Fibromyalgia disorder in the musculoskeletal system. Fibromyalgia is a combination of symptoms, it is mainly characterized by persistent pain in the musculoskeletal system. This concerns the tendons, muscles, and ligaments. The pain complaints usually occur in combination with stiffness and fatigue.
You experience the pain mainly around the joints because there are the ligaments and tendon attachments. This is also where the places are created that are painful when pressure is exerted, the so-called tender points.
Fibromyalgia disorder in the musculoskeletal system
The physical examination focuses on these painful points. The American College of Rheumatology organization decided in 1990 that there must be at least eleven tender points to be able to speak of fibromyalgia.
There are no specific tests or studies with which you can detect fibromyalgia. Additional examinations such as blood and X-ray examinations are sometimes done to be sure. These will not cause any abnormalities if there is only fibromyalgia.
A doctor will make the diagnosis by examining the combination of complaints and tender points and excluding other disorders with similar complaints.
Fibromyalgia is more common in women than in men and usually starts between 20 and 40 years.
Although the severity of the symptoms can vary, it is not a progressive or life-threatening condition. It is quite possible to reduce or even fully restore the amount of complaints.
Symptoms of Fibromyalgia disorder in the musculoskeletal system
You may experience fibromyalgia if the following three core symptoms are present for longer than three months:
- Pain in the musculoskeletal system The pain often starts in the back or neck and can spread to other places such as shoulders, elbows, wrists, hips, knees or ankles.
- Stiffness in the muscles
- Fatigue Many people with fibromyalgia do not feel fully rested when they get up in the morning and continue to feel tired all day, even if they seem to get enough sleep. Sleep is often restless.
Other complaints that can occur are:
- Intestinal complaints abdominal pain and alternating constipation and diarrhea complaints.
- Headache and facial pain usually in combination with pain and stiffness in the neck and shoulders.
- Pain around the jaw joints
- Increased sensitivity to sound, bright light, touch or smell
- Stimulating or deaf feelings in the hands and feet
- Depressive feelings
- Concentration and memory problems
- Feelings of fear
How does fibromyalgia develop?
It is not yet known exactly how fibromyalgia arises. There are various theories about this. According to a modern theory, the brains of people with fibromyalgia have increased sensitivity to pain stimuli. This is also called ‘sensitization’. This involves an increased amount of chemicals in the brain that transmit pain stimuli, the so-called neurotransmitters. The places where these substances attach, the receptors, would build a kind of ‘pain reminder’. As a result, they respond faster with a feeling of pain with fewer pain stimuli. How and why this increase in sensitivity to pain stimuli is initiated is not yet entirely clear. Other factors that may play a role in the development of fibromyalgia are:
- Sleep disorders According to some theories, sleep disorders would be a cause and not a consequence of fibromyalgia.
- Infections It is possible that a viral or bacterial infection is, as it were, a ‘trigger’ for the development of fibromyalgia.
- Physical injury An injury, for example as a result of an accident, could also be a ‘trigger’.
- Disruptions of the unconscious (= autonomous or sympathetic) nervous system This part of our nervous system controls all kinds of processes in our body that we cannot exert conscious influence on, such as heart rhythm, breathing, blood pressure, sweating and gastrointestinal activity. In people with fibromyalgia, one or more of these processes may be disrupted. Here too, however, it is not clear what cause and effect is.
- Mental stress Stress is a factor that appears to play a role in many physical disorders. For example, the stress in fibromyalgia can also be a (co-) cause.
Is it serious and what can you expect?
Fibromyalgia is not a progressive or life-threatening condition. However, the course can be very different per person. The symptoms can gradually increase, but will often gradually decrease and disappear. Fibromyalgia never leads to damage to joints or muscles.
When to the doctor?
If you have pain in one or more joints with symptoms of swelling, redness, limitation of movement or fever, it is advisable to have your doctor assess the symptoms in the short term.
The combination of persistent pain symptoms in multiple places in the body and fatigue can also occur with other conditions and does not necessarily mean that there is fibromyalgia. If such complaints persist for longer than a few months, it is advisable to consult your doctor. Your doctor can advise you whether it is necessary to have the symptoms investigated further and give advice on how to proceed.
What can you do about it yourself?
To reduce your symptoms, it is best to try to incorporate as much regularity as possible into your daily life. Ensure a healthy and regular lifestyle and gradually expand your activities (see ‘General advice and precautions’).
General advice and precautions
If you have fibromyalgia, you can do a lot yourself to reduce your symptoms:
Ensure a healthy and regular lifestyle
As it applies to everyone, it is wise to eat healthy and regularly. Limiting the use of caffeine (coffee, tea, cola) and alcohol.
Make sure you get a good night’s sleep
Here it can help to go to bed at a fixed time and to get up at a fixed time. Try to sleep as little as possible during the day. It is also advisable to arrange a more or less regular load during the day. This can help to prevent the complaints from getting under control. If you do more than usual on a ‘good’ day, chances are that there will be a ‘bad’ day on which you can do less. You can gradually expand your activities.
Ensure regular physical training
Exercise and exercise can cause more pain in the beginning, but in the longer term, it will reduce the symptoms. You could (possibly with help) make a training program for 3 to 4 times a week on set days and times. Try to adhere to this as much as possible, even if you have complaints at that time. You can choose an activity that you enjoy, such as walking, cycling, swimming or aqua aerobics. Increase the load very gradually (step by step), for example by increasing the duration of the activity by a few minutes every week. You can also continue this if you are still experiencing (some) complaints.
To function properly, we need a certain amount of stress. However, too much stress is unhealthy and can increase the symptoms of fibromyalgia. It is therefore advisable to learn to set limits and to learn to say ‘no’ in due course. Also make time for relaxing, enjoyable activities. You could also try out stress-reducing activities such as meditation.
This form of therapy is aimed at strengthening the belief in one’s own possibilities, which can contribute to the recovery.
These programs have been developed because combinations of factors can play a role in fibromyalgia. Various interrelated treatment methods are coordinated with each other with the aim of expanding the functional possibilities. The results can be called favorable.
Be cautious when using medicines / self-care products
Painkillers generally have a very moderate or even no effect on the symptoms and often have unpleasant side effects. Muscle relaxants (benzodiazepines) usually only work for a short time, have side effects and can only be prescribed to a limited extent in connection with the risk of dependence. Sleeping aids usually only work for a short time and then often lead to more sleeping problems. A number of antidepressants can reduce the symptoms at a low dose. Such agents are only available on prescription and have side effects that usually occur earlier than the effective effect. For all these types of resources, it is, therefore, advisable to use them as little as possible.
Fibromyalgia disorder in the musculoskeletal system
Source: Dr. PM Stuurman and R. Burger (psychologist)