Fibromyalgia – colloquially called fibrous muscle pain syndrome – (synonyms: Fibromyalgia syndrome (FMS); fibromyositis; soft-tissue rheumatism; ICD-10-GM M79.70: Fibromyalgia) is a common syndrome that can result in chronic pain (at least 3 months) in multiple body regions. It can affect the entire musculoskeletal system (muscle pain of varying localization); in addition, stiffness, sensory disturbances, sleep disturbances or nonrestorative sleep, fatigue or chronic fatigue tendency (physical and/or mental), and cognitive impairment may occur.
Because the clinical picture is defined by a complex of symptoms, the term “fibromyalgia syndrome” is more appropriate than the term “fibromyalgia.”
For criteria for the clinical diagnosis of fibromyalgia syndrome (FMS), see Classification.
Some rheumatologists and pain physicians classify FMS as “central hypersensitivity syndrome.”
Chronic widespread pain (CWP) in fibromyalgia syndrome may have specific causes (e.g., inflammatory rheumatic disease). However, in most patients with chronic pain in multiple body regions, no specific somatic causes of disease can be found. Fibromyalgia is therefore also referred to as a functional somatic syndrome. It may be associated with depressive disorders.
Optimal treatment requires early diagnosis, which unfortunately is rarely the case.
Sex ratio: males to females is 1: 9.
Frequency peak: The disease occurs predominantly between the 30th and 60th year of life.
The prevalence (disease incidence) in the general adult population of various countries is between 0.7 and 8% (Germany: 3.5%). In women between the ages of 70 and 79, the prevalence is as high as 7.4 %. In total, approximately 3 to 3.5 million people in Germany are affected.
Course and prognosis: Due to the pain, those affected are sometimes severely restricted in their everyday activities. Patients also frequently report episodes of pain that can last for one or more days.Therapy should be started with non-pharmacological interventions. The main focus is on anaerobic exercises and strength training. If pharmacotherapy (drug therapy) is required, it should be individualized.Beyond the age of 60, symptoms decrease. If fibromyalgia is diagnosed and treated early, i.e. in the first two years of the disease, the remission rate (remission = freedom from symptoms; percentage of successfully treated patients) is 50%. In the later course of the disease, the remission rates become smaller and smaller. Life expectancy is not reduced by the disease.
Note: In a follow-up study of patients diagnosed with fibromyalgia, only just under 40% of diagnoses met the criteria established by the American College of Rheumatology, i.e., the diagnosis of fibromyalgia may be made too frequently. Note: With a total of only 56 participants, the study was too small to draw universally valid conclusions.
Comorbidities (concomitant diseases): Fibromyalgia syndrome is increasingly associated with emotional disorders (75%), e.g. Anxiety disorders, depression, posttraumatic stress disorder (PTSD), somatoform disorders, and physical illnesses such as low back pain, osteoarthritis, gastrointestinal (affecting the gastrointestinal tract) pain, headache, facial pain, urogenital pain, and chronic fatigue syndrome (90%), insomnia (sleep disturbances), and cognitive impairment.
