Fibromyalgia syndrome (FMS) is a disease characterized by widespread pain accompanied by symptoms such as fatigue, morning stiffness, depression, and sleep disorders, along with various somatic and psychological symptoms.

The prevalence of fibromyalgia (FM), which negatively affects quality of life, is approximately 1-2% in the general population and is seen three times more frequently in women. FM is most commonly observed between the ages of 40-55 and is especially more common among individuals with above-average education and economic levels.

What is Fibromyalgia Syndrome?

FMS, also known as soft tissue rheumatism, is a disease marked mainly by sleep disturbances, widespread muscle pain and tenderness, fatigue, weakness, and morning stiffness.

Patients with fibromyalgia frequently experience muscle pain accompanied by depression and sleep disorders. Studies have shown that the likelihood of depression accompanying fibromyalgia ranges between 20-80%, while non-restorative sleep (inability to achieve deep sleep) accompanies 75-90% of cases.

What are the Causes of Fibromyalgia Syndrome?

Although FMS has been recognized for a long time, its exact cause is still unknown.

• Genetic factors have been considered for many years. Individuals with a first-degree relative diagnosed with FM have an 8 times higher risk of developing the disease.
• Environmental factors, especially emotional and physical traumas experienced during childhood, are known risk factors for FM.
• Psychological factors show a close relationship with FM. Depression, anxiety, and sleep disorders increase the frequency of FM significantly.
• Traumas such as major physical injuries from motor vehicle accidents are accepted causes.
• Rheumatic diseases such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are considered triggers for FM.
• Some viruses are suggested as possible causes of fibromyalgia.
• Education and economic status are higher in people more commonly affected.
• Personality traits: Perfectionists and workaholics, especially architects, journalists, and finance professionals, are more frequently affected. It is also more common in people unhappy with their job. High job stress is considered a trigger.
• Physical activity: Sedentary lifestyles and inactivity are associated with a higher frequency of FM.
• Recent studies suggest that hormonal and immunological factors might play a significant role among FM causes.

What Are the Symptoms of Fibromyalgia Syndrome?

The most common complaint in FMS is muscle pain. Pain is generally more common in the neck and lower back, as well as in the shoulders, elbows, knees, and hands. Pain experienced on one side of the body may be less or more intense than the other side. The pain can manifest as throbbing, spreading, or intense stabbing sensations. For some patients, the pain is continuous, while in others, it fluctuates with periods of remission and flare-ups. Although pain is the main symptom, the disease often presents with multi-system complaints.

Common symptoms include chronic fatigue, especially in the morning and later in the day; waking up tired despite prolonged sleep; sleep problems such as non-restorative sleep and difficulty getting out of bed; depressive mood, anxiety, panic attacks; cognitive symptoms like difficulty concentrating, dizziness, confusion, and brain fog; tension and migraine-type headaches; unclear pain in the teeth, jaw joint, and ear area; sensitivity to light, sound, and odors; vague digestive symptoms such as nausea, acid reflux, bloating, pain, diarrhea, constipation, and stomach cramps; frequent urination, painful urination, pelvic pain; difficulty breathing, tinnitus, chest pain, and palpitations as nonspecific symptoms.

How is Fibromyalgia Syndrome Diagnosed?

Diagnosis is challenging. The nonspecific nature of patient complaints and the lack of specific laboratory tests for FM complicate diagnosis. Therefore, a detailed medical history and thorough physical examination are necessary. Laboratory tests help especially in differential diagnosis.

How Should Fibromyalgia Syndrome Be Treated?

Muscle knots called fibrositis, which cause pain in FMS, can be treated with physical therapy. A stress-free regular lifestyle, balanced and anti-inflammatory nutrition, quality sleep, and exercise form the basis of treatment. Generally:

• Exercise is the most important aspect of treatment. Particularly, low-intensity aerobic exercises performed at least three times a week yield positive results. Swimming, brisk outdoor walking, cycling, and water sports should be preferred.
• Physical therapy, especially targeting muscles, provides very good outcomes. The goal is to reduce the discomfort of those suffering from pain and fatigue and whose physical and social lives are affected.
• Activities such as aerobic dance, stretching and relaxation exercises, Pilates, yoga, swimming, gymnastics, cycling, and horseback riding also show significant benefits alongside physical therapy.
• The psychological state (morale and motivation) of the individual should be kept as high as possible. Friends, family, and social relationships should be managed in a stress-free and peaceful manner. The person should surround themselves with cheerful people and, if necessary, receive psychiatric support and appropriate medication.
• Physiotherapy methods such as heat applications, electrical stimulation, spa treatments, and massage therapy should be tried to relieve fibrositis and reduce pain. Prolonged sitting, standing, stress, and tension should be avoided.
• Since sleep and rest are very important, sleep hygiene should be observed. Drinks like tea, coffee, and alcohol should be avoided before bedtime, and sleep should be sufficient enough to wake up refreshed.
• Processed and ready-made foods, sugar, and flour should be avoided as much as possible; a diet rich in fiber should be preferred.
• Neural therapy, prolotherapy, manipulation, ozone therapy, and regional injections may be tried.
• When necessary, painkillers, muscle relaxants, and psychiatric drugs (such as antidepressants) prescribed by the physician can be used. However, the side effects of long-term use of these medications should not be overlooked.