Fibromyalgia – causes, symptoms, treatment. Living with fibromyalgia

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To była mało znana, zaliczana do schorzeń reumatycznych, choroba. Teraz zrobiło się o niej głośno, bo Lady Gaga przyznała, że na nią cierpi. Jakie są objawy fibromialgii? Rano budzisz się wyczerpany, zesztywniały i obolały. Zawodzi cię pamięć, a ból w całym ciele pojawia się na zmianę z innymi dolegliwościami. Szukasz pomocy u lekarzy różnych specjalności, ale wszystko na nic. To może być hipochondria, przewlekłe zmęczenie, stres lub FMS.

Fibromyalgia is a chronic non-inflammatory rheumatic disease of soft tissues – this is the full medical name of the disease. But before such a diagnosis is made, the patient is often treated like a hysterical. It also happens that when the patient says that everything hurts, the doctor spreads his hands helplessly. Because how to treat such a sick person? The annoyance of both sides grows when the recommended tests do not explain anything and the treatment does not make you feel better.

Fibromyalgia – symptoms

The most troublesome symptom of fibromyalgia is pain. It may cover a fragment or the whole body. It usually starts in the area of ​​the lower back where it radiates down the spine to the back of the head, to the shoulders, elbows and hands. It goes down to the hips as well as to the knees and ankles. The jaws and chest may hurt. Pains in the tissues surrounding the joints (periarticular tissues), i.e. in tendons, muscles and ligaments, are characteristic. The more the patient rests, the stronger the pain. Movement brings relief quickly. Pain takes many forms – it grows and decreases, it can be deep, throbbing, prickly. Often you feel numbness or tingling, and in the morning the so-called muscle stiffness. The pain you experience overlaps with areas of tenderness traditionally known as trigger points or pain points.

But there are other ailments as well. Fatigue can be so severe that it makes it impossible to perform the simplest activities and often leads to a reduction in independence. Insomnia is equally troublesome because it does not allow you to regenerate. The brain of sick people is constantly active, which is the result of inappropriate secretion of malatonin, cortisol and DHEA. Other symptoms that torment patients are intestinal and bladder oversensitivity, migraine-like headaches, restless leg syndrome, memory and concentration disorders, skin hypersensitivity, rash, dry eyes and mouth, anxiety, depression, ringing in the ears, dizziness, visual disturbances and coordination. Patients have cold hands and feet and complain about an obstruction in the throat. It happens that they experience uncontrolled, rapid breathing, palpitations even at rest, abdominal distension, stomach discomfort, constipation or a tendency to diarrhea, and frequent urination. Some people find that the “mental haze” (trouble concentrating, constant alertness, and mental fatigue) caused by fibromyalgia is more annoying than physical pain.

Also read: The world’s strangest diseases

Fibromialgia – punkty spustowe

In the past, a person has been diagnosed with fibromyalgia if they have had extensive pain and tenderness in at least 11 of the 18 specific points around their body. Healthcare professionals would check how many of these points were painful by pressing hard on them.

Common trigger points included:

1. back of the head;
2. arms;
3. górna część klatki piersiowej;
4. outer part of the elbows;
5. hips;
6. knees.

Most trigger points are no longer part of the diagnostic process.

Fibromyalgia from

Pain is a characteristic symptom of fibromyalgia. The person feels it in a variety of muscles and other soft tissues around the body, and the pain can range from mild pain to intense and almost unbearable discomfort. Its severity can dictate how well the patient is doing day-to-day. The following are distinguished in the course of fibromyalgia:

Fibromyalgia and chest pain

When fibromyalgia pain occurs in the chest it can be similar to the pain following a heart attack. The chest pain in fibromyalgia is concentrated in the cartilage that connects the ribs to the sternum. Pain can radiate to the arms and shoulders.

Chest pain may be sharp, stabbing, or burning. Sometimes you may also feel pain as if you are struggling to breathe, which is also a symptom of a heart attack.

Fibromyalgia and back pain

The back is one of the most common places where a person with fibromyalgia will experience pain. Most people suffer from low back pain at some point in their lives. If your back hurts, it may not be clear whether fibromyalgia is to blame or whether it is another condition such as arthritis or a strained muscle. Other symptoms, such as brain fog and fatigue, may point to fibromyalgia as the cause. It is also possible to combine fibromyalgia and arthritis. The same medications a person is taking to relieve other symptoms of fibromyalgia may also help with back pain. Stretching and strengthening exercises can help support the muscles and other soft tissues of the back.

