How does fibromyalgia fatigue affect daily life. What are the main symptoms of fibro fog. Can exercise help manage fibromyalgia-related fatigue. How to improve sleep quality for fibromyalgia patients. What workplace accommodations can help individuals with fibromyalgia. How to communicate fibromyalgia symptoms to friends and family. Are there underlying conditions that can exacerbate fibromyalgia fatigue.

Understanding Fibromyalgia: More Than Just Pain

Fibromyalgia is a complex condition that extends far beyond the realm of chronic pain. While widespread musculoskeletal discomfort is a hallmark symptom, many individuals with fibromyalgia also grapple with cognitive difficulties and overwhelming fatigue. These additional symptoms, often referred to as “fibro fog” and extreme exhaustion, can significantly impact daily functioning and quality of life.

Do invisible symptoms make fibromyalgia challenging to diagnose? Indeed, the absence of visible signs and the lack of specific diagnostic tests for fatigue and cognitive impairment can make fibromyalgia a perplexing condition for both patients and healthcare providers. This necessitates a collaborative approach between individuals and their medical teams to address the unique challenges posed by fatigue and fibro fog.

Fibromyalgia Fatigue: A Pervasive and Debilitating Symptom

Fatigue in fibromyalgia is not simply feeling tired. It’s an all-encompassing exhaustion that affects up to 80% of individuals with the condition. This profound weariness often coincides with sleep disturbances, creating a vicious cycle of sleepless nights and daytime exhaustion.

Is fibromyalgia fatigue different from normal tiredness? Absolutely. Fibromyalgia-related fatigue is characterized by its severity and persistence. It’s a deep-seated exhaustion that doesn’t improve with rest and can significantly impair one’s ability to perform daily activities. This fatigue can be so overwhelming that it rivals pain as the most debilitating aspect of fibromyalgia for many individuals.

The Impact of Fatigue on Daily Life

• Reduced physical endurance
• Difficulty concentrating and completing tasks
• Decreased motivation and productivity
• Emotional strain and mood fluctuations
• Social isolation due to limited energy reserves

Decoding Fibro Fog: The Cognitive Challenges of Fibromyalgia

Fibro fog, also known as cognitive dysfunction in fibromyalgia, is a term that aptly describes the mental haziness experienced by many individuals with the condition. This cognitive impairment can manifest in various ways, affecting memory, concentration, and overall mental clarity.

How prevalent is fibro fog among fibromyalgia patients? Studies indicate that over half of individuals with fibromyalgia report experiencing cognitive difficulties. For many, these cognitive symptoms can be even more disruptive than pain or fatigue, significantly impacting their ability to function effectively in personal and professional settings.

Common Manifestations of Fibro Fog

1. Difficulty maintaining focus and attention
2. Short-term memory lapses
3. Challenges in word-finding and verbal fluency
4. Impaired multitasking abilities
5. Slower processing speed

The Exercise Paradox: Moving Beyond Fatigue to Find Relief

While the idea of exercising may seem daunting when battling fibromyalgia-related fatigue, physical activity is consistently recognized as one of the most effective management strategies for the condition. The key lies in finding the right balance and approach to exercise.

Can exercise really help alleviate fibromyalgia symptoms? Research strongly supports the benefits of regular physical activity for individuals with fibromyalgia. Exercise has been shown to reduce pain, improve sleep quality, boost energy levels, and enhance overall well-being. However, it’s crucial to approach exercise with caution and gradually increase intensity to avoid exacerbating symptoms.

Effective Exercise Strategies for Fibromyalgia

• Start with low-impact activities like walking or swimming
• Incorporate gentle strength training to rebuild muscle
• Explore movement therapies such as yoga, tai chi, or qi gong
• Work with a physical therapist to develop a personalized exercise plan
• Focus on consistency rather than intensity

Pacing and Energy Conservation: Mastering the Art of Balance

For individuals with fibromyalgia, learning to pace activities and conserve energy is crucial for managing fatigue and maintaining quality of life. This approach involves carefully balancing activity with rest to avoid overexertion and subsequent symptom flares.

