Diseases

Fibromyalgia: symptoms and treatment. Treatment of fibromyalgia with folk remedies. Fibromyalgia: Diagnosis and Treatment Are there Alternative Treatments for Fibromyalgia?

Talking about what is fibromyalgia, then this is the most common complex nature of the disease, which is characterized by constant, most often debilitating bouts of pain in the muscles and joints, and is also accompanied by fatigue throughout the body. This pathology is also called fibrosis or fibromyositis.

Pain points of fibromyalgia and local pain syndromes

Physicians among all typical pain points fibromyalgia allocate places when the muscles are actually woven into the bone - these are entheses. In the case of the development of fibromyalgia, the patient's immunity will attack them, eventually leading to the development of the inflammatory process and pain attacks.

Talking about what is local pain syndrome- in this case, we are talking about a form of pathology, when an attack of pain has a vivid expression, localization in one, specifically taken part of the body, organ. In addition, all other so-called typical pain points will also be active.

If we talk about typical pain points, then in this case, the pain syndrome will manifest itself in the form of:

  • seizures headaches and atypical facial pain;
  • chronic bouts of pain in the pelvis or coccyx;
  • brachial and scapular periarthritis, which is non-traumatic in nature;

As shows medical practice, effective treatment fibromyalgia, its negative symptoms are quite possible and all this is possible only if it is normalized good sleep, trigger infections will be treated inflammatory processes and restored the full functioning of the immune system.

Symptoms of pathology

Even if there are symptoms that indicate this pathology, it is imperative to visit a doctor.

With regard to the symptoms of fibromyalgia, the latter will manifest itself in the following signs:

In this case, if the patient suffers from this disease, he may be diagnosed with health problems such as:

  • problem to remember and remember even an elementary, small text, learn something new;
  • a person has problems with concentration and the ability to focus on a particular topic or subject;
  • he is slurred, slow paced or confused bunch of words, speech.

Diagnosis

At the moment, doctors do not distinguish special tests, a method of examination that allows you to accurately diagnose the pathology. For the most part, the diagnosis is made on the basis of a long-term questioning of the patient, his examination, with the help of palpation of trigger points - as medical practice shows, in this way, it is possible to diagnose pathology in 8 cases out of 10.

Suffice it to say that the symptoms may be similar to such problems in the body as:

  • lack of vitamin D;
  • an excess of calcium in the body;
  • hypothyroidism;
  • oncology.

According to the doctors themselves, the majority laboratory tests and tests do not provide complete information on the issue of diagnosing fibromyalgia- through examinations and sampling of biomaterial for analysis, it is possible to refute or confirm concomitant or similar pathologies, such as rheumatoid arthritis or lupus.

It is impossible to recognize the problem itself with the help of radiography- in the resulting picture, the doctor simply will not see deviations in the human organ system in one or another painful area.

In order to identify and diagnose the disease, it is necessary to conduct not only an external examination of the patient, but also to check the sensitivity of all symmetrical points on his body. So, if a doctor diagnoses pain in 11 out of 18 of them, then we can say that the patient has been diagnosed with fibromyalgia.

In addition, the doctor:

  • holds examination and general assessment of pain sensitivity of trigger points;
  • turns out area of ​​pain attack location;
  • evaluated the very state of the points;
  • turns out the cause of fatigue and sleep failure;
  • evaluated and how often a person is exposed to stress and his resistance to stress.

So, the diagnosis itself - fibromyalgia, doctors diagnose if attacks of pain and stiffness in movement are diagnosed in a patient more than 3 months.

Treatment at home

In each case, the course of treatment should be prescribed exclusively by a doctor, and in this case it can be said that the pathology is most effectively treated with an integrated approach, when both medications and non-drug methods are used, supplementing them with recipes from the arsenal of traditional medicine.

In a relationship medical course of treatment - doctors most often prescribe patients taking antidepressants of the tricyclic group - they are prescribed in slightly lower doses than in the treatment of depression.

These medicines allow:

  • relieve fatigue;
  • relieve spasms in the muscles;
  • improve sleep.

In addition, physicians prescribe non-steroidal anti-inflammatory means - as practice shows, they act less effectively than when they are used to treat rheumatological diseases. As well as additional funds that will enhance the medical course of treatment, there is a course massage and acupuncture.

Speaking about the non-drug course of treatment, it is primarily aimed in its action at reducing the level of stress, normalizing both the physical and mental state:

  1. Excellent results give and yoga or other relaxation techniques to relieve stress.
  2. In addition, often just it is enough to change the situation, living conditions and the patient will feel a significant improvement.
  3. Also optimal for the patient the amount of sleep - at least 8 hours, is a prerequisite for the speedy recovery of the patient.
  4. Promote Recovery there will also be minor physical activity - cycling, visiting the pool and just walking.
  5. Also shown is a certain a diet that lacks alcohol and strong tea and coffee, especially before bedtime.
  6. When a patient is diagnosed irritable bowel syndrome - remove from your own menu those foods that irritate the intestines, thereby disrupting the digestive tract.

Treatment with folk remedies

Since the pathology itself is provoked primarily by stress - trauma and overstrain, as well as by operations that provoke a malfunction in the body, treatment is primarily aimed at eliminating negative consequences, as well as restore the functioning of the body itself, its immunity and nervous system:

  • Be sure to practice physical exercise- let it be either light morning exercises or a walk in the park, but it should be every day.
  • Attacks of pain can successfully remove with a massage or baths with the addition of aromatic oils - just add 5 drops of lavender and cypress oils to the bathroom and the pain will go away.
  • Spasmed and muscle pain can be successfully rubbed with the following folk rubbing - mix rosemary oil - 10 drops, chamomile oil - 2 drops, and 1 tbsp. l. olive oil or sweet almonds. It is her who is rubbed into the diseased area of ​​\u200b\u200bthe body.

Fibromyalgia is a condition of the body caused by constant and sometimes debilitating pain in the muscles, which is accompanied by fatigue of the whole body. No one knows exactly what causes it, but fibromyalgia can be the result of both physical and emotional trauma, as well as viral infections. Fibromyalgia is also known as fibrosis or fibromyositis.

Causes of fibromyalgia

The underlying cause of fibromyalgia is not known. physical or emotional injury, and viral infections can cause a general disorder of the body, but so far it has not been proven that they are the primary causative agents of fibromyalgia.

Many experts believe that fibromyalgia is not a disease, but rather a chronic condition of pain caused by several abnormal body responses to stress. The areas of the brain that are responsible for the sensation of pain in healthy people and patients with fibromyalgia react differently in the same areas.
People with fibromyalgia have a decrease in opioid receptor activity in parts of the brain that affect mood and the emotional aspect of pain. This explains why patients with fibromyalgia are more likely to be depressed and less responsive to opioid pain medication.

Some research has helped elucidate the main possible causes of fibromyalgia:

- Hormonal disturbances in brain chemicals. Many hormonal, metabolic, and chemical brain abnormalities have been described in studies of fibromyalgia patients. The changes mainly occur in a few brain chemicals. Fibromyalgia may be the result of pain and stress affecting the central nervous system, leading to changes in the brain, but not to the brain disease itself.

- Serotonin. Of particular interest to researchers is serotonin, an important nervous system chemical messenger in the brain, gut, and other areas of the body. Serotonin helps create a sense of well-being, regulates pain levels and promotes deep sleep. Lower levels of serotonin have been noted in some patients with fibromyalgia.

