Skip to main content

Fibromyalgia: Insights into the symptoms and causes of chronic pain

Fibromyalgia is a chronic disease characterized by persistent pain in various parts of the body. Women are affected six to seven times more often than men. The pain usually occurs near joints, in muscles and along the spine. Although the exact causes are not yet fully understood, it is assumed that various factors can contribute to the development of the disease.


What are the possible causes and risk factors for fibromyalgia syndrome?

Anyone diagnosed with fibromyalgia will no doubt wonder how the condition can develop. There are various factors that may contribute to the development of chronic pain:

Genetic predisposition: There are indications that there is a familial clustering. [1]

Nervous system disorders: Hypersensitivity of the central nervous system can lead to impaired pain processing. [2]

Hormonal imbalances: Hormonal imbalances may be partly responsible for the symptoms. [3]

Psychological factors: Chronic stress, trauma or depression could play a role and influence the symptoms or treatment. [4]

Infections: Certain viral diseases are being considered as possible triggers. [5] 


Symptoms of a disease with fibromyalgia

There are many typical symptoms of fibromyalgia. The most common fibromyalgia symptoms are as follows:

Chronic pain: The pain of fibromyalgia is often described as burning, stabbing or dull. It can affect the whole body or be concentrated in certain areas. It is characteristic that the pain persists over a longer period of time (at least three months) and cannot be explained by other illnesses. 

Sleeping disorders: Many sufferers report non-restorative sleep. They have difficulty falling asleep, wake up frequently or do not feel refreshed in the morning despite getting enough sleep. Such sleep disorders can lead to a vicious circle, as a lack of sleep can increase the perception of pain.

Chronic fatigue (exhaustion): The exhaustion caused by fibromyalgia goes beyond normal tiredness. Those affected often feel as if they have a severe flu. Fatigue can occur suddenly and make it considerably more difficult to cope with everyday tasks. Physical exercise is then often almost unthinkable. 

Cognitive impairment (fibro-fog): Fibro fog includes difficulty concentrating, memory problems and difficulty expressing oneself clearly. Many sufferers describe it as a feeling of light-headedness or as if they are thinking through a fog.


Fibromyalgia syndrome can also manifest itself through numerous other symptoms. These symptoms include:

  • Headaches,
  • gastrointestinal complaints,
  • Sensory disturbances in hands and feet,
  • Increased menstrual cramps,
  • palpitations and shortness of breath and
  • increased sensitivity to pain, especially to pressure.


The pain of fibromyalgia can be felt on the skin, in the muscles and joints. It is often diffuse and of varying intensity and localization.


What does the pain of fibromyalgia syndrome feel like?

The pain of fibromyalgia syndrome, also known as fiber-muscle pain (hereinafter referred to as “FMS”), can be experienced in a variety of ways. 

Typically, FMS is described by patients as deep-seated and diffuse. Patients often report that FMS feels similar to intense muscle soreness or a pulled muscle. The pain is not limited to certain areas of the body, but can occur and travel to different areas.

The intensity of the FMS can also fluctuate during the illness and occur in episodes. Some patients describe FMS as persistent, while others report that it alternates between different parts of the body or disappears temporarily and then returns. In addition, conditions such as stress, dampness, cold and prolonged sitting or lying down can intensify FMS. 


How is fibromyalgia diagnosed?

The diagnosis of fibromyalgia syndrome can be challenging as there are no specific laboratory values or imaging techniques that can clearly identify the condition. Instead, the diagnosis is based on a combination of symptoms and the exclusion of other conditions.

Doctors often use two validated questionnaires to diagnose their patients:

  1. The pain index (Widespread Pain Index, WPI): This records in which of 19 defined body regions pain or discomfort has occurred in the past week.
  2. The Symptom Severity Scale (SSS): This assesses the frequency of fatigue, sleep disturbances and concentration problems as well as the presence of other complaints.


Fibromyalgia can be diagnosed if certain scores are achieved in both questionnaires and the symptoms have been present for at least three months. If a diagnosis is made, the doctor will begin appropriate treatment or therapy for the condition.


Details on the diagnosis of fibromyalgia syndrome

The path to diagnosis usually involves several steps:

Detailed medical history: The doctor will ask you about your symptoms, their duration and intensity as well as possible triggers.

Physical examination: This involves examining the so-called tender points. Tender points are specific pressure points on the body that can be particularly sensitive to pain in fibromyalgia.

Laboratory tests: Blood tests are carried out to rule out other diseases.

Imaging procedures: In some cases, X-rays, MRI or CT scans may be ordered to rule out other causes of the pain.