How can pacing techniques improve daily functioning for fibromyalgia patients? Effective pacing allows individuals to accomplish tasks without depleting their energy reserves. By breaking down activities into manageable segments and incorporating regular rest periods, people with fibromyalgia can maintain a more consistent level of activity throughout the day, reducing the likelihood of severe fatigue and post-exertional malaise.

Practical Pacing Strategies

1. Prioritize activities based on importance and energy requirements
2. Break large tasks into smaller, more manageable steps
3. Alternate between high and low-energy activities
4. Schedule regular rest periods throughout the day
5. Learn to recognize and respect personal energy limits

Navigating the Workplace with Fibromyalgia

Maintaining employment while managing fibromyalgia can be challenging, but with appropriate accommodations and strategies, many individuals can continue to thrive in their careers. Open communication with employers and colleagues is often key to creating a supportive work environment.

Are there specific workplace accommodations that can benefit individuals with fibromyalgia? Yes, several adjustments can help accommodate the needs of employees with fibromyalgia. These may include flexible work schedules, ergonomic workstations, frequent break opportunities, and modified job responsibilities. The goal is to create an environment that allows for productivity while minimizing symptom exacerbation.

Potential Workplace Accommodations for Fibromyalgia

• Flexible or reduced work hours
• Option for remote work when possible
• Ergonomic office equipment to reduce physical strain
• Adjustments to lighting and temperature controls
• Permission for short rest periods or stretching breaks
• Noise-cancelling headphones or quiet workspaces

The Sleep-Fatigue Connection: Improving Rest Quality

Sleep disturbances are a common and significant contributor to fatigue in fibromyalgia. Addressing sleep issues is often a crucial step in managing overall symptoms and improving quality of life for individuals with the condition.

Why is quality sleep so important for fibromyalgia management? Restorative sleep plays a vital role in pain regulation, cognitive function, and energy levels. For individuals with fibromyalgia, improving sleep quality can lead to reduced pain sensitivity, enhanced mood, and increased daytime energy. However, achieving restful sleep can be challenging due to pain, anxiety, and other fibromyalgia-related symptoms.

Strategies for Improving Sleep Quality

1. Establish a consistent sleep schedule
2. Create a relaxing bedtime routine
3. Optimize the sleep environment (dark, cool, quiet)
4. Limit caffeine and screen time before bed
5. Practice relaxation techniques such as deep breathing or meditation
6. Consider cognitive-behavioral therapy for insomnia (CBT-I)

Unmasking Hidden Contributors to Fatigue

While fatigue is a primary symptom of fibromyalgia, it’s essential to consider that other underlying conditions may contribute to or exacerbate exhaustion. Identifying and addressing these coexisting issues can lead to more effective overall symptom management.

Could other medical conditions be contributing to fibromyalgia-related fatigue? In some cases, yes. Individuals with fibromyalgia may have concurrent conditions that can intensify fatigue. These may include thyroid disorders, anemia, sleep apnea, or autoimmune diseases. Proper diagnosis and treatment of these conditions can significantly improve energy levels and overall well-being.

Common Conditions That May Coexist with Fibromyalgia

• Chronic fatigue syndrome
• Autoimmune disorders (e.g., rheumatoid arthritis, lupus)
• Thyroid dysfunction
• Iron-deficiency anemia
• Sleep disorders (e.g., sleep apnea, restless leg syndrome)
• Mood disorders (e.g., depression, anxiety)

Communicating the Invisible: Helping Others Understand Fibromyalgia

One of the most challenging aspects of living with fibromyalgia is explaining the condition to friends, family, and colleagues. The invisible nature of symptoms like fatigue and cognitive difficulties can make it hard for others to comprehend the full impact of the disorder.

How can individuals with fibromyalgia effectively communicate their experiences to others? Clear, honest communication is key. Educating loved ones about the nature of fibromyalgia, including its neurological basis and wide-ranging symptoms, can foster understanding and support. It’s also helpful to be specific about needs and limitations, allowing others to provide appropriate assistance and accommodations.

