Fibromyalgia (fibromyalgia syndrome)
What is fibromyalgia?Infogram to the pain regions in fibromyalgia. Click on the image to enlarge.
Fibromyalgia, also called fibromyalgia syndrome (FMS), is a condition that causes pain in muscles, tendons, and bones.
Most initially, other diseases are suspected, such as rheumatism or back damage. Fibromyalgia is a generalized condition, which means that it not only causes discomfort in certain areas or in a few parts of the body, but affects the whole body.
Fibromyalgia usually spreads symmetrically. Patients are particularly prone to muscle pain, but generally have a lower pain threshold. Often it comes in the course of depression. Organs may be limited in their ability to function due to fibromyalgia.
The syndrome is divided into two types, primary and secondary fibromyalgia. The primary form has no detectable trigger, while the secondary form occurs as a consequence of rheumatic inflammation, infection or autoimmune disease.
The causes of fibromyalgia are not fully understood. It is now known that the disease occurs familial, 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. Even after so-called autoimmune diseases, in which the immune system is not directed against harmful pathogens but against the body, the secondary fibromyalgia occurs.
Furthermore, it has been observed that after tumors, accidents or surgery, pain persists and can develop into fibromyalgia. Also, a disorder in the brain is considered as a trigger. It is believed that the pain memory is not working properly and so permanently sends pain signals, although there is no organic cause for it.
Recent biochemical studies have also found that in fibromyalgia certain substances in cerebrospinal fluid and blood serum are lower or higher than normal.
Symptoms, complaints & signs
The symptoms of fibromyalgia syndrome usually develop slowly over many years. Rarely does it occur suddenly after an accident or other injuries. The main symptoms of fibromyalgia are chronic, lasting pain that can affect the entire musculoskeletal system. The pain is found in different parts of the body simultaneously and occurs spontaneously.
Particularly noticeable are painful pressure points, which are often in the range of muscle-tendon transitions. These points are called "tender points". Overall, the patients are much more sensitive to pain than unaffected people. In addition to chronic pain, a variety of concomitant symptoms can occur. Many sufferers suffer from fatigue, fatigue and decreased performance.
In addition, there are insomnia, headaches or migraine attacks and increased hypersensitivity. Especially on the arms and legs, it can lead to emotional disorders and discomfort. Another symptom is functional cardiac and respiratory problems, ie complaints in which no physical cause can be found. In many cases, the disease also has a mental component.
Patients are prone to depressive moods, depression and increased irritability. The gastrointestinal tract may also be affected. Nausea, a dry mouth or other so-called gastrointestinal problems may occur. Less commonly occurring symptoms of fibromyalgia are dizziness, tinnitus, bladder problems in the form of a irritable bladder or the feeling of having a lump in the throat.
Diagnosis & History
Fibromyalgia causes severe pain in muscles and tendons. These usually occur symmetrically, not only on the arms and legs but also on the entire hull. The back is particularly affected.
The pain is perceived as burning or boring over a large area, the tissue feels sore and swollen. In addition to pain, fibromyalgia is associated with many other conditions, such as insomnia, depression, panic attacks, tremors, or irritation of the bowel. For the diagnosis, a detailed physical examination will first take place and the patient's medical history will be found out.
Furthermore, the doctor will test the so-called pain pressure points (tender points). These total of 18 points are located on the shoulders and neck, as well as on the back and on the hip. If at least 11 of the 18 painful points respond to pressure and the symptoms persist for more than three months, this is considered a sure sign of fibromyalgia.
Due to the fibromyalgia syndrome, the patient suffers from extremely severe pain that occurs throughout the body. It is not possible to limit the pain to specific areas or to treat them specifically. The affected person is restricted in his actions and the quality of life is reduced enormously.
Often, especially the back is affected by the pain of the fibromyalgia syndrome. The pain usually does not disappear even when the patient is not physically operated or resting. The so-called resting pain occurs. The pain can also lead to depression and sleep disorders. Often there is an aggressive attitude as the patient is permanently irritated.
The treatment takes place primarily by the intake of painkillers. Mostly, the pain can not be completely limited. Furthermore, the person concerned must attend a physiotherapy. With an improvement even light sports are carried out. There are no further complications.
For mental health problems, treatment by a psychologist and possibly medication is necessary. Unfortunately, it can not be predicted whether the fibromyalgia syndrome will heal again or not. Some patients suffer from fibromyalgia syndrome throughout their lives.
When should you go to the doctor?
Doctor visits are not uncommon in patients affected by fibromyalgia. Since hardly any doctor takes this painful disease seriously, many patients with chronic muscle pain experience a true medical odyssey. In many cases they are accused of masked mental problems or they are considered hypochondriacs. Even though the developmental process and causes of fibromyalgia have not yet been adequately clarified, sufferers suffer severe and constant pain.
In spite of the many pointless visits to the doctor, a further visit to the doctor makes sense in order to diagnose pain with constant pain throughout the body. By differential diagnosis and questioning the patient, the physician should exclude other causes of illness such as rheumatism, inflammation or strong tension due to displaced intervertebral discs.
