Fibromyalgia is defined as a chronic pain disorder of unknown cause, characterized by widespread body pain and sensitivity of certain anatomical regions.
When fibromyalgia is detected, it must last for at least 3 months. In addition to being widely felt in the body, fatigue, restless sleep, forgetfulness and reluctance affecting social life are important indicators.
Physical Therapy and Rehabilitation Specialist Prof. Dr. Alev Alp points out that Fibromyalgia, defined as a chronic pain disorder whose cause is unknown, is especially common in women between the ages of 25-55.
Prof. Dr. Alev Alp, in individuals with genetic predisposition; He also emphasizes that environmental factors, person-related metabolic and biochemical disorders, autonomic nervous system disorder, sleep problems, psychological and immune system anomalies may trigger it.
FTR Expert Prof. Dr. Alev Alp answers your questions about Fibromyalgia as follows.
How does fibromyalgia progress?
Fibromyalgia is a muscle disease. It is not a disease and there is no inflammation in the body. Nervous system and hormonal axis irregularities reduce a person's response to stress, increasing the perception of pain and also increasing the susceptibility to depression. The immune system may also be in an exaggerated response and stimulate a neurological inflammation. Most fibromyalgia patients (90%) have symptoms and complaints such as not being able to go into deep sleep or experiencing alpha wave activity that should not be present in deep sleep, and waking up unrefreshed in the morning. All these symptoms may cause structural and functional changes in brain anatomy in the long term.
How is Fibromyalgia disease detected?
The notable features in the patient's examination are; Stimuli that do not cause pain in healthy people cause pain in these people, and the perceived pain is felt much more severely than normal. In diagnosis; feeling the pain widely throughout the body for at least 3 months, the presence and severity of other accompanying symptoms (fatigue, restless sleep, forgetfulness, reluctance affecting social life), as well as somatic (body primary) symptoms are decisive. These symptoms; feeling of swelling in the hands and morning stiffness, sensitivity to many sensory stimuli such as hot and cold, muscle pain, restless legs, irritable bowel, abdominal pain, nausea, constipation, hair loss, dry mouth, ray noud phenomenon, taste disturbance, shortness of breath, skin rash, urticaria, dizziness and nervousness may occur. Reasons that increase pain: cold weather, humidity, restless sleep, tension headache, migraine, teeth grinding, physical and mental fatigue, stress, inactivity, smoking and menstruation.
Differential diagnosis includes endocrinological problems such as thyroid-parathyroid-adrenal-pituitary dysfunction. disorders, anemia, hematological diseases such as lymphoma and leukemia, inflammatory rheumatism, muscle diseases, vitamin D deficiency, Multiple Sclerosis, myasthenia and malignancy should be investigated. In almost every chronic painful condition, perceived pain increases with increased sensitivity in the central nervous system, and a certain degree of fibromyalgia may occur.
Fibromyalgia Treatment
Drug and non-drug treatments are used in the treatment.
Exercise at the right intensity (mild-moderate) increases physical endurance by regulating muscle blood flow, optimizes oxygen use and reduces stress. This indirectly increases the levels of serotonin and opioids, which are mediators that reduce depression. In the beginning, exercise should be done under supervision (group exercises are more beneficial as they also enable socialization). If pain occurs, the intensity should be reduced, not the frequency.
In differential diagnosis, screening of metabolic, endocrine and inflammatory processes in the laboratory; Complete blood count, ESR, CRP, serum calcium, creatine kinase, TSH, 25 OH vitamin D and imaging methods are important.
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With the new definition, fibromyalgia refers to pain relief. It is characterized by abnormal processing in the nervous system, as well as fatigue, sleep disturbance, changes in mood and cognitive functions. It was defined as psychogenic/soft tissue rheumatism (fibrositis) involving soft tissue in the 1950s, and in 1976 it was named 'fibromyalgia' by combining 'algia' and 'myo' (muscle), which describe the painful condition instead of rheumatism.
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