Fibromyalgia, also known as soft tissue rheumatism and muscle rheumatism, is a disease that negatively affects the quality of life. Although there was an opinion that there was no such disease in the 1990s, but that it was only psychological, due to the presence of depression and resistant pain in some patients, it is among the main painful diseases that continue to be studied in detail today.
Cause of fibromyalgia
Today, it is accepted that fibromyalgia is caused by a defect in pain processing mechanisms in the brain (central sensitivity). Genetic, sleep disorders, neurohormonal disorders, infection and psychological factors are blamed for the formation of central sensitivity. The reason is not fully understood.
Symptoms of Fibromyalgia
There are roughly 3 types of fibromyalgia: with pain only, psychological disorders such as pain and depression, and sleep disturbance, and mixed type. In fact, these 3 symptoms, namely pain, psychological disorders and sleep disorders, are more or less present in all patients. In addition to all these, patients also complain of traveling pains, weakness, and waking up tired in the morning. In addition, a feeling of swelling, numbness and tingling in the arms and legs can also be seen. Complaints such as constipation, headache, burning in urination are also often accompanied. Patients report that their complaints increase with weather changes, physical or mental stresses.
It was stated that fibromyalgia was caused by a central pain processing disorder. It is one of the central sensitivity syndromes. Other central sensitivity syndromes; migraine, jaw joint dysfunctions, irritable colon syndrome, myofascial pain syndrome, chronic fatigue syndrome, restless legs syndrome, painful menstruation, painful urination problems, post-traumatic stress disorder. Therefore, it is possible for fibromyalgia patients to have one or more of these diseases.
Diagnosis of fibromyalgia
The diagnosis of fibromyalgia begins with the patient’s history and examination. There is no specific blood test or imaging method for fibromyalgia. First of all, hormone tests (goiter tests) to rule out diseases that can cause general body pain, liver and kidney function tests to rule out organ problems, rheumatism tests (sedimentation, CRP) to rule out the presence of inflammatory rheumatic diseases, B12 and D to rule out vitamin deficiency problems. Vitamin levels and blood counts are recommended. According to the results of these tests, a diagnosis should be made, for example, in the presence of anemia, in the presence of vitamin deficiency, it should be added to the treatment.
Treatment of fibromyalgia
The most difficult part of fibromyalgia is its treatment. First of all, the patient should be informed about the disease. Relatives of patients are often bored and weary because they live with a patient who is in constant pain. There may even be those who think that the patient’s pain is due to disbelief, psychological or attention-seeking. Therefore, it is important to inform the relatives of the patient as well. It should be explained that the disease does not have a debilitating or life-limiting effect, but impairs the quality of life.
Medication : The drug treatment for fibromyalgia is decided according to which of the pain, depression, and sleep disorders are more dominant. Although drugs can usually control the symptoms, there is a possibility that the pain will start again if the drug is stopped. In addition, drugs that regulate sleep and pain should be used for at least 2 months.
Complementary medicine methods:
Acupuncture: Acupuncture, which acts by regulating the energy systems in the body, is a method that can be used both in the control of pain, in sleep control and in regulating the psychological state.
Neural therapy: Neural therapy, which regulates the nervous system by using local anesthetics and enables the patient’s own healing mechanisms to be activated, is successfully used in fibromyalgia patients.
Ozone therapy: It is possible to control sleep patterns, fatigue and general pain with ozone therapy, which acts by activating the antioxidant mechanism in fibromyalgic patients.
Physical therapy: Treatment with superficial and deep heat, low-frequency electric currents helps to control pain, especially in patients who feel intense pain locally.
Exercise: There is a very certain information that one of the most important treatment methods of fibromyalgia is exercise. The patient whose pain is relieved by the above-mentioned treatments, whose sleep pattern is provided and whose fatigue is relieved, should be directed to exercise as soon as possible. Exercise maintains joint movements, lengthens and strengthens shortened muscles, thereby stabilizing painful areas. With aerobic exercises (such as swimming, walking, running, cycling, dancing), respiratory and cardiac functions should be improved and resistance should be increased. In addition, it is possible to increase the release of pain relievers and happy substances (endorphin, serotonin) with regular aerobic exercises. In order to achieve this effect, the patient must exercise regularly for at least 8 weeks. It is very important to do all the exercises continuously and make it a way of life. Regular exercises provide more and longer-acting treatment opportunities than the drugs that the patient drinks. It is very important to inform the patient about this issue. In fibromyalgia patients, exercises should be started with light intensity and low durations and increased over time. Exercise intensity that will create excessive stress should be avoided in patients who already have fatigue.
Yoga:Yoga is one of the most loved and benefited methods by fibromyalgia patients, providing both stretching, strengthening and relaxation with its unique postures, breathing work, relaxation methods.
Pilates:The majority of fibromyalgia patients consist of female patients, and pilates, which consists of stretching and strengthening exercises such as yoga, is a form of exercise that is loved and benefited by female patients.
Swimming:Swimming is very effective in fibromyalgia patients with its relaxing effect and resistance to movements.
Massage:It should be paid attention to be done by competent hands while having a massage, which is preferred by the patients because of its circulation regulation and muscle relaxation.
spa treatment : The thermal springs are based on the use of healing waters for the purpose of illness. The relaxation and therapeutic effects created by hot water make it preferred by patients. Spa treatment should be done in the form of a 21-session cure, and a light exercise program should be added together. Spa treatment is not suitable for heart and blood pressure patients, those with open wounds, varicose veins and anemia. In any case, before the spa treatment, it should be started by going through a doctor’s control.
Diet: In fibromyalgia, it is very important to exclude refined sugar foods and carbonated drinks from the diet. Since each patient’s bowel sensitivity is different, it is recommended that patients evaluate their pain, fatigue, and insomnia by taking a bowel sensitivity test or taking note of what they ate for a week, and not to consume unsuitable foods.
As a result, it should not be forgotten that fibromyalgia is a chronic (continuous) treatment, and attacks may occur from time to time despite any treatment. It is necessary to ensure that the patient stays away from temperature changes, physical and mental stress.