yogabook / pathologie / fibromyalgia

fibromyalgia (formerly: generalised tendomyopathy, GMT)

Definition of

Chronic, usually therapy-resistant pain syndrome with multilocular, alternating pain in muscles and joints without signs of inflammatory or degenerative processes, falls into the category of „soft tissue rheumatism“. Prevalence 2-4%, W:M 9:1, no change in life expectancy. Usually patients between 30 and 60 years, mostly around the age of 50. Frequently ruled out as a diagnosis of embarrassment! Sometimes fibromyalgia occurs secondary to inflammatory rheumatic systemic diseases or autoimmune diseases, infectious diseases, tumors, surgery and especially after viral infections such as hepatitis C. A disorder of the pain memory^ is also discussed.

ICD M79

Cause

unknown

Diagnosis

1. clinically after exclusion of all differential diagnoses

Symptoms

Diagnostic criteria:

1. Spontaneous muscle pain apparently without a trigger, mainly in tendons and tendon insertions over at least 3 months in various regions
2. tenderness of the tender points, preferably painful areas
3. Accompanying vegetative and functional symptoms such as insomnia, headache/migraine, feeling of coldness in hands/feet, hyperhidrosis, dry mouth, dry mucous membranes, dizziness, circulatory complaints, GIT complaints, lump in throat, tingling, breathing difficulties, functional (non-organic) heart complaints, dysuria, dysmenorrhea

Or according to the ACR (American College of Rheumatology):

1. Chronic or recurrent pain in at least 3 of 4 body quadrants
2. Chronic or recurrent pain in at least 11 of 18 pressure pain points („tender points“)

plus any additional findings

1. cold acra
2. Dry mouth
3. Hyperhidrosis
4. Tremor
5. Sleep disorders
6. Tiredness
7. Globe feeling

According to the definition, there must be NO pathological laboratory findings or similar that could explain the symptoms. Other possible symptoms:

1. Altered nerve endings
2. Trembling
3. Tiredness
4. Exhaustion
5. wakes up as if struck
6. Morning stiffness and stiffness after prolonged sitting
7. Lack of concentration and drive
8. Weather sensitivity
9. Feeling of swelling
10. Loss of muscle strength
11. Tendency to muscle cramps, especially in the morning/at night and after exercise
12. Possibly slightly increased temperature
13. Impaired libido and sexual function
14. Edema
15. Hypersensitivity to cold and wet
16. Fear
17. Depression
18. Balance disorders
19. the pain that occurs is dull, sharp or radiating and of fluctuating intensity. Cold, emotional stress, prolonged hard work and fatigue worsen the pain.

Therapy

1. Pain therapy
2. Psychotherapy
3. Physiotherapy
4. Balneotherapy
5. Order therapy
6. Sports therapy (the best possible aerobic fitness has been proven to improve and is the main starting point: swimming, cross-training, walking, aqua jogging)
7. Relaxation therapy
8. Nutritional therapy: progressive muscle relaxation, autogenic training, Qigong, meditation,…
9. Physical therapy (especially heat)
10. Drug approaches: Narcotics, neuroleptics, antiepileptics, antiemetics,….
11. Life expectancy not reduced, but early retirement more frequent
12. Self-help groups
13. Acupuncture may help
14. Heat therapy, also whole-body

DD

1. RA