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Diagnosis of fibromyalgia: understanding symptoms and fibromyalgia syndrome

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  • Fibromyalgia is a chronic disease characterized by widespread pain, fatigue and a variety of accompanying symptoms.
  • Diagnosis is mainly based on a thorough medical history and physical examination, as there are no specific laboratory tests.
  • Typical symptoms include pain, fatigue, sleep disturbances, cognitive impairment and stiffness. Treatment is often multimodal and may include medication, physiotherapy, psychotherapy and complementary therapies. A balanced diet with omega-3 fatty acids can also help relieve pain by reducing inflammatory responses in the body. Patients with fibromyalgia benefit from a holistic approach that takes into account physical, psychological and social aspects.
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What is fibromyalgia and how is it diagnosed?

Fibromyalgia is a chronic condition characterized by widespread pain, fatigue and other symptoms. Diagnosis is usually made through a combination of medical history, physical examination and exclusion of other conditions. There are no specific laboratory tests that can clearly identify fibromyalgia.

Diagnosis Fibromyalgia 001

What are the most common symptoms of fibromyalgia?

The most common symptoms of fibromyalgia include:

  • Chronic, widespread pain
  • Tiredness and exhaustion
  • Sleep disorders
  • Cognitive impairment ("fibro fog")
  • Stiffness, especially in the morning
  • Headaches and migraines
  • Irritable bowel syndrome
  • Sensitivity to touch, noise or light

How is fibromyalgia diagnosed?

The diagnosis of fibromyalgia is based on the criteria of the American College of Rheumatology (ACR). These criteria include:

  • A history of widespread pain that has persisted for at least three months.
  • The presence of certain symptoms such as fatigue, sleep disturbances and cognitive impairment.
  • The exclusion of other diseases that could cause similar symptoms.

What does the medical history include in the diagnosis of fibromyalgia?

The medical history for the diagnosis of fibromyalgia includes

  • A detailed medical history, including the duration and nature of the pain.
  • Information on accompanying symptoms such as fatigue, sleep disorders and cognitive impairment.
  • Questions about previous illnesses, medication and family medical history.

What treatment options are there for fibromyalgia?

The treatment of fibromyalgia is often multimodal and includes:

  • Medication such as antidepressants, anticonvulsants and painkillers.
  • Physiotherapy and movement therapy.
  • Psychotherapy and behavioral therapy.
  • Complementary and alternative therapies such as acupuncture and massage.
picture showing a person behind treatmant dots

How can fibromyalgia pain be relieved?

Pain from fibromyalgia can be alleviated by various measures:

Balance between omega-3 and omega-6:

It is important to have a good balance between omega-3 and omega-6 fatty acids. A diet rich in omega-3 fatty acids can help to restore this balance. Foods rich in omega-3 fatty acids include oily fish such as salmon, mackerel and sardines, flaxseed, chia seeds and walnuts. Omega-3 fatty acid supplements can also be considered, especially if the diet does not provide sufficient omega-3 fatty acids.

  • Anti-inflammatory effect of omega-3Omega-3 fatty acids, especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), inhibit the production of inflammatory mediators such as prostaglandins and leukotrienes. This can help to reduce inflammatory reactions in the body and thus alleviate pain.
  • Pro-inflammatory properties of omega-6Omega-6 fatty acids, such as arachidonic acid, promote the production of inflammatory mediators. An excess of omega-6 fatty acids in relation to omega-3 fatty acids can lead to an increased inflammatory response, which can exacerbate the pain of fibromyalgia.

By supplementing omega-3 fatty acids and reducing the intake of omega-6 fatty acids, the inflammatory response in the body can be reduced and the pain of fibromyalgia alleviated. It is advisable to consult a doctor or nutritionist to obtain an individual recommendation for the intake of omega-3 fatty acids.

Further measures

  • Regular physical activityAerobic exercises and stretching exercises are particularly helpful.
  • MedicationAntidepressants, anticonvulsants and painkillers can be used.
  • Physiotherapy and massageThese can help to relax the muscles and improve mobility.
  • Stress management techniquesMeditation, yoga and other relaxation techniques can reduce stress and decrease the perception of pain.

The following internet links may be helpful for further information and current research results:

These links provide comprehensive information and resources on the diagnosis and treatment of fibromyalgia.

psychological treatment fibro

What role does psychotherapy play in therapy?