- Stress hormones. The researchers also found abnormalities in the hormonal system known as the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis controls important functions, including sleep, responses to stress, and depression. Changes in HRA are characterized by lower levels of the stress hormones norepinephrine and cortisol. Lower levels of stress hormones lead to disruptions in psychological or physical exertion. Several factors can inappropriately trigger a person's stress response and contribute to the development of fibromyalgia, including:

Infections (Epstein-Barr virus, Lyme disease);
- physical injury (for example, a car accident);
- emotional stress;
- hormonal changes (such as illness thyroid gland) ;
- taking medications.

- Low levels of the hormone IGF-1. Some studies have shown that approximately one third of patients with fibromyalgia have low levels of insulin-like growth factor-1 (IGF-1). IGF-1 is a hormone that promotes bone and muscle growth. Low levels of growth hormone can lead to impaired thinking, lack of energy, muscle weakness, and cold intolerance. Studies show that changes in growth hormone likely originate from the hypothalamus in the brain. Although researchers have not found an association between IGF-1 levels and fibromyalgia, blood levels of growth hormone may be a marker of the disease.

- Abnormal perception of pain. Some research has shown that people with fibromyalgia may perceive pain differently than healthy people. Fibromyalgia can cause too much activity in the parts of the central nervous system that process pain (the nociceptive system). Brain scans of fibromyalgia patients found abnormalities in pain processing. Some fibromyalgia patients may be hypersensitive to external stimulation and worry too much about pain. This increase in awareness is called generalized hypervigilance. Fibromyalgia patients are also more sensitive to sounds and lights.

- Immune disorders. Fibromyalgia has symptoms similar to some rheumatic diseases, including rheumatoid arthritis and lupus (systemic lupus erythematosus). These autoimmune diseases in which the immune system mistakenly attacks the body's own healthy tissues, creating inflammation and damage. However, fibromyalgia pain is not associated with autoimmune factors, and there is no evidence to support a role for the inflammatory response in the study of fibromyalgia.

Psychological and social factors are not the main causes of fibromyalgia, but they can contribute to the condition in three ways:

They make people more susceptible to fibromyalgia;
- they may play some role in initiating the onset of the condition;
- they can perpetuate the fortune.

Risk Factors for Fibromyalgia

Some evidence suggests that certain factors may make people more susceptible to fibromyalgia. These risk factors are:

Female. Nine out of 10 patients with fibromyalgia are women. Women may be especially prone to developing fibromyalgia during menopause;

Tense cultural or social environment;

Increased psychological vulnerability;

Physical and emotional trauma of childhood. Studies have reported that physical and emotional abuse of people exposes them to fibromyalgia more often than other people. Most often, family members or partners are the perpetrators. Sexual assault is generally not a risk factor for fibromyalgia, however, women who have been raped may be at increased risk of developing the condition.

Age. The disorder usually occurs in people between 20 and 60 years of age. Some studies note peaks of disease outbreaks around the age of 35 years. Others point out that fibromyalgia is most common in middle-aged women. In one study, cases of fibromyalgia increase with age and reach rates of over 7% among people aged 60 to 70. There is such a thing as juvenile primary fibromyalgia. This type of fibromyalgia appears in teenagers, more often in girls. The disease usually manifests itself after the age of 13 and reaches its peak at the age of 14 years. Cases of primary fibromyalgia are rare, but studies show that the incidence may be increasing. The symptoms are similar to those of adult fibromyalgia, but treatment outcomes are much better in adolescents.

hereditary factors. Studies report an increased prevalence of fibromyalgia among family members. Children and siblings of people with fibromyalgia are eight times more likely to develop the disease than the rest of the population. Family members are also more sensitive to pain and are more likely to have similar conditions and the same syndromes.

Fibromyalgia Symptoms

The main symptom of fibromyalgia is pain. It can focus in one place or throughout the body. The exact locations of the pain are called tender points. People diagnosed with fibromyalgia are very sensitive to pain, with at least 18 specific tender points able to identify about 11.

Basically, the pain starts in the muscles, usually in the neck and shoulders, and then spreads further out of these areas. Usually it does not affect the joints, although many patients feel it in the joints. The skin becomes more sensitive to touch.
Pain can be aching, causing burning and fatigue of the whole body. In this case, the intensity of pain may increase or decrease. It can change depending on the time of day, changes in the weather, physical activity or inactivity. The most intense pain becomes when sleep is disturbed.

- Fatigue and sleep disturbance are also common symptoms in patients with fibromyalgia. At the same time, restless legs syndrome (RLS) and periodic limb disorders (PLMD) are felt.

Many patients complain that they cannot fall asleep or stay asleep, and as a result they feel tired when they wake up. Some report that fatigue bothers them more than pain because it interferes with enjoying life, the body does not relax during sleep. Some experts believe that if a person does not experience sleep problems, then their risk of developing fibromyalgia is significantly reduced.

- Depression and bad mood. About a third of fibromyalgia patients suffer from depression. Impairments in memory and concentration are also very common. These symptoms are very often diagnosed.

Other symptoms. Fibromyalgia can also cause the following symptoms:

Digestive problems, including irritable bowel syndrome with excessive gas formation, diarrhea is often replaced by constipation;
- Dizziness;
- Dry mouth;
- Painful menstruation;
- Problems with balance in the body;
- Migraine;
- Tingling or numbness in the hands and feet;
- Frequent urination caused by spasms Bladder.

Symptoms of fibromyalgia in children

Children with fibromyalgia often have sleep disturbances and severe pain. They may also experience fatigue, stress, depression, and headaches.

Several studies have shown muscle abnormalities in fibromyalgia patients, including:

- Biochemical disorders: Fibromyalgia patients may have lower levels of muscle cell phosphocreatine and adenosine triphosphate (ATP). These chemicals regulate calcium levels in muscle cells. Calcium is an important component in the ability of muscles to contract and relax. If the ATP level is low, calcium is not released into the cells and the muscle weakens.

- Functional disorders: the pain and stress caused by fibromyalgia can themselves be detrimental to muscle function.

- Structural and circulatory anomalies: Some researchers have seen excessively thickened capillaries (tiny blood vessels) in the muscles of fibromyalgia patients. Abnormal capillaries can produce lower levels of compounds needed for muscle function and also reduce the flow of oxygen-rich blood to the muscles.
To date, none of these anomalies has a well-defined relationship with fibromyalgia.

It is important to diagnose fibromyalgia early and start treatment as soon as possible. But since there are no clear methods for diagnosing it (for example, laboratory tests or special examinations), three out of every four patients with fibromyalgia go undiagnosed. It can take an average of 5 years to receive a diagnosis.

The symptoms of fibromyalgia can be helpful in making a diagnosis, but if the patient does not have an overt disorder such as depression or arthritis, the diagnosis can be difficult. However, the absence of any symptoms does not exclude the course of the disease. Fibromyalgia should be suspected in any person who has muscle and joint pain without a specific cause.
The American College of Rheumatology (ACR) has proposed a new set of diagnostic criteria that take into account symptoms such as fatigue, sleep disturbances, and cognitive problems, in addition to pain.

