Sufferers with fibromyalgia syndrome (FMS) suffer from pain all over the body and an increased pain perception, especially in the muscles and the tendon attachments. The attacks of fibromyalgia often last for several days, during which time the patient is completely incapacitated. After – on average – only two weeks of breather, the next batch starts. With increasing age, the disease progression of the pain disorder usually becomes weaker.
In this article we would like to bring you closer to the symptoms and the diagnosis of fibromyalgia. Because often those affected do not know what is wrong with them for a long time. On the other hand, we want you to be able to classify your symptoms and check for yourself whether the symptoms mentioned coincide with your own.
If this is the case or if you have been diagnosed with fibromyalgia, we would like to show you ways and measures with which your breather can become longer and longer and your quality of life can significantly improve in the long run. You can find out more about this in the chapters on treatment and exercises .
1. Overview of fibromyalgia
Fibromyalgia syndrome (FMS) was formerly also known as soft tissue rheumatism and is defined by chronic pain in several parts of the body, accompanied by fatigue, sleep disorders and accompanying psychological symptoms. 1)
Fibromyalgia syndrome (FMS) affects around three percent of the population in all industrialized countries. 2) The majority of those affected with this clinical picture are middle-aged women.
For a long time, fibromyalgia syndrome (or soft tissue rheumatism ) was not recognized as a disease and many of those affected were regarded as “pensioners”, “slackers” or “simulators”. Today there are several studies and a large number of reliable data that show that fibromyalgia syndrome is actually a clinical picture with immense psychological stress, which considerably restricts the quality of life of many people, especially with pronounced symptom severity.
Fibromyalgia or soft tissue rheumatism are counted among the rheumatic diseases. Since the psyche also plays a decisive role in fibromyalgia, it is often unclear in this context which doctor / psychologist sufferers should go and which treatment is the right one.
How are those affected really doing and what helps?
If you already know some of our videos, you have probably seen our Ina exercise model there. She is a former fibromyalgia patient and in this interview she tells you how she fared with the disease and how she was able to help herself with our pain therapy. Perhaps you can draw new courage from their descriptions.https://www.youtube.com/embed/psB4VmZRIII?enablejsapi=1&origin=https%3A%2F%2Fwww.liebscher-bracht.com
With this article we would like to give you an overview of your different treatment options, so that you too can feel comfortable in your skin as soon as possible. To do this, we will first show you the typical symptoms of fibromyalgia. Then we will explain to you which diagnostic methods are used to diagnose the disease. In order to be able to alleviate your symptoms quickly, we will then introduce you to the treatment options and, with our exercises, show you an important building block on your way to pain relief.
2. Symptoms of fibromyalgia
“I just hurt everywhere” – if you suffer from fibromyalgia, then you know these symptoms only too well. Therefore, the main symptom of fibromyalgia is “pain everywhere”. This is related to an increased pain perception and an increased sensitivity to the body’s own pain stimuli. Chronic muscle pain is considered to be the main symptom of fibromyalgia, but those affected usually suffer from a wide variety of other symptoms at the same time – and each with a different frequency and severity.
Most of those affected from the age of 35 complain, in addition to pain, of exhaustion, unrefreshing sleep, the resulting daytime sleepiness and cognitive impairments such as poor concentration or problems with memory and memory. Irritable bowel syndrome, prolonged morning stiffness of the musculoskeletal system, pain in the joints , headaches , restless legs (RLS) and other physical abnormalities also occur as symptoms. 3)
Since the symptoms are so numerous and varied, we have put together an overview for you here: 4)
- Exhaustion, tiredness and sleep disorders in connection with thinking or memory disorders, concentration disorders and headaches
- Muscle pain and weakness, restless legs syndrome, sore joints
- Depression and nervousness
- Hearing impairment, tinnitus
- Dizziness and seizures, bladder cramps
- Nausea, vomiting, heartburn, and loss of appetite
- Irritable bowel syndrome
- Chest pain and shortness of breath
- Raynaud’s syndrome (finger pain)
- Itching, rash, sensitivity to the sun
- Loss or change in sense of taste
- Tendency to more or more rapid hematoma formation (“bruises”)
3. Diagnosis and causes of fibromyalgia
It often takes several years before a diagnosis of fibromyalgia is made. Those affected usually go from doctor to doctor and clinic to clinic – with no result. The course of the disease often begins with complaints such as back pain , which later develop in episodes into whole-body pain . The diagnosis also takes so long because those affected often have to justify themselves to their environment, but also to doctors. Then again and again there are terms like “slacker” or “simulant” – unfortunately, those affected have to listen to these expressions far too often completely wrongly. So that hopefully this does not happen to you, we will explain the way to the diagnosis.
First of all: In conventional medicine, no clear cause of the development of fibromyalgia is known. However, observations could be recorded in examinations and studies that mostly only affect fibromyalgia patients. These include hormonal changes, biological factors or personality factors. Whether one of the factors is the cause and the actual trigger for the pain syndrome has so far remained unclear. What is certain is that the patient’s pain processing is disturbed due to the factors. This disruption in pain processing ensures that those affected perceive pain more strongly throughout the body.
