Fibromyalgia

The podiatrist regularly sees people with rheumatism in their practice, including those with fibromyalgia. Fibromyalgia is the second most common form of rheumatism. Around 2 per cent of the population has fibromyalgia, mainly women. Fibromyalgia patients are usually aged between 35 and 60. However, children and older people can also develop it.

Fibromyalgia is a long-term chronic condition that primarily causes pain in connective tissue and muscles. There is no evidence of inflammation or scarring in the body.

People with fibromyalgia are often treated with painkillers, pain management education and exercises. Read more here more about the treatment of fibromyalgia.

Much remains unknown about the causes of fibromyalgia. Consequently, the condition is difficult to diagnose through a physical medical examination using MRI scans or blood tests. To determine whether someone has fibromyalgia, the rheumatologist must first rule out other forms of rheumatism.

A rheumatologist is a doctor who specialises in rheumatic diseases. The rheumatologist recognises many types of rheumatism by examining specific symptoms. The rheumatologist’s clinical reasoning is very important in determining whether someone has rheumatism. By clinical reasoning, we mean the process whereby the rheumatologist thinks logically to understand what is wrong with a patient. In doing so, the rheumatologist examines the patient’s complaints and symptoms. The rheumatologist compares these with their knowledge of rheumatism and uses this information to determine which form of rheumatism the patient has. The rheumatologist then decides on the best course of treatment for the patient.

• Pain and tenderness when specific areas of the body are touched (tender points);
• Morning stiffness;
• Tingling;
• Fatigue;
• Sleep disorders;
• Headache;
• Anxiety;
• Mood changes: feeling down and not wanting to do anything (mental health symptoms).

People with fibromyalgia do not usually have specific symptoms affecting their feet. They can develop the same foot problems as anyone else. However, people with fibromyalgia experience more pain from a ‘normal’ foot problem than people without fibromyalgia. This is because the brain (the place where pain is generated and registered) is already overloaded by the pain that people with fibromyalgia feel every day in other parts of the body. As a result, recovery from a common foot or walking problem can take much longer.

A podiatrist can help people with fibromyalgia who experience problems or pain when walking. This may affect the feet, ankles, lower legs, knees, thighs, hips and back.

With fibromyalgia, symptoms often change. If someone stands or walks incorrectly, this can put extra strain on the muscles and tendons. This can cause pain. The podiatrist assesses how to ensure the gait is as efficient as possible. In this way, the podiatrist ensures that the load on the muscles and tendons is as normal as possible.

When pain in the feet and/or legs is caused by fibromyalgia, the gait changes. This is because people walk differently in order to avoid the pain. The podiatrist assesses how these symptoms can be alleviated.

• Podiatric insoles to improve the alignment of the feet;
• Providing pain education is important for understanding the causes of pain;
• Advice on shoes: what should you look out for when buying new shoes?
• Teenortheses for toe complaints;
• Advice on foot strain;
• Stretching or muscle-strengthening exercises;
• Taping.

Podiatric insoles can help to reduce pressure under the forefoot. They can help to correct poor foot alignment and an abnormal gait. Orthotic insoles can also help to stabilise the feet and ankles. This can reduce pain in the soft tissues of the feet and lower legs.

Do you have fibromyalgia and do you experience pain in your feet or legs, or when walking? If so, it’s a good idea to get a appointment to see a podiatrist at you in the neighbourhood to see what he or she can do for you.