Fibromyalgia Classification Criteria

In 1990, the ACR established the following classification criteria for fibromyalgia:

Severe pain must be present for at least 3 months. This pain should appear in all of the following places:
- both sides of the body;
- above and below the belt;
- along the entire length of the spine;
- Pain should be felt in at least 11 out of 18 specific areas called sensitive points on the body. When the doctor presses on the tender point, the pain is very palpable and localized. Tender points can be located in the following locations:
- in the left or right side from the back of the neck, just below the hairline;
- in the left or right side of the front of the neck, above the collarbone (collarbone);
- in the left or right side of the chest, just below the collarbone;
- on the left or right side of the upper back, near where the neck and shoulders join;
- on the left or right side of the spine in the upper back between the shoulder blades (shoulder blades);
- inside any arm, where it bends at the elbow;
- in the left or right side of the lower back, right below the belt;
- on both sides of the lower pelvic bones(buttocks);
- in the kneecaps.

The physician should always carefully study the personal and family medical history, which includes a psychological profile and a history of any factors disease-causing, such as:

Infectious diseases;
- muscle weakness;
- physical injuries;
- rash;
- recent weight changes;
- sexual or physical disorders, as well as the abuse of psychoactive substances or alcohol.

Patients should tell their doctor about any medications they are taking, including vitamins and herbal medicines.

Methods for diagnosing fibromyalgia

- Medical checkup. The physical examination cannot provide much information about the disease, other than sensitive points that are included in the diagnostic criteria. These points should be painful when pressed. When diagnosing fibromyalgia, they should not show signs of inflammation (redness, swelling, or damage to the joints and soft tissues are not relevant). The health care provider should also examine the nails, skin, mucous membranes, joints, spine, muscles, and bones to rule out arthritis, thyroid disease, and other conditions.

- Analyzes. Blood, urine, or other laboratory tests cannot definitively diagnose fibromyalgia. If these tests show incorrect results, the doctor should look for other methods. The following tests and tests can be done to detect fibromyalgia:

Antibody tests;
- general analysis blood;
- C-reactive protein;
- erythrocyte sedimentation rate (ESR).

- Studies of thyroid and liver function. In cases where previous laboratory results do not indicate a specific disease, the physician may suggest this study to make a diagnosis.

- Exclusion of diseases with similar symptoms. Approximately 10%-30% of patients visit doctors with symptoms that resemble fibromyalgia, including fatigue, malaise, and widespread muscle pain. Because no laboratory test can confirm a diagnosis of fibromyalgia, doctors usually first look for a disease with similar symptoms.

Initiating a diagnosis of a condition from one of the conditions listed below does not always rule out fibromyalgia, as several conditions can overlap or coexist with fibromyalgia, and moreover have similar symptoms. Like fibromyalgia, a number of these diseases are not subject to easy diagnosis. It is not yet clear whether these symptoms cause fibromyalgia, are risk factors for its disorder, or have nothing to do with it at all.

List of diseases with similar symptoms to fibromyalgia

- Chronic fatigue syndrome. There are significant similarities between fibromyalgia and chronic fatigue syndrome (CFS). As with fibromyalgia, the causes of CFS are unknown. A doctor can only diagnose a disorder based on the patient's symptoms. Fibromyalgia and CFS experience and treat most of the same symptoms. However, there is some difference between them:

Painful points are the main symptom in fibromyalgia. Some CFS patients have similar pressure points, but their muscle pain is less severe.
Fatigue is the main symptom of CFS. It is not caused by excessive physical exertion, and it does not go away even after sleep and rest.

Some doctors believe that fibromyalgia is simply the extreme end of chronic fatigue syndrome. However, the data shows that the two diseases are different and each has its own symptoms.

- Myofascial pain syndrome. Myofascial pain syndrome can be easily confused with fibromyalgia. However, unlike fibromyalgia, myofascial pain tends to be concentrated at trigger points and generally does not spread widely. Trigger point is pain in tight muscles, and when the doctor presses on these points, the patient may experience muscle twitching. Unlike pain points, trigger points are most often small lumps about the size of a pencil eraser.

- Depression. The link between psychological disorders and fibromyalgia is very strong. Studies report that 50 to 70% of fibromyalgia patients experience lifelong depression. However, only 18 to 36% of fibromyalgia patients experience major depression.

Some studies have shown that people who have both psychological disorders and other symptoms of fibromyalgia seek medical help more quickly. medical care compared to patients who simply have fibromyalgia symptoms. If this is the case, then the results of the study may be inaccurate, so we need to look for something more serious than just the link between depression and fibromyalgia.

The suppressed feelings in people with fibromyalgia may be a normal response to pain and fatigue caused by the syndrome. Such emotions, unfortunately, are often accompanied by this disease. However, they are not considered a disorder or depression. Unlike normal periods of sadness, depression can last for many months.

Symptoms of severe depression include the following:

Depressed mood every day;
- inability to concentrate or make decisions;
- insomnia or excessive sleepiness;
- reduced energy every day;
- anxiety or feeling of fear;
- significant weight gain or loss (10% or more of a person's habitual body weight);
- suicidal thoughts.

If some of the above signs are present, and none of the physical symptoms of fibromyalgia exist, the diagnosis is most likely prolonged depression.


- Chronic headache and migraine. Chronic headaches such as migraine are common in patients with fibromyalgia. Some experts believe that both migraine headaches and fibromyalgia headaches are due to defects in the system that regulates certain chemicals in the brain, including levels of serotonin and adrenaline. Also, patients with both fibromyalgia and migraine have low magnesium levels. Symptoms of a migraine attack may include increased sensitivity to light and sound, nausea, vision problems (auras), speech difficulties, and severe pain that is mainly concentrated in one part of the head.

- Some chemical sensitivity. Some chemical sensitivity (MCS) is a term for situations in which certain chemicals cause symptoms that are similar to CFS or fibromyalgia. Like CFS and fibromyalgia, MCS can be a medical or psychological problem. Each of us is exposed to many chemicals on a daily basis, so it is very difficult to determine whether chemicals are causing specific symptoms. Experts have come up with several criteria to help recognize MCS:

Symptoms can be caused by several substances that are chemically related;
- symptoms affect many organs and systems;
- symptoms always recur upon repeated contact with the chemical;
- the symptoms disappear when the chemical is removed.

- Restless legs syndrome. About 15% of people with fibromyalgia have Restless Leg Syndrome (RLS). RLS brings anxiety and impairs physical activity, which is sometimes described as a feeling of restlessness and fatigue in the lower leg.

- Lyme disease. Lyme disease is bacterial disease and transmitted by ticks. Healthcare professionals typically (but not always) diagnose Lyme disease using blood tests that identify antibodies directed at the bacteria that caused the disease. But if the disorder is not diagnosed right away and the symptoms return, then Lyme disease can be mistaken for fibromyalgia. Some experts believe that 15 - 50% of patients referred to the clinic for Lyme disease actually have fibromyalgia. If fibromyalgia patients are misdiagnosed and treated for Lyme disease with long courses of antibiotics, the drugs can have serious side effects.

- Drugs and alcohol. Fatigue is a side effect of many prescription and over-the-counter medications, such as antihistamines. Constant fatigue is also a symptom of drug and alcohol addiction or abuse. Health care providers should consider the medications the patient is taking as a possible cause of fatigue. Withdrawal from caffeine can also produce depression, fatigue, and headache.

- Polymyalgia rheumatica. Polymyalgia rheumatica is a condition that causes pain and discomfort. It usually occurs in older women. In this disorder, tender points are also present, although they are almost always located in the hip and shoulder joint. Morning stiffness is a common symptom, some patients may also experience fever, weight loss and fatigue. It is important to diagnose the symptoms of polymyalgia rheumatica on early stages because some PMR patients have associated conditions (giant cell arteritis) that can lead to blindness if left untreated. Polymyalgia rheumatica is usually treated with small doses of steroid drugs such as prednisone.

Treatment fibromyalgia

Fibromyalgia is not yet a fully understood condition of the body. What causes it, and how it damages the human body, is still largely unknown. Its treatment usually includes not only relieving symptoms, but also changing people's attitudes towards their illness, which helps them cope with their illness more quickly.

The Fibromyalgia Society of America recommends a combined treatment approach using cognitive behavioral therapy and exercise. A combination of non-drug therapies works in the same way as drug therapy to reduce pain, depression, and disability. This method includes exercise, stress management, massage, and diet.

If this set of treatments fails to improve symptoms, antidepressants or muscle relaxants may be added to the treatment. Doctors usually prescribe these drugs to lower the pain threshold.

Patients should have realistic expectations about the long-term outlook for their condition. It is important to understand that fibromyalgia can be managed so that people can live fulfilling lives.

Many studies have shown that exercise is the most effective part of managing fibromyalgia. Physical activity prevents muscle wasting, improves emotional well-being, and, over time, reduces fatigue and pain. Exercise programs for the treatment of fibromyalgia are often combined with aerobic and strength training with gymnastics. Some studies have shown that improvement in body condition can last up to 9 months after the end of an exercise program.

- Adapted exercises. The main approach that is used in the treatment of fibromyalgia is called graduated exercises. According to these exercises, the patient gradually increases the amount of physical activity. Enough effective exercises stretching before work. Doing them daily helps to relax tense muscles and prevent soreness. Swimming and water procedures are very good, they do not contribute to the distribution of the load on the joints. Swimming, walking, and exercising with equipment such as treadmills or exercise bikes have a positive effect on people with fibromyalgia.

Adding cognitive behavioral therapy (CBT) to an exercise program may also help people with fibromyalgia feel better.

It is important to start your exercise program gradually. Patients who attempt compound exercises early experience only increased pain, become discouraged, and quit. Each patient should be prepared for relapses and failures, but do not give up. Exercise can help relieve fibromyalgia. Studies show that adding small amounts of physical activity daily improves pain and reduces fatigue in patients.

- Physiotherapy can also be very helpful. Research shows that physical therapy can not only reduce muscle overload and fatigue, but also strengthen weak muscles.

- Tai Chi program. There is an ancient Chinese Tai Chi exercise program that combines slow movements, proper breathing and meditation. It can also help people with fibromyalgia by reducing pain, fatigue, physical functioning, insomnia, and depression.

- Sleep normalization. When treating fibromyalgia, it is also important to maintain normal sleep. . Sleep is essential, in part, because sleep disturbance exacerbates pain. Many fibromyalgia patients suffer from insomnia, which prevents the body from resting at night. To normalize sleep you need:

Avoid caffeine or alcohol 4 to 6 hours before bedtime;
- avoid drinking liquids immediately before bedtime so that you do not have to wake up at night to urinate;
- Avoid large meals before bed. You can be quite satisfied with light snacks;
- avoid drowsiness, especially in the evening or late afternoon;
- set the bedtime and wake up hours in the morning. Maintain this schedule even on weekends and during holidays;
- if you can't fall asleep within 15 - 20 minutes, go to another room and start a quiet activity. Return to bed when you feel sleepy;
Minimize light and maintain a comfortable, moderate temperature in the bedroom. Keep the bedroom well ventilated;
- use the bed only for sleeping and sexual relations.


- Proper nutrition. While being treated for fibromyalgia, patients should also maintain a healthy diet that is low in animal fat and high in fiber. The diet should include plenty of whole grains, fresh fruits and vegetables. However, despite this, patients are still allowed to consume certain types of fats belonging to the Omega-3 fatty acids group. The fact is that oils containing these acids are of particular interest for reducing joint pain. These oils can be found in cold water fish species or purchased as supplements called EPA-DHA or omega-3s.
Omega-3 fatty acids are a form of polyunsaturated fats that are ingested through food. Omega-3s are known as essential fatty acids (EFAs) because they cannot be produced by the body. These healthy fatty acids can be found in some fish, rapeseed oil, flax seeds, and walnuts. Omega-3 fatty acids have anti-inflammatory properties that help prevent blood clots, lower cholesterol and triglycerides, and lower blood pressure. Omega-3s may also reduce the risks and symptoms of diabetes, stroke, rheumatoid arthritis, asthma, inflammatory diseases intestines, ulcerative colitis and even some cancers.
The actual benefit of a vegetarian diet for people with fibromyalgia remains unproven.

- Getting rid of stress. Experience shows that people with fibromyalgia have a more stressful response to daily conflicts and confrontations than healthy people. Some stress reduction techniques may be helpful for chronic pain management, including:

- Biofeedback. During a biofeedback session, electrical wires are glued to a person's head. The patient is encouraged to relax using whatever method works. Brain waves are measured and a beep sounds when alpha waves are detected. Alpha waves are brain waves that occur in a state of deep relaxation. By repeating the process, people who use biofeedback learn to relax on their own over time. These studies do not prove that biofeedback is a very useful method for treating fibromyalgia patients.

- Hypnosis. One small study found that hypnosis was even more effective in improving body condition and reducing pain than physical therapy.

- Massotherapy. Massage helps to slow down the heartbeat and relax the body. In one study, patients who received 30-minute massage sessions twice a week experienced a reduction in stress and anxiety.

- Meditation. Meditation, which has been used for many years in Eastern cultures, is now widely used throughout the world as an effective form of relaxation. A number of studies prove certain benefits of meditation in the treatment of fibromyalgia. Meditation provides the following physical benefits:

Decreased heart rate, blood pressure, adrenaline levels and skin temperature;
- improvement of well-being;
- improved sleep - melatonin helps regulate the sleep-wake cycle;
Reducing pain, possibly from lower levels of cortisol, the stress hormone.

The main purpose of meditation is to calm the mind - basically to let the thoughts relax. This redirection of brain activity away from thoughts and worries into the self disrupts the stress response, providing rest and renewable energy.
People who are trying to meditate for the first time should understand that it will be difficult to get their thoughts in order initially, so they should not be discouraged by the lack of immediate results. Some experts recommend meditating for no more than 20 minutes in the morning after waking up, and then again in the early evening before dinner. Meditating only once a day is helpful. It is not recommended to meditate before going to bed because some people wake up in the middle of the night after meditation with a feeling of anxiety and are unable to sleep.

Medical treatment fibromyalgia

When combined with exercise and behavioral therapy, patients may receive drug treatment. The main treatments for fibromyalgia are pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). However, many other drugs, including antidepressants, sleeping pills, pain relievers, and muscle relaxants, are also widely used in the treatment of this condition. The main purpose of using medications is to improve sleep and lower the pain threshold. Short description medicines:

- Anticonvulsants. Pregabalin is a medical anti-epileptic. Anticonvulsants interfere with the gamma-aminobutyric acid (GABA) chemistry, which helps prevent nerve cells from overburning.
Studies show that pregabalin can improve sleep quality, relieve symptoms of fatigue and pain. Its most common side effects consist of mild dizziness and drowsiness. Pregabalin may also impair motor function and cause problems with concentration and attention. Patients should consult their physician about whether pregabalin may affect their ability to drive.

Studies have shown that another anticonvulsant, gabapentin (Neurontin), is similar to pregabalin in relieving pain in some people with fibromyalgia. Patients reported that after taking this drug they began to sleep better and feel less tired. However, gabapentin may cause side effects such as dizziness, drowsiness, and swelling.

- Antidepressants. The main antidepressants used in the treatment of fibromyalgia include tricyclic, selective serotonin reuptake inhibitors (SSRIs), and serotonin and norepinephrine serotonin reuptake inhibitors (SNRIs). Although these drugs are antidepressants, doctors prescribe them even to non-depressed patients with fibromyalgia to improve sleep and relieve pain. The doses used to treat fibromyalgia are usually lower than the doses prescribed to treat depression.

- Tricyclics. Tricyclic antidepressants are among the first drugs that have been well studied for the treatment of fibromyalgia. In some cases, they may be more effective than SSRIs and SNRIs, although all three of these drug classes show some effectiveness. Tricyclics cause drowsiness, which can improve the patient's sleep. Studies have shown that they are also effective in reducing pain and improving depressed mood and quality of life. The most commonly used tricyclic drug for fibromyalgia is amitriptyline (Elavil, Endep), which significantly reduces pain and improves sleep, but may lose its effectiveness over time. Other tricyclics are also used: nortriptyline (Pamelor, Aventyl), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), and amoxapine (Asendin).

- Selective serotonin reuptake inhibitor. Selective serotonin reuptake inhibitors (SSRIs) increase the level of serotonin in the brain, which is very important for patients with fibromyalgia. Commonly prescribed drugs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and fluvoxamine. Studies show that they can improve sleep, fatigue, and mood in many patients. These drugs should be taken in the morning as they can cause insomnia. Common side effects are manifested through agitation, nausea, and sexual dysfunction.

- Serotonin and norepinephrine reuptake inhibitors (SNRIs), also known as dual inhibitors, they act directly on two chemical messengers in the brain, serotonin and norepinephrine. These drugs in the treatment of fibromyalgia are more effective than SSRI drugs. They also have fewer side effects than tricyclic antidepressants and are very well tolerated. The most common SNRIs in the treatment of fibromyalgia is Duloxetine (Cymbalta), which reduces fibromyalgia pain by more than 30%. The most common side effects after taking this drug are nausea, dry mouth, constipation, decreased appetite, drowsiness, increased sweating, and agitation. Duloxetine may also increase the risk of bleeding in patients. The drug milnacipran (Savella) can significantly improve pain and physical function in patients with fibromyalgia. Milnacipran should not be given to children. It is also not suitable for patients who are taking monoamine oxidase inhibitors. Venlafaxine (Effexor) is similar in efficacy and tolerability to fluoxetine (Prozac). Venlafaxine impairs sexual function and some patients experience changes in blood pressure.

- Muscle relaxers. Cyclobenzaprine (Flexeril) relaxes muscle spasms in certain places without affecting its overall muscle function. It helps relieve the symptoms of fibromyalgia. Cyclobenzaprine is similar to tricyclic antidepressants and has similar side effects, including drowsiness, dry mouth, and dizziness.

- Medicines to improve sleep. Zolpidem (Ambien) or other new sleep medicines such as zaleplon (Sonata) and Eszopiclone (Lunesta) may improve sleep in patients with insomnia.

- Painkillers. Pain management is of great concern in patients with fibromyalgia. Pain relievers for fibromyalgia include:

Tramadol (Ultram), used alone or in combination with acetaminophen (Tylenol), is often prescribed for pain relief. Its most common side effects are drowsiness, dizziness, constipation, and nausea. Tramadol should not be used with tricyclic antidepressants. Patients can become addicted to this drug and potentially abuse it. For mild pain relief, acetaminophen is most commonly recommended. Anti-inflammatory drugs that are commonly used for arthritis are less helpful for treating fibromyalgia. These include corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen (Advil). For older people with chronic pain, the use of NSAIDs is not recommended, as the risks of cardiovascular and gastrointestinal diseases are increased.

Capsaicin (Zostrix) is an ointment derived from the active ingredient hot chili peppers. Capsaicin is effective tool to relieve pain. It may also be helpful for patients with fibromyalgia.

Pramipexole, a drug used to treat Parkinson's disease and restless leg syndrome, may help relieve pain and fatigue in people with fibromyalgia. Pramipexole stimulates the production of dopamine, a chemical messenger in the brain.

- Other drugs. Nabilone, a synthetic drug derived from marijuana, may be another effective addition to fibromyalgia treatment. In one study, the drug nabilone (Cesamet), which is also used to treat nausea and vomiting in patients using chemotherapy, significantly improved the pain associated with fibromyalgia. There are some problems with using nabilone to treat fibromyalgia: firstly, this substance is under control and can be addictive, and secondly, the cost of the drug is quite expensive, so it is not appropriate to use it for a chronic disease such as fibromyalgia.

There is no consensus on which treatment method is most beneficial, or which combination of treatments works best. Patients may receive drug treatment in combination with exercise, patient education, and behavioral therapy.

Alternative treatments fibromyalgia

Due to the difficulties in treating fibromyalgia, many patients seek alternative treatments. The effectiveness of these treatments has not been proven, so doctors do not particularly recommend them. These methods include:


 Research continues to report conflicting results about acupuncture's ability to relieve pain. Several small studies show that acupuncture has some results, especially for people who cannot take medication due to side effects. Acupuncture also helps to relieve pain in combination with tricyclic antidepressants and exercise, and improvements are observed for several months after the end of treatment. Other studies have not found enough evidence to support the use of acupuncture for the treatment of fibromyalgia.

- Chiropractic or manual therapy. Chiropractic or chiropractic may also help some patients. Osteopathic methods include various actions with the spine or muscles. Some studies have shown that osteopathic manipulation relieves pain and improves sleep. Larger and better studies are needed to clearly determine whether this is an effective treatment. There is always a very small risk of side effects from any of these methods. For example, in rare cases, massaging the neck can cause a stroke or damage to the major blood vessels in the neck area.

- Herbs and supplements. Several alternative treatments are in development for the treatment of fibromyalgia. Examples include: melatonin, a natural hormone associated with the sleep-wake cycle, and S-adenosylmethionine, a natural substance with antidepressant, anti-inflammatory, and analgesic properties. According to research, there are small positive results in the treatment of some patients with fibromyalgia, but all of these trials have not been well thought out so far.

Here, it is extremely important for patients to understand that any herbal medicine, while having a positive effect, is likely to have negative side effects and toxic reactions, like any conventional drug. A significant number of cases have been reported with serious and even fatal side effects from herbal products. Before using any herbal preparations or nutritional supplements, be sure to consult your doctor. Potential interactions between existing medications and herbal and supplement supplements should also be discussed with them.

- Behavioral therapy. Cognitive behavioral therapy (CBT) is an effective way to help patients cope with chronic pain and stressful situations. Experience shows that CBT may help some patients with fibromyalgia.

Although the effects of CBT and other non-drug treatments for fibromyalgia do not always last long, they can help certain groups of people, especially those with high levels of psychological stress. Cognitive behavioral therapy may be especially helpful for insomnia, one of the main symptoms of fibromyalgia.

Goals of Cognitive Behavioral Therapy . The main tasks of CBT are to change the erroneous ideas of patients and their doom to failure. Patients learn to think of pain as something other than a negative factor that rules their lives. Over time, the idea that they are helpless goes away and they realize that they can control the pain. Patients learn to prioritize their responsibilities, they learn to prioritize less important tasks or delegate them to others. Learning these skills can ultimately lead to greater control over your life.

How does cognitive behavioral therapy work. CBT usually consists of 6 to 20 hour sessions. Patients also receive homework, which typically includes journaling and solving problems they have avoided in the past.
A typical CBT program might include the following:

Keeping a diary. Patients are usually asked to keep a diary. The diary serves as a guide for setting limits and planning activities. Patients use a diary to keep track of any stress, such as work or relationships, that may worsen their pain.
- Confronting negative or discouraging thoughts. Patients challenge all their negative thoughts by making a reverse belief. For example, "I'm not good enough to control this disease, I can't do anything," the reverse belief is "I can learn to control this disease."
- Setting limits. Restrictions are designed to keep both mental and physical activity within reasonable levels. For example, tasks are broken down into sequential steps and patients focus on completing one step at a time.
- Search for enjoyable activities. Patients are enumerated a number of pleasant low-energy activities where they can express themselves.
- Setting priorities. Patients learn to give up a number of less important tasks or delegate them to others.
Patients must learn to accept that relapses may occur over time. They must be prepared for this, so they must not feel that they have failed.

Research also suggests that patient education programs should be effective in treating fibromyalgia, especially when combined with cognitive behavioral therapy, exercise, and other therapies. Educational programs may take the form of group discussions, lectures, or printed materials, although there is no clear evidence that any particular type of education works better.

Treatment of fibromyalgia in children

Experts say treatment for fibromyalgia in children should begin with non-drug treatments, including exercise and cognitive behavioral therapy. Medications such as pregabalin and milnacipran are recommended for adults, and in trials whether they can be used in children, they have shown no effect. at its best. Analgesics and NSAIDs are not very effective in treating children. Psychological therapies can help control pain in children, although there is no evidence that they improve physical activity or mood.

Complications of fibromyalgia

Fibromyalgia can be both mild and severe, with significant emotional losses. People with fibromyalgia experience a great psychological shock, pain has a significant impact on their quality of life, they bring more inconvenience to the patient than, for example, pain such as pain during chronic disease back.
About half of all patients experience difficulty in normal daily life. The constant pain, lack of sleep, distraction, nervousness associated with fibromyalgia prevents people from doing their usual activities, they lose their ability to function in the usual mode at home and at work, therefore they become irritable, restless, depression and a feeling of dissatisfaction with life appear. According to experts, about 30 - 40% of patients diagnosed with fibromyalgia were forced to quit or change jobs.

All this leads to the fact that patients suffering from fibromyalgia often self-medicate, while abusing sleeping pills, alcohol, drugs or caffeine, which in turn has an adverse effect on the body. Such self-treatment can also lead to the emergence of other diseases, which can be eliminated only with the help of a qualified specialist.

- Outlook in adults. Although fibromyalgia is a lifelong condition, it is not fatal. Some studies show that fibromyalgia symptoms remain stable in the long term, while others report that more than a quarter of patients experience improvement in symptoms over time. Research also shows that regular exercise improves prognosis.

- Outlook in children. Children with fibromyalgia tend to have a better prognosis than adults. Some studies have shown that more than half of children with fibromyalgia recover in 2-3 years.

Many medications are used to treat the symptoms of fibromyalgia, including sleeping pills and antidepressants. Some drugs relieve pain, others improve sleep and improve mood. However, you should not rely on drugs alone. An individual treatment program should be developed with the doctor in order to cope with the symptoms of the disease.

Most often, in the treatment of fibromyalgia, the drugs Cymbalta (antidepressant) and Lyrica (antiepileptic drug) are used.

One third of patients with fibromyalgia suffer from depression and anxiety. Doctors often prescribe antidepressants to patients, which improve mood and sleep, and reduce pain. The most effective in the treatment of fibromyalgia are tricyclic antidepressants and cyclobenzaprine (muscle relaxers).

Tricyclic antidepressants

Tricyclic antidepressants (Elavir, Pamelor) increase the level of neurotransmitters in the brain. Low doses of tricyclic antidepressants improve sleep.

Tricyclic antidepressants increase the levels of serotonin and norepinephrine in the brain. Patients with chronic pain have reduced level these calming neurotransmitters. Tricyclic antidepressants relax muscles, enhance the effect of endorphins - the body's natural painkillers. However, these drugs cause side effects such as drowsiness, dizziness, dry mouth, dry eyes, and constipation.

Duloxetine (Tsimbalta) relieves fibromyalgia pain and other symptoms.

Selective serotonin reuptake inhibitors (SSRIs) are a new generation of antidepressants (Prozac, Zoloft). They block the uptake of serotonin, allowing serotonin to move freely from neuron to neuron. As a result, the patient's mood improves.

Increased serotonin levels may also help reduce pain and weakness. SSRIs can disrupt a person's sleep, so doctors prescribe tricyclic antidepressants along with these drugs.

What drugs relieve pain?

In some cases, doctors prescribe analgesics and pain medications to relieve the severe muscle pain that accompanies fibromyalgia. However, analgesics do not have the same effect on all people.

Over-the-counter drugs of the acetaminophen group increase pain threshold which reduces pain. Aspirin blocks the production of prostaglandin, a chemical that causes pain, inflammation, and swelling.

Non-steroidal anti-inflammatory drugs do not relieve the pain of fibromyalgia. However, in combination with drugs such as Elavil, Flexeril and SSRIs, they often give a positive effect. Among the drugs in this group are over-the-counter aspirin, ibuprofen, naproxen.

Side effects of pain medications

If the patient suffers from any disease gastrointestinal tract, he should be careful with aspirin and other non-steroidal anti-inflammatory drugs, which can cause heartburn, nausea and vomiting, ulcers, gastrointestinal bleeding. They can also slow blood clotting.

Aspirin and other drugs in this group may cause or exacerbate peptic ulcer duodenum. Patients who have had gastrointestinal bleeding or ulcers should consult their doctor before taking these drugs.

Acetaminophen does not usually cause serious side effects, however, it should not be taken by those with liver disease.

Some people cannot take aspirin and other drugs in this group because of the so-called "aspirin" triad. Sensitivity to aspirin occurs in 10%-15% of people with asthma. Among those with asthma and nasal polyps, the incidence rises to 30%-40%. If a person is sensitive to aspirin, they may experience symptoms such as itching, rash, swelling, runny nose, wheezing.

Fibromyalgia Treatment: Muscle Relaxers

Cyclobenzaprine (Cycloflex, Flexeril), a muscle relaxant, is effective in the treatment of fibromyalgia. Preparations of this group relieve tension in the muscles, improve sleep, affecting the central nervous system. These drugs relieve pain in the muscles and head, etc.

Muscle relaxers can cause the following side effects: dry mouth, dizziness, drowsiness, distraction, blurred vision, discoloration of urine. These drugs increase the likelihood of an epileptic seizure, in some cases cause hallucinations.