Tips for Discussing Fibromyalgia with Others

1. Provide simple, clear explanations of fibromyalgia and its symptoms
2. Share reputable resources and information about the condition
3. Be honest about limitations and needs
4. Explain how symptoms can fluctuate from day to day
5. Encourage questions and open dialogue
6. Express appreciation for understanding and support

Living with fibromyalgia-related fatigue and cognitive challenges requires a multifaceted approach to management. By understanding the complexities of these symptoms, implementing effective strategies, and fostering open communication, individuals with fibromyalgia can improve their quality of life and maintain meaningful relationships and activities. Remember that each person’s experience with fibromyalgia is unique, and finding the right combination of treatments and coping mechanisms may take time and patience. With the support of healthcare providers, loved ones, and fellow fibromyalgia warriors, it’s possible to navigate the fog and fatigue of fibromyalgia and lead a fulfilling life.

How it Feels & Treatment Tips

Written by Julie Canter

• They’re Real
• Slow but Steady Exercise
• Scale Back
• Get Organized
• Make Your Day More Fibro-Friendly
• Better Sleep
• Help Others See What You Feel
• More

Fibromyalgia goes beyond pain. It can also affect your thinking ability, a symptom called fibro fog, and your energy level, leaving you with extreme fatigue. Even though you feel these symptoms, they aren’t visible, and there aren’t any tests that can measure them.

You’ll need to work closely with your medical team to address your specific challenges with fatigue and fibro fog, because they’re a little different for everyone. Do your part by taking steps to conserve energy and overcome concentration and memory issues to power through your day.

Severe fatigue — more than just being tired — affects up to 4 out of 5 of people with fibromyalgia. It often goes hand-in-hand with sleepless nights. Together, they leave you drained and exhausted.

While scientists are learning more about what’s happening in your brain that causes the pain and some other symptoms, what’s behind fibro fog remains unclear. That name says it all: a fuzzy-headed feeling that keeps you from thinking clearly. You may get distracted, forget or lose things, and struggle to keep up with conversations.

Over half of people with fibromyalgia say they have these kinds of problems, and many feel the fog impacts their lives more than the pain, tenderness, and fatigue.

Given how you feel, you may want to shy away from exercise. But it’s one of the most effective ways to handle fibromyalgia.

When you’re too tired to exercise, that lack of activity leads to greater muscle weakness and more fatigue. Over time, regular exercise lessens fatigue. Consistency can have a greater impact than intensity.

It’s possible that exercise also creates a positive chain reaction that boosts brain function. Studies show a link between physical ability and thinking ability. People who can do more physically often do better in areas like attention and decision-making.

Start out at an easy pace. Work with a physical therapist to find the right beginner program for you and adapt it as you get stronger. This is especially helpful if you’re nervous about exercising.

Strength training helps you regain muscle, and that helps with pain and fatigue for some people. Use resistance bands or a light weight to start.

Very gentle movement therapies like yoga, tai chi, and qi gong all get you moving, but yoga often has best effect on fatigue.

If you’re frustrated by what you can’t do, try pacing yourself. Cut back on less important activities to have the energy to enjoy more meaningful ones.

Break down big tasks into manageable bites. As you complete each one, you’ll have a sense of accomplishment rather than feel discouraged.

Build in short rest periods between tasks. Keep a journal to find the best activity/rest balance for you.

Use an online calendar or app that lets you color-code activities by importance. Plan work projects and home responsibilities at least a week in advance.

Then take a big-picture look. Are there too many high-priority items and not enough down time? Make adjustments, even if it means sometimes saying “no.”

Take a fibromyalgia education program to learn healthy behaviors and how to tweak everyday activities for less stress.

If you work outside the home, talk to your employer about things that might help you do your job:

• Take breaks more often
• Change your work schedule
• Switch to a different position that better matches your abilities

A psychologist or neurologist may be able to suggest more adaptations, or use biofeedback or cognitive behavior therapy to boost your focus. An occupational therapist can show you how to make physical changes, from a better workstation to stretches you can do at your desk.

