Fibromyalgia: information and specialists

15.11.2023
Leading Medicine Guide Editors
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Leading Medicine Guide Editors

Everyone has probably experienced sore muscles at some point. Muscle pain can occur in very different ways. If the pain lasts for an unusually long time and is accompanied by general and non-specific symptoms, it may be fibromyalgia.

The disease, which has not yet been fully researched, is also known as fibromyalgia syndrome (FMS), generalized tendomyopathy or literally translated as fibre-muscle pain. It is a non-inflammatory disease and is one of the rheumatological diseases. However, it is not the same as rheumatism.

Here you can find out more about fibromyalgia and find selected fibromyalgia specialists for treatment.

ICD codes for this diseases: M79.7, M79.9

Recommended specialists

Brief overview:

  • What is fibromyalgia? Fibromyalgia is fiber-muscle pain, which in a broader sense is a rheumatological disease.
  • Symptoms: Hardened muscles, muscle pain, painful joints, pain in other parts of the body; plus non-specific complaints such as tiredness, exhaustion, sleep and concentration problems and others.
  • Causes: Doctors assume that the combination of several risk factors triggers the disease. These include genetic predisposition, some autoimmune and rheumatological diseases, tumors, infections, injuries, operations and others.
  • Diagnosis: The doctor examines the pain pressure points in 18 different areas of the body. If at least 11 of them have been responding to pressure for more than three months and the laboratory values are still unremarkable, the disease is diagnosed.
  • Treatment: The focus is on treating the symptoms in order to enable the person affected to lead a normal life. This includes regular exercise, but also relaxation techniques, sometimes psychotherapy and the temporary administration of medication.

Article overview

Symptoms of fibromyalgia

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.

Erschöpfung als Symptom
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.

Causes of fibromyalgia

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.

Diagnosis 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 :

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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.

Treatment of fibromyalgia

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.).

Bewegung und Ausdauertraining
© 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 specialists - training and qualifications


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.

References

https://www.fibromyalgie-fms.de/
https://schmerzliga.de/fibromyalgie.html
https://www.dgss.org
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