- Hormonal disorders: Studies have shown that some messenger substances are out of balance in fibromyalgia patients. For example, there is often a decreased level of growth hormone and an increased level of prolactin. 5)Now you might be wondering what you need growth hormone for as an adult. The answer is very simple: These messenger substances ensure the regeneration of your body cells and become more active in your deep sleep phases. Since many of those affected suffer from insomnia, their deep sleep phases are too short. As a result, the body cannot regenerate as well and the level of growth hormones drops. This will further aggravate your complaints. An increased level of prolactin prevents ovulation in women. Other messenger substances are also in imbalance in this disease, just like in depression.
- Muscular insufficiency: Due to muscular tension, those affected develop a pronounced pain-avoidance behavior. Maybe you can see this in yourself? But this makes everything worse and creates a vicious circle: The reduced use of the muscles results in even greater muscular insufficiencies (functional weaknesses) and an increase in pain. We’ll explain why you shouldn’t take it easy here . How you can break the vicious circle, we show you in our chapter treatment.
- Biographical factors: It is said again and again that sexual abuse in childhood or a frequent experience of violence are risk factors that can increasingly be observed in fibromyalgia patients. However, since many of those affected have not had such experiences, it is unclear what influence trauma and severe stress in the past have on the onset and course of the disease. 6)
- Personality factors: It has often been observed in fibromyalgia patients that they no longer perceive chronic stress as such, but experience it as a normal state. They usually strive for acceptance and recognition, which leads to highly pronounced behaviors that are considered socially desirable. Chronic excessive demands on oneself, which are not recognized as such, are also typical. 7)
Criteria for diagnosis
The American College of Rheumatology (ACR) developed criteria for diagnosing fibromyalgia back in 1990. In the first step, an anamnesis (recording, determination) of the pain is carried out for the diagnosis. The following definition is used for fibromyalgia:
Pain localized in the left and right halves of the body, in the upper and lower body and in the area of the axial skeleton (i.e. in the cervical spine (Cervical spine), thoracic spine (thoracic spine) and lumbar spine (LWS) (American College of Rheumatology)
In a second step, 18 so-called tender points (pressure points) with a force of four kg are examined. 8) This pressure is roughly reached when the thumbnail turns white when pressed. Fibromyalgia is when at least 11 of the 18 pressure points are painful. The tender points are distributed over the whole body (see illustration). People without fibromyalgia react with this level of pressure at no or very few points with pain.
In addition to the ACR criteria, if fibromyalgia syndrome (FMS) is suspected, there is an extended diagnostic algorithm according to the medical S3 guideline. This provides for an “if-then-entanglement” to which the doctor and patient can orient themselves. We have put the scheme together for you here.
As you already know, diagnosing fibromyalgia syndrome is often long and tedious. However, most people feel better once the diagnosis is made. Because then they will no longer be branded as “slackers” and can finally do something to alleviate their complaints. Extensive patient training on how to deal with the disease, accompanying symptoms and existing fears is therefore very important.
Differential diagnosis – differentiation from other diseases
Symptoms similar to fibromyalgia can be found, for example, in rheumatoid arthritis , an inflammatory joint disease. In this case, however, increased inflammatory parameters are also detected in the blood. A myofascial syndrome also causes stress and pain in many parts of the body, whereby local hardenings in the muscles can then be felt and pain occurs at the transitions to the tendons. Polymyalgia rheumatica, an extremely inflammatory disease of the pelvic and shoulder girdle , must also be distinguished from the fibromyalgia syndrome . In addition, it should be differentiated from other mental illnesses such as depression. 9)
4. Treatment of fibromyalgia syndrome (FMS)
If you suffer from fibromyalgia syndrome (FMS), then you have probably already had an odyssey of visits to the doctor and clinic stays behind you, perhaps also of psychosomatic treatments or behavioral therapies. In our experience, these are usually not very satisfactory for the patient and the doctor, because they simply do not lead to the goal: The patient hopes in vain for an improvement in the pain all over the body and the doctor finds no cause for the disease from a conventional medical point of view.
Our experience has also shown that excessive tension in your muscles and fasciae throughout the body plays a major role and causes most of the pain. Since – in our opinion – this is the cause of your excruciating pain, we do not speak of fibromyalgia as a disease in some of our videos. That does not mean that we want to deny your complaints and your great suffering.
Those affected avoid unnecessary movements – correct movement and muscle relaxation are essential in order to take the path to recovery. It is no coincidence that in the guidelines of the European rheumatologists (European League Against Rheumatism, EULAR) from 2016, physical exercises are the only therapy variant given the rating “strongly recommended” – from endurance training to aqua jogging. 10)
Pain therapy according to Liebscher & Bracht
Our pain and movement therapy can be connected to this, although you have to invest much less time than for your endurance training or for several aqua jogging sessions per week. We are now introducing you to the most important components of our treatment, with which you can find your way back to your comfort zone piece by piece.