Fibromyalgia pain

The patient may experience fibromyalgia in the muscles and soft tissues of the legs. The pain in the legs from fibromyalgia can be similar to stiff joints or soreness in a stretched muscle. The pain can be described as deep, burning or throbbing.

Sometimes the patient feels numbness or tingling in the legs. An uncontrolled urge to move your legs is a sign of Restless Legs Syndrome that may overlap with fibromyalgia. Fatigue sometimes manifests itself in the legs as well. The limbs may appear heavy, as if some huge weights are attached to them.

Fibromialgia – czynniki ryzyka

The available studies have still not identified the exact cause of fibromyalgia. The factors that may increase the risk of its development are very diverse.

1. Sex. Most cases of fibromyalgia are now diagnosed in women, but the reason for this difference is not clear.
2. Age. Najczęściej fibromialgia zostaje zdiagnozowana w średnim wieku, a ryzyko wzrasta wraz z wiekiem. Dzieci również mogą rozwinąć fibromialgię.
3. Family history. If we have close family members with fibromyalgia, we may be more likely to develop it.
4. Other illnesses and conditions in the past. Although fibromyalgia is not a form of arthritis, rheumatoid arthritis (RA) can increase the risk of developing fibromyalgia. Fibromyalgia also affects about 30 percent of people with lupus.

Fibromyalgia – why do we get sick?

This is still unknown. About 3-6 percent suffer from fibromyalgia. population. In Poland, it is about 1,2-2,4 million people affected by this ailment. They are usually women between 35 and 55 years of age, but the disease can appear at any age, even in children.

Initially, there are no symptoms, and an avalanche of discomfort is triggered by trauma or inflammation. Most doctors agree that patients feel more pain because of incorrect processing of sensory inputs in the central nervous system. Detailed studies show many abnormalities in the functioning of the body, for example, increased levels of substance P (a neuropeptide released from nerve fibers) in the spinal cord, low blood flow around the thalamus, low levels of serotonin. Some people blame the development of the disease on a genetic predisposition. Scientists believe that certain gene mutations may play a role in causing fibromyalgia. They identified several possible genes that influence the transmission of chemical pain signals between nerve cells.

But it is also known that the disease develops more often in people who have lost their parents at a young age, have been harassed or beaten by their caregivers (fibromyalgia has been linked to post-traumatic stress disorder, or PTSD); also in those who have had congenital or acquired changes in the spine or joints. Like a trauma, stress can have long-lasting effects on the body. Stress has been linked to hormonal changes that may contribute to fibromyalgia.

A previous illness may cause fibromyalgia or worsen its symptoms. Infections that may be related to fibromyalgia include the flu, pneumonia, Epstein-Barr virus, and gastrointestinal infections (such as those caused by Salmonella and Shigella).

See also: Appearance, intelligence or disease tendency? What do we inherit from our mother’s genes?

Fibromyalgia and autoimmune diseases

In autoimmune diseases such as RA and lupus, the body mistakenly attacks its own tissues. The immune system uses proteins called autoantibodies to attack joints or other healthy tissue in the same way it would normally attack viruses or bacteria. It is normal to have a small number of autoantibodies, but high levels could indicate an autoimmune disease.

Autoimmune diseases and fibromyalgia have some overlapping symptoms, such as fatigue and trouble concentrating. It can be difficult for doctors to determine if a patient has an autoimmune disease or fibromyalgia. A sick person may even have both kinds of conditions at the same time. Moreover, the overlap of symptoms has led to the theory that fibromyalgia may also be an autoimmune disease.

This claim has been difficult to prove, partly because there is little evidence that autoantibodies are involved in fibromyalgia. Fibromyalgia also does not traditionally cause inflammation. Inflammation is a common symptom of autoimmune diseases.

However, a 2021 study published in the Journal of Clinical Investigation found that autoantibodies may still contribute to fibromyalgia. In the study, researchers injected mice with autoantibodies from people with or without fibromyalgia. Mice injected with autoantibodies from people with fibromyalgia began to experience fibromyalgia-like symptoms, such as decreased muscle strength and increased sensitivity to painful sensations (such as a cold). Mice injected with autoantibodies from healthy humans had no symptoms.

Another study in the same year, published in Frontiers in Immunology, found a link between fibromyalgia and an inflammatory autoimmune disease, Sjögren’s syndrome. According to data collected between 2000 and 2012, people with fibromyalgia were twice as likely to develop Sjögren’s syndrome as people without fibromyalgia.

If fibromyalgia is an autoimmune disease, treating autoimmune diseases can also potentially help treat fibromyalgia. However, more research is still needed on this topic.

