As a disease of the soft tissue, fibromyalgia syndrome (ICD code M79.70) is characterized by the following symptoms
- hardened muscles,
- muscle pain,
- painful joints,
- pain in other parts of the body (for example the back).
In addition, non-specific complaints such as
- fatigue,
- physical and mental exhaustion,
- sleep problems and
- concentration problems
can occur.
Some patients also experience psychological (nervousness, restlessness, loss of drive, etc.) and physical complaints(irritable bowel syndrome, irritable bladder, etc.). Increased sensitivity to certain stimuli (light, noise, smell) also occurs occasionally.
Andrey Popov / Fotolia
In the western world, around 3-4% of the population are affected by this chronic condition, mainly women between the ages of 40 and 60. The symptoms are chronic if they persist for at least 3 months.
The severity of the symptoms can vary greatly from patient to patient. Some show hardly any symptoms. In others, however, the disease takes a more severe course with severe pain and significant impairment.
The causes of fibromyalgia are not yet fully understood. However, it is assumed that not just one cause is needed for fibromyalgia syndrome to develop. Rather, a combination of different factors - biological, psychological and social - is thought to be responsible for the development of FMS.
As the disease occurs more frequently in some families, genetic predisposition appears to play a certain role. However, certain diseases are also thought to promote the development of fibromyalgia syndrome:
- Autoimmune diseases
- Rheumatologic diseases
- tumors
- infections
Injuries and operations are also suspected of triggering the disease. Smoking, obesity and a lack of physical activity, physical and sexual abuse and stress also increase the likelihood of fibromyalgia.
In addition to the personal medical history (anamnesis), the physical examination is particularly important for the diagnosis of fibromyalgia. The doctor uses pressure points(trigger points or tender points) to check whether the muscles and attachment points of tendons are painful (tenderness). These pain pressure points are located on
- Neck,
- back,
- shoulders,
- arms,
- legs and
- hips.
The video shows the principle of trigger point treatment :
If at least 11 of the total of 18 pressure points react painfully to pressure and have done so for more than three months, fibromyalgia is likely. This is particularly true if the laboratory values are unremarkable. Imaging examinations (such as X-rays) are not usually carried out if fibromyalgia is suspected, at most to rule out other diseases.
The primary contact for patients with symptoms that indicate fibromyalgia is the family doctor. At the latest, however, if there is a suspicion that an
- internal (e.g. inflammatory rheumatic disease),
- orthopaedic (e.g. joint wear and tear, arthrosis),
- neurological (e.g. muscle disease) or
- psychological disorder
is responsible for the symptoms, the affected person should consult a specialist for more detailed clarification. This may be a rheumatologist, neurologist, orthopaedist or internist, for example.
There is no causal treatment for fibromyalgia. Fibromyalgia therapy therefore focuses on alleviating the symptoms and maintaining or improving the patient's ability to function in everyday life. This should also improve the patient's quality of life .
Patients with mild forms of fibromyalgia syndrome should exercise regularly (endurance training); further treatment is then usually not necessary. In more severe forms, drug therapy is also used for a limited period in addition to body-related therapies. Typical fibromyalgia medications are antidepressants and anticonvulsants.
Body-related therapies include
- Endurance training,
- functional training,
- strength training with stretching exercises and
- relaxation techniques (Tai Chi, Qi Gong, yoga, Feldenkrais, etc.).
© elnariz / Fotolia
Although pain is the dominant symptom of fibromyalgia, painkillers or anti-inflammatory substances are usually ineffective. This is because fibromyalgia is not an inflammatory disease. This is why psychotherapy and exchanges in self-help groups are particularly important. Here, patients learn how to cope better with the pain and thus with the disease.
If patients make no progress despite these measures, multidisciplinary and multimodal treatment may be considered. In addition to the treatment of accompanying mental illnesses, this also includes
- body-related therapies and
- physical measures and
- psychotherapeutic and
- drug therapies
are used.
Fibromyalgia syndrome is a complex clinical picture. Several specialists are often involved in the diagnosis and treatment.
A good point of contact if fibromyalgia is suspected is a rheumatologist. Rheumatologists deal with the diagnosis and treatment of diseases that are classified as rheumatic. In addition to polyarthritis, this also includes fibromyalgia. A rheumatologist can be an internist with an additional qualification in rheumatology or an orthopaedist with additional training in rheumatology.
Pain therapists play a particularly important role in the treatment of fibromyalgia. For a long time, there was no official training for pain therapists in Germany. However, since the end of the 1990s, doctors have been able to complete further training and then use the additional title of "special pain therapy". Pain therapists are specially trained in the areas of pain anamnesis, pain analysis and the use of pain therapy procedures.