Persistent widespread pain syndrome, also known as fibromyalgia, is a condition where joints, muscles and many other body tissues become painful and can be ‘oversensitive’.

Multiple bodily symptoms are often complicated by poor sleep, depression and anxiety.

It is thought to be due to a problem with the pain processing system rather than damage or inflammation in the tissues.

About our service

New research suggests an increased ‘connectivity’ between sensory, pain, attention and mood networks in the brain.

Sadly, fibromyalgia does not respond to medication very well. Often, there is only a 1 in 10 chance of improvement in symptoms.

It means few patients respond well to medication and patients with fibromyalgia are often more prone to side effects.

With that in mind, if strong medications (such as tramadol, amitriptyline, fluoxetine and pregabalin) are used, it is important to be realistic about their possible benefits, and withdraw them if there are no significant improvements.

Many patients still describe their pain score as 10/10, despite being on four medications for pain, and in addition experience a lot of detrimental side effects.

One of the best approaches is trying to get fit again – this is termed as a ‘graded aerobic exercise programme’ - and there are simple changes that can start this off, such as short walks, using stairs more and gentle exercise in a swimming pool.

An exercise programme using the principles of Tai Chi can also be helpful.

We don’t normally see patients with an established diagnosis of fibromyalgia in the rheumatology department because there are no specialist treatments available.

Sometimes patients with other conditions such as rheumatoid arthritis develop fibromyalgia and we may discuss some of the medications above or direct them to the online resources below.


Although the cause of osteoporosis is largely genetic, there are a number of things you can do to help prevent osteoporosis or slow progression, including:

  • Maintaining a healthy body weight
  • Leading an active lifestyle, particularly through safe walking
  • Eating well with enough calcium in your diet
  • Getting enough vitamin D from sunlight and your diet
  • Avoiding smoking
  • Not drinking above the weekly recommended alcohol limit
  • Reducing your risk of falls by maintaining good balance and co-ordination

Further information about all these aspects of management can be found from the royal osteoporosis society website (see below).

Patient information leaflets

We produce a wide range of leaflets which provide information about our services and about the treatment you might receive in our clinics or during your stay in hospital. 

We also produce these in different formats including large print, please contact the department you are visiting for more information.

Find out more

Useful videos

We have a wide range of videos which provide information about our services and about the treatment you might receive in our clinics or during your stay in hospital. 

Find out more

Information for healthcare professionals

Further information can be found on the Devon formulary website

Last updated: September 20, 2022.


Our site uses cookies to help give you a better experience. By continuing to use it you consent to the use of cookies as set out in our privacy policy.