There’s a strong connection between sleep quality and your level of fatigue. While some fibromyalgia medications may help, they may not be enough. In addition to regular exercise and pacing yourself, practice good sleep habits. These include a regular bedtime and wake-up time and a dark, cool, quiet room

Some people with fibromyalgia have a second condition that causes fatigue, like an inflammatory disease, anemia, or low thyroid. Get tested and, if needed, treated.

Because fibro fog and fatigue aren’t obvious, it can be hard for friends and loved ones to understand what you’re dealing with.

Let the people in your life know that you have a disease that affects your muscles and causes pain, fatigue, and thinking problems. It might help to say researchers are pretty sure that certain areas of the brain don’t process nerve signals correctly, leading to a wide range of symptoms.

When you ask for help — and it’s OK to do that — be specific about what you need.

Top Picks

How it Feels & Treatment Tips

Written by Julie Canter

• They’re Real
• Slow but Steady Exercise
• Scale Back
• Get Organized
• Make Your Day More Fibro-Friendly
• Better Sleep
• Help Others See What You Feel
• More

Fibromyalgia goes beyond pain. It can also affect your thinking ability, a symptom called fibro fog, and your energy level, leaving you with extreme fatigue. Even though you feel these symptoms, they aren’t visible, and there aren’t any tests that can measure them.

You’ll need to work closely with your medical team to address your specific challenges with fatigue and fibro fog, because they’re a little different for everyone. Do your part by taking steps to conserve energy and overcome concentration and memory issues to power through your day.

Severe fatigue — more than just being tired — affects up to 4 out of 5 of people with fibromyalgia. It often goes hand-in-hand with sleepless nights. Together, they leave you drained and exhausted.

While scientists are learning more about what’s happening in your brain that causes the pain and some other symptoms, what’s behind fibro fog remains unclear. That name says it all: a fuzzy-headed feeling that keeps you from thinking clearly. You may get distracted, forget or lose things, and struggle to keep up with conversations.

Over half of people with fibromyalgia say they have these kinds of problems, and many feel the fog impacts their lives more than the pain, tenderness, and fatigue.

Given how you feel, you may want to shy away from exercise. But it’s one of the most effective ways to handle fibromyalgia.

When you’re too tired to exercise, that lack of activity leads to greater muscle weakness and more fatigue. Over time, regular exercise lessens fatigue. Consistency can have a greater impact than intensity.

It’s possible that exercise also creates a positive chain reaction that boosts brain function. Studies show a link between physical ability and thinking ability. People who can do more physically often do better in areas like attention and decision-making.

Start out at an easy pace. Work with a physical therapist to find the right beginner program for you and adapt it as you get stronger. This is especially helpful if you’re nervous about exercising.

Strength training helps you regain muscle, and that helps with pain and fatigue for some people. Use resistance bands or a light weight to start.

Very gentle movement therapies like yoga, tai chi, and qi gong all get you moving, but yoga often has best effect on fatigue.

If you’re frustrated by what you can’t do, try pacing yourself. Cut back on less important activities to have the energy to enjoy more meaningful ones.

Break down big tasks into manageable bites. As you complete each one, you’ll have a sense of accomplishment rather than feel discouraged.

Build in short rest periods between tasks. Keep a journal to find the best activity/rest balance for you.

Use an online calendar or app that lets you color-code activities by importance. Plan work projects and home responsibilities at least a week in advance.

Then take a big-picture look. Are there too many high-priority items and not enough down time? Make adjustments, even if it means sometimes saying “no.”

Take a fibromyalgia education program to learn healthy behaviors and how to tweak everyday activities for less stress.

If you work outside the home, talk to your employer about things that might help you do your job:

• Take breaks more often
• Change your work schedule
• Switch to a different position that better matches your abilities

A psychologist or neurologist may be able to suggest more adaptations, or use biofeedback or cognitive behavior therapy to boost your focus. An occupational therapist can show you how to make physical changes, from a better workstation to stretches you can do at your desk.

