Fibromyalgia (fibromyalgia syndrome)

The Fibromyalgia or Fibromyalgia Syndrome (FMS) is a condition characterized by severe pain throughout the body. The causes have not yet been researched and treatment is primarily aimed at alleviating the symptoms. Fibromyalgia is currently incurable, but the severity of the symptoms can weaken with age.

What is fibromyalgia?

Fibromyalgia, also known as fibromyalgia syndrome (FMS), is a disease that causes pain in muscles, tendons and bones.

Usually other diseases are initially suspected, such as rheumatism or back damage. Fibromyalgia is a generalized disease, which means that it not only causes symptoms in certain areas or a few parts of the body, but affects the entire body.

Fibromyalgia usually spreads symmetrically. Patients experience muscle pain in particular, but generally have a lower pain threshold. Depression often develops as the disease progresses. Organs can be restricted in their functionality by fibromyalgia.

The syndrome is divided into two types, primary and secondary fibromyalgia. The primary form has no recognizable trigger, while the secondary form occurs as a secondary disease after rheumatic inflammation, infections or autoimmune diseases.

causes

The causes of fibromyalgia are not fully understood. It is now known that the disease occurs in families, which suggests a genetic predisposition.

It is also known that the secondary form of fibromyalgia occurs as a result of viral infections and rheumatic inflammation. Secondary fibromyalgia also occurs after so-called autoimmune diseases, in which the immune system is not directed against harmful pathogens but against the own body.

It was also observed that after tumors, accidents or operations, pain persists and can turn into fibromyalgia. A disorder in the brain is also considered a trigger. It is assumed that the pain memory does not work properly and thus permanently sends pain signals, although there is no organic cause for this.

In more recent biochemical studies it has also been found that in fibromyalgia certain substances in the liquor (brain fluid) and blood serum are lower or higher than normal.

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Symptoms, ailments & signs

The symptoms of fibromyalgia syndrome usually develop insidiously over many years. More rarely, it occurs suddenly after an accident or other injury. The main symptom of fibromyalgia is chronic pain that lasts for months and can affect the entire musculoskeletal system. The pain is found in different parts of the body at the same time and occurs spontaneously.

Painful pressure points, which are often located in the area of ​​muscle-tendon junctions, are particularly noticeable. These points are called "tender points". Overall, the patients are significantly more sensitive to pain than unaffected people. In addition to the chronic pain conditions, a variety of accompanying symptoms can occur. Many of those affected suffer from tiredness, exhaustion and decreased performance.

In addition, there are insomnia, headaches or migraine attacks and an increased sensitivity to cold. Sensory disturbances and paresthesia can occur, especially in the arms and legs. Another symptom are functional heart and breathing problems, i.e. complaints for which no physical cause can be found. In many cases the disease also has a psychological component.

The patients tend to be depressed, dejected and irritable. The gastrointestinal tract can also be affected. Nausea, dry mouth, or other so-called gastrointestinal problems can occur. Less common symptoms of fibromyalgia are dizziness, tinnitus, bladder problems in the form of an irritable bladder or a feeling of lump in your throat.

Diagnosis & course

Fibromyalgia causes severe pain in the muscles and tendon attachments. These usually appear symmetrically and not only on the arms and legs but also on the entire trunk. The back is particularly badly affected.

The pain is perceived as burning or boring over a large area, the tissue feels sore and swollen. In addition to pain, fibromyalgia also has numerous other symptoms, such as insomnia, depression, panic attacks, tremors or intestinal irritation. For the diagnosis, a detailed physical examination will be carried out and the patient's medical history will be found out.

The doctor will also test the so-called tender points. These 18 points are located on the shoulders and neck, as well as on the back and hips. If at least 11 of the 18 points react painfully to pressure and the symptoms have existed for more than three months, this is considered a sure sign of fibromyalgia.

Complications

Due to the fibromyalgia syndrome, the patient suffers from extremely severe pain that occurs all over the body. It is not possible to limit the pain to certain areas or to treat it specifically. The affected person is restricted in his actions and the quality of life is reduced enormously.

The back is often particularly affected by the pain of fibromyalgia syndrome. The pain usually does not go away even if the patient does not exercise or rest. The so-called resting pain occurs. The pain can also lead to depression and difficulty sleeping. Often an aggressive posture occurs because the patient is permanently irritated.

Treatment is primarily carried out by taking painkillers. Most of the time, the pain cannot be completely limited. Furthermore, the person concerned must attend physiotherapy. If there is improvement, light sports are also performed. There are no further complications.

In the case of psychological complaints, treatment by a psychologist and possibly medication is necessary. Unfortunately, it cannot be predicted whether the fibromyalgia syndrome will heal or not. Some patients have fibromyalgia syndrome for their entire life.

When should you go to the doctor?

Visits to the doctor are not uncommon for patients with fibromyalgia. Since hardly any doctor takes this painful disease seriously, many patients with chronic muscle pain experience a true doctor odyssey. In many cases they are accused of mental health problems in disguise or are mistaken for hypochondriacs. Even if the development process and the causes of fibromyalgia have not yet been adequately clarified, those affected suffer severe and constant pain.

Despite the many senseless visits to the doctor, a further visit to the doctor is useful to make a diagnosis of constant pain all over the body. The doctor should use differential diagnosis and questioning the patient to rule out other causes of the disease such as rheumatism, inflammation or severe tension due to displaced intervertebral discs.

