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Arthritis Clinic
Consultant Rheumatologist
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The office is open 9 am -5 pm, Monday to Friday

The Clinics times are Flexible to accommodate the needs of our patients: mornings and evenings, Monday to Friday.

Regular Clinics are also held on Tuesday afternoons and Thursday Mornings.

Phone: 01 200 0520

Fax: 01 200 0521
Regional Joint and Soft tissue Conditions

Trigger tender Points

chronic pain & chronic fatigue syndrome

Shoulder tendonits/bursitis
elbow tennis elbow
elbow golfers elbow
olecranon bursitis
De quervain's tenosynovitis
Trigger (locked) fingers
trochanteric bursitis
knee bursitis
ankle tendonitis & bursitis
achilles tendonitis
plantar fasciitis



Fibromyalgia is a condition that causes people to feel pain in the muscles all over their body. People with fibromyalgia also have “tender points,” places on their body that hurt when they are touched. No one knows what causes fibromyalgia.

Some people seem to get over fibromyalgia. But in most people it cannot be cured. Even so, people can learn to deal with the condition and to lead fairly normal lives. Fibromyalgia does not get worse over time, and it is not life-threatening.

People with fibromyalgia often say they feel tired all the time and that sleep does not help them feel rested. They may also have:

· Flu-like symptoms

· Headaches

· Depression and anxiety

· Stomach pain

· Too many or too few bowel movements (diarrhea or constipation)

· Pain in the bladder or the need to urinate in a hurry or often

· Problems with the jaw

There is no test. To diagnose it, doctors and nurses have to go by symptoms. First they look for other causes of the symptoms, such as arthritis or a hormone problem. They diagnose the condition if they can find no other cause, and if a person has:

· Muscle pain all over their body

· Severe tenderness in at least 11 of the 18 known “tender points” of fibromyalgia

Sometimes doctors diagnose fibromyalgia without checking for the number of tender points a person has. This might happen if the person has many areas that feel painful, and is bothered a lot by symptoms that are often caused by fibromyalgia. Some of these symptoms include feeling tired when getting up in the morning and during the day, and having trouble thinking clearly.

There are medicines and strategies to help with the symptoms of fibromyalgia. But there is no one treatment that works for everyone. You and your healthcare team will need to work together to find the right mix of treatments for you. In general, treatment can include:

· Medicines to relieve pain, improve sleep, or improve mood

· Physical therapy to learn exercises and stretches

· Relaxation therapy

· Working with a counselor

To get the best treatment, many people need a team that includes:

· A doctor

· A physical therapist

· Someone trained in mental health (such as a social worker or counselor)

Your doctor may suggest that you take a medicine normally used to treat depression or seizures. If so, be open to trying it. Even if you are not depressed and do not have seizures, these medicines may help. That is because they work on the brain areas that deal with pain.

It is really important that you stay active. Walking, swimming, or biking can all help ease muscle pain.  If you have not been active, it might hurt a little more when you start. But being active can help improve your symptoms.

It is also really important that you try not to be too negative about your life. Your outlook has a big effect on how you feel pain. Do your best to be positive.

Chronic fatigue syndrome


Chronic fatigue syndrome is a disorder that makes you feel very tired all the time. Sometimes the disorder is so bad that it makes it hard for you do your normal activities.

Living with chronic fatigue syndrome can be tough because most people, even many doctors, don’t really understand the condition. Plus, there aren’t a lot of treatment options.

The most common symptom is feeling tired all or most of the time. People who get the disorder usually begin to feel tired suddenly, right after they recover from a cold or an infection called “mono.” Even though they are over their cold or mono symptoms, they still feel very tired. Plus, being active makes them feel even more tired.

Besides feeling tired, people with chronic fatigue syndrome have other symptoms, such as: Sore throat, Trouble thinking clearly, Pain all over, Headaches, Trouble sleeping and Tender lymph nodes (glands) in the neck or armpits

Chronic fatigue syndrome is hard to deal with, because people who get it were usually active before. They did not tend to worry about being sick. Then, all of sudden, they feel tired and can’t figure out what is wrong with them. Even the doctor often can’t find a cause for the symptoms. And to make matters worse, other people sometimes think their symptoms are “all in their head.” This can make people with chronic fatigue syndrome feel angry, helpless, and sad.

If you suddenly feel tired all the time, you should see a doctor. Lots of health problems can cause tiredness. It’s important to get checked out to find out what might be causing the problem.

There is no test to specifically diagnose this condition. To diagnose chronic fatigue syndrome, doctors have to go by symptoms. Often they look for other causes of the symptoms first. If they can find no other causes of the symptoms, they consider chronic fatigue syndrome.

To be diagnosed with chronic fatigue syndrome, you must feel tired all the time for no reason, and you must have some of the other symptoms listed above.

There is no cure for chronic fatigue syndrome, but there are treatments that can help with the symptoms.  The most effective treatments seem to be cognitive behavioral therapy and graded exercise.

Cognitive behavioral therapy (CBT) is a type of “talk” therapy. During CBT you talk with a psychologist or counselor about the things you think and do. Then he or she helps you change how you see your situation and how you react to your situation. This teaches you how to cope better with your condition.

Exercise sometimes makes chronic fatigue syndrome symptoms worse. But not exercising at all can also make symptoms worse. That’s why experts recommend that people with chronic fatigue syndrome do gentle exercises. As they get used to that, they can slowly increase the amount of exercise they do. Sometimes it helps to work with a trainer who understands chronic fatigue syndrome.

Researchers have also checked whether different medicines, supplements, and special diets help with chronic fatigue syndrome. So far, none of these approaches has proven helpful.

Your doctor might offer you antibiotics, especially if you test positive for Lyme disease. But antibiotics do not work on chronic fatigue syndrome. And testing positive for Lyme does not mean that your symptoms are caused by Lyme disease. Plus, taking antibiotics for a long time when you do not need them can cause health problems.

If you have chronic fatigue syndrome, try to remember that you have a real medical condition. You are not imagining your symptoms, and your problem is not “made up.” Scientists have not yet figured out how to explain or cure chronic fatigue syndrome, but they do know that it is real.

The most important thing you can do to deal with your condition is to find a doctor whom you trust and like and who believes that your condition is real. Only that way can the 2 of you work together to figure out how best to deal with your symptoms.

Many people with chronic fatigue syndrome also have depression. If you are depressed, get treated for your depression. Doing so can make your chronic fatigue syndrome easier to handle.

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