There’s a strong connection between sleep quality and your level of fatigue. While some fibromyalgia medications may help, they may not be enough. In addition to regular exercise and pacing yourself, practice good sleep habits. These include a regular bedtime and wake-up time and a dark, cool, quiet room

Some people with fibromyalgia have a second condition that causes fatigue, like an inflammatory disease, anemia, or low thyroid. Get tested and, if needed, treated.

Because fibro fog and fatigue aren’t obvious, it can be hard for friends and loved ones to understand what you’re dealing with.

Let the people in your life know that you have a disease that affects your muscles and causes pain, fatigue, and thinking problems. It might help to say researchers are pretty sure that certain areas of the brain don’t process nerve signals correctly, leading to a wide range of symptoms.

When you ask for help — and it’s OK to do that — be specific about what you need.

Top Picks

causes, symptoms and treatment in Moscow at the FSCC FMBA

Fibromyalgia (fibromyalgia syndrome) is a complex, long-term disorder that is accompanied by widespread pain, severe fatigue, sleep problems. Pain occurs in muscles and joints throughout the body for no apparent reason.

The disease can develop in anyone, including the elderly and children. It is worth noting that fibromyalgia is more often recorded in adult women aged 25 to 55 years.

Scientists suggest that the cause of fibromyalgia is an abnormal reaction of the central nervous system to pain signals that are transmitted throughout the body. In the process of complex diagnostics, it is not possible to establish the nature of the symptoms. Laboratory and instrumental diagnostic parameters are within the normal range.

In clinical practice, doctors use criteria to make a diagnosis. The hallmarks of fibromyalgia are the presence of widespread, intense pain that persists for three months or more, as well as the lack of a clear explanation for the development of symptoms.

A rheumatologist specializes in the diagnosis and treatment of fibromyalgia. Treatment options include patient education, exercise, management of comorbid conditions that may contribute to symptoms, and medication.

Symptoms

Prolonged, widespread pain in all parts of the body is the main manifestation of fibromyalgia. Pain may be more pronounced in some parts of the body, such as the neck or back. The pain may feel like burning or tingling. The pain syndrome grows slowly, patients seek medical help after a few years, when pain reduces the quality of life.

Patients have many other symptoms that may come and go, get worse or worse over time. It is often difficult to establish a pattern in the appearance of symptoms.

The main signs of fibromyalgia include:

• Generalized pain. The pain is often described as dull. To be considered common, pain must occur on the right and left sides of the body, and above and below the waist;
• Fatigue. “Broken” condition, fatigue immediately after waking up accompanies patients, even despite prolonged sleep;
• Cloudiness of consciousness. Patients complain of problems with thought processes, memory loss, difficulty concentrating.

Fibromyalgia is a multi-symptom disorder.

Common associated features include:

• Hypersensitivity to pain
• Constant muscle tension
• Stiffness in the joints more in the morning and evening hours
• Touch sensitivity
• Sleep disorder
• Headaches, migraines
• Symptoms of anxiety disorder, depression
• Gastrointestinal disorders, irritable bowel syndrome, which is manifested by abdominal pain, bloating, stool disorder

Fibromyalgia patients are more likely to have functional symptoms such as cold hands and feet, wet palms, dry mouth and eyes, and dizziness when changing body position.

Symptoms may worsen or improve depending on the following factors:

• Stress level
• Cold weather, high humidity
• Climate Change
• Morning Hours
• Physical activity level

Reasons

The exact causes of fibromyalgia remain unknown and continue to be the subject of scientific debate.

Recent studies show the genetic nature of fibromyalgia. The disease often runs in families among siblings and their parents.

Fibromyalgia is not an autoimmune disease or a pathology caused by inflammation. The main role is played by changes in the functioning of the nervous system. It is believed that people with fibromyalgia have an increased reaction of the central nervous system in response to stimuli in the form of pain symptoms. This reaction is associated with an excessive accumulation of chemicals in the brain that signal pain. It is worth noting that usually these stimuli do not cause pain in healthy people.

The development of fibromyalgia can provoke acute conditions. These include acute infectious diseases, traumatic injuries. Provoking factors also include intense physical activity, emotional stress.

Diagnostics

Fibromyalgia is a diagnosis of exclusion. There is no specific diagnostic test for fibromyalgia, and the symptoms that patients describe are similar to a number of other conditions. Before making a diagnosis, the doctor must rule out all possible causes of symptoms.

Fibromyalgia can occur in isolation, as well as against the background of other rheumatic diseases. Often coexists with psychiatric disorders such as anxiety and depression. For this reason, each patient at the appointment is asked to fill out an anxiety and depression questionnaire.

A rheumatologist deals with diagnostic issues, confirms the diagnosis and prescribes effective treatment to control the symptoms of fibromyalgia.

Attention is drawn to the three characteristic features of fibromyalgia, which include:

• Generalized severe pain
• Presence of symptoms for three months
• Absence of other health problems that could explain the pain and other symptoms

Diagnostic criteria include widespread pain in all parts of the body for at least three months, as well as pain when pressure is applied to trigger points in certain anatomical locations. The pain threshold at these points is reduced.

Painful points are identified symmetrically on both halves of the body. The force of pressure should not exceed 4 kg. The doctor can use a dolorimeter – a device that gives a dosed load.

It should be noted that according to the latest recommendations from 2016, the determination of sensitive points is not required. The key criteria are widespread pain for at least three months.

To qualify, pain must be in at least four of these five areas:

• Left upper area including shoulder, arm, jaw
• Right upper region including shoulder, arm, jaw
• Left lower region including thigh, buttock, leg
• Right lower region including thigh, buttock, leg
• Vertical which includes the neck, back, chest or abdomen

The doctor conducts a physical examination, during which he identifies or excludes other causes of muscle pain. An underactive thyroid gland (hypothyroidism) as well as polymyalgia rheumatica can mimic fibromyalgia. Blood tests allow you to establish the presence of the described diseases.

The symptoms of fibromyalgia are also similar to those of rheumatoid arthritis and systemic lupus erythematosus. A careful examination, questioning, as well as laboratory and instrumental diagnostics allow the attending physician to detect these conditions.

To exclude other conditions that may have similar symptoms, the doctor prescribes tests:

• General and biochemical blood test;
• Erythrocyte sedimentation rate;
• Antibodies to cyclic citrulline-containing peptide;
• Rheumatoid factor;
• Thyroid hormones;
• Antinuclear antibodies.

Treatment at the Federal Scientific and Practical Center

Standard approaches to the treatment of fibromyalgia include drug therapy, behavioral therapy and patient education, and exercise programs. The maximum effect is achieved when using several types of treatment.

Non-drug therapy

• Physical exercise. Research shows that outdoor exercise is the most effective treatment. They activate a powerful pain relief system, it is recommended to perform in addition to drug treatment;
• Cognitive Behavioral Therapy (CBT) is a psychotherapeutic technique that has shown the greatest effectiveness in the treatment of fibromyalgia. CBT focuses on understanding how thought processes and ingrained habits affect pain and other symptoms. The technique focuses on changing the emotional response and behavior;
• Alternative acceptable therapies that include acupuncture, physiotherapy, massage, myofascial relaxation may be useful in combination with primary treatment.

Medical therapy

The goal of conservative therapy is to relieve symptoms and improve quality of life.

To control the manifestations of fibromyalgia, drugs from the following groups are used:

• Pain medications available without a prescription. Acetaminophen, ibuprofen may be effective in reducing pain symptoms;
• Antiepileptic drugs. Epilepsy medicines help reduce certain types of pain. Pregabalin is the first drug approved for the treatment of fibromyalgia. This drug blocks the excessive activity of nerve cells involved in the transmission of pain impulses;
• Antidepressants. The drug relieves pain and fatigue.

