Perhimpunan Reumatologi Indonesia
Indonesian Rheumatology Association

Fibromyalgia: Causes, Diagnosis, Symptoms & Treatment

What is Fibromyalgia?

Fibromyalgia is a chronic condition that causes pain, stiffness and tenderness of muscles, tendons, and joints. It is also characterized by insomnia, feelings of tiredness, chronic fatigue, anxiety, depression, and impaired bowel function. This condition is not life threatening and does not cause bodily damage, deformity, or injury to internal organs. Fibromyalgia is sometimes referred to as fibromyalgia syndrome and is abbreviated as FMS. Fibromyalgia was previously known as fibrositis.

What Meaning Fibromialgia?

The word fibromyalgia comes from the Latin term for fibrous tissue (“fibro”) and the Greek term for muscle (“myo”) and pain (“algia”).

Is fibromyalgia? Is one Form of arthritis?

Fibromyalgia is considered an arthritis-related condition. However, it is not a form of arthritis (joint disease) because it does not cause inflammation of the joints or muscles, and does not damage other tissues but is only a muscle disorder. Fibromyalgia can (like arthritis) cause significant pain and fatigue, and it can also interfere with a person’s ability to carry out daily activities.

Who Who Can Be Affected Fibromialgia?

Fibromyalgia affects a large proportion of women (more than 80% of sufferers are women) aged between 35 and 55 years. However, fibromyalgia can also affect men, children, and the elderly. This can occur independently or can be associated with other diseases, such as lupus or rheumatoid arthritis.

The prevalence of fibromyalgia varies in different countries. In Sweden and the UK, 1% of the population has fibromyalgia. In the United States, approximately 4% of the population has fibromyalgia.

What Causes Fibromyalgia?

The cause of fibromyalgia is unknown. Those affected feel pain in response to stimuli that are not usually painful. Researchers have found elevated levels of nerve chemical signaling, called substance P, and nerve growth factor ( growth factor ) in the spinal fluid of fibromyalgia patients. Levels of the brain chemical serotonin are also relatively low in patients with fibromyalgia. Pain studies in fibromyalgia reveal that the central nervous system (brain) may be supersensitive. In addition, patients with fibromyalgia have impaired eye movement, or non-REM, sleep phases (which may, at least in part, explain the common features of tired and unrefreshed waking in these patients). The onset of fibromyalgia is also associated with psychological stress, trauma, and infection.

What Are the Symptoms and Signs of Fibromyalgia?

Fibromyalgia is not always easy to diagnose because the symptoms vary, many of them mimic other disorders, there are no visible signs of the disorder, and there are no clear laboratory tests for fibromyalgia. It should be noted that each patient with fibromyalgia is unique. Any of the following symptoms may come and go & nbsp; and in different forms.

Fibromyalgia T ender points

Fibromyalgia “ tender point ” or a tender point is a local area of ​​the body that is painful with gentle pressure / light touch. Pain pressure points are generally found around the elbows, shoulders, knees, hips, back of the head, and sides of the sternum. Tender Point is sometimes incorrectly referred to as a “trigger point,” the terminology used to describe a situation where pressing & nbsp; on certain trigger points can cause & nbsp; sequential symptoms. This is not the case with tender point fibromyalgia.

Symptoms Fibromyalgia: Pain

The common symptom of fibromyalgia is pain. As mentioned earlier, pain in fibromyalgia is not caused by tissue inflammation. In contrast, patients appear to have an increased sensitivity to many different sensory stimuli and an unusually low pain threshold. The pain from fibromyalgia is generally widespread, involving both sides of the body. Pain usually affects the neck, buttocks, shoulders, arms, upper back, and chest. Body aches from fibromyalgia can be made worse by noise, weather changes, and emotional stress.

Symptoms Fibromyalgia: fatigue

Fatigue occurs in 90% of patients. Fatigue may be related to abnormal sleep patterns. Usually, there are several stages of sleep. Getting an adequate amount of deep sleep may be more important in refreshing a person than the total number of hours slept. Patients with fibromyalgia experience what is called “ non-rapid eye movement ” (non-REM) sleep. As a result, patients with fibromyalgia often wake up in the morning without feeling completely rested, even though they appear to have had sufficient hours of sleep. Some patients wake up with muscle aches or a sensation of muscle weakness as if they had been “working” all night!

Symptoms Symptoms: Mental and / or emotional disorders

Mental and / or emotional disturbances occur in more than half of people with fibromyalgia. These symptoms include poor concentration, neglect, memory problems, mood changes, irritability, depression, and anxiety. Because there are no laboratory tests available, patients with fibromyalgia are often misdiagnosed as having depression as the main problem.

Symptoms Fibromyalgia: Additional Symptoms

Other symptoms include migraine headaches and tension, numbness or tingling from different parts of the area, stomach pain associated with irritable bowel syndrome (“spastic colon”), and irritated bladder, causing irritable bowel syndrome. urinating painful and frequent.

How Is Fibromyalgia Diagnosed?

