively engaged in each of the following components:

• sleep quality plan (how to get a good night’s sleep)
• exercise and activity plan (including ‘dose’ and frequency’ depending on your specific condition and any other general health conditions)
• mood management plan (strategies to help you relax, possibly through meditation)
• nutrition plan
• medicines plan (most medicines do not work well for FM, so it is important to discuss this with your GP or specialist to make sure you get medicines appropriate for you and understand how to use them and what the benefits and side effects are)
• other therapies (such as massage, heat and hydrotherapy).

Currently there is no cure for FM. Therefore, the best approach based on the current evidence is to have a plan for managing your symptoms, as outlined above. With a good team around you, and a skillful physiotherapist to support your exercise management, you will be better equipped to manage the pain and improve your function. How quickly this occurs will vary between people depending on the severity of their condition and any additional health concerns. You should discuss this with your GP or other health professional to get a better guide.