Fibromyalgia is a chronic pain syndrome that affects the musculoskeletal system, resulting in widespread pain, significant fatigue, and sleep disturbances. One of the diagnostic criteria is based on tenderness in 18 specific areas of the body. These tender points, also called pressure points , help identify fibromyalgia, although this criterion alone is not sufficient for a complete diagnosis. This syndrome affects approximately 2 to 6% of the population in industrialized countries, primarily women. This article presents the 18 points of fibromyalgia, its symptoms, causes, and the many approaches to managing this condition.
Definition of fibromyalgia
Fibromyalgia is a chronic condition characterized by widespread pain throughout the body, associated with stiffness, sleep disturbances, and persistent fatigue. This pain is not related to visible muscle or joint damage, making fibromyalgia difficult to diagnose. The World Health Organization (WHO) has officially recognized fibromyalgia since 1992. The pain is primarily due to an abnormal response of the nervous system that amplifies the perception of pain even to minimal stimuli.
The 18 points of fibromyalgia
The 18 specific points are distributed symmetrically across the body. When pressure is applied to these points, it triggers pain in people with fibromyalgia. Here are these points and their locations:
- Base of the skull (occiput) : at the back of the head, where it joins the neck.
- Nape of the neck (lower cervical region) : on the front of the neck, just above the collarbone.
- Trapezius : midway between the neck and shoulder, on the trapezius muscles.
- Scapulae (supraspinatus) : above the shoulder blades, slightly below the shoulders.
- Elbows (lateral epicondyles) : on the outer part of the elbows.
- Chest (second intercostal space) : below the collarbones, to the left and right of the sternum.
- Hips (greater trochanter) : on the outer side of the hips.
- Lower back (glutes) : in the upper part of the gluteal muscles.
- Knees (fatty pads of the knees) : just above the kneecaps.
The diagnosis of fibromyalgia is often based on pain felt in at least 11 of these 18 points for a period of at least three months.
Symptoms associated with fibromyalgia
In addition to chronic pain, fibromyalgia is accompanied by many other symptoms that vary from person to person and may include:
- Fatigue : persistent and often disabling.
- Sleep disturbances : light, non-restorative sleep.
- Muscle stiffness : especially in the morning.
- Headaches and migraines : common.
- Irritable bowel syndrome : abdominal pain, diarrhea, or constipation.
- Mood disorders : anxiety and depression.
- Difficulty concentrating : often described as “brain fog.”
- Numbness and tingling : in the hands and feet.
- Increased sensitivity : to noise, light, temperature and physical contact.
Causes and risk factors
The exact cause of fibromyalgia remains unknown, but several risk factors and hypotheses have been put forward:
Genetic factors
It has been observed that fibromyalgia can affect several members of the same family, suggesting a genetic predisposition. However, the genes involved have not yet been precisely identified.
Physical or emotional trauma
Physical trauma, such as a car accident, or emotional shock, such as bereavement or assault, can trigger fibromyalgia in some people. These stressful events disrupt the balance of the nervous system, leading to an abnormal response to pain.
Infections
Certain infections, such as hepatitis C or Lyme disease, have been linked to triggering fibromyalgia. They can cause changes in the immune and nervous systems, promoting the onset of the disease.
Sleep disorders
People with sleep disorders, such as restless legs syndrome or sleep apnea, are at greater risk of developing fibromyalgia because poor sleep disrupts pain regulation in the brain.
Ways to Live Better with Fibromyalgia
Although there is no cure for fibromyalgia, several approaches can help alleviate symptoms and improve quality of life.
Balneotherapy
Balneotherapy (hot water baths) is used to relieve muscle pain. The hot water relaxes muscles and improves blood circulation. Many patients report pain relief after regular balneotherapy sessions. Spa treatments, which combine swimming and exercise, are particularly beneficial.
Adapted physical activity
Physical exercise is essential for maintaining mobility and alleviating pain. Pool exercises are recommended as they allow muscles to be worked without too much strain. Walking, cycling, or gentle yoga are also recommended to improve flexibility and endurance. Exercise produces endorphins, which help alleviate pain and improve mood.
Relaxation and stress management
Stress management is crucial for fibromyalgia patients because stress worsens symptoms. Relaxation techniques , such as meditation, deep breathing, and yoga, help relax muscles and reduce the perception of pain. Music therapy and visualization are also often used to promote relaxation and reduce anxiety.
Psychological therapies
Cognitive behavioral therapy (CBT) is one of the most effective therapies for fibromyalgia patients. This approach helps change negative thoughts and better manage stress, leading to better control of chronic pain. CBT also helps develop strategies to manage symptoms on a daily basis.
Food supplements and natural substances
Certain natural substances and dietary supplements are sometimes used to reduce the symptoms of fibromyalgia.
Magnesium and malic acid
Many people with fibromyalgia have low magnesium levels, which can worsen muscle pain and fatigue. Combining magnesium with malic acid has shown promising results in alleviating these symptoms. Malic acid, naturally found in fruits like apples, plays a role in cellular energy production, which helps combat fatigue, a common symptom in fibromyalgia patients.
Studies generally recommend a dose of 1200 to 2400 mg of malic acid per day, in combination with 300 to 600 mg of magnesium , divided into several doses. This combination may help reduce muscle pain and stiffness, while improving endurance and fatigue in patients.
S-adenosylmethionine (SAM-e)
SAM -e is a naturally occurring chemical involved in mood and pain regulation. Some clinical trials have shown that SAM-e can improve mood, relieve pain, and reduce stiffness in people with fibromyalgia. It is primarily used to treat depression, but it may also relieve fibromyalgia symptoms.
5-HTP (5-hydroxytryptophan)
5 -HTP is a precursor to serotonin, a neurotransmitter involved in regulating mood, sleep, and pain. Studies have shown that 5-HTP supplements can improve sleep quality and reduce pain in people with fibromyalgia. A dose of 300 mg per day, divided into three doses, is often recommended.
Cayenne (Capsicum frutescens)
Cayenne peppers contain capsaicin, a compound known for its analgesic effects. Capsaicin creams can be applied topically to sore spots to relieve muscle and joint pain. Capsaicin has been shown to reduce pain by depleting stores of substance P , a molecule involved in transmitting pain signals.
Complementary and alternative approaches
Chinese Pharmacopoeia
In traditional Chinese medicine, herbs such as Xiao Yao Wan (Free Walking Powder) are used to relieve fibromyalgia pain. This approach aims to restore energy balance in the body. Results vary from person to person, but some studies have shown improvements in symptoms in patients.
Vegetarian diet
Some studies have shown that following a vegetarian diet may reduce pain and improve overall health in people with fibromyalgia. Foods rich in antioxidants, such as fruits and vegetables, help fight inflammation and eliminate free radicals. This diet may also aid in weight management, which is important for joint relief.
Sound resonance (Psycho Physio technique)
The Sound Resonance Intervention Technique is a method that uses sound vibrations to stimulate the brain and promote relaxation. This method, also called the Psycho Physio method , aims to recall traumatic memories to release them, thus improving the symptoms of fibromyalgia. Although this technique is still not widely used, preliminary studies indicate an improvement in symptoms in 90% of patients.
Biofeedback
Biofeedback is a technique that helps patients control certain physiological functions such as muscle tension, breathing, and heart rate. Using devices that measure these parameters, patients learn to better manage their pain and stress. Several studies have shown that biofeedback can reduce fibromyalgia symptoms, including morning stiffness, pain, and fatigue.
Conclusion
Fibromyalgia is a complex condition that profoundly affects the quality of life of those who suffer from it. Diagnosis is based in part on sensitivity at 18 specific points on the body, but a comprehensive approach is necessary to effectively treat symptoms. Solutions such as balneotherapy, adapted physical activity, nutritional supplements, relaxation, and psychological therapies can provide lasting relief. By exploring different complementary approaches, patients can find methods that work for them to better manage their condition on a daily basis.