Psychotherapy plays an important role in the treatment of fibromyalgia as it helps patients to cope with the pain and emotional stress of the condition. Cognitive behavioral therapy (CBT) is particularly effective as it teaches patients techniques for coping with pain and stress.

Are there special medications for the treatment of fibromyalgia?

Yes, there are specific medications approved for the treatment of fibromyalgia, including:

  • Pregabalin (Lyrica)
  • Duloxetine (Cymbalta)
  • Milnacipran (Savella)
    These medications can help to relieve the pain and other symptoms.

How does fibromyalgia affect the quality of life of those affected?

Fibromyalgia can have a significant impact on quality of life. Those affected often report

  • Restrictions in daily life and at work.
  • Social isolation and withdrawal.
  • Mental stress such as anxiety and depression.
  • Financial difficulties due to inability to work.

How do patients deal with the symptoms?

Patients with fibromyalgia often develop different strategies to deal with the symptoms:

  • Lifestyle adjustments, including regular exercise and a healthy diet.
  • Use of relaxation techniques and stress management.
  • Participation in self-help groups and support from family and friends.
  • Regular medical care and adjustment of treatment.

Which chronic symptoms are typical?

Typical chronic symptoms of fibromyalgia are

  • Widespread pain
  • Tiredness and exhaustion
  • Sleep disorders
  • Cognitive impairment ("fibro fog")
  • Stiffness, especially in the morning
  • Headaches and migraines
  • Irritable bowel syndrome

What are the latest findings on fibromyalgia syndrome?

The latest findings on fibromyalgia syndrome indicate that it is a complex disorder caused by a combination of genetic, neurological and environmental factors. Research shows that changes in the central nervous system and pain processing play an important role.

How is fibromyalgia treated in research?

Fibromyalgia is the subject of intensive research in order to better understand the underlying mechanisms and develop new treatment options. Current research focuses include:

  • Genetic and epigenetic factors
  • Neurobiological mechanisms of pain processing
  • Psychological and social factors
  • Development of new drugs and therapies

What guidelines are there for diagnosis and treatment?

Algorithm-of-fibromyalgia-management-Adapted-from-reference-7-Macfarlane-GJ-Kronisch (1)

There are various guidelines for the diagnosis and treatment of fibromyalgia, including

  • The guidelines of the American College of Rheumatology (ACR)
  • The guidelines of the European League Against Rheumatism (EULAR)
  • The guidelines of the German Society for Rheumatology (DGRh)
    These guidelines provide recommendations for the diagnosis, treatment and management of fibromyalgia.

When should I see a specialist?

A specialist should be consulted if:

  • The symptoms are persistent and significantly impair the quality of life.
  • Other treatment approaches are not effective.
  • There are indications of other underlying diseases.

How does the family doctor recognize the symptoms of the disease?

The family doctor can recognize the symptoms of fibromyalgia through a thorough medical history and physical examination. Important indications are

  • Reports of widespread pain and fatigue.
  • Accompanying symptoms such as sleep disorders and cognitive impairment.
  • Exclusion of other diseases through targeted diagnostic tests.

When is a referral to a specialist necessary?

A referral to a specialist is necessary if:

  • The diagnosis is uncertain.
  • The symptoms are severe and require specialized treatment.
  • Other diseases must be excluded.

Are there special questionnaires for diagnosing fibromyalgia?

Yes, there are special questionnaires for diagnosing fibromyalgia, including:

  • The Fibromyalgia Impact Questionnaire (FIQ)
  • The Widespread Pain Index (WPI)
  • The Symptom Severity Scale (SSS)
    These questionnaires help to assess the severity of symptoms and the impact on quality of life.

What questions are asked in a fibromyalgia questionnaire?

A fibromyalgia questionnaire asks questions on the following topics:

  • Type and duration of pain
  • Accompanying symptoms such as fatigue, sleep disorders and cognitive impairment
  • Effects on daily life and ability to work
  • Mental stress and stress factors

How do questionnaires help with diagnosis?

Questionnaires help in the diagnosis of fibromyalgia by:

  • Enable a standardized assessment of symptoms.
  • Measure the severity of the disease and the impact on quality of life.
  • Monitor the course of the disease and the effectiveness of the treatment.

The following internet links may be helpful for further information and current research results:

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