Fibromyalgia is a chronic condition that causes muscle pain, stiffness, and numbness in muscles, tendons, and joints.
Fibromyalgia is characterized by sleep disturbances, feeling tired upon awakening, chronic fatigue, anxiety, depression and intestinal complaints.
An outdated term is fibrositis.
Primary fibromyalgia (which is not caused by another disorder) is one of the most common conditions that affects the muscles and leads to chronic disability and pain, but the cause is still unknown.
The affected painful tissues do not have acute inflammation.
Therefore, and although the pain can lead to potential disability, patients with fibromyalgia do not develop lesions or deformities.
This disease does not cause damage to the internal organs of the body.
In this sense, fibromyalgia is very different from other rheumatic diseases (such as rheumatoid arthritis, systemic lupus erythematosus, and polymyositis). In these diseases, tissue inflammation is the main cause of pain, stiffness and numbness of the joints, tendons and muscles and can lead to deformation of the joints, as well as damage to muscles and internal organs.
The emotional price is very high
In addition to the daily battle with pain, patients with fibromyalgia may be forced to fight another battle to convince doctors, friends, colleagues, and others that their condition is real and the pain is not imaginary.
Women are disproportionately more likely than men to suffer from fibromyalgia, the symptoms are complex and there is no treatment for it.
For these reasons, many patients and some doctors say fibromyalgia is not always recognized and treated in the United States.
In 2007, in a study of more than 2,000 fibromyalgia patients, over a quarter reported that their doctor did not perceive fibromyalgia as a “real” condition.
The situation has improved because in 2007 the Food and Drug Administration approved a drug for fibromyalgia: pregabalin (Lyrica). But patients still have to withstand this challenge.
Why do you feel pain?
Doctors consider a theory called central sensitization to be credible.
This theory states that people with fibromyalgia have a low pain threshold because of the brain’s increased sensitivity to pain signals.
Scientists believe that repeated nerve stimulation leads to changes in the brain in people with fibromyalgia.
These changes lead to an abnormal increase in the concentration of certain chemical substances in the brain that conduct pain signals (neurotransmitters).
In addition, the pain receptors of the brain seem to develop a kind of pain memory. As a result, they become more sensitive and this means that they can react excessively to pain stimuli.
Causes of fibromyalgia
Doctors do not know the cause of fibromyalgia, but it is possible that there are a number of factors that work together.
- Genetics. Since fibromyalgia mainly affects people from the same family, genetic mutations may be present that promote the development of this disorder.
- Infections. Some infections seem to trigger or worsen this condition.
- Way of life. Poor diet and lack of exercise are the most likely and common causes of fibromyalgia.
- Physical and emotional trauma. Post-traumatic stress disorder is associated with fibromyalgia.
Risk factors for fibromyalgia include:
- Gender. This disorder is diagnosed much more often in women than in men. The female reproductive hormones may play a role in the onset of pain.
- Family history. There is a greater chance of developing fibromyalgia if a relative already has this condition.
- Rheumatic disease. People who have a rheumatic condition, such as rheumatoid arthritis or lupus, are more likely to be affected by fibromyalgia syndrome.
How to recognize the disease? Symptoms of fibromyalgia
The main symptom of fibromyalgia is chronic and diffusely distributed pain in the body.
Most people with fibromyalgia suffer from:
- fatigue, which can be mild to extreme, drowsiness and insomnia,
- Disturbances of equilibrium
- blurred vision,
- impaired sensitivity to hot and cold or altered heat perception,
- hypersensitivity of the skin, hearing, eyes and sense of smell,
- Fasciculations: these are fast, rhythmic and unwanted muscle twitches,
- Light intolerance (photophobia), especially to objects such as PC monitor, TV, etc.
Many people also suffer from other symptoms and diseases at the same time, such as irritable bowel syndrome, lupus and arthritis.
Pain. The pain of fibromyalgia is profound, chronic and diffuse.
The patient may have back pain, neck pain, lumbar pain, and arm or leg pain.
The pain in fibromyalgia syndrome is described as stabbing, deep, throbbing or spasmodic.
Often neurological disorders such as numbness, tingling and burning occur, which join the patient’s complaints.
The intensity of pain and stiffness are strongest in the morning.
Factors that increase pain include moist cold, non-restful sleep, physical and mental fatigue, excessive physical activity, physical inactivity, anxiety and stress.
Fatigue. In today’s world, many people complain of fatigue. However, the fatigue of fibromyalgia is much more stressful than that which one feels after a particularly strenuous day or after a sleepless night.
The fatigue associated with fibromyalgia can be severe and can interfere with professional, personal, social, or educational activities.
Symptoms are: extreme fatigue and lack of resistance.
Many patients with fibromyalgia also have a sleep disorder that makes deep, restful and regenerating sleep impossible.
Sleep. Medical researchers have found special abnormalities in phase 4 of deep sleep in patients with fibromyalgia syndrome.
People with fibromyalgia have sleep interrupted by spikes in brain activity. They wake up as soon as they reach the deep sleep phase, limiting the time they sleep well.
Other concomitant diseases that cause additional symptoms: irritable bowel and irritable bladder, headache and migraine, mild fever, restless legs syndrome (periodic movement disorders of the limbs), concentration and memory disorders, skin rashes, dry eyes and dry mouth, anxiety, depression, chills, tinnitus (ringing in the ears), dizziness, blurred vision, Raynaud’s syndrome, neurological symptoms and impaired coordination.
Many women report that the symptoms of fibromyalgia intensify in the premenstrual phase and become lighter when the menstrual cycle is over.
This explosion of symptoms is likely to be the result of hormonal changes.
Diagnosis of fibromyalgia
The doctor to turn to is the rheumatologist, who will perform a physical examination and prescribe instrumental examinations if he deems it necessary.
Blood tests are done to rule out other serious illnesses. Antinuclear antibodies (ANA), rheumatoid factor (RF), sedimentation rate of erythrocytes (red blood cells) (BKS), prolactin levels, calcium levels and vitamin D levels are examined.
The doctor checks to see if the symptoms meet the diagnostic criteria for fibromyalgia created by the American College of Rheumatology.
These criteria include diffuse pain that persists for at least three months. Diffuse complaints are pain that occurs right and left on both sides of the body, both above and below the waist, on the chest, neck and back of the body.
The criteria also include the presence of tender points at different body points.
The doctor assesses the severity of symptoms associated with fatigue, sleep disturbances and mood swings. This helps to gauge the impact of fibromyalgia on the mind and body and on quality of life in general.
For the diagnosis of fibromyalgia, pain and numbness must occur in at least 11 out of 18 points in the special zones, including:
- Arms (elbows)
- Lower back
- Gluteal muscle
Most people who suffer from fibromyalgia are adults, but the condition can also occur in young people (for example, from 18 to 20 years old) or in pregnant young women.