Fibromyalgia /chronic widespread pain

Availability

North South North West Statewide

Pre-referral work-up

History

Referrals will be accepted for diagnostic purposes only and on a non-urgent basis. Once the diagnosis has been confirmed by the Rheumatologist a management plan will be recommended. Re–referrals are unable to be seen.

Please note: Medical causes (hypothyroidism, depression) must be excluded before diagnosis but fibromyalgia can co-exist with other managed conditions.

All referrals should comply to referral standards and include in particular:

  • A history of:
    • Onset of symptoms
    • Muscle or joint pain pattern during/after activities
    • Morning stiffness duration
    • Fatigue
    • Sleep disturbance
  • Please include:
    • Psychological evaluation
    • Examination findings
      • Tender points
      • Pain behaviours
      • Normal clinical findings
    • Current capacity restrictions to assist with prioritisation of referral

Tests

  • FBE
  • ESR and CRP
  • U+E
  • LFT
  • TSH
  • CK
  • Vitamin D
  • Calcium, PO4

Interim/GP management

To refer a patient with this condition, please see the Rheumatology clinic page for the full referral process and templates.

Consider medical causes of fatigue, myalgia e.g. statins

Patient education and reassurance.

Exercise and lifestyle advice.

Simple analgesics.

Consider antidepressants.

For more information please see the Tasmanian Health Pathways website.

Routine / category 3

Fibromyalgia

Chronic musculoskeletal pain

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Patient information advice is found at Arthritis Australia

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED
– Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED
– Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED
– Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED
– Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Please discuss with registrar or consultant. We will endeavour to see these patients within four weeks.

Urgent referrals (e.g. temporal arteritis, septic arthritis) should be accompanied by a phone call to the Rheumatology Registrar or Consultant for urgent assessment, or patient should be directed to the Emergency Department.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment