Fibromyalgia Syndrome (FMS) is a multisystemic disease accompanied by many sensitive points, accompanied by widespread chronic pain and many physical problems, the etiology of which is unknown. The incidence of FMS increases with age and is most common between the ages of 40-60. Its incidence is 4-9 times higher in women than in men. The presence of sensitive points is associated with pain, as well as with anxiety, depression, fatigue and somatic symptoms. There may be different subgroups depending on pain sensitivity and psychological factors, and the response and course of patients in these subgroups to treatment It is reported that it may differ in terms of Pain is the main symptom in FM and is at the forefront of treatment. The cause of pain in FM is not yet fully explained. It has been reported that FM may be a symptom of psychiatric disorders or psychophysiological abnormalities, as chronic painful conditions are often accompanied by depression and anxiety. However, it is also reported that the chronic pain seen in FM can disrupt social life and cause depression or anxiety. FMS is often caused by sleep-related problems, fatigue (waking up tired, not being able to rest), exhaustion, morning stiffness, migraine, dysmenorrhea, frequent urination, It is accompanied by irritable colon syndrome, and a study reported that FMS often begins as a result of a physical trauma or a viral infection. While FMS is seen in 2% of the general population in America, 3.4% in adult women, and 0.5% in adult men, the prevalence of the disease was found to be 3.6% in a study conducted in our country. The problem that significantly affects the quality of life in FMS is chronic pain and disability that develops over time. Patients cannot continue their normal activities due to severe pain, reluctance and disability, thus causing them to experience problems in their social and professional lives. In addition, FMS patients experience many psychological problems such as depression, anxiety, increased somatization and post-traumatic stress disorder due to the problems caused by the disease. Fibromyalgia patients often experience depression related to the severe pain and disability they experience. Studies show that 20% of fibromyalgia patients It was found that e had major depression and approximately 50% of them had high depression scores. Some studies conducted in our country have determined that FMS patients are more frequently depressed and have higher levels of depressive symptoms than individuals in the control group. Another psychological problem frequently experienced by fibromyalgia patients is anxiety. In fact, many studies have found that fibromyalgia patients experience more anxiety than depression. It has been suggested that the chronic, widespread pain experienced by fibromyalgia patients is an anxiety-increasing factor. A group of scientists reported in their study of 529 fibromyalgia patients that fibromyalgia patients reported more anxiety (71%) than depressive symptoms (56%). Social support is an important factor in helping individuals with chronic diseases cope with the problems caused by the disease. Social support gives patients emotional comfort, provides them with ways to cope with their problems, or protects individuals against the negative effects of stress in daily life and during crisis. Many studies have found that patients who receive or perceive higher levels of social support have lower levels of depression and anxiety. One of the important concepts that affect a person's life is self-efficacy, which is defined as individuals' beliefs about how well they can perform the actions necessary to cope with various situations. It has been stated that people improve their coping skills in line with their lifelong experiences, and as their self-efficacy beliefs increase, there are positive changes in their behavior. . As their self-efficacy beliefs increase, individuals feel healthier both physically and psychologically. For this reason, it would be beneficial for healthcare personnel working with fibromyalgia patients to give importance to interventions that will increase the social support and self-efficacy levels perceived by the patients in order to reduce the psychological problems of this patient group. Fibromyalgia causes widespread body pain of unknown cause, painful points in certain areas, especially in the waist and neck. Chronic, extra-articular musculoskeletal disease accompanied by stiffness felt throughout the body, decreased pain threshold, fatigue, and sleep disorders We mentioned that it was. Fibromyalgia is sometimes accompanied by pelvic pain, chronic low back pain, and irritable bladder and bowel syndrome. Although genetic factors play a role in the formation of fibromyalgia, we can say in the light of studies that both genetic, environmental and neurohormonal factors also have an impact. One of the most common complaints in patients with fibromyalgia is chronic and widespread pain. The pain is burning and stinging. Exercise becomes difficult for patients who complain of pain that increases with activity. Stiffness, which usually occurs in the morning, may continue throughout the day for some people. Patients with fibromyalgia are sensitive to pressure and may also have decreased tolerance to heat and cold. A wide variety of problems occur together in fibromyalgia, so evaluation and treatment should be multifaceted. Our aim with physiotherapy is to reduce pain, fatigue and stiffness complaints, and increase functionality, exercise capacity and quality of life. In exercise training; We can list aerobic exercise, strength exercises, flexibility and aquatic exercises, and clinical pilates. A decrease in muscle strength and endurance has been detected in FMS. Studies have investigated the effectiveness of aerobic, strengthening, stretching, relaxation exercises and aquatic exercises, and it has been shown that exercise is effective in the treatment of FMS. The main purposes of exercise in FMS are reducing stress, correcting impaired posture, increasing endurance and restoration of cardiovascular endurance. Today, low-intensity aerobic exercises and exercise programs that can be combined with other treatment methods are recommended in the treatment of FMS. In FMS, exercise programs should be arranged individually, starting below the patient's exercise capacity and gradually increasing the adjustments according to the patient's tolerance level. Relaxation techniques, superficial heat agents, hydrotherapy, balneotherapy, warm-hot baths, mud baths and spa may also be included in the treatment. Studies have shown that medical massage may be beneficial in improving sleep quality in patients with fibromyalgia. A combination of approaches such as drug therapy, exercise therapy, patient education and cognitive behavioral treatment is recommended for fibromyalgia.
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