Fibromyalgia

Fibromyalgia is a chronic pain disorder that is expressed through pain in various parts of the body. Those affected may find that their skin, muscles or joints are painful. Other symptoms such as sleep disorders, fatigue and concentration problems can also occur. Fibromyalgia is also known as fibromyalgia syndrome or FMS.

Fibromyalgia is not dangerous – the organs are healthy and it does not affect life expectancy.

Fibromyalgia primarily causes chronic, dull muscle pain in various parts of the body. The pain often feels like a pulled muscle or intense muscle ache.

It is frequently unpredictable and can change from one day to the next. For example, the intensity of the pain can vary or it can occur in different parts of the body. This makes it difficult for people with fibromyalgia to make plans – including for everyday activities like shopping or day trips.

Some people find that the pain recedes for a few hours each day, enabling them to get things done during that time.

Other typical symptoms are poor, unrestorative sleep, tiredness and exhaustion. Many people with fibromyalgia also sometimes struggle to think clearly, remember things, find their words or concentrate. This is known as “fibro fog”.

If people have fibromyalgia, their brain’s ability to process pain is disrupted. This means that their threshold for perceiving stimuli as pain is lower than in other people.

The condition is thought to be caused by multiple factors. It is believed to be triggered by both genetic and physical or psychological factors. These lead to the body processing pain differently.

Fibromyalgia is often referred to as soft-tissue rheumatism but this term is misleading as the pain does not originate from soft tissue (e.g. muscles) and is not caused by a rheumatic condition. What’s more, soft-tissue rheumatism is a generic term for various health conditions and not a condition in its own right.

Further information about fibromyalgia, including what is known about its development, can be found at gesundheitsinformation.de.

According to a representative study about 2 percent of adults in Germany suffer from fibromyalgia.

The condition is usually diagnosed between the ages of 40 and 60, with women more commonly affected than men. However, it is also possible for children, adolescents and young adults to present fibromyalgia symptoms.

Fibromyalgia usually begins inconspicuously and develops over a long period. Many people have diffuse pain or other pain disorders for a long time before being diagnosed with fibromyalgia. Potential symptoms include irritable bowel syndrome, back, neck and jaw pain as well as headaches. Women can also experience severe period pain, endometriosis or chronic bladder inflammation (interstitial cystitis).

Some people affected already had frequent headaches, stomach aches, muscle ache or joint pain as children or adolescents.

The symptoms of fibromyalgia and the way it progresses can differ greatly. Phases of severe pain can alternate with almost symptom-free ones.

A large study of people with fibromyalgia that lasted for more than 10 years found that the symptoms improved slightly in 25 percent of the participants and significantly in 10 percent. However, most people’s symptoms remained unchanged over the long term.

In addition, many people with fibromyalgia also have other physical conditions such as rheumatoid arthritis or mental conditions such as anxiety disorders or depression.

It often takes several years for fibromyalgia to be diagnosed as the clinical picture is extremely complex.

As the pain begins gradually or even only affects a single area of the body, doctors often initially think that it is something else. Furthermore, as fibromyalgia cannot be confirmed by either laboratory tests or X-rays, many doctors are reluctant to give this diagnosis. This can lead to misdiagnosis and a lack of understanding.

Patients often feel that they are not being taken seriously. Many also feel that their doctor believes they are imagining the pain. Fibromyalgia is often only diagnosed in a rheumatological practice or pain management clinic.

To make a diagnosis, a detailed doctor-patient consultation and a physical examination are required. If in the 3 months prior to the examination, pain has occurred in at least 7 out of 19 defined areas of the body, this could indicate fibromyalgia. The body areas in question include the chest and abdomen, back, jaw, shoulders, upper and lower arms, hips, thighs and calves – on both sides of the body. A “fibromyalgia symptom questionnaire” can help describe the symptoms.

Other symptoms must also occur, such as:

• concentration problems
• exhaustion
• feeling tired first thing
• stomach pain or cramps
• headaches
• depression

To be a sign of fibromyalgia, these additional symptoms have to reach a certain level of severity and have persisted alongside the pain for at least 3 months.

To determine whether the symptoms are actually caused by something else, medical societies recommend a thorough analysis of the person’s medical history, various blood tests and a physical examination. This makes it possible to rule out other possible causes such as rheumatoid arthritis, hypothyroidism, muscle disorders and mental disorders.

Many people with fibromyalgia refrain from physical activity for fear of exacerbating the pain or overdoing things. However, studies have shown that exercise and low-intensity sports like cycling or walking can be good for people, strengthen the body and alleviate the pain somewhat. This explains why exercise is an important aspect of the treatment.

Medication can significantly alleviate fibromyalgia pain for some people. Studies have proven the efficacy of amitriptyline, duloxetine, milnacipran and pregabalin. Conventional painkillers such as diclofenac, ibuprofen and paracetamol are usually advised against.

Certain physical therapies, in particular thermal baths, are often found to be pleasant. Some people with fibromyalgia also find sauna sessions or gentle massages beneficial.

Multimodal pain therapy can sometimes be helpful, especially in the case of severe symptoms. This treatment combines exercise, relaxation and pain management techniques used in cognitive behavioral therapy (CBT).

CBT and other psychotherapeutic procedures can help those affected to better deal with their condition. Multimodal pain treatment can also include the use of medication. 

What people with fibromyalgia find beneficial and how they deal with their condition can differ greatly. It is therefore important to develop personal strategies for managing the condition. This primarily means finding ways to cope with the symptoms instead of putting all your strength into fighting the condition itself.

The following can be helpful, for example:

• Think about what aspects of everyday life are really important.
• Do not strive for perfection.
• Explore and respect your own limits.

This can mean:

• giving yourself more time for strenuous activities right from the outset.
• taking regular breaks.
• using various relaxation techniques.
• trying stress management – for example autogenic training or progressive muscle relaxation.

Many things are possible despite fibromyalgia and people can still do lots of things that bring them joy. This also applies to social relations and activities. It is important not to be discouraged from these activities. Talking to other people with fibromyalgia can also be extremely helpful in this regard as they are familiar with the problems that the condition brings. This can be done by attending a self-help group, for example.

Real-life stories by people with fibromyalgia can be found on the website gesundheitsinformation.de.