Also read: Koronawirus może sprawić, że nasz organizm zaczyna atakować sam siebie

Fibromyalgia – diagnosis

Diagnosis is difficult because the disease has many faces. It can be said that each patient has it differently. Fibromyalgia can occur alone or with other conditions.

A characteristic symptom of the disease is tenderness in the so-called sore points. Their sensitivity is measured with a special device – a dolorimeter. The doctor presses on certain areas of the body and gradually increases the intensity to tell when the feeling of pressure is turning into pain. The device measures electronically and mechanically.

The diagnosis is made (after a thorough interview with the patient) according to criteria developed by the American Rheumatological Union. In order for the doctor to be able to say that we suffer from fibromyalgia, we must meet two basic conditions:

1. Pain must be widespread (extensive) in all parts of the body (called quadrants) and last for at least three months.

2. Pain or tenderness must appear after compression of at least 11 of the 18 characteristic points.

Fibromyalgia in women

According to the Centers for Disease Control and Prevention (CDC), fibromyalgia occurs twice as often in women as in men. Studies have traditionally shown that at least 80 to 90 percent of fibromyalgia cases are diagnosed in women, according to a 2018 study on fibromyalgia misdiagnosis. However, fibromyalgia may be underdiagnosed in men. Fibromyalgia symptoms were generally more severe in women than in men. Women have more extensive pain and symptoms of irritable bowel syndrome (IBS).

Ponadto przejście w menopauzę może pogorszyć fibromialgię. Sprawę komplikuje fakt, że niektóre objawy menopauzy i fibromialgii wyglądają niemal identycznie.

See also: The most common cancers among Polish women. The situation worsened after the pandemic

Fibromialgia u mężczyzn

Men may have fibromyalgia but may go undiagnosed as the condition is viewed as predominantly female. It is commonly believed that at least 80 to 90 percent of fibromyalgia cases affect women. After re-analyzing the data from the German study, the researchers found that women accounted for only 59,2% of fibromyalgia cases. This means that 40,8 percent of the cases were male.

Men with fibromyalgia may experience severe pain and emotional symptoms. The condition can affect quality of life, career, and relationships, according to a 2018 study published in the American Journal of Men’s Health. Part of the stigma and difficulty in making a diagnosis stem from society’s expectation that men who suffer should “pull themselves together”. People who visit a doctor may experience emotional discomfort and the risk that their complaints will not be taken seriously.

See also: Seven genetic diseases that mainly affect men

Fibromyalgia – treatment

No drug can overcome fibromyalgia. Instead, treatment focuses on reducing symptoms and improving quality of life through medications, self-care strategies, and lifestyle changes. However, some measures can, if used correctly, provide significant relief. This group includes anti-depressants such as duloxetine and milnacipran, which are sometimes used to treat pain and fatigue caused by fibromyalgia. These drugs can also act to restore the balance of neurotransmitters and improve sleep quality.

Most often, however, patients take painkillers, although their effectiveness is modest. If the pain is mild, patients use over-the-counter painkillers, such as paracetamol, aspirin, ibuprofen, and naproxen. These medications can lower your pain levels, reduce discomfort, and help you manage your condition better. They can even help you sleep better. Many of them also reduce inflammation. Although inflammation is not the main symptom of fibromyalgia, you may experience it if you have a related condition such as rheumatoid arthritis (RA).

Dlatego też, chorzy sięgają po niesteroidowe leki przeciwzapalne, ale te łagodzą ból u mniej niż 1/4 chorych. Należy pamiętać, że niesteroidowe leki przeciwzapalne (NLPZ) mają skutki uboczne. Zaleca się ostrożność, jeśli NLPZ są stosowane przez dłuższy czas, jak to zwykle ma miejsce w przypadku radzenia sobie z przewlekłym bólem.

Opioids are also prescribed for pain relief. However, studies have not shown their effectiveness over time. In addition, their dosage is usually increased sharply, which can pose a health risk to people taking these drugs. Tramadol is one of the opioids most closely associated with the relief of fibromyalgia. However, some experts do not consider it a traditional opioid, and any possible benefit for fibromyalgia may be due to the fact that it is also a serotonin-norepinephrine reuptake inhibitor (SNRI). According to a study published in the International Journal of Clinical Practice in 2020, there is insufficient evidence to support or oppose the use of tramadol in fibromyalgia. More opioid research is needed on this topic.

Muscle relaxants have the desired effect also in a few patients. Sedatives and sleeping pills are related to these substances, but we quickly get addicted to them.

Also read: Adverse drug reactions

How to deal with fibromyalgia?

So there is no effective treatment for fibromyalgia patients?

