[Fibromyalgia Symptoms, Diagnosis, and Treatment] It's not malingering; middle-aged women experience unexplained pain.

Fibromyalgia, which causes unexplained pain in various parts of the body, is a typical chronic pain condition with an estimated prevalence of about 1-2% of the general population.

 

Fibromyalgia, a condition that occurs frequently in middle-aged women, had a diagnosis rate of 58% among health insurance subscribers aged 50 to 70 in 2014, with women accounting for 68%. Through Dr. Jeong Ho-yeon, head of the Department of Rehabilitation Medicine at Huiyeon Hospital, we explore the symptoms, diagnosis, causes, and treatment of fibromyalgia, which causes suffering in middle-aged women.

 

 

◇Symptoms

 

If generalized pain lasting for at least three months, accompanied by symptoms such as fatigue and sleep disturbances, persists but the cause is not identified through blood tests or imaging, fibromyalgia may be suspected.

 

The location of the pain can shift, and its intensity varies. Sensory abnormalities may be felt, and symptoms resembling neuralgias such as numbness and tingling can occur. Headaches, dry eyes, abdominal pain and diarrhea, and dry mouth may also appear. Most fibromyalgia patients experience fatigue and sleep disturbances, with 30-50% also suffering from depression and anxiety, and 50-80% experiencing migraines or tension headaches.

 

◇Cause

 

The exact cause of fibromyalgia is not yet fully understood, but it has been confirmed that various factors such as physical, psychological, and environmental stimuli influence the peripheral and central nervous system sensory transmission systems, leading to the development of the condition. In particular, environmental factors that can trigger fibromyalgia include viral infections such as influenza, endocrine disorders like hepatitis C and hypothyroidism, physical trauma, and psychological stress. Additionally, similar to other rheumatic diseases, it is affected by family history, so it is known that symptoms can occur when individuals with genetic predispositions are exposed to certain environments.

 

◇Diagnosis

 

Diagnosis of fibromyalgia does not require imaging tests such as MRI or CT scans, and instead considers the patient's subjective pain or symptom severity quantified by the widespread pain index and symptom severity scale. The widespread pain index categorizes pain severity across 19 areas of the body including the jaw joint, neck, chest, back, waist, abdomen, waist, arms, and legs, expressing it numerically. The symptom severity scale evaluates and quantifies the degree of symptoms such as fatigue and depression.

 

 

◇Treatment

 

As previously stated in the diagnostic criteria, treatment begins with tests that confirm that the cause of chronic pain is not due to other diseases. Once diagnosed as fibromyalgia rather than another condition, it may be better to have a positive perception of health status. Since it does not threaten life or cause permanent changes in the musculoskeletal system, the disease can be effectively treated through appropriate treatment after diagnosis. Although fibromyalgia is a relatively common disease, it takes an average of five years to diagnose, and only 25% of patients are diagnosed. Specific treatment methods include medication and non-medication therapies.

 

In pharmacological treatment, medications that reduce nerve pain transmission are used. Analgesics and anti-inflammatory drugs alone have limited effects beyond short-term pain relief, but their effectiveness increases when combined with antidepressants and anticonvulsants that consider accompanying physical symptoms. If pain is accompanied by sleep disturbances, depression, anxiety, or other issues that interfere with daily life, active medication therapy should be considered.

 

The core of non-pharmacological treatment is exercise therapy. Exercise can play a positive role in reducing patients' pain and improving physical function. Effective exercises include stretching and yoga, as well as aerobic activities such as walking, running, cycling, and swimming. The intensity of exercise should start at a low level and gradually increase; however, excessive exercise that causes pain and fatigue can have the opposite effect and worsen the condition, so caution is necessary.

 

 

 

 

Reporter Kim Jin-ho kimjh@knnews.co.kr