General measures Nicotine restriction (refraining from tobacco use). Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program. If necessary, increase the physical activity! Avoidance of psychosocial stress: Stress Nutritional medicine Nutritional … Fibromyalgia: Therapy
To prevent fibromyalgia, attention must be paid to reducing individual risk factors. Behavioral risk factors Consumption of stimulants Tobacco (smoking) Physical activity Physical inactivity Psycho-social situation Emotional stress Stress in the workplace Overweight (BMI ≥ 25; obesity).
The following symptoms and complaints may indicate fibromyalgia: Leading symptoms Burning or gnawing pain that is aggravated by specific stimuli, such as cold or damp weather, stress, physical exertion, anxiety, or lack of sleep Tender points (pressure painful points), especially on the muscle attachments at the back of the head, elbow, and inside of the … Fibromyalgia: Symptoms, Complaints, Signs
Pathogenesis (disease development) The cause of fibromyalgia is not yet clearly understood.Several hypotheses are currently being discussed.First, a sleep disorder seems to be an important factor in the development of the disease.Furthermore, it is suspected that the concentration of various hormones such as growth hormone (somatotropic hormone (STH)) or the concentration of cortisol (hormone that … Fibromyalgia: Causes
Medical history (history of illness) represents an important component in the diagnosis of fibromyalgia. Family history Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). Do you have chronic pain in multiple body sites? Please indicate which parts of your … Fibromyalgia: Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Hyper-/hypoparathyroidism (parathyroid hyperfunction/ hypothyroidism). Hyper-/hypothyroidism (hyperthyroidism/ hypothyroidism). Vitamin D deficiency Infectious and parasitic diseases (A00-B99). Bacterial infections (e.g., Lyme disease, yersiniosis). Musculoskeletal system and connective tissue (M00-M99). Collagenoses (group of connective tissue diseases caused by autoimmune processes) – systemic lupus erythematosus (SLE), polymyositis (PM) or dermatomyositis (DM), Sjögren’s syndrome … Fibromyalgia: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by fibromyalgia: Musculoskeletal system and connective tissue (M00-M99). Early retirement due to chronic pain Psyche – nervous system (F00-F99; G00-G99) Depression Feeling of lack of understanding of society Social isolation
Criteria for the clinical diagnosis of fibromyalgia syndrome (FMS). American College of Rheumatology (ACR) 1990 Classification Criteria. Modified ACR 2010preliminary diagnostic criteria. Obligatory main symptom CWP (chronic widespread pain) according to ACR 1990 criteria. > 3 months of existing pain in: Axial skeleton (cervical spine (C-spine) or anterior thorax/chest or thoracic spine (C-spine) or lumbar … Fibromyalgia: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Palpation (palpation) of tender points (pressure painful points) with a pressure of about 4 kiloponds (the thumbnail shows paling in the distal area) – especially at the muscle insertions … Fibromyalgia: Examination
The diagnosis is made by history and physical examination. Note: Fibromyalgia is a diagnosis of exclusion!To rule out fibromyalgia, testing of the following laboratory parameters is recommended: Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate) – eg due topossible polymyalgia rheumatica, rheumatoid arthritis. Creatinine kinase (CK) … Fibromyalgia: Test and Diagnosis
Therapy target To improve health-related quality of life while weighing the benefits and risks of the therapy components. Therapy recommendations Therapy initiation as a non-pharmacological intervention, first and foremost aerobic exercise and strength training. If the non-pharmacological measures do not lead to success → individualized and the needs of the patient adapted pharmacological therapies (see … Fibromyalgia: Drug Therapy
If the complaint complex is typical and there is no clinical evidence of internal, orthopedic, or neurologic disease (history and clinical examination without evidence of diseases other than causes of pain and fatigue, unremarkable baseline laboratory), it is recommended that no further medical device diagnostics be performed.
