Fibromyalgia is a chronic condition that causes pain throughout the body. Fibromyalgia is not fully understood, but it is thought to be caused by chemical and hormonal imbalances or abnormalities in the central nervous system’s ability to transmit correct pain messages in the body. It is thought that between 2 and 4% of the UK population is living with some degree of fibromyalgia.
What are the signs and symptoms of fibromyalgia?
Fibromyalgia is characterised by pain in the body, either throughout or more localised, such as in the back or neck. This pain could be of the following natures:
It may also encompass hyperalgesia (extreme pain sensitivity) or allodynia (pain resulting from usually painless phenomena such as light touches).
Other symptoms include:
- Limb stiffness, particularly in the morning after waking up
- Extreme fatigue
- Poor sleep
- Memory and attention difficulties
- Confused speech
- Irritable bowel syndrome
- Inability to regulate body temperature
- Pins and needles (paraesthesia)
- Restless legs
How is fibromyalgia diagnosed and treated?
Fibromyalgia is difficult to diagnose because there is no conclusive test and symptoms are similar to those of other conditions. For example, swollen joints could be symptomatic of arthritis and not fibromyalgia. Blood tests may help rule out rheumatoid arthritis and multiple sclerosis.
The criteria for diagnosis typically include:
- Severe pain in 3-6 different areas of the body, or milder pain in 7 or more areas
- Other causes of the symptoms have been ruled out
- And symptoms have been consistent for three months or more
Treatment for fibromyalgia could involve monitoring by a rheumatologist (doctor specialising in muscles and joints), or by a neurologist (specialist in the central nervous system). They will typically prescribe a combination of lifestyle changes and pain relief medication, although there is no one-size-fits-all approach.
There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with fibromyalgia:
An employee may not disclose their fibromyalgia upfront, but if they do, questions regarding the nature of an employee’s fibromyalgia and what extra support they may need can be broached sensitively. For example:
- Have they required adjustments in the past? For example, avoiding certain types of manual tasks which might exacerbate their symptoms.
- Encouraging the employee to express their strengths and interests and which tasks they might enjoy doing is a positive way of adapting to their needs and empowering them, in spite of their fibromyalgia.
- Even if the employee does not wish to disclose their fibromyalgia – or they have not even received a precise diagnosis – an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
What reasonable adjustments are possible for employees with fibromyalgia?
Employers have a legal duty to make reasonable adjustments for employees with fibromyalgia if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has fibromyalgia. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.
If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of fibromyalgia:
- Flexible working hours to accommodate medical appointments and periods of increased absence or decreased productivity following a flare-up in symptoms.
- Additional breaks if the person’s pain medication causes their concentration to lapse or makes them drowsy shortly following taking it.
- Adjustments to duties depending on the severity of their symptoms, which may be variable and improve or deteriorate from one week to the next. This may also be dependent on when they take their medication if they are required to operate machinery, for example.
- Raising awareness so that colleagues understand the employee’s fibromyalgia and can help ensure the employee feels comfortable at work, for example, when taking additional breaks.
- Ergonomic equipment to reduce pressure on the back, joints and other susceptible parts of the body while sitting at a desk.
Fibromyalgia Action UK – a charity signposting information and resources to help people live with their fibromyalgia. It also runs a support forum, provides guidance on fundraising and educates medical professionals on the condition (0300 999 3333).
Versus Arthritis – charity campaigning for better policies to protect people with arthritis and fibromyalgia and to provide them with better healthcare, as well as campaigning to counter common misconceptions about the conditions (0300 790 0400).
UK Fibromyalgia – organisation making sure that people in the UK living with fibromyalgia have access to correct diagnoses, effective treatments and protection against medical and workplace discrimination.