yogabook / pathologie / fibromyalgia
Contents
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
- clinically after exclusion of all differential diagnoses
Symptoms
Diagnostic criteria:
- Spontaneous muscle pain apparently without a trigger, mainly in tendons and tendon insertions over at least 3 months in various regions
- tenderness of the tender points, preferably painful areas
- 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):
- Chronic or recurrent pain in at least 3 of 4 body quadrants
- Chronic or recurrent pain in at least 11 of 18 pressure pain points („tender points“)
plus any additional findings
- cold acra
- Dry mouth
- Hyperhidrosis
- Tremor
- Sleep disorders
- Tiredness
- Globe feeling
According to the definition, there must be NO pathological laboratory findings or similar that could explain the symptoms. Other possible symptoms:
- Altered nerve endings
- Trembling
- Tiredness
- Exhaustion
- wakes up as if struck
- Morning stiffness and stiffness after prolonged sitting
- Lack of concentration and drive
- Weather sensitivity
- Feeling of swelling
- Loss of muscle strength
- Tendency to muscle cramps, especially in the morning/at night and after exercise
- Possibly slightly increased temperature
- Impaired libido and sexual function
- Edema
- Hypersensitivity to cold and wet
- Fear
- Depression
- Balance disorders
- 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
- Pain therapy
- Psychotherapy
- Physiotherapy
- Balneotherapy
- Order therapy
- Sports therapy (the best possible aerobic fitness has been proven to improve and is the main starting point: swimming, cross-training, walking, aqua jogging)
- Relaxation therapy
- Nutritional therapy: progressive muscle relaxation, autogenic training, Qigong, meditation,…
- Physical therapy (especially heat)
- Drug approaches: Narcotics, neuroleptics, antiepileptics, antiemetics,….
- Life expectancy not reduced, but early retirement more frequent
- Self-help groups
- Acupuncture may help
- Heat therapy, also whole-body