Symptoms of fibromyalgia

Fibromyalgia symptoms can have multiple, but the main clinical sign is diffuse (common) pain in the muscles, tendons and ligaments. It is no coincidence that fibromyalgia is considered one of the main diseases, called myalgia, from the Greek words myos and algos - muscle and pain. Previously, the disease had a variety of names - and fibrositis, and tendomyopathy, as well as psychogenic or muscular rheumatism. Myalgia, unlike arthritis and arthrosis, is not accompanied by pain in the joints, only soft tissues hurt, the nature of the pain is spilled or intermittent.

Symptomatically manifested pain in fibromyalgia is localized in such areas as shoulders, neck, neck and waist. Painful sensations are not associated with inflammation or pathological changes in the skeleton or muscular apparatus, they are difficult to describe and verbally concretize, in addition, the fibromyalgia symptoms show extremely similar to the manifestations of other diseases, perhaps that is why fibromyalgia is diagnosed at later stages of its development. Fibromyalgia is the leader in diseases that provoke depression, which significantly reduces the quality of life of the patient. To date, statistics registers about 20 million patients with this disease, and the prevalence of myalgia increases every year. In European countries and the United States, fibromyalgia is considered a separate nosological unit and ranks second after arthritis in the number of diagnosed cases in the category of pathology of the musculoskeletal system

[1], [2], [3], [4]

Signs of fibromyalgia

The pain arises from insignificant sensations, which the person initially does not pay attention to, then practically all the time of wakefulness is devoted to a painful struggle with pain that can not be "attached" to any specific disease. There is growing misunderstanding and, at times, irritation of the surrounding sick people, often such manifestations can also be from unintelligent doctors. The sick person is redirected to various narrow specialists - from a therapist, surgeon, neuropathologist to a psychiatrist or psychotherapist. By the way, the latter's help will not be superfluous in any case, since fibromyalgia has psycho-neurological symptoms, that is, it is always accompanied by a depressive condition.

Symptoms continue to increase, fatigue, apathy, insomnia. Even small emotional, intellectual or physical loads become a serious test for the patient. Few people believe, but a simple movement, such as a slope, in order to get a shoe, sometimes brings unbearable torment to a person, not to mention performing some more hard work. Feeling misunderstanding, distrust and unable to explain and, most importantly, to prove their problems, the diseased myalgia falls into despair. It is no accident that those few doctors who study and can diagnose fibromyalgia call the disease the invisible disability - an invisible disability.

In addition, that diffuse pains seize the whole body, fibromyalgia symptoms demonstrates the following:

• Continuous fatigue, a feeling of fatigue, even after rest and sleep.
• Constant stiffness of muscles and joints, especially in the morning. The body "wakes up" for a long time.
• The broken slow phase of sleep (deep sleep), during which the body really rest and relax. As a consequence, the morning feeling of weakness.
• Periodic headaches that occur after pain in the shoulder girdle and neck.
• Feeling of numbness in the extremities, puffiness of the tissues around the joints, especially in the morning (the joint does not hurt).
• The increased sensitivity of the trigger points (see below), the zones around the joints.
• Periodic disorders of the digestive system, not related to poisoning, eating disorders and gastroenterological diseases.
• RLS is a restless leg syndrome, a neurological symptom characterized by paresthesia of the legs (excessive motor activity, often in a dream).

Most often, patients describe painful sensations in an unclear, but very emotional, most typical description of "pain throughout the body" or "from head to foot." Obviously, this corresponds to reality, especially if the pain is accompanied by intermittent seizures and numbness. In recent decades, the signs of fibromyalgia have become increasingly observed not only in adults, but also in children, especially in girls of pubertal age. The manifestations of myalgia in adult patients and the symptoms of the disease in children differ from each other.

Symptoms of fibromyalgia that are characteristic of adults

FMS (fibromyalgia - fibro / ligament, my / muscle, algia / pain) exhibits the following clinical symptoms:

