Fibromyalgia, as a multisystem disease, is characterized by the chronic and widespread musculoskeletal pain. Fibromyalgia, which can be triggered by the stressful working conditions, became the disease of the time.
As the fibromyalgia patients can be misdiagnosed due to the diversity of the symptoms and findings, the observed incidence does not reflect the real incidence. The conducted studies showed that the worldwide incidence of fibromyalgia is between 0.5% and 5.8%.
The proven risk factors are the age and female gender. Its incidence increases after traumas, especially in the spine, surgical interventions, road accidents, and infections. Acute or chronic emotional stress factors such as traumatic childhood, hyperactive and perfectionist lifestyle may increase the incidence of fibromyalgia. The genetic transition can also play an important role.
Until today, studies were not able to elucidate the cause of the widespread pain and low pain threshold in the fibromyalgia patients. Furthermore, the mechanism of the disease could not be demonstrated although several pain mechanisms were investigated and blamed. The hormonal changes, neuroendocrine dysfunction, sleep disorders, disorders of the functional activity of CNS are also considered responsible for the etiology of fibromyalgia.
In addition to the widespread pain; fatigue, sleep disorders, stiffness, emotional disorders like depression and anxiety, deterioration in cognitive functions have a negative impact on the quality of life. These problems impair patient’s ability to face problems during the daily activities and deteriorates his/her social relationships. In addition, multisystem findings like attention deficit, headache, migraine, dizziness, jaw joint disorders, tachycardia, chest pain, dyspnea, gastrointestinal problems, paresis in arms and legs and hypermenorrhea can be encountered.
The main complaint is the widespread pain in the body. The pain emerges in the neck and shoulders at the early phase of the disease but spreads in time to the whole body. In the outpatient departments of the physiotherapy, the patients often complain from widespread pain and have difficulty to show a specific area.
The methods chosen for the treatment in fibromyalgia patients with chronic pain depend on the complaints of the patient and on the severity of the disease. The studies showed that the most effective treatment methods are based on a systemic approach instead of a regional muscle disorder. In order to achieve optimal success, the severity, diversity and functional characteristics of the disease should be taken into consideration. The pharmacological and non-pharmacological methods are usually combined. Multidisciplinary approaches, which comprise psychosocial and behavioral methods and training, are required. Fibromyalgia should be treated by a physiatrist from every aspect.