Complications

Pain, chronic fatigue, sleep problems disrupt the daily routine at home and at work, reduce the quality of life. Lack of understanding of one’s own condition, difficulties at the stage of diagnosis, long-term treatment lead to persistent depression and health-related anxiety. To correct the complications of fibromyalgia, you need to contact psychotherapists, psychiatrists.

Forecast

Fibromyalgia is a chronic pathology that significantly affects the quality of life, but it is still considered benign. Timely seeking medical help, the doctor’s attentive attitude to the patient, the patient’s desire to provide self-help and adjust their lifestyle are key factors in achieving recovery.

Prevention

Prevention is to eliminate provoking factors. The following recommendations will help control the manifestations of fibromyalgia:

• Allow enough time for rest and recovery each day. Deep breathing exercises and meditation practices help reduce the stress that triggers symptoms;
• Organize a sleep schedule. It is recommended to go to bed and get up at the same time. An hour before bedtime, as well as in the first two hours after waking up, it is worth limiting the time on the phone. Limit your intake of caffeinated beverages, avoid daytime naps. These factors can disrupt nighttime sleep;
• Exercise regularly in the fresh air, move, stay active. Regular exercise reduces pain, promotes a surge of energy, and eliminates fatigue. It is recommended to slowly increase physical activity day by day.
• Focus on things to come, not on things that are painful.

References

1. Teplyakova OV, Popov AA, Volkova LI, Sarapulova AV. Fibromyalgia: clinical picture and variants of the disease. Modern rheumatology. 2020;
2. Chichasova N.V. Fibromyalgia syndrome: clinic, diagnosis, treatment. breast cancer. 1998.

This article is an informational material and is not intended for self-diagnosis and self-treatment. If signs of discomfort appear, you should contact your doctor.

How to distinguish fibromyalgia from chronic fatigue?

Fibromyalgia and chronic fatigue syndrome: two often underestimated and poorly recognized chronic conditions

But can they be distinguished? How are they diagnosed? And what can be done to relieve often disabling symptoms?

Fibromyalgia: what it is and how it manifests itself

The term fibromyalgia means pain in the muscles and fibrous structures of the connective tissue, i.e. ligaments and tendons.

Fibromyalgia is characterized by:

• widespread musculoskeletal pain present for more than 3 months;
• fatigue;
• non-restorative sleep;
• difficulties with memory and attention,
• rigidity and mood disorders.

Disturbance of sleep and its quality is almost the rule.

It has been suggested that the alteration of his cycles, especially the shortening of the deep sleep phase, during which the pain threshold is normally elevated, is responsible for the increased sensitivity to pain characteristic of fibromyalgia.

In people who already have a pre-existing migraine, fibromyalgia causes an increase in the intensity and frequency of headaches, which may even become daily.

Link between fibromyalgia and long-term Covid

The ongoing Covid-19 pandemic leads to the observation that while most people recover after a few weeks, chronic and complex symptoms, not just respiratory ones, may persist or even manifest at a distance in some recoveries from infection.

This condition is called long covid and its main component is pain.

Many people who are recovering months after contracting the coronavirus complain of complex neurological symptoms such as:

• fatigue;
• persistent headache, often aggravated by lying down;
• insomnia;
• malaise after exercise;
• memory problems;
• speech problems and cognitive dysfunction;
• muscular and neuropathic pain.

Diagnosis

Fibromyalgia is described as a generalized non-inflammatory form of uncertain origin.

This is why the diagnosis and clinical features of fibromyalgia have long been controversial.

The first step in diagnosis, as this is a condition with a predominantly neuropathic pain component, is to see a neurologist for an initial evaluation, which can be followed up with in-depth examinations if necessary.

Diagnosis is mainly based on history and finding painful muscle areas.

It is also important to exclude blood, rheumatological, muscular, neurological, psychological and radiological signs.

For this, the neurologist can use

• hematochemical and radiological studies;
• psychological or rheumatological consultation.

therapy

Once the presence of fibromyalgia is recognized, the course of treatment is not short and requires commitment to achieve significant improvements.