Anticonvulsants

"Lyric" - new drug, which is used to treat fibromyalgia. This drug slows down the impulses in the brain that cause convulsions. Lyrica affects chemicals in the brain that relay pain signals to the nervous system. Thus, the drug reduces pain and improves sleep.

Fibromyalgia Treatment: Other Drugs

Fibromyalgia is treated with drugs such as Ultram, which is stronger than acetaminophen. This drug affects how the human brain perceives pain. The drug does not treat inflammation, is not addictive.

Many doctors prescribe benzodiazepines to patients with fibromyalgia, which help relieve muscle pain, improve sleep, and relieve restless legs syndrome (an unpleasant sensation that causes you to constantly move your legs when a person is at rest). These drugs affect the central nervous system and are addictive if taken in high doses. Before taking, you should consult with your doctor.

In extreme cases, when nothing helps to ease the patient's pain, a doctor may prescribe strong opioid pain medications ("OxyContin").

A fairly common symptom complex, characterized by depressive disorders, morning stiffness, chronic fatigue, and muscle weakness spreading throughout the body, is called fibromyalgia, ICD-10 code: M79.1. How to deal with such a disease?

The basis of the pathology is malfunctions in the functioning of the central nervous system and the endocrine system. This ailment accompanied by a decrease in the threshold of pain sensitivity, due to which any normal effect on the body, for example, temperature changes or physical and emotional stress, which do not cause healthy person pains are perceived as excessive and are characterized by severe soreness. Such changes affect the psychological and emotional status and lead to depression.

What provokes the development of myofascial pain syndrome? To date, a number of reasons have been formed, one way or another affecting the appearance of the disease. Fibromyalgia can occur for a number of reasons:

  • frequent stress;
  • overwork;
  • accident, injury or serious incurable pathology;
  • malfunctions in the functioning of the hormonal system;
  • the use of certain medications.

Many scientists and experts do not see the disease in this symptom complex and call it a chronic ailment caused by stress. But after all, everyone knows that stress is a kind of protective reaction of the body, in particular the central nervous system. In fact, this reaction is useful for the body, but only if it is short-lived.

If the stress is prolonged, it most negatively affects the functioning of the nervous, immune and endocrine systems. Prolonged stress provokes disruption of the adrenal and pituitary glands, as well as improper production of hormones by them. Disorders and violation of the composition of hormones provoke the appearance of muscle pain.

It has been proven that in people who are faced with an illness, there is an insufficient concentration of the neurotransmitter serotonin in the body. Frequent and prolonged stressful situations can provoke a decrease in the body's defenses. The body becomes vulnerable, it begins to attack various pathogenic microorganisms that did not previously have such an opportunity. These bacteria include: chlamydia, herpes, toxoplasma, cytomegalovirus, streptococcus.

The active effect of microorganisms on the human body contributes to the release into the bloodstream a large number antibodies that, in an attempt to fight bacteria and viruses, begin to attack their own tissues, in particular bone and muscle.

Women aged 25-40 are more likely to develop fibromyalgia. In men, this pathology practically does not occur, because, compared to representatives of the weaker half of society, they are less prone to stress.

In addition, the appearance of chronic malaise may be due to: trauma, genetic predisposition, increased psychological vulnerability.

Fibromyalgia Symptoms

Signs and symptoms of the disease are nonspecific and can occur with other pathologies, as well as with normal sleep deprivation or fatigue. Typically, fibromyalgia is characterized by:

  • intense pain in the muscles and bones, patients describe this condition as “it hurts and aches the whole torso”;
  • soreness and swelling in the joints;
  • emotional disorders;
  • tingling in the muscles;
  • rapid muscle fatigue;
  • sleep disturbance: insomnia or drowsiness;
  • morning stiffness.

As you can see, the above manifestations are characteristic of both ordinary fatigue and many various diseases. Often a person does not attach much importance to such symptoms, as he writes them off as banal overwork or lack of sleep. However, ignoring the disease is fraught with the development of depression, and protracted ones, the treatment of which is laborious and lengthy.

That is why you should not underestimate a headache or muscle pain, especially one that appears too often. Seek medical attention if symptoms occur.

Diagnostics

Fibromyalgia is a diagnosis of exclusion. This means that the doctor must first rule out other diseases. As a rule, in addition to the survey and physical examination of the patient, the following is prescribed: blood sampling. Most effective method diagnostics - a specific scheme for determining pain points.

Fibromyalgia is diagnosed if:

  • sensitivity was detected in eleven of eighteen pain points: areas 4, 5, and 6 cervical vertebra, left and right trapezius muscles, elbow joints, in the area of ​​the shoulder blades, knee joints, the upper part of the gluteal muscles;
  • duration of pain - three or more months;
  • sleep is not beneficial, after it fatigue does not go away;
  • in the morning there is stiffness in the joints;
  • impossible to concentrate.

The search for points of pain is of the greatest importance, because this is the method that will help distinguish fibromyalgia from other pathologies that affect the muscle and bone tissue. The search is carried out by palpation. The pressure on the points should not exceed four kilograms. If you feel when pressed strong pain, the point is marked as positive. Often, in order to exclude the subjective factor, the procedure is carried out several times.

Treatment of the disease

Treatment of fibromyalgia should be comprehensive. As a rule, the use of medications is prescribed; physiotherapy; massage and physiotherapy exercises. The first thing to do is to eliminate the root cause of the disease, in this case, stress.

What about drug therapy, then the following drugs are prescribed:

  • antidepressants: Melipamine, Amitriptyline - contribute to the normalization of the exchange of serotonin and norepinephrine;
  • anticonvulsants: Gabapentin, Pregabalin;
  • painkillers: Norflex - help to minimize pain in the muscles;
  • anti-inflammatory drugs: Voltaren, Ibuprofen, Relafen.

In addition, the use of muscle relaxants and sedatives is often prescribed.

As for non-drug methods, it is possible to improve the patient's condition with the help of: balneotherapy, cryotherapy, massage, acupuncture, physiotherapy exercises.

Forecast and prevention

Fibromyalgia is a disease characterized by a chronic course, that is, it can appear again. Symptoms persist throughout life and will be mild if the patient adheres to all the doctor's recommendations, takes prescribed medications, eats properly and is active and active. healthy lifestyle life.

If symptoms of a pathology appear, be sure to make an appointment with a neurologist or therapist. This symptom complex is not fatal and does not lead to damage to internal organs. However, if left untreated, it can adversely affect the quality of life.

In order to prevent the development of fibromyalgia, it is necessary to avoid stressful situations, observe the regime of work and rest, and also not to abuse medications eat right and boost your immune system.

Reviews: who helped?

Irina, 39 years old, seamstress. I suffered from fibromyalgia a few years ago. Often there were headaches, weakness and pain in the muscles. I chalked them up to fatigue. But the symptoms began to intensify, I decided to go to the doctor. They said fibromyalgia and prescribed a whole bunch of drugs: antidepressants, painkillers. In addition, enrolled in courses therapeutic gymnastics. I took Norflex and Cyclobenarine. I lead a healthy lifestyle, go in for sports. The doctor said that the disease is chronic, and any stress can provoke an exacerbation. To this day, everything is fine, I save my nerves with all my might.