The answer is very difficult because the success of therapy depends on lifestyle changes. The doctor must teach him to treat his body differently. If possible, you should eliminate monotonous activities from life or spread them over time. Repeating the same actions increases the tension in muscles and tendons, and therefore can cause pain. The same applies to housework or hobbies, e.g. knitting will be painful.

It is extremely important to relax and unwind. You can choose one way to relax and use it regularly. Some patients are helped by isometric exercise, which also tolerates stress, which is very dangerous for patients with fibromyalgia.

Oto kilka poradników, które mogą pomóc Ci lepiej radzić sobie ze stresem:

1. Dagmara Gmitrzak — «Trening relaksacji. Jak uwolnić się od stresu, lęku i depresji» (porównaj ceny)
2. Andy Collins – »Overcome your stress. Treatment of stress with the four equilibrium method »(compare prices)
3. Doron Hanoch – «Yoga, Ayurveda, breathing techniques. The most effective methods to relieve stress, restore balance and a healthy life »(compare prices)

Movement is an irreplaceable medicine. Gymnastics should always start with a gentle warm-up. Proper exercise must be adapted to individual fitness. It can be said that you should exercise as much as your body allows. It can be very difficult at first, but over time you find that regular training reduces pain. Relief is also brought by well-chosen physical therapy (mainly TENS or transcutaneous electrical nerve stimulation), cryotherapy, heat treatment, massage, acupuncture, hydrotherapy and a balanced, nutrient-rich diet.

Living with a chronic disease is always a challenge. The sick person must have the psychological support of family and friends. It is worthwhile for the relatives to raise the patient’s self-esteem, help them fight stress and avoid conflicts. Therapy to help the person cope with stress may be a good idea. Particularly, group therapy may be the cheapest option and can give you a chance to get to know others who are having the same problems. Cognitive Behavioral Therapy (CBT) is one of the ways to cope with stressful situations.

It should be noted that most alternative treatments for fibromyalgia have not been thoroughly studied or proven to be effective. It’s best to ask your healthcare professional about the benefits and risks before trying some of these treatments.

See also: What are the types of psychotherapy? Indications for a visit to a psychotherapist [WE EXPLAIN]

Fibromyalgia – alternative therapies

Uzupełniające i alternatywne terapie radzenia sobie z bólem i stresem nie są nowe. Niektóre, takie jak medytacja i joga, były praktykowane od tysięcy lat. Jednak w ostatnich latach ich stosowanie stało się bardziej popularne, zwłaszcza u osób cierpiących na choroby przewlekłe, takie jak fibromialgia.

Several of these therapies appear to safely relieve stress and reduce pain, and some are gaining acceptance in mainstream medicine. However, many practices remain unproven because they have not been adequately researched.

Acupuncture. Acupuncture is a Chinese medical system based on restoring the proper balance of life forces by sticking very thin needles into the skin at different depths. According to Western acupuncture theories, needles cause changes in blood flow and the levels of neurotransmitters in the brain and spinal cord. Some studies show that acupuncture helps relieve symptoms of fibromyalgia, while others say acupuncture treatments are of no benefit.

Massage. It is one of the oldest health care methods still in use. It involves the use of various manipulative techniques to move the muscles and soft tissues of the body. Massage can reduce heart rate, relax muscles, improve joint range of motion, and increase the body’s production of natural painkillers. It often helps relieve stress and anxiety.

Yoga and tai chi. Praktyki te łączą medytację, powolne ruchy, głęboki oddech i relaksację. Oba okazały się pomocne w kontrolowaniu objawów fibromialgii.

Diet for fibromyalgia

Some people with fibromyalgia report that they feel better when they follow a certain diet plan or avoid certain foods. However, studies have not proven that any diet alleviates fibromyalgia symptoms.

If a patient has been diagnosed with fibromyalgia, he or she may generally follow a balanced diet. Nutritious foods provide a constant supply of energy and help keep your body healthy. They can also help prevent your symptoms from getting worse.

A few eating strategies to keep in mind.

1. Eat fruits and vegetables, as well as whole grains, low-fat dairy products, and lean protein.
2. Jeść więcej roślin niż mięsa.
3. Drink lots of water.
4. Reduce the amount of sugar in your diet.

You can also incorporate regular exercise into your daily routine and work to achieve and maintain a healthy weight (studies have shown that people with fibromyalgia and obesity have shown improvements in quality of life and pain symptoms after losing weight).

You may find that certain foods or substances, such as gluten or monosodium glutamate (MSG), make your symptoms worse. If that’s the case, it’s best to keep a diary to keep track of what you are eating and how you feel after each meal. It’s a good idea to share these notes with your doctor. It can help identify foods that make our symptoms worse.