• Stiffness - stiffness, ossification of the whole body. A symptom that is most noticeable in the morning, but it can also manifest itself depending on the temperature change.
• Symptoms similar to migraine symptoms. Pain can begin at the back of the neck, radiate into the temples or the area behind the eyes. The temporomandibular joint is affected in 25-30% of patients diagnosed with FMS.
• Insomnia or sleep disturbance, insomnia. Over the length of time, sleep can correspond to the norm, but the person does not lose the feeling of fatigue. There is also a violation of the stage of falling asleep, there are often cases of a feeling of lack of air during sleep, up to stopping breathing, asphyxiation.
• Constant complaints that can be attributed to gastroenterological problems: flatulence, irritable bowel syndrome, diarrhea, or constipation. Often, the pain can not swallow food, it is associated with neurological disorders, which also "is famous" for fibromyalgia.
• Disorders of the functioning of the genitourinary system - frequent urge to urinate without infection or inflammation of the bladder. Women, who most often suffer from fibromyalgia, note an excessively long menstrual cycle, painful and protracted.
• Sensitivity disorder in the extremities, burning, sensation of tingling or numbness - paresthesia of the extremities.
• Thermal sensitivity is the reaction to the slightest temperature changes, both the environment and internal sensations. Also, the patient with fibromyalgia is characterized by the so-called Reynaud-angiodystonia syndrome, in which an ischemic patch is formed on the limb that changes color. 8.
• Dermatological manifestations - dry skin, often symptoms similar to ichthyosis (keratosis, keratinization of the skin). Often swelling of the fingers, swelling is not associated with articular diseases, that is, with arthrosis.
• Pain in the chest area, which Western doctors call thoracic pain and dysfunctio. Such pain is most often manifested after a person has been for a long time in one position (work, sitting at a table, working, standing, and so on). Pain in the thoracic region is accompanied by symptoms similar to manifestations of cardialgia (prolapse of the mitral valve).
• Fibromyalgia symptoms can manifest in the form of imbalance - ataxia. The inconsistency of muscle groups provokes impaired motor coordination, dizziness up to nausea and loss of consciousness.
• Ophthalmic problems can also be one of the symptoms of fibromyalgia. Sensory disorders in the form of difficulties in focusing the look, difficulty in reading, according to experts, are caused by weakened, atonic neck muscles that can not adequately participate in the transmission of nerve impulses.
• Arterial pressure jumps, mainly in the direction of a sharp decline - one of the secondary symptoms of FMS. This is especially evident when the patient sharply changes the position of the body from horizontal to vertical.
• Cognitive impairment - a decrease in concentration of attention, memory (especially operational, short-term). In clinical practice, similar phenomena are called fibro-fog - "fibromyalgic fog".
• Neurological symptoms are restless legs syndrome or restless leg syndrome, which is observed in almost every third patient with fibromyalgia.
• Increased sensory reactivity, sensitivity. Any smell, color, or light flashes can trigger a seizure of myalgic pain, almost the same as with migraine, with one difference - hemicranium is accompanied by a headache, not a muscle pain.
• Allergic symptoms are rare, but it can also be a secondary sign of fibromyalgia. Differentiation from the symptoms of the underlying allergic disease is based on additional pain sensations, for example in the sinuses of the nose, which are not typical for classical allergies.
• Fibromyalgia symptoms manifests itself in the form of psychoemotional disorders - depressions, which must be differentiated from classical dysthymia and the psychiatric nosological category. FMS can not be a form of hypochondriacal disorder or depression, on the contrary, it is these conditions that are the concomitant symptomatic syndromes of fibromyalgia.
• Subfebrile body temperature, transient febrile state - a frequent phenomenon. Fibromyalgia also manifests symptoms in hyperthermia, when the temperature can rise rapidly and fall just as quickly to normal levels.

Symptoms of fibromyalgia that are characteristic of children

Fibromyalgia in children is diagnosed extremely rarely, because it is much more difficult for children than for adults to formulate and specify their feelings.

The main diagnostic obvious symptoms may be painful sensations in specific tender points of the body. These criteria were developed more than twenty years ago by the specialists of the American Association of Rheumatologists (ACR). Adult patients are also characterized by pain in these areas, but in children fibromyalgia symptoms are more hidden, so the sensitivity of trigger points is determined externally when examined by palpation. If the child has pain in 5-7 points out of 18 proposed as diagnostic symptoms, this indicates the presence of the disease. Pain zones are located in the area of the shoulder girdle, back, buttocks and waist, and also there are control ones - the forehead and the zone above the epiphysis of the fibula. Pain in these areas for 2-3 months is a symptom of fibromyalgia in children.

Fibromyalgia symptoms can be one-sided, in which case the child tries to limit movement with that hand or foot, from which discomfort appears. Also, children often quite often involuntarily try to compensate for the pain sensations with the one-sided position of the body when performing simple actions, for example, when eating, doing lessons (turning the body, neck). Over time, the pain begins to acquire a diffuse character and spreads to the second, previously unaffected part of the body.

The child may complain of pain in the hands or feet, although outwardly the joints look quite healthy. Also characteristic for fibromyalgia in children, pain in the heart, not having objective indicators of cardiopathology. Attentive parents usually notice such symptoms, however, when counseling in a medical institution, the child is most often diagnosed with a disease with similar symptoms - a violation of the body's posture (scoliosis, kyphosis and others). Often the symptoms of childhood fibromyalgia due to poor knowledge are diagnosed as rheumatism or cardiac diseases, although laboratory and hardware examinations do not reveal significant deviations from the norms.

Additional signs that can help to identify fibromyalgia in children in a timely manner are the following symptoms:

• Constant fatigue, not having objective reasons - intense physical or mental stress. A characteristic feature of "child" fatigue is the desire to sleep in the evening (between 17 and 19 hours).
• Sleep disorders - problems with falling asleep, morning fatigue, a sense of weakness.
• Depressive state, despondency, apathy, most often in the morning hours.
• Disorders from the digestive tract, most often diarrhea (as opposed to the symptoms in adults, when such disorders are of a mixed nature).
• Unlike adults, a child often complains of headaches, rather than muscular.
• Decreased cognitive abilities. Unlike adults, children do not suffer from memory, but long-term memory. Developed absent-mindedness, declines in school performance.
• In children, restless legs syndrome is more common than in adults.

Fibromyalgia symptoms increase, the child becomes withdrawn, depressed, feeling his isolation and helplessness due to the fact that he can not specifically describe his feelings.

In general, the symptoms of fibromyalgia can be systematized according to the scheme proposed by American rheumatologists:

Criteria according to ACR	Description
Anamnestic information on pain	The pain is diffuse, lasting at least 3 months and spreading in 4 zones: above and below the waist, left and right side
Pain sensations in trigger points (bilateral - right and left): 11 points out of 18 for adults; 4-5 points out of 18 for children	The back of the neck, the lower zone of the neck, the periosteal muscles above the scapula, the trapezius muscles, the second rib, the epicondyle of the shoulder bone, the buttock muscles, the large spit, the knee.
Clinical signs	Description of feelings from the patient's words (subjective signs)
Energy indicators (activity)	Fatigue, lethargy, apathy
The quality of life	Significantly reduced
Common social and household functions	Significantly reduced activity, down to helplessness
Sensitivity - physical, sensory	Increased
Sleep	Sleep superficial, difficulties with falling asleep and awakening, insomnia
Cognitive abilities	Memory impaired, attention
Rigidity	Increased
Psycho-emotional status	Depression