Real pain, often misunderstood
Many people with fibromyalgia have been told that "everything is normal" after blood tests and X-rays. That does not mean the pain is imaginary: fibromyalgia does not change the body's structures or test results, but it changes the way the nervous system processes pain.
What is fibromyalgia?
According to the Swiss League against Rheumatism, fibromyalgia affects between 2 and 4 % of the world's population, most often young and middle-aged adults, and women are two to five times more often affected than men. In the WHO's new International Classification of Diseases (ICD-11), it belongs to the chronic primary pain syndromes.
Why does it develop?
The exact cause is not known. Research focuses mainly on pain sensitisation, meaning a nervous system that reacts too strongly to normally harmless stimuli, and on the role of stress, whose processing in the brain overlaps with that of pain. To understand this mechanism better, read our article Why does pain become chronic?.
The symptoms: much more than pain
The League describes four main symptoms:
- chronic widespread pain in muscles, joints or bones, varying in intensity and location;
- sleep problems: according to the League, 90 % of people affected have trouble falling asleep or wake during the night, and do not feel rested in the morning;
- chronic exhaustion, with slow recovery after effort;
- concentration problems, often described as a "fog" ("fibro fog").
These are often joined by increased sensitivity to light, noise or touch, digestive problems and cold hands and feet. Pain often gets worse in cold weather, with stress or with effort. If fatigue is the main issue, our page Fatigue and brain fog may also interest you.
How is the diagnosis made?
There is no blood test or imaging that confirms fibromyalgia. The doctor uses two simple questionnaires: one maps where you hurt, the other measures how strong your fatigue, sleep problems and concentration problems are. Pain must be spread over several regions of the body and have lasted at least 3 months. Fibromyalgia is no longer a diagnosis of exclusion: it can coexist with other conditions.
Warning signs: when to seek care without delay
Fibromyalgia is not life-threatening. Some signs, however, call for looking for another cause or getting help quickly:
Seek care immediately (emergency department) if you have:
- suicidal thoughts;
- sudden loss of strength, or speech or vision problems.
See your doctor promptly if:
- you have fever, night sweats or unexplained weight loss;
- one or more joints are swollen, red or warm;
- you notice real muscle weakness rather than tiredness;
- your symptoms change markedly or worsen quickly;
- you feel overwhelmed, discouraged or that you can no longer cope: talk about it without waiting.
In the vast majority of cases, none of these signs is present.
Fibromyalgia: recommended non-drug treatment
The Swiss League against Rheumatism points out that there is no one-size-fits-all programme: it recommends a multimodal strategy that combines several approaches and self-management measures, with patient education at the centre. These measures include gentle, regular physical activity (walking, swimming, water aerobics, cycling), energy management ("pacing"), relaxation and mindfulness, psychological support and a balanced diet.
What does the research say?
The European EULAR recommendations, revised in 2017, assessed 107 literature reviews. Exercise is the treatment that received the strongest recommendation. The other approaches, including psychological therapies, medicines and rehabilitation programmes, received weaker recommendations and are tailored to each person's needs. The authors note that the effect of most treatments remains modest, which argues for a combination of approaches built with the patient. Medicines should always be discussed with your doctor.
The first consultation lasts 1 h 30 to 2 h (CHF 182). Bring your medical file, your examinations (blood tests, MRI, reports) and a list of your medicines; a diary of your pain and sleep can help. We review your situation and build your plan together. Follow-up is then adapted to your progress. We work alongside your GP and the other professionals involved in your care.
Which approaches can have a place at Centre Algos?
Depending on your situation, several approaches can be combined, alongside your medical care:
- Naturopathy: sleep, stress management, activity rhythm and diet, to work on the lifestyle habits that can influence pain.
- Functional biology and micronutrition: to take stock of your diet and micronutrient intake.
- Breathing and cold: breathing exercises to help you manage stress; cold exposure is considered only very gradually, if it suits you, and never if it increases your pain.
- Cupping and Breuss massage: gentle approaches that can promote muscle relaxation.
- Percutaneous hydrotomy: subcutaneous micro-injections; it may be considered for a particularly painful area when the situation is suitable, after assessment, once warning signs have been ruled out and in agreement with your medical care. Price on quotation, set at the first consultation according to your situation.
Everyone responds differently: the aim is to look, with you, for more comfort in daily life, without promising a result.
When to seek care
What is happening in your case
This text describes general mechanisms. What keeps your pain and fatigue going, in your specific situation, deserves a real conversation rather than a generic answer.
A question before you decide? Book a free 10-minute call to see whether our approach suits you.