The pain therapy according to Liebscher & Bracht works with a manual therapeutic technique, the so-called osteopressure. In doing so, pain receptors in the periosteum are specifically pressed. In this way, a particularly fast feedback with your brain can take place via the bones. Because your brain then gives the muscles and fascia in the affected body region the signal to relax. In this way, excessive muscular-fascial tension can be quickly and effectively normalized. You will notice that with the use of this effective relaxation procedure, your discomfort will also decrease and the painful points will decrease.
Since several areas are very painful in fibromyalgia patients, we can always start or apply our relaxation technique to the pain points where the symptoms are currently the worst. In this way, all painful areas can be worked off gradually. The best thing to do is to go to a therapist in your area who has been trained according to Liebscher & Bracht . If you’d rather get active yourself, you can also press some of the points from our pain therapy yourself with our specially developed push button set .
However, relieving the pain is only the first step. We would like to give you everything at hand so that you can reduce or even eliminate your pain in the long term. For this, it is extremely important that you regularly do our exercises – i.e. the bottleneck stretches and fascia rolling massages. Our exercise model Ina explains how important regular training is in the video in the first chapter . The high-quality movements from our movement therapy have already helped many fibromyalgia patients to enormously increase their well-being despite the painful illness.
Diet also plays an important role. It is assumed that the so-called oxidative stress is increased in fibromyalgia. As a result, your body has to deal with a large number of aggressive oxygen atoms, the free radicals. A diet rich in antioxidant ingredients is therefore recommended. These are mainly found in fruits and vegetables.
The problem with this is that many foods now contain far fewer micronutrients than they did a few decades ago. For this reason, a balanced diet is often not enough to prevent acidification, vitamin deficiencies or bottlenecks in the supply of minerals. We therefore recommend a high-quality dietary supplement to our patients . It supports the body in
- to be able to absorb more water in his fascia, which can promote mobility and reduce tension,
- to replenish its nutrient stores with the most important vitamins, minerals and trace elements
- to regenerate the structure of its joints, the spine as well as muscles and fascia (tendons, ligaments, capsules).
Find out more about our dietary supplements here
Conventional therapeutic approaches for fibromyalgia
In conventional medicine, fibromyalgia syndrome is treated with a combination of three different approaches (multimodal), which also includes extensive patient training:
- medical therapy,
- non-drug therapy, usually in the form of physiotherapy with special functional training, supplemented by physical therapy forms (cold, warmth)
- and psychotherapy.
Doctors have recorded the respective recommendations for the treatment of pain syndrome in the so-called S3 guideline.
It is important that you listen to your own feelings and well-being and combine exactly the treatment options that will help you best. Our pain therapy offers you a self-help offer to choose from, with which you can possibly reduce the amount and dose of your medication and painkillers and no longer have to rely on referrals from your doctor for physiotherapy.
Drug therapy: In most cases, drugs against depression, i.e. antidepressants, are used to treat fibromyalgia. But often the drugs work or help differently in different patients and only the combination of several drugs shows an effect. 11)
The standard drugs are special antidepressants in low doses, so-called tricyclic antidepressants such as amitriptyline. They block the reuptake of serotonin and / or norepinephrine. This is intended to increase the ability to concentrate and counteract concentration disorders. 12) Agents against epilepsy, such as pregabalin, are also used. Some studies have shown the effectiveness of amitriptyline and duloxetine. In general, however, the cause of the pain syndrome can only be treated poorly or not at all effectively with medication. The same applies, of course, to the use of painkillers or even cortisone, which have a long list of side effects.
Non-drug measures: When it comes to therapy options without drugs, physiotherapy and physiotherapy are at the top of the list. For many patients, this already brings the first improvements in pain in muscles and tendons through special functional training, but the therapists are usually not able to relieve the symptoms satisfactorily. In addition, physiotherapy or physiotherapy must always be prescribed by a doctor. With our method you can become active yourself – and our therapists will support you if you need help.
Other therapies and applications are sometimes advised against by doctors in the “guideline-based therapy of fibromyalgia”. These include chiropractic, laser therapy, magnetic field therapy or transcranial direct current stimulation. 13)
New studies show that acupuncture at individually selected points alleviates the symptoms of fibromyalgia patients. 14) However, the costs and duration of treatment are comparatively high here. In addition, it needs a few applications before an effect occurs. The same applies to a TENS treatment. TENS stands for transcutaneous electrical nerve stimulation. Pain is treated with electrical impulses. In a placebo-controlled study, a short-term improvement in symptoms of movement pain was achieved.
5. Exercises for the whole body
You yourself know best which parts of your body your symptoms are at the worst right now. It’s best to start there, but don’t overdo yourself or do too many different exercises at once. Please also be patient: It will take several months for the exercises to fully develop. We have put together different exercises from head to toe so that you can choose the right exercise for you. If you are new to our exercises, please read our notes on the exercises under the boxes first. Then you can start right away.