Note

This topic is a continuation of our Fibromyalgia topic.

treatment

So far there is no causal (concerning the cause)but a purely symptomatic one (aims at alleviating or eliminating symptoms) therapy. There is a risk of drug abuse and consequential damage from long-term medications.

As with all chronic illnesses, one is crucial comprehensive = multimodal treatment concept, that except the medication (medical therapy = specialist in pain medicine, rheumatologist) and physiotherapeutic / sports therapeutic Treatment one psychological behavior therapy (psychotherapists / psychologists) with a focus on pain management and Nutritionist should definitely include. Surgical procedures are also carried out in which thickenings and adhesions on the fibromyalgic pressure points are loosened, but these are very controversial.

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Medical therapy

  • Antidepressants that intervene in the serotonin balance and primarily affect the treatment of chronic pain processes, especially the 5-HT3 receptor antagonist tropisetron, in which, according to studies, some symptoms can be achieved.
  • Tricyclic antidepressants such as amitriptyline or serotonin reuptake inhibitors (SSRIs) are also used, which can have a positive effect on pain perception.
  • Anti-epileptic drugs used to treat neuropathic pain
  • Muscle relaxants that have a beneficial effect on the relaxation of the muscles
  • Medicines to treat irritable stomach / irritable bowel syndrome
  • less common classic pain relievers (e.g. paracetamol)
  • non-steroidal creams (e.g. Proff® pain cream)
  • Rarely opiates (e.g. Tramal or Valoron)
  • Cortisone or anti-inflammatory drugs for rheumatism are usually not very effective
  • Infusion therapy
    Infusions over 5 weeks, 2 units per week
    • Sodium hydrogen carbonate 4.2%
    • NaCl 250 ml
    • Uni zinc 10 ml
    • Magnesium 10 ml
    • vitamin C

acupuncture

According to the diagnostic criteria from the chinese medicine (acupuncture) is often found in fibromyalgia patients a weakness of the Yin (usually there are Yin = the substance and Yan= the function in equilibrium), so that there is an overactivity of the yang. Typical symptoms of yin weakness in fibromyalgia are:

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  • Pallor of the skin
  • Paresthesia
  • temperature dysregulation
  • Tiredness, exhaustion
  • sleep disorders
  • fear / depression
  • Ringing in the ears (tinnitus)


The therapy principle of acupuncture in fibromyalgia, nourishing the weakened yin while harmonizing the yang.

Diet change

In the case of food intolerance such as If gluten intolerance is common in fibromyalgia patients or if the intestines are infected with fungi, a change in diet should be carried out.
This often not only reduces gastrointestinal problems, but also often has a positive effect on musculoskeletal pain. In the case of gluten intolerance, food supplements (e.g. iron, zinc, magnesium, calcium) should also be added, as not all substances are absorbed in sufficient quantities through the attacked intestinal mucosa.

In addition, “acidic” foods such as meat, coffee, etc. should be avoided to avoid a shift in the acid-base balance to the “acidic” side and thus an over-acidification of the muscles and connective tissue.

Recommended diet for fibromyalgia

  • Pay attention to your serotonin intake every day, serotonin is contained in secondary plant substances (fruits and vegetables 5 servings per day)
  • In the case of flatulence, the intake of caraway, fennel and lemon balm is recommended
  • Probiotic dairy products to support the immune system
  • When drinking coffee and alcohol, symptoms such as restless legs can worsen (restless legs in the resting phase)
  • Chinese tea, drunk 4-5 cups in the morning has a positive effect on states of exhaustion

Differential diagnoses (alternative causes)

  • Inflammatory forms of rheumatism such as the Rheumatoid arthritis
  • Somatoform pain disorders, e.g. depressionwhich are mainly noticeable through pain
  • Neuropathic pain syndromes such as the Polyneuropathies (PNP)
  • Lyme disease, a tick-borne bacterial disease
  • Thyroid disease (Hyperthyroidism, Hypothyroidism, Hashimoto's thyroiditis)
  • Drug side effects, e.g. by cholesterol-lowering drugs (so-called statins) drugs against asthma (Salbutamol), Drugs against gout (Allopuriol), basic therapeutic agents rheumatism (D-penicillamine) and antimalarials (chloroquine) and others
  • Myofascial Pain Syndrome
  • chronic fatigue syndrome
  • multiple sclerosis

Overlaps with other diseases and disease areas are common, so that individual disease symptoms cannot be clearly distinguished.

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