The Complete Guide to Understanding, Diagnosing and Treating
80% of Fibromyalgia diagnoses are women (4 out of 5) and 3 out of 4 sufferers of the condition develop depression or anxiety throughout their lives. But what is Fibromyalgia anyway? Is it just a psychological condition? Is it a mixture of psychological and physical pain? Let's find out!
Have you ever heard a description of what it's like to have Fibromyalgia? Anyone who has come into contact with this disease knows how disabling it can be.
Immediately on waking up, pains break through the body heavy, persistent. With these, a feeling of extreme tirednessI find it difficult to complete tasks or concentrate on anything. In addition to these symptoms, which are already extremely disabling, at the end of the day, when it's time for restSleep doesn't come, or it's very superficial, agitated from moment to moment by the pain.
What do we know today about Fibromyalgia? What can we do, inside and outside the office, to alleviate the suffering brought on by this reality?
🧭 Table of Contents
- 1. 🤔 What is Fibromyalgia?
- 2. ↔️ Difference Between Fibromyalgia and Common Pain
- 3. 📋 Most common symptoms of Fibromyalgia
- 4. Causes and risk factors
- 5. The Diagnosis of Fibromyalgia
- 6. Fibromyalgia and other pathologies
- 7. 👧👦 Fibromyalgia in children and adolescents
- 8. 📉 Impact of Fibromyalgia on daily life
- 9. 💊 How is Fibromyalgia treated?
- 10. When to seek professional help
- 11. 🤝 How do you deal with the condition on a day-to-day basis?
- 12. 🍎 Eating with Fibromyalgia
- 13. ❓ Myths and Truths about Fibromyalgia
- 14. 💼 Rights and the labour context
- 15. 🔬 Advances in scientific research
- 16. 🇵🇹 Resources and support available in Portugal
- 17. Conclusion
- 18. FAQ's (Frequently Asked Questions)
What is Fibromyalgia?
Fibromyalgia is a condition of chronic generalised pain which affects the muscles, tendons and ligaments. It goes far beyond physical pain: it is accompanied by intense fatigue, sleep disturbances, cognitive difficulties, and anxious and depressive symptoms.
Although it does not cause visible deformities or inflammation, severely impacts quality of lifeThis makes the most basic day-to-day tasks difficult.
Medical definition
According to World Health OrganisationFibromyalgia is classified as a generalised chronic pain syndrome. It is also an "idiopathic" disease - with no known cause. It is not an autoimmune or inflammatory disease, but it does involve the central nervous system, altering the perception of pain.
Recognition of status in Portugal
In Portugal, fibromyalgia is now officially recognised as a chronic condition, although many sufferers still face challenges in accessing appropriate diagnosis and treatment. Awareness is growing, but stigma persists.
Difference Between Fibromyalgia and Common Pain
To understand the difference between Common Pain and Fibromyalgia, it's important to realise what pain isand its purpose in the functioning of the human body.
Pain is a defence mechanism, embedded in the nervous systemThe nervous system's function is to alarm the brain into correcting something that is threatening the body's well-being - it's a reaction to a stimulus that the body considers negative or dangerous. The nervous system, through the nerves spread throughout the bodyIn this way, the brain is able to localise the focus of the pain, alerting the brain where the problem is so that it can be corrected. In addition, the brain registers different pain intensitiesindicating the urgency of stopping/ending the threat.
Pain is therefore a universal experience.
But fibromyalgia represents something very different from the common pain we all know.
A Common pain arises for a specific reason - an injury, inflammation or identifiable problem. It's a signal from the body that something needs attention. Generally, when the cause is treated, the pain disappears.
A Fibromyalgia It's like an alarm system that has become hypersensitive. An alarm that goes off all the time, with no apparent cause. The base level of pain is increased permanently, not temporarily, and even normal stimuli that wouldn't cause pain become painful, with the pain persisting even for no identifiable reason. In addition, the pain is not localised, reserved for one place - it is spread throughout the body. We call this pain "nociplastic pain".
Fibromyalgia it's not just "severe pain"This is a fundamental change at the root of the nervous system's pain perception mechanisms - in the way the nervous system perceives pain. process/receive sensations.
In other words, the brain interprets normal as well as dangerous signals, e natural and painful stimuliThis creates an experience of constant, generalised pain.
Here's a simple comparison:
| Characteristics | Common pain (non-fibromyalgia) | Fibromyalgia. |
| Location | Localised | Generalised |
| Cause | Identifiable | Often with no visible organic cause |
| Sleep | Restorer | Not restorative |
| Fatigue | Absent or mild | Constant, intense |
| Memory | Intact (variable) | Common "mental fog" |
| Duration | Hours/days | Months or years |
Fibromyalgia's most common symptoms
Fibromyalgia manifests itself widely and varies from person to person, which can make it difficult to recognise clinically. However, there are striking symptoms shared by many patients:
Diffuse musculoskeletal painon both sides of the body
Intense fatigueeven after resting
Non-restorative sleep
Mental fog (difficulty concentrating and remembering)
Morