Status: 12.02.2024 00:00 | from North German Broadcasting logo

Pain all over the body, digestive problems, a feeling of complete exhaustion: the symptoms of fibromyalgia are rather non-specific. The disease is similar to rheumatism and mainly affects women.

People suffering from fibromyalgia suffer greatly – partly because the disease is often diagnosed very late. The symptoms can occur in phases and with varying intensity, influenced for example by emotional stress or lack of sleep.

Fibromyalgia is a recognized disease. However, there is still no clear evidence of its causes. This is why many sufferers are still labeled as hypochondriacs or mentally ill.

Causes of fibromyalgia not clear

One possible cause is impaired pain processing. Normally, insignificant pain stimuli are filtered out at the level of the spinal cord, so that only pain stimuli with a warning function reach the brain. In fibromyalgia, this filter no longer seems to work, so that many pain stimuli reach the brain. As a result, those affected perceive stimuli as pain that would not be painful for healthy people.

The reason for this reduced pain threshold is not yet fully understood. Genetic predisposition probably plays a role. Studies have shown that many patients have altered nerve fibers. In addition, severe stress and trauma can trigger fibromyalgia.

Fibromyalgia symptoms: muscle pain and fatigue

Fibromyalgia means muscle pain – this is the main symptom of the disease. Deep muscle pain is often accompanied by stiffness in the joints, burning, tingling or numbness. Muscles and joints feel swollen. The intensity of this diffuse and chronic pain can vary depending on the weather, time of day, stress and activity.

Headaches and irritable bowel symptoms also occur frequently. Those affected also suffer from extreme fatigue and sleep disorders. Psychological problems such as depression or anxiety disorders are also common.

Often a long time until diagnosis

Despite the constant pain in the muscles and connective tissue, fibromyalgia does not cause any pathological changes in the bones and muscles. Because of the non-specific symptoms, it often takes a long time before fibromyalgia is finally diagnosed. This is done first with a thorough anamnesis, i.e. questions about the patient’s life situation and medical history, sleep and existing complaints. Special questionnaires and pain scales help with the assessment.

18 pressure-sensitive tender points

During the physical examination, the doctor will particularly test the pain sensitivity of the so-called tender points. These are defined transitions between muscles and tendons that are distributed throughout the body. If those affected feel pain in at least eleven of a total of 18 points, this is considered an important indication of fibromyalgia.

In order to rule out an inflammatory rheumatic disease as the cause, the diagnosis always includes a blood test.

Treatment: Relieve pain, not cure

The treatment of this chronic disease is about influencing the impaired perception of pain. Fibromyalgia cannot be cured, but the symptoms can be alleviated with individual therapy. In addition to the family doctor, pain therapists, neurologists, psychologists and physiotherapists can be consulted.

Reduce pain with exercise

Targeted exercise is an important component of treatment. Light endurance training in particular has proven to be effective. Important:

  • Those affected should start exercising carefully – for example with gradually increasing walks – and not overexert themselves.
  • The exercise sessions can also cause pain. If those affected accept this and overcome inner resistance, they usually feel better afterwards. This way they avoid a downward spiral of lack of exercise and pain.

Other therapies for fibromyalgia

In addition to exercise therapy, doctors recommend:

  • Activating psychotherapy to change pain perception (cognitive behavioral therapy)
  • Drug treatment with pain-relieving opioids, cannabinoids and low-dose antidepressants (no anti-inflammatory painkillers such as ibuprofen, acetylsalicylic acid or paracetamol, as there are no acute inflammatory changes in muscles or joints in fibromyalgia)
  • Relaxation exercises against stress, such as autogenic training, breathing therapy, meditation, Tai Chi or yoga.
  • Heat therapy

In some circumstances, it may be useful to spend several weeks in a psychosomatic clinic that specializes in the treatment of fibromyalgia. Even partial inpatient treatment can help if outpatient treatment is not sufficient. This allows many patients to return to a regular everyday life and continue working. Numerous self-help groups offer tips, advice and contacts.

Relieve pain with nutrition

Nutrition Docs Fibromyalgia © NDR
A diet with antioxidant and omega-3-containing foods is an important component of therapy.

A targeted diet has also made the pain more bearable for many sufferers. It is advisable to switch to a diet that is mostly plant-based, as these have an antioxidant effect. Studies have shown that many sufferers have increased levels of so-called oxidative stress. This means that their bodies are burdened by systemic inflammatory reactions, and the release of various messenger substances from the immune system can play a role in the pain process. Lots of vegetables, fruit and green tea strengthen the body with antioxidants. Inflammatory foods such as meat, sugar, wheat and cow’s milk products should only be consumed in moderation.

Fasting for cell cleansing

Therapeutic fasting or individual days of fasting can also have a positive effect, as temporary abstinence from food stimulates the self-cleaning process of the cells (autophagy) and thus reduces pain.

Further information

Various healthy foods such as vegetables, yoghurt and oils stand or lie on a wooden plate. © NDR

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This topic in the program:

The Nutrition Docs | 12.02.2024 | 9:00 p.m.