What can trigger an attack in fibromyalgia patients?

Fibromyalgia flare-ups can be triggered or exacerbated by a variety of factors. The most common triggers include stress at work and in everyday life as well as psychological strain. An unbalanced lifestyle can also play a role: Both too little physical activity and excessive physical strain can promote flare-ups. [6]

In order to better understand and manage personal triggers, keeping a symptom diary can be very helpful. This can be used to document daily activities, stress factors, weather conditions and other possible influences together with the intensity of the symptoms. Over time, patterns can be recognized and individual strategies developed to reduce or better manage flare-ups.


Are there ways for patients to avoid an attack of fibromyalgia?

To reduce fibromyalgia flare-ups, patients can pay attention to the following:

Stress management: Make your everyday life as stress-free as possible and organize yourself well. 

Regular exercise: Find a balanced level of physical activity.

Good sleep hygiene: establish regular bedtimes and a relaxing evening routine.

Balanced diet: Make sure you eat a nutrient-rich diet or a healthy and balanced diet in general.

Pacing: learn to spread your activities throughout the day and take regular breaks.


Treatment and therapy for fibromyalgia 

The treatment or therapy of fibromyalgia aims to alleviate the symptoms and improve the quality of life of those affected. A multimodal therapy is usually recommended:

Endurance training and regular moderate exercise such as swimming, cycling or walking can reduce pain and fatigue.

Cognitive behavioral therapy can help people cope better with pain and break negative thought patterns, which is why it is often part of therapy.

Relaxation techniques and methods such as progressive muscle relaxation or meditation can reduce stress and improve sleep quality.

In some cases, drug therapy can also be used to alleviate symptoms as part of the treatment.

Physiotherapy and occupational therapy can help to improve mobility and make everyday activities easier.

In addition to conventional treatment methods, complementary approaches can also be helpful for some sufferers. These include acupuncture, tai chi and qigong, biofeedback and heat treatments.


Are dietary supplements useful for fibromyalgia syndrome??

In practice, dietary supplements are sometimes used in addition to other forms of therapy for fiomyalgia syndrome: The supplements used mainly contain magnesium, vitamin D and omega-3 fatty acids. 

However, it is important that you always consult your doctor before deciding to take dietary supplements. Furthermore, dietary supplements should never be seen as a substitute for comprehensive treatment, which includes exercise therapy, stress management and, if necessary, drug therapies.


Frequently asked questions about fibromyalgia


Can fibromyalgia syndrome be cured?

There is currently no cure for fibromyalgia, but the symptoms can often be significantly alleviated with suitable treatment strategies. [7]


Can fibromyalgia syndrome lead to organ damage?

No, fibromyalgia does not lead to damage to organs, muscles or joints. Life expectancy is normal. 


Regular blood tests for fibromyalgia?

In fibromyalgia syndrome, no specific blood values are usually conspicuous. Nevertheless, blood tests are often carried out to rule out other diseases. Among other things, factors for rheumatic diseases, inflammatory parameters and thyroid values are examined. 


How does fibromyalgia affect everyday life? 

Fibromyalgia can have a significant impact on everyday life. Many sufferers have difficulties at work, in social relationships and with everyday activities. However, good treatment and coping strategies can help to improve quality of life.


Is there a connection between fibromyalgia syndrome and other diseases? 

Fibromyalgia can occur as a secondary disease in other rheumatic diseases such as rheumatoid arthritis. In addition, many sufferers also suffer from depression or anxiety disorders. Patients with fibromyalgia are also more likely to suffer from restless legs syndrome. [8]


Can fibromyalgia occur for the first time or worsen during pregnancy? 

Fibromyalgia syndrome can occur both before and during pregnancy. Some women report a worsening of symptoms during pregnancy, while others report an improvement. Close cooperation with the doctor treating you is particularly important during this time.


Sources:

[1] https://pubmed.ncbi.nlm.nih.gov/23280346/ 

[2] https://pubmed.ncbi.nlm.nih.gov/20961685/

[3] https://www.fibromyalgie-fms.de/fileadmin/user_upload/Mitteilungen/Vorträge/Facharbeit_Jasmin_Faith

[4] https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-0648-0219

[5] https://www.springermedizin.de/de/ist-die-fibromyalgie-eine-viruserkrankung/8386624

[6] https://pubmed.ncbi.nlm.nih.gov/19177530/ 

[7] https://www.netdoktor.de/krankheiten/fibromyalgie/ 

[8] https://www.rheumaliga.ch/assets/doc/ZH_Dokumente/Broschueren-Merkblaetter/Krankheitsbilder/Fibromyalgie.pdf