Fibromyalgia: What is it, symptoms and treatment

Fibromyalgia; It is a rheumatic disease that occurs in the musculoskeletal system and is characterized by pain that spreads throughout the body. Although it can be seen at all ages, it is most common in middle age. Women get this disease more often than men. Closely examining the symptoms of the disease, conditions that may cause the disease, diagnosis and treatment of the disease will help us understand fibromyalgia better.

Fibromyalgia Symptoms

Fibromyalgia symptoms may vary from person to person. The most common symptoms:

• Widespread pain: It is the main symptom of fibromyalgia. Pain is felt throughout the body and may be concentrated in areas such as the back and neck. Pain may persist for a long time or get better or worse over time. Pain felt; The burning may be sharp and stinging.
• Hypersensitivity: Sensitivity to pain increases in fibromyalgia. The patient may feel pain even with the slightest touches. The duration of the pain felt with small touches and light bumps may be prolonged.
• Stiffness: Patients feel stiff and have difficulty moving, especially after staying in the same position for a long time. For example, they may have trouble getting out of bed after waking up in the morning.
• Muscle cramps: Muscles may contract tightly and painfully, causing pain.
• Fatigue: The level of fatigue may vary from person to person. It can range from mild weakness to feeling too tired to do anything.
• Impairment of sleep quality: Patients may not feel rested and relaxed even if they sleep for a sufficient time. The reason for this is that the part called deep sleep, which allows the body to renew itself, is shortened in fibromyalgia patients. This change in sleep quality may manifest itself as fatigue and distraction.
• Cognitive problems: People with fibromyalgia may experience problems in processes such as thinking and learning. Patients may have a mental state that can be described as hazy or blurry. Some symptoms may occur, such as difficulty in learning new events and remembering old events, inability to focus, and slowed speech.
• Feeling too hot or too cold: This occurs because the body cannot regulate the appropriate temperature.

Fibromyalgia can occur with some other diseases. Diseases that are frequently seen together:

• chronic headaches
• Depression/Anxiety
• Irritable bowel syndrome
• Painful bladder syndrome
• Primary dysmenorrhea (painful menstrual period)
• restless feet syndrome
• Raynaud’s phenomenon
• It can be listed as restless feet syndrome.

What causes fibromyalgia?

It is not fully clear what causes fibromyalgia. However, there are some factors known to be effective in the development of the disease.

• Changes in the nervous system: Pain sensations in different parts of the body are transmitted to the brain through specialized nerve cells. It is thought that changes in the chemicals that occur in this transmission pathway or are involved in transmission may cause fibromyalgia.
• Changes in hormone levels: Changes in the levels of hormones involved in the transmission of pain and processing processes in the brain are important in the development of the disease. The amount of serotonin, noradrenaline and dopamine hormones was found to be low in fibromyalgia patients. The hormones listed are; In addition to pain, it has been shown to be important in regulating many events such as general condition, appetite, sleep, behavior and response to stress. Decreases in this hormone level in patients; It can change not only pain but also other effects of hormones.
• Sleep disorders: Decreased sleep quality may be a symptom of fibromyalgia or its cause.
• Genetics: It is thought that some people have a genetic predisposition to the disease and that the disease occurs as a result of encountering a trigger. The fact that the disease clusters in some families strengthens this idea.

What are the factors that trigger fibromyalgia attacks?

Fibromyalgia can be triggered by physical or psychological stress. These situations:

• Trauma
• Infection
• undergo surgery
• Loss of a loved one
• It can be exemplified like separation.

What are the risk factors for fibromyalgia?

• Female gender: Fibromyalgia occurs approximately twice as often in women than in men.
• Traumatic event: Events that can lead to trauma, such as a car accident, pose a risk for disease because they are both physical and psychological stressors.
• Repetitive injuries: Repeated injuries to the same area or joint may increase the risk.
• Infection
• Having a family history of fibromyalgia: Since the disease also has a genetic component, the risk increases if there is fibromyalgia in the family and close relatives.
• Obesity

What are fibromyalgia points?

In fibromyalgia patients, pain occurs when a little pressure is applied to certain points on the body. These points are called tender points. Sensitive points are symmetrically located on the body. There are a total of 18 sensitive points, 9 on the right side and 9 on the left. Locations of these points:

• Occiput (nape)
• trapezius
• Supraspinatus (together with the trapezius, they are located in the upper back, on the medial part of the scapula close to the spine)
• Gluteal (at the upper outer part of the hip)
• Greater trochanter (located near the junction of the upper leg with the hip, near the outside)
• Neck
• Second rib (just below the point where the collarbone meets the ribs)
• Elbow (on the inner side)
• Knee (inside)

It is in the form.

Sensitive points; These are important indicators used to distinguish fibromyalgia from other rheumatic diseases that cause similar pain.

How is fibromyalgia diagnosed and treated?

There is no specific test to diagnose fibromyalgia. Imaging methods do not give clues about the disease. In order to make the diagnosis, it is necessary to rule out other diseases that may cause symptoms. Blood tests or biochemical tests may be requested to evaluate the general condition of the patient and to investigate the presence of possible patients. Although the presence of tender points is not used as much in diagnosis as before, the presence of these points brings the physician closer to the diagnosis of fibromyalgia. Chronic pain, which is commonly described as occurring on both sides of the body and lasting longer than 3 months, is diagnosed as fibromyalgia unless another cause is found. When diagnosing fibromyalgia, other syndromes with which the disease may coexist should be taken into consideration, and if necessary, examinations related to the relevant syndrome/disease should be performed.

Fibromyalgia is a disease that cannot be completely treated. Full recovery is not expected in patients. Treatment is given to treat symptoms and improve quality of life.

Medicines used for treatment:

• Painkillers: Ibuprofen and acetaminophen group drugs can be used for fibromyalgia pain.
• Antidepressants: Medicines containing active ingredients such as duloxetine and milnacipran are used in the treatment of both pain and fatigue. It also positively affects sleep quality.
• Antiepileptics: Effective in relieving neuropathic pain.
• Muscle relaxants: These are agents used for patients with muscle cramps.
• Sleeping pills: Since fibromyalgia is a disease that negatively affects sleep quality, these pills ensure that the person gets enough sleep. It may be effective in eliminating symptoms such as fatigue caused by disrupted sleep patterns.

In addition to medical treatment, lifestyle changes and some therapies have been shown to be effective in relieving the symptoms of fibromyalgia patients. These:

• Sitting in warm/hot water, also known as hydrotherapy, swimming
• Activities with personalized exercise programs
• With psychotherapy, patients are relieved by explaining their situation and sharing their feelings.
• relaxation techniques
• It can be considered as group therapies.

Methods such as acupuncture, aromatherapy and massage are also tried methods for fibromyalgia treatment. However, there are not enough studies to show that they are effective.

One of the points that should not be overlooked in the treatment is that other diseases that may coexist with fibromyalgia should also be treated. Skipping the treatment of these diseases in addition to fibromyalgia may cause fibromyalgia treatment to fail.

Even if full recovery cannot be achieved in fibromyalgia, many solutions such as reducing pain during attacks and eliminating the trigger factor contribute to improving the patient’s quality of life. Patients; People should not see fibromyalgia as insoluble and become hopeless, and should increase their standard of living by receiving appropriate treatment, both medically and with various therapies.

If you have long-term pain that you feel widely throughout your body, we recommend that you go to the nearest health institution.