Treatment of pain, chronic headache, and other symptoms of fibromyalgia is currently based on medications for

• neuropathic pain
• severe migraine;
• sleep disorders.

In particular, there are specific drugs for neuropathic pain, others for muscle contractures, but the gold standard is certain antidepressants that also have an analgesic effect.

It is also important not to underestimate the psychosomatic component of the disease, which can be negatively affected by psychophysical stresses and anxieties that exacerbate symptoms.

Chronic fatigue: how to recognize?

Fibromyalgia has a lot in common with Chronic Fatigue Syndrome, a problem that mainly affects young women and is often erroneously classified as “feigning illness (intentional faking of symptoms)”.

Chronic fatigue syndrome is a syndrome characterized by disabling asthenia lasting more than 6 months, of unknown origin.

It is associated with various symptoms, including:

• sleep disorders
• feeling cognitive disorder;
• fatigue;
• pain;
• worsening of symptoms on exertion.

Although the term “chronic fatigue syndrome” was first used in 1988, the disorder has been well described since the mid-1700s, but under different names: fever, neuroasthenia, chronic brucellosis, exercise stress syndrome.

Causes of chronic fatigue

The origin of chronic fatigue syndrome is still unknown.

No infectious, hormonal, immunological or psychiatric causes identified. Similarly, there are no allergic markers or immunosuppression.

In the last 2 years of the pandemic, Covid-19 infection has also been suspected as one of the causes of this syndrome, as in part in the case of fibromyalgia.

Some people who recovered from Covid 19 became carriers of chronic fatigue with persistent symptoms, some of which are the result of

Related reports

• organ damage due to infection and/or treatment;
• post-traumatic stress disorder.

Some researchers argue that the etiology will be multifactorial, including predisposition to factors

• psychosomatic;
• genetic;
• exposure to microbes;
• toxins;
• physical injury.

In any case, it is important to emphasize the physiological pattern of chronic fatigue syndrome.

Symptoms: fatigue that does not go away even with rest.

Whereas in fibromyalgia the predominant symptom is pain, in chronic fatigue syndrome, as the name suggests, it is asthenia.

The onset of chronic fatigue syndrome is usually abrupt: it often occurs after a psychologically or clinically stressful event.

Many patients report:

• virus-like illness;
• severe fatigue;
• fever;
• upper respiratory symptoms.

The initial syndrome resolves but causes prolonged and severe fatigue that interferes with daily activities and is usually worse with exertion but little or no improvement at rest.

Important common features are widespread pain and sleep disturbances, which may be associated with cognitive impairments such as memory problems.

How chronic fatigue is diagnosed

If symptoms are present that may lead to suspicion of chronic fatigue syndrome, the first step is to conduct a physical examination in combination with laboratory tests to rule out other pathologies and any possible alternative causes of chronic fatigue syndrome.

Objective examination of a patient with chronic fatigue syndrome is normal, without objective signs of muscle weakness, arthritis, neuropathy or organomegaly.

Laboratory tests are also normal and usually include a blood test with formula and measurements of electrolytes, azotemia, creatinine, erythrocyte sedimentation rate, and thyroid hormones.

If clinical evidence suggests, further investigations in selected patients may include sleep x-rays and tests for adrenal insufficiency.

Thus, the diagnosis of chronic fatigue syndrome is based on characteristic symptoms in patients with a normal clinical examination and normal laboratory findings.

Any abnormal physical findings or laboratory tests should be evaluated and alternative diagnoses causing these findings and/or symptoms should be ruled out.

It is important to emphasize that because people with chronic fatigue syndrome usually appear healthy, friends, family members, and even sometimes healthcare professionals express skepticism about their condition, and this can exacerbate the frustration and depression that patients often experience about their condition. poorly understood disorder.

Treatment

In order to offer effective treatment to patients with chronic fatigue syndrome, the clinician must first recognize and accept the validity of the symptoms.

Whatever the underlying causes, patients are not malingerers but sufferers.

On the other hand, patients should accept and accept their disability by focusing on what they can still do rather than being frustrated with what they can’t do.