With a higher level of pain that seems unacceptable, referral to a pain therapist makes sense. This can put the patient through a multimodal pain therapy in a position to perceive his constant pain differently and to deal with them better.
People with fibromyalgia are also entitled to appropriate pain relief and treatment. Therefore, they should not be deterred by medical visits until the right doctor is found. Unexplained chronic pain is a heavy burden. If left untreated, you may be unable to work. As a minimum, regular physiotherapy and relaxation therapies can provide relief. In some cases, temporary painkillers are necessary.
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Treatment & Therapy
Fibromyalgia can not be treated causally at the current state of medical research. Therefore, the therapy is a relief of the symptoms. This includes several areas. The pain is treated with medication, in addition physiotherapy, connective tissue massages and heat therapy are recommended.
A degree of physical activity, such as regular endurance training under sports therapy instructions, can relieve the symptoms. Especially suitable is the training in the water (swimming, aquajogging), because here the body is felt lighter and so the movements are not so painful. As a rule, medication is prescribed against any existing depression and, in addition, a behavior-oriented psychotherapy is recommended.
The symptoms usually persist throughout life, but do not worsen and can be mitigated with the right treatment. The therapy also includes a long-term care with special programs, through which the patients learn to deal with their complaints and despite the symptoms to master their everyday lives. In some cases, there is a spontaneous improvement in old age, that is, there is no apparent reason for improvement.
Outlook & Forecast
The prospects in people with fibromyalgia depend very much on whether an understanding doctor can be found. It is often the opinion of physicians that the fibromyalgia syndrome is imagined pain or pain due to emotional distress and a misprogrammed pain memory. With this diagnosis, recovery is difficult to impossible.
The prospects for improving the level of pain and managing the pain appropriately are good when it comes to a sensible treatment strategy. Because of their addictive potential, painkillers tend to be unsuitable for long-term improvement. Instead, moderate sports and physiotherapy treatments are useful to improve the prospects of a pain-free life.
Multimodal pain therapy represents an interdisciplinary approach that is associated with a positive prognosis. Complete healing of the soft tissue rheumatism is usually not possible. However, those affected may be offered relief by physiotherapy, breathing training, relaxation exercises, activity, and long-term medical care.
The prognosis without adequate treatment approaches is worse. Here are the affected by restraint, an internalized pain memory and chronification of the possibility of permanent incapacity for work. It looks better if the victims join a self-help group. Here you will find important tips and addresses that you can turn to.
You can not prevent fibromyalgia. If the pain is treated early, then you can influence the course of the disease quite favorable.
In fibromyalgia, aftercare is more of a difficult field. This painful soft tissue disorder is still ridiculed by many doctors. It is considered by most medical professionals as a psychologically caused pain syndrome or as a psychosomatic illness. Consequently, there are orthopedists who are reluctant to be responsible only for skeletal damage but not for muscle and soft tissue pain. Many patients with fibromyalgia do not experience physiotherapy.
But fibromyalgia syndrome is more than a psychiatric pain syndrome. It was once called soft tissue rheumatism. If there is a follow-up, for example, after a stay in hospital, in addition to the somatic aftercare and mental health care is provided. Its purpose is to convince the pain-stricken patient with suitable strategies for better handling of the fibromyalgia syndrome.
In addition to mental stress but also stress and physical stress, changes in weather, cold and other factors influence the level of pain. The extent to which follow-up refers to all therapy areas that have already been treated varies individually.
Continued physical therapy, medical treatment, renewed pain therapy interventions in case of exacerbations or multimodal pain therapy with a new hospital stay are possible. In addition, those affected can do moderate sports. In addition, warm baths and water aerobics in aftercare relieve the discomfort 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 your personal preference, an affected person can choose from numerous offers. These range from autogenic training to yoga and progressive muscle relaxation.
As a result of pain management training, inner attitudes and pain perception also develop positively. With certain breathing techniques the pain can be breathe away. For example, in addition to yogic full-blown (pranayama), women may use the same technique that midwives recommend to breathe out labor pains.
Studies show that hypnosis reduces some of the disease's symptoms, including sleep problems and increased pain sensation. The willingness to accept pain grows under trance. Special directories help sufferers to find reputable hypnotherapists.
Alternative healing methods - such as Reiki and Healing Touch - improve the overall constitution. These release internal blockages, relax, reduce the sensation of pain and activate self-healing powers. Reiki can be learned by anyone and is good for self-treatment. Heat and water applications release the painfully tensed muscles.
Particularly efficient are warm full baths and a shower with soft shower head. Targeted water and damp cloths also relieve muscular discomfort. A hot water bottle, a cherry stone cushion or a red light lamp provide for a dry heat supply and also act as a muscle cramp. Targeted stretching exercises relax tense body parts sustainably.
A moderate, individually created strength and endurance training as well as a meditative movement therapy give the everyday life of fibromyalgia patients again a better quality of life.