Fibromyalgia (Muscle Rheumatism) What Is It? Symptoms And Treatment

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You ache everywhere. You have been aching from head to toe for weeks. You think you have rheumatism or osteoporosis. You have no energy. You can’t concentrate. You can’t remember the last time you had a good night’s sleep. You have been to the doctor many times, but all the doctor can tell you is what is wrong with you. You have questions, but the answers are not clear

  • My head is all over the place and I’m so tired.
  • I want them to believe me.
  • This is not the life I dreamed of!
  • Am I lazy?
  • Am I exaggerating my complaints?
  • Do I have a psychiatric problem?

You have heard about fibromyalgia, maybe you have even read about it. But you still feel that you do not know exactly what your illness is.

What Is Fibromyalgia?

  • Muscle rheumatism
  • Soft tissue rheumatism
  • Unseen disease

Generalised prolonged pain condition / generalised chronic pain syndrome


  • Fibro: fibroid tissues: ligaments and tendons
    • Myo: muscle
    • Algia: Pain
  • Feeling pain almost everywhere
  • Causes widespread pain in the body
  • It is a common rheumatic disease
  • Not a joint disease
    • Joint does not hold
    • It does not cause deformity in your body.
  • Fibrositis / soft tissue rheumatism
  • Fibrositis: used by a British neurologist in 1904
  • Psychosomatic rheumatism: Recognised in the early 20th century as a psychological disorder
  • Fibromyalgia Syndrome was defined by an American rheumatologist in 1981 as widespread body pain and tender points in the muscles in certain areas.
  • It is a musculoskeletal problem of unknown cause.
  • It affects a significant part of the society. 2-4 out of 100 people have fibromyalgia. It can be seen in all ages and sexes. The incidence increases with age. It is most common between the ages of 30 and 50. It is more common in adult women. Men and children are also affected.

Which Of My Complaints Are Related To This Disease?

  • Widespread pain
    • Morning stiffness
  • Fatigue
  • Bodywide pain
  • Sleep disturbance: Waking up feeling unrefreshed
  • Depression, anxiety
  • Jaw pain

Accompanying Symptoms

  • Constipation/diarrhea/abdominal pain
  • Frequent urination, waking up to urinate at night
  • Headache
  • Numbness and tingling in the arms and legs
  • Swelling in the hands and feet


  • Many patients describe the pain as a deep ache, stiffness, and fatigue in the muscles surrounding the joints.
  • The pain can worsen in the morning when waking up, later in the day, or with any activity.
  • Emotional fluctuations and humid weather can also worsen the pain.

Areas With Most Pain Complaints

  • Waist
  • Neck
  • Shoulder girdle
  • Arms
  • Hands
  • Knees
  • Hip region
  • Legs


  • General fatigue, lack of energy, and resistance
  • Patients may find it difficult to climb stairs, do daily household chores, or go to work.
  • It increases with physical activity and causes significant functional impairment in daily living activities.
  • Half of the patients describe swelling and numbness in the hands and feet.
  • Pain and numbness that radiates from the waist to the leg may occur.

Sleep Disorder

  • Difficulty falling asleep
  • Frequent awakening at night
  • Inability to sleep soundly
  • After all, restless sleep
  • Waking up in the morning without rest
  • tension
  • unhappiness
  • mental stress
  • Difficulty concentrating
  • Slowing down of simple mental activities
  • Mood disorders such as feeling bad about oneself
  • Fibromyalgia Syndrome is not a psychiatric illness.
  • Psychological factors are an important component of any kind of pain.
  • Psychological stress and pain form a vicious circle of interaction that feeds each other.
  • Treatment of psychological factors in the majority of patients
    • positively influences the treatment of Fibromyalgia Syndrome
    • However, it does not eliminate complaints

Psychological disorders accompany 30-40% of patients with fibromyalgia syndrome.

Less Frequent Complaints:

  • Tingling, numbness, swelling in hands and feet
  • Headache, nervousness,
  • Feeling depressed or tearful
  • Forgetfulness or lack of concentration
  • Diarrhoea or abdominal pain
  • Cold intolerance
  • Chest pain
  • Dry eyes, dry mouth

Factors Increasing Pain

  • Cold and damp weather
  • Anxiety and stress
  • Overuse or lack of movement
  • Sleep disturbance and noise

Pain Reducing Factors

  • Light physical activity
  • Regional hot application
  • Massage
  • Rest
  • Relaxation and stretching exercises
  • Aerobic exercise: walking, swimming, cycling

The biggest problem is looking very well and feeling very ill.

What Caused This Disease In Me?

  • The cause of its formation is still under investigation
  • There can be many causes that initiate the disease.
  • Muscle disorders and mechanical factors
  • Neuroendocrine disorders
  • Central Nervous System
  • Psychiatric condition
  • Sleep disturbance
  • Neurohormones
  • Genetic Factors
  • Other

How Is This Disease Diagnosed? Why Can't I Find Out What My Disease Is?

  • No definitive diagnostic blood or urine test or X-ray, MRI, CT
  • There are many complaints
  • May be associated with other diseases
  • Can be confused with other diseases
  • Fibromyalgia is diagnosed by long-standing widespread pain and the presence of specific tender points
  • Tender spots on certain parts of the body
  • Discomfort when sufficient pressure is applied to these areas
  • Since there are significant differences from patient to patient in terms of accompanying findings, it may mimic a wide variety of diseases.
  • It may coexist with other rheumatic diseases.

