Fibromyalgia Syndrome: What Is It?

Chronic pain in several parts of the body, sleep disorders, exhaustion: such symptoms can indicate fibromyalgia. What you should know about it

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Fibromyalgia - briefly explained

  • Fibromyalgia syndrome is a chronic pain syndrome.
  • Persistent pain occurs in various parts of the body, accompanied by other symptoms such as exhaustion and sleep disorders.
  • It often takes a long time to get the correct diagnosis because there are currently no specific methods of detection, such as a blood test.
  • The therapy depends on the severity of the disease and consists of various components.

What is Fibromyalgia Syndrome?

Fibromyalgia syndrome, or FMS for short, is a chronic pain syndrome that can significantly reduce the quality of life. It is characterized by extensive and persistent pain in various parts of the body, often on the chest, back, arms and legs. In addition to the pain, there are other complaints, including sleep problems and exhaustion.

Fibromyalgia as the word describes "fiber muscle pain". Doctors speak of a syndrome because there is a typical complex of various symptoms that cannot be explained by a specific trigger.

Scientists disagree about what causes it and what promotes the syndrome. It is not a mental illness, it is not soft tissue rheumatism or any other inflammatory rheumatic disease. As far as we know, there are no underlying disorders in the muscles or joints. FMS is often associated with a depression or anxiety disorder, which probably develops as a result of many years of suffering and doctor odysseys. Other diseases also occur more frequently in connection with FMS.

Significantly more women develop FMS than men, mostly between the ages of 30 and 50. In Germany, around two to three percent of the population is affected. Fibromyalgia syndrome can also occur in children and adolescents.

What causes could trigger fibromyalgia syndrome?

The German medical guideline classifies fibromyalgia as a "functional somatic syndrome". This means: There is a typical complex of physical symptoms (syndrome) that lasts for a certain period of time and cannot be explained by a (verifiable) physical cause (somatic).

It is unclear which disease mechanism could be behind this. There are currently different explanations:

Disturbed pain processing in the central nervous system

Acute pain occurs when, for example, we touch the hot stove or fall while exercising. Then nerve fibers from the affected region - for example the hand or knee - send electrical signals via the spinal cord to the central nervous system (CNS). There the signals are processed and pain is perceived. All of this happens very quickly and ebbs away again. Chronic pain occurs, among other things, when the nerve fibers from the periphery constantly send signals to the CNS. It "remembers" the stimuli, is sensitized and over time reacts to the incoming stimuli earlier and earlier. A so-called central sensitization arises.

Some researchers suggest that this could also happen with fibromyalgia syndrome. Persistent pain signals could lead to the central nervous system becoming overactive and, among other things, not processing pain normally. It could react with an increased sense of pain. For example, those affected perceive external influences as painful that should normally not hurt, such as a massage. Doctors call this allodynia.

Numerous messenger substances are involved in the processing of pain. These so-called neurotransmitters include, for example, serotonin, glutamate and dopamine. In subgroups of fibromyalgia patients, the concentrations of these messenger substances can be changed, as some studies indicate.

How does pain arise?

© W & B / Michelle Günther

TO THE PICTURE GALLERY

© W & B / Michelle Günther

If we take hold of the hot pot lid, the first thing we notice is special sensory cells that are distributed in the skin and organs. The sensory nerve endings are also called nociceptors. In a fraction of a second they react to heat, cold or pressure and send this information as electrical signals via sensory nerve fibers into the spinal cord.

© W & B / Michelle Günther

The sensory nerve fibers conduct the "hot" signal to the spinal cord. There is a switching point here that decides whether and which reflex should be triggered. The sensory signal is switched to a motor nerve, which is then responsible for the reaction. That's why we pull our fingers away from the hot pot at lightning speed - without thinking too much about it. In order for the reflex to be triggered and for us to pull our hand away from the hot pot, the impulse does not have to be passed on to the brain. This ensures that we can react quickly to the pain.

© W & B / Michelle Günther

Only shortly after the reflex has been triggered is the message "pain" transmitted to the brain via the spinal cord. We then become aware of the pain.

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Malfunction of the autonomic nervous system

The autonomic nervous system (involuntary functions) is one part of our entire nervous system, the other is the somatic nervous system (arbitrary, i.e. controllable functions). Both are in turn part of the central and peripheral nervous systems. The CNS is made up of the brain and spinal cord, the peripheral nervous system runs through the various organs and regions of the body. The autonomic nervous system consists of the sympathetic ("flight or attack") and the parasympathetic ("rest and digestion"). Some studies indicate that subgroups of patients with fibromyalgia syndrome could also be caused by a malfunction of the autonomic nervous system (dysautonomy). In some patients the sympathetic nervous system is too active, in other patients the parasympathetic nervous system. Since the autonomic nervous system controls numerous body functions, this could explain the often diverse symptoms of those affected.

Disturbances in the area of ​​the peripheral nervous system

The peripheral nervous system includes large and small nerve fibers that run through the body and transmit signals to the CNS. Recent studies suggest that a disorder in the area of ​​small nerve fibers, especially so-called small fibers, could also contribute to FMS pain in some of those affected. The small fibers end in the skin, where they are responsible, among other things, for the perception of pain, temperature sensation, itching and the perception of pleasant touch. A review article showed that an average of 49 percent of the FMS patients examined had abnormalities in the area of ​​small fibers. However, it is not yet clear how these nerve fibers are impaired in the patient and how this damage can possibly contribute to the pain.

Since the nervous system, immune system, endocrine system and psyche are closely linked and influence numerous body functions, the fibromyalgia syndrome has a variety of effects.

Which factors can favor an FMS?

  • Genetic predisposition: Some people with FMS break down the brain messenger serotonin too quickly. This could help to perceive pain as such earlier and interfere with pain processing.
  • Whether certain infections promote FMS is controversial, but patients repeatedly cite it as a potential trigger.
  • A lack of vitamin D is often discussed as an influencing factor. However, very many people have low vitamin D levels, so this factor is very unspecific.
  • An excess of negatively perceived psychological and / or physical stress is a common risk factor for fibromyalgia syndrome.
  • People with certain character traits and behaviors seem to develop fibromyalgia more often, which is why some doctors see psychological factors as triggers. It typically affects people who, among other things, are very conscientious, help others, are self-critical and suppress emotions.
  • Smoking, obesity, lack of exercise
  • Emotional or physical trauma, such as sexual abuse or an accident

Due to the possible influencing factors, some scientists try to explain the fibromyalgia syndrome with the so-called biopsychosocial model: Certain physical and psychological factors trigger the disease with a corresponding predisposition. However, this does not mean that it is a mental illness, just that several unfavorable circumstances come together and upset the body.

Important NOTE:
This article contains general information only and should not be used for self-diagnosis or self-treatment. He can not substitute a visit at the doctor. Unfortunately, our experts cannot answer individual questions.

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