Your Health A-Z

Fibromyalgia – the invisible disease

Fibromyalgia is a chronic, debilitating condition that is essentially all about pain.

The word fibromyalgia comes from the Latin term fibro meaning fibrous tissue, and the Greek words myo meaning muscle and algia meaning pain.

The illness is a non-inflammatory, non-autoimmune syndrome that affects the body’s central processing of pain. Simply put, fibromyalgia causes a low pain threshold for those who suffer from the condition. But what makes the disease particularly complex is that it presents nothing visible on or in the body to prove its presence. Sufferers of fibromyalgia have nothing to show for their condition, such as swollen joints, lesions or inflamed organs. They battle constant, debilitating pain that affects every aspect of their lives, at the hands of what’s best described as an ‘invisible’ disease.


Symptoms of fibromyalgia include increased sensitivity to pain, extreme fatigue, muscle stiffness, difficulty sleeping and impaired cognition. These symptoms are not unique to the condition, making it all the more difficult to identify. To pinpoint fibromyalgia, specialists look for pain that has been present for longer than three months, that is painful to the touch above and below the waist, and front and back.

Additional symptoms may include nausea, vomiting, bloating, abdominal pain, irritable bowel syndrome and migraines .


The causes of fibromyalgia are not yet known to medical science. Research suggests that a stressor early in life, or acute trauma, can trigger the process. It is thought that constant exposure to excessive stress can cause deregulation of the central processing of pain, but because not everyone subjected to stress develops fibromyalgia, science believes there might be some underlying genetic or biochemical predisposition to the disease for some people.

What science does know is that the condition is seven times more common in women than in men, and usually manifests between the ages of about 25 and 55*.


Dr Francois Bouwer, a rheumatologist at Mediclinic Vergelegen, describes the multi-faceted impact fibromyalgia has on the lifestyle of its sufferers.

‘Fibromyalgia impacts sufferers not only on a physical level, but also psychologically and socially. Imagine having to battle constant pain and deep fatigue while still having to manage the usual activities and demands of daily life. To add to this stress, because the disease carries no visible symptoms, people are often not sympathetic to those with the condition. Without visible symptoms of a condition, family and people within the community often struggle to understand what the patient is going through, and tend to avoid interaction with the patient, thinking them neurotic.

‘Not having their illness taken seriously inevitably causes more stress, and the lack of support can often lead to depression. The best thing that people can do for those with the condition is to be supportive.’


Unfortunately there is no cure for fibromyalgia on the horizon. Research on the understanding of pain perception and the complicated neuro-processing of pain is ongoing, and scientists hope someday there will be a breakthrough.

Dr Bouwer says the best treatment for the disease uses a combination of pharmacological and non-pharmacological modalities to manage the pain, together with trying to improve sufferers’ quality of life and their understanding of the disorder.

Fact box:

  • Fibromyalgia is a real disease and should be managed by specialists with experience in treating the condition.
  • The best treatment advice is a multi-disciplinary approach with a therapeutic combination of pharmacological and non-pharmacological intervention.
  • Support groups are essential.
  • Sufferers should keep away from regular use of analgesics as some can cause dependency, and from non-steroidal anti-inflammatories (such as ibuprofen, diclofenac, naproxen, etc.) as these have little long-term benefit and potential negative side effects.

*the EULAR Textbook on Rheumatic Diseases and Rheumatology Secrets.

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.