To Diagnose The Disease:

  • Since it may be associated with other diseases, a detailed examination and laboratory examination is performed
  • The results of all tests are usually normal
  • However, in some patients, it may be associated with other diseases
    • Thyroid problems, other rheumatic diseases, depression, diabetes…

What Kind Of Permanent Problems Will This Disease Cause In My Body?

  • Does not cause permanent damage to tissues
  • But the symptoms can last for months or years.
  • There may be tenderness in the joints due to widespread pain in the body, which is typical of the disease.
  • Patients with fibromyalgia syndrome have a healthy appearance. Although they sometimes have anxious and depressed facial expressions.
  • FM doesn’t kill me, but I’m crushed by the feeling of loss.
  • He complains of so much pain and fatigue that others may not believe him because he looks so healthy and may not take his complaints seriously
  • They may not be taken seriously by family, friends, employers or even doctors
  • The important thing in fibromyalgia is to recognise the complaints and take them seriously.

Eular Fibromyalgia Recommendations

  • For a complete understanding of fibromyalgia
    • Pain
    • Functional status
    • Detailed assessment of the psychosocial dimension is necessary
  • FM should be recognised as a complex and variable disease with abnormal pain production and other associated factors

What Will I Do In The Treatment?

  • The aim of treatment is to reduce or eliminate complaints
    • reduction of pain
    • increasing functionality in everyday life
    • Reducing fatigue
  • The most effective treatment is organised through the creation of an individual treatment programme.

1) Drug treatment – 2) Non-drug treatments

  • Teamwork is necessary for effective treatment.
  • Non-drug treatments and drug treatment should be given together by talking to the patient and considering the accompanying factors such as pain, functionality, depression, fatigue and sleep problems.
  • Individual exercise programme should be organised
  • Aerobic and strengthening exercises
  • Cognitive behavioural therapy
  • Relaxation, rehabilitation, physiotherapy, psychological support can be used

Non-drug treatments

  • Exercise
  • Aerobic exercises
  • Muscle strengthening exercises
  • In-pool exercises
  • Behaviour therapy
  • Balneotherapy


  • 1-Analgesics
  • 2-Muscle relaxants
  • 3-Antidepressants
  • 4-Antiepileptic drugs

Education About Disease

  • Addressing their concerns
  • Identification of factors that increase complaints
  • Treatment of concomitant diseases
  • Regulating sleep and improving its quality
  • Developing coping mechanisms with pain
  • Transforming perceptions of helplessness, frustration and anger into feelings of activity and hope
  • The focus should not be on the complete elimination of complaints, but on the improvement in function.
  • Fibromyalgia can persist for a long time
  • Despite all the pain, there will be no permanent disability
  • Factors that increase and decrease complaints should be known and attention should be paid.

Increasing Factors

  • Cold or humid weather
  • Barometric pressure changes
  • Unrefreshing sleep
  • Physical/mental fatigue
  • Excessive physical activity
  • Excessive tension/stress

Mitigating Factors

  • Hot, dry air
  • Hot shower or bath


  • Restful sleep
  • Moderate activity
  • Stretching exercises and massage
  • Patients should avoid caffeine-containing foods such as chocolate, soda, coffee, and tea, and stimulant drugs before going to bed.
  • The bedroom should be cleared of distracting things, and a TV should not be placed in the bedroom.
  • Fibromyalgia complaints often improve with improved sleep.



  • Improve conditioning
  • Increase resistance to microtrauma
  • Gain strength
  • Gain flexibility
  • Increase overall activity levels

Exercises That Are Particularly Useful In Treatment

  • Whole-body aerobic exercises
  • Biking, dancing, swimming
  • Walking
  • Stretching and strengthening exercises

Fibromyalgia patients may develop painful bands in their muscles or connective tissue due to prolonged incorrect positioning or repeated injuries.

Fibromyalgia affects the entire body. Bands, on the other hand, are a localized condition that typically affects specific areas such as the neck, shoulders, or upper back.


Fibromyalgia patients often do not continue with their exercise program due to reasons such as increased pain and lack of motivation.


It is important to continue exercising. It increases a person’s self-confidence.

Instead of short-term intense exercise, light exercises that can be continued for life should be done.

Alternative Treatments

  • Acupuncture
  • Nerve therapy
  • Hypnotherapy
  • Ozone therapy
  • Cupping (hijama)
  • Dietary changes
  • Dietary supplements

It doesn’t matter what you can do, what you can’t do

Make a list of your symptoms: pain, fatigue, concentration problems, headache…


  • Increase your knowledge about the disease
  • It doesn’t matter what you can do, what you can’t do
  • Make a list of your symptoms: pain, fatigue, concentration problems, headache, …
  • Don’t drink tea or coffee late at night as it can affect your sleep.
  • Relaxation and gentle exercises can help you sleep.
  • Find effective communication ways to express your emotions.
  • Learn to cope with sadness and challenges
  • Don’t fight with depression-anxiety
    • Know that pain is a part of it
    • But don’t get too caught up in it
    • Write a journal about your pain
  • Tell yourself, this will speed up your recovery
  • Learn relaxation techniques
  • Don’t hesitate to ask for help
  • Eat healthy and don’t gain weight.
  • Exercise regularly
  • Even if fibromyalgia improves, there is a risk of recurrence
  • We should always have a positive attitude and not let this disease ruin our daily lives.
  • Physical therapy, spa treatments, environmental changes, soft tissue injections contribute to improvement
  • There is no known way to prevent fibromyalgia. However, balanced nutrition, non-challenging exercises, restful sleep, and regular exercise prevent the recurrence of pain

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