There are no blood tests or X-rays that specifically provide instructions for doctors to diagnose fibromyalgia. Tests are performed only to rule out other possible diagnoses. Ultimately, the diagnosis of fibromyalgia is made solely on clinical grounds based on the doctor’s history and physical examination. In patients with extensive chronic body pain, a diagnosis of fibromyalgia can be made by identifying the area of ​​the pain point (usually, but not always, the patient will have at least 11 of the 18 classic fibromyalgia tender points), without any tissue swelling or inflammation, and by excluding any medical conditions. others that can mimic fibromyalgia. According to the American College of Rheumatology , before a fibromyalgia diagnosis can be made, muscle pain must be present for more than three months.

Conditions Resembles Fibromialgia

As mentioned, there is no simple blood test or X-ray that can tell you if you have fibromyalgia. Because so many medical conditions can cause pain in different areas of the body, your doctor may still want to do blood tests or X-rays to rule out fibromyalgia-like disease.

What is the Treatment for Fibromyalgia?

Although there is no cure for fibromyalgia, treatment can relieve some of the symptoms. Because symptoms vary and vary between patients, the treatment program must also be individualized for each patient. Treatment programs are most effective when they combine patient education, stress reduction, regular exercise, and medication. Ultimately, physicians, physiotherapists and all patients can play an active role in the management of fibromyalgia. Recent studies have confirmed that the best outcome for patient therapy is a combination approach that involves the patient in adjusting the treatment plan.

Treatment Fibromyalgia: Education Patients

Patient education is an important first step in helping patients understand and manage multiple symptoms. Unfortunately, not all doctors recognize the peculiarities of this disease. The fibromyalgia support group community is an important educational resource for patients and their doctors.

Treatment Fibromyalgia: Stress Reduction

It is very difficult to measure the level of stress in different patients. For some people, spilling milk on the table can represent a significant tragedy. For others, a tank rolling into the living room might just represent a mundane day’s happenings! Therefore, stress reduction in fibromyalgia treatment must be individualized. This includes simple stress modification at home or work, biofeedback , relaxation tapes, psychological counseling, and / or support among family members, friends, and doctors. Sometimes, changing environmental factors (such as noise, temperature, and weather exposure) can exacerbate fibromyalgia symptoms, and these factors need to be modified. Optimal sleep is highly recommended.

Treatment Fibromyalgia: Exercise

The most important therapy for muscle pain is routine light exercise. Keeping muscles healthy by exercising three times a week reduces the amount of discomfort. Light exercises such as aerobics, swimming, cycling, walking, skiing, can be effective treatments for fibromyalgia. Exercises are most effective when done daily in the morning. How exercise benefits fibromyalgia is unknown. Exercise can exert beneficial effects by promoting deep levels of sleep (non-REM sleep). Physical therapy (physiotherapy) can help to optimize exercise.

Treatment Fibromyalgia: Diet

Studies have shown that there are no specific foods that people with fibromyalgia should avoid. But it’s worth taking a closer look at how food affects how you feel. A good way to start identifying foods that may worsen your symptoms is to keep a daily food journal. To find out what’s good for you, try eliminating one food at a time. As you make changes to your diet, keep in mind that people with fibromyalgia benefit the most from a variety of approaches to managing their symptoms. Avoiding alcohol and caffeine before bed can make sleep calmer. Foods that induce comfortable sleep should be tried. Although diet changes may not apply to everyone, they can be very helpful for some. If the patient has irritable bowel syndrome, the diet should be adjusted so as not to aggravate the stomach. Likewise, when a patient has bladder inflammation ( interstitial cystitis) , foods that irritate the bladder should be avoided.

Treatment Fibromyalgia: Medications

Traditionally, the most effective drugs in the treatment of fibromyalgia are tricyclic antidepressants, which are often used in the treatment of depression. Tricyclic antidepressants are used to reduce fatigue, relieve muscle aches and spasms, and promote a restorative, restorative sleep in patients with fibromyalgia. & nbsp; This therapy is also effective in inducing deep sleep and increasing comfort.

Treatment Fibromyalgia: Other Treatment

Reduces pain in soft tissues, by breaking the cycle of pain and muscle tension. Nonsteroidal anti-inflammatory drugs (NSAIDs), which are helpful in treating other rheumatic conditions, have only limited value in treating fibromyalgia pain. Painkillers that contain narcotics are usually avoided in fibromyalgia patients because they have not been shown to be beneficial and have adverse side effects, including dependence, if used long-term.

Alternative Treatments for Fibromyalgia

For people with fibromyalgia, several treatment alternatives work well. That way, they can allow you to cut back on medications and increase your normal activities.

Check to see what limitations apply to you. Talk to your doctor, to find ways to combine conventional medicine with alternative medicine or natural remedies. When you do, you may be able to improve restful sleep and reduce your fibromyalgia pain.

Alternative Fibromyalgia Treatment? Acupuncture

With acupuncture, the acupuncturist inserts one or more needles into the skin and underlying tissue at a specific point. Movement of gently twisting or manipulating the needle causes the release of endorphins into the bloodstream. Endorphins are the body’s natural opioids. In addition, according to acupuncturists, energy blocks open up, restoring energy flow along the meridians, which are specific energy channels.