In the case of a higher degree of pain that appears unacceptable, referral to a pain therapist makes sense. Using multimodal pain therapy, this can enable the patient to perceive his constant pain differently and to deal with it better.

People with fibromyalgia are also entitled to appropriate pain relief and treatment. Therefore, you shouldn't let yourself be deterred from seeing a doctor until the right doctor has been found. Inexplicable chronic pain is a heavy burden. If left untreated, they can lead to incapacity for work. At a minimum, regular physical therapy and relaxation therapies can provide relief. In some cases, temporary pain relievers are needed.

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Treatment & Therapy

Fibromyalgia cannot be treated causally at the current state of medical research. Therefore, the therapy consists in relieving the symptoms. This includes several areas. The pain is treated with medication, and physiotherapy, connective tissue massages and heat therapy are also recommended.

A certain amount of physical activity, such as regular endurance training under the guidance of sports therapy, can also alleviate the symptoms. Training in water (swimming, aqua jogging) is particularly suitable, as the body is felt easier here and the movements are not so painful. Medication is usually prescribed for any depression that may be present, and behavioral psychotherapy is also recommended.

Symptoms usually remain lifelong but do not get worse and can be alleviated with the right treatment. The therapy also includes long-term care with special programs through which the patients learn to deal with their complaints and to cope with everyday life despite the symptoms. In some cases, there is spontaneous improvement with age, that is, there is no apparent reason for the improvement.

Outlook & forecast

The outlook in people with fibromyalgia depends very much on whether an understanding doctor can be found. The prevailing view among medical professionals is that fibromyalgia syndrome is an imaginary pain or pain that can be traced back to mental disorders and an incorrectly programmed pain memory. With this diagnosis, improvement will be difficult or impossible.

The prospect of an improvement in the degree of pain and an appropriate management of the pain are good if a meaningful treatment strategy is found. Because of their addiction potential, pain killers are not particularly suitable for achieving long-term improvement. Instead, moderate exercise and physical therapy treatments make sense to improve the prospects for a more pain-free life.

Multimodal pain therapy is an interdisciplinary approach that is associated with a positive prognosis. Complete healing of soft tissue rheumatism is usually not possible. However, those affected can be promised that they will experience relief through physiotherapy, breathing training, relaxation exercises, activity and long-term medical care.

The prognosis without adequate treatment approaches is worse. Here, those affected are faced with the possibility of permanent incapacity for work due to relieving postures, an internalized pain memory and chronification. It looks better when those affected join a self-help group. Here you will find important tips and addresses that you can turn to.

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prevention

There is no preventive measure against fibromyalgia. If the pain is treated early, the course of the disease can be influenced positively.

Aftercare

With fibromyalgia, aftercare is a rather difficult area. This painful disease of the soft tissues is still laughed at by many doctors. Most physicians regard it as a psychologically caused pain syndrome or a psychosomatic illness. As a result, there are orthopedic surgeons who rely on being responsible only for the skeletal damage that is present, but not for the muscle and soft tissue pain. Many patients with fibromyalgia therefore do not experience physiotherapy treatment.

But the fibromyalgia syndrome is more than a psychological pain syndrome. It used to be called soft tissue rheumatism. If there is follow-up care, for example after a stay in a hospital, psychological support is also provided in addition to somatic follow-up care. The aim of this is to use suitable strategies to encourage pain-affected patients to better cope with the fibromyalgia syndrome.

In addition to emotional stress, stress and physical stress, weather changes, cold and other factors also influence the degree of pain. The extent to which aftercare relates to all therapy areas that have already been treated varies from person to person.

Continued exercise therapy measures, drug treatment steps, renewed pain therapy interventions in the event of deterioration or multimodal pain therapy with a renewed hospital stay are possible. In addition, those affected can do moderate sport. In addition, warm baths and aqua aerobics during aftercare alleviate the symptoms and increase the quality of life.

You can do that yourself

All relaxation techniques help fibromyalgia patients to develop a different relationship to pain. Depending on personal preference, a person concerned can choose from numerous offers. These range from autogenic training to yoga to progressive muscle relaxation.

As a result of a pain management training, inner attitude and pain perception also develop positively. The pain can be breathed away with certain breathing techniques. In addition to full yogic breathing (pranayama), women can use the same technique that midwives recommend for breathing away labor pains.

Studies show that hypnosis reduces some of the symptoms of the disease, including sleep problems and increased pain. The willingness to accept pain also grows under trance. Special directories help those affected to find reputable hypnotherapists.

Alternative healing methods - for example Reiki and Healing Touch - improve the overall condition. These release inner blockages, relax, reduce the sensation of pain and activate self-healing powers. Reiki can be learned by anyone and is suitable for self-treatment. Heat and water applications loosen the painfully tense muscles.

Warm full baths and a shower with a soft shower head are particularly efficient. Targeted sprays of water and damp cloths also alleviate muscular complaints. A hot water bottle, a cherry stone pillow or a red light lamp provide a dry supply of heat and also have a muscle-relaxing effect. Targeted stretching exercises loosen tense body parts sustainably.

Moderate, individually created strength and endurance training as well as meditative movement therapy give fibromyalgia patients a better quality of life.