Valeria, 33 years old, massage therapist. Periodically there were muscle pains, dizziness. Didn't attach much importance to them. I constantly felt tired, did not get enough sleep, although I always went to bed on time. A doctor friend advised me to get tested. I knew about such a syndrome as fibromyalgia, but I could not imagine that my headaches and muscle pain because of him. I was prescribed Pregabalin and Meloxicam ointment. Sleep has improved, the feeling of fatigue and stiffness in the morning has disappeared. Now, in order not to face adversity again, I go to the gym, eat right and try to avoid stress.

Alena, 28 years old, teacher. The work is stressful, but I knew where I was going to work. There were pains in the muscles, especially in the legs. I thought it was because I spend a lot of time on my feet. I follow the daily routine, because at school you need to be concentrated. But I forgot what sleep is. I got up in the morning, and it felt like I didn’t go to bed. I noticed that I became too irritable. Went to the hospital, was diagnosed with fibromyalgia and prescribed Pregabalin. Very good medicine. The symptoms disappeared quickly.

most common cause referral to a neurologist is a pain syndrome of various localization and origin. In this case, the doctor often detects signs of damage to the nervous structures or the spine. But there is a disease in which the detected pathological changes are scarce and do not correspond to the severity, duration and abundance of complaints.

This is fibromyalgia. This is the name of the lesion of extra-articular soft tissues, leading to a persistent prolonged diffuse pain syndrome. This disease most often affects middle-aged women and requires complex long-term treatment.

Causes of the disease

Despite the sufficient prevalence of the disease (up to 5% in the population), doctors and neurophysiologists until now, the exact cause has not yet been fully elucidated. appearance of fibromyalgia. There are several theories, each of which takes into account one of the possible mechanisms for the appearance of persistent diffuse pain.

Currently as possible causes diseases indicate:

  • a hereditary factor affecting the number and activity of opioid, dopaminergic and serotonin receptors in the brain, as well as the functioning of certain enzymes in the central nervous system;

  • destabilizing effect of physical trauma, prolonged immobilization, chronic or acute stresses suffered viral diseases with damage to the nervous structures or intoxication;

  • disorders of circadian rhythms, leading to changes in the structure of sleep and an imbalance in the production of biologically active substances;

  • hormonal disorders with a change in the work of the hypothalamic-pituitary-adrenal system in the first place;

  • the presence of latent (larvated), somatized and somatoform affective disorders with the presence of an anxiety-depressive syndrome, which is often mistaken for a consequence of chronic pain.

The mechanism of development of fibromyalgia is associated with an imbalance in the perception of various stimuli by the structures of the peripheral and central nervous system. A pathological response to stress is also of some importance, along with a change in the work of the hypothalamic-pituitary-adrenal complex and the autonomic nervous system.

Symptoms

The main manifestation of fibromyalgia is chronic pain syndrome. At the same time, unpleasant sensations are almost constant and diffuse. Pain captures all four quadrants of the body (with conditional division by lines running along the spine and horizontally just above the pelvic bones), it is necessarily noted in the paravertebral region or in the region of the sternum.

To confirm the diagnosis of fibromyalgia, it is necessary that the pain syndrome be noted for at least 3 months.

Patients complain of pulling, twisting, aching and bursting sensations in the muscles. They can change their intensity, migrate, capture the entire body, or be localized in several zones. Fibromyalgia pain is not associated with physical activity and does not go away after rest and sleep. In addition, it tends to increase after stress.

Compulsory symptom of fibromyalgia is the presence of paired pain points, which are detected by the doctor during the examination. Pressing on certain parts of the body with a precisely calculated effort can cause an increase in pain and the appearance of local pain in the area of ​​pressure. In total, there are 18 pairs of such points, with fibromyalgia, 11 pairs can be painful.

Additional symptoms of the disease are:

  • sleep disorders,

  • feeling of morning fatigue

  • fast fatiguability,

  • decreased concentration of attention with a feeling of memory impairment,

  • depressed mood with anxiety.

In addition to pain, patients with fibromyalgia often report other unpleasant sensations in the body. This may be a feeling of fullness, swelling, enlargement of the limbs, transient rigidity and stiffness.

Typical and skin symptoms- Hypersensitivity to touch, crawling sensation, transient feeling of slight numbness. At the same time, violations of surface sensitivity do not correspond to the zones of innervation and cannot be explained by damage to certain nerves or spinal roots.

Fibromyalgia is often referred to as a psychosomatic illness. With targeted questioning, the doctor often reveals other disorders of the same register: irritable bowel syndrome, migraine, dysuria due to spasms of the bladder, tension headache.

Survey

The diagnosis of fibromyalgia is made if the clinical picture cannot be explained by the presence of other diseases. In chronic pain syndrome, it is necessary to exclude the following conditions:

  • paraneoplastic syndrome and the presence of metastases in malignant tumors;

  • chronic intoxication;

  • consequences of an infectious disease;

  • autoimmune diseases;

  • rheumatic polymyagia;

  • hypothyroidism, because the lack of function thyroid gland can imitate fibromyalgia;

  • row neurological diseases with damage to various structures of the nervous system.

The volume of additional laboratory and instrumental diagnostic studies determined by the doctor and depends on the general clinical picture. Common blood tests are usually ordered biochemical indicators, the level of rheumatic factors and hormonal background, electromyography, immunogram, imaging methods (radiography, MRI, CT). Fibromyalgia does not cause any changes on these tests, so this diagnostic search designed to rule out other diseases.

Medical treatment

In the treatment of fibromyalgia in adults, drugs of different groups are used, which makes it possible to influence several links of pathogenesis. These include antidepressants, anticonvulsants (anticonvulsants or antiepileptics), NSAIDs, narcotic and non narcotic analgesics. The use of tranquilizers is currently not recommended, as ongoing studies have shown the ambiguity of the effects obtained.

Antidepressants are intended for long-term therapy. They should be continued for several months and after improvement. Tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), or selective serotonin and norepinephrine reuptake inhibitors (SSRIs) may be prescribed.

The selection of the drug and therapeutic dosage is carried out by a doctor.

Anticonvulsants not only harmonize the processes of excitation and inhibition in the brain, but also have vegetostabilizing and normothymic effects. For fibromyalgia, drugs based on pregabalin and gabapentin are recommended.

NSAIDs are usually prescribed in addition to basic therapy with antidepressants and anticonvulsants. Preparations of different groups are used in the form of tablets, injections, ointments and patches. It is desirable to use non-narcotic and narcotic analgesics as rarely as possible, because they do not affect the pathogenesis of the disease. Muscle relaxants are prescribed for stiffness, spastic increase in muscle tone, most often Baclofen and Sirdalud are used.

With a pronounced pain syndrome at the beginning of treatment, blockade of pain points with a solution of lidocaine can be used. This reduces not only local pain, but also improves the general well-being of the patient.

Non-drug therapy

Chronic pain syndrome in fibromyalgia most often does not respond well to drug therapy alone. Therefore, it would be advisable to include other methods in the treatment regimen: cognitive psychotherapy, physiotherapy and acupuncture, autogenic training, exercise therapy, cryotherapy with local cooling of the skin with liquid nitrogen.

TO alternative methods treatments include herbal medicine, elements of chiropractic and acupuncture, the use of dietary supplements and homeopathy. All these methods in some cases can alleviate the patient's condition, but it is better to use them as an addition to the treatment regimen recommended by the doctor.