INFLAMMATION AND FIBROMYALGIA
One of the first medications the GP may give you could be a nonsteroidal anti-inflammatory e.g. Diclofenac, Mobic or perhaps just good old ibuprofen. The question is - is the Dr giving you these because he thinks that Fibromyalgia is an inflammatory condition or because he is unsure what else to give. Perhaps he may be trying to ascertain whether you do indeed have Fibromyalgia at all - whereby if they work then you don't.
First lets look at the reasoning behind this. The Merck Manual which is about one of the most accurate medical handbooks about states:
"Fibromyalgia (Myofascial Pain Syndrome; Fibrositis; Fibromyositis) - A group of common nonarticular disorders characterised by achy pain, tenderness, and stiffness of muscles, areas of tendon insertions, and adjacent soft tissue structures.
The term myalgia indicates muscular and/or soft-tissue pain. In contrast, myositis is caused by inflammation of muscle tissues and is an inappropriate term for fibromyalgia, in which inflammation is absent. Fibromyalgia indicates pain in fibrous tissues, muscles, tendons, ligaments, and other sites. Any fibromuscular tissues may be involved, but those of the occiput, neck (neck pain or spasm), shoulders, thorax (pleurodynia), low back (lumbago), and thighs (aches and charley horses) are especially affected."
Much research is now being carried out into Fibromyalgia (mostly in the US) and there is little, if any, evidence to suggest that FM is an inflammatory condition. We in N.Ireland have been lucky to have listened to a lecture given by renowned FM specialist, Dr Patrick Wood, who provided a great deal of evidence to suggest that there is no inflammatory response in patients with FM.
Obviously it is also possible to have both problems - in other words you have both a true inflammatory condition and also Fibromyalgia but some people may only have one. Those who have true FM on its own will find the NSAIDs of no value whatsoever in normal circumstances, but having said that - many people with fibro may often have small pockets of inflammation - not enough to show up on blood tests perhaps, maybe localised to one specific area, but which may be helped by such drugs as these. And of course if you've got inflammation in any area of your body it will cause much more pain than 'normal' and so if you get that suitably alleviated, you may then feel better overall and again attribute that to mean that your Fibromyalgia is being helped by the anti-inflammatories.
Ironically many FM patients would state they personally feel they must have inflammation as the pain is 'burning' in nature - however, that isn't necessarily the case. A burning character to pain indicates a particular form termed "neuropathic" - which is fairly typical for many FM sufferers.
As I mentioned at the start - if you have a good GP who is knowledgeable about the condition, and most now are, they will most likely be happy to refer you on to a Rheumatologist for confirmation. If instead you find yourself being given NSAIDs don't refuse them, just be aware that they may not work and if they do, you need to try and educate your GP that it's most likely not your FM they've helped as much as something else needing investigated.
At the end of the day - the important thing is to always ensure you've been adequately screened for these other inflammatory rheumatic conditions regardless, given how similar the symptoms often are. This is best done as always by the specialists only because that's what they're well trained at - many GP's can certainly do the blood tests but may not be in a position to accurately translate the results. And obviously don't turn round and refuse any medication from your GP either as you won't know until you try, whether it may indeed either alleviate some of your symptoms or help your doctor to better evaluate your problems if it doesn't.