"Your bloods are normal, so there's nothing wrong."— what you've probably been told
Fibromyalgia
NICE NG193 covers the assessment and management of chronic primary pain, including fibromyalgia. It sets out specific recommendations for assessment, shared decision-making, and which pharmacological treatments should and should not be offered.
The wait: Average UK diagnostic delay is 5+ years.
NG193 explicitly recommends against starting paracetamol, NSAIDs, opioids or gabapentinoids for chronic primary pain. It does recommend supervised group exercise, acceptance and commitment therapy, and certain antidepressants.
- An NG193-aligned chronic pain assessment
- Discussion of recommended interventions (supervised exercise, ACT)
- Reasoning if non-recommended medications are continued
Why is the letter useful if there's no cure?
Even where treatment options are limited, NG193 sets clear expectations for assessment and shared decision-making. A documented request gets that assessment on record.
What's usually said in the room
"Your bloods are normal, so there's nothing wrong."
What the guideline actually says
NG193 explicitly recommends against starting paracetamol, NSAIDs, opioids or gabapentinoids for chronic primary pain. It does recommend supervised group exercise, acceptance and commitment therapy, and certain antidepressants.
Outcomes from people with Fibromyalgia
One short email each Sunday — anonymised stories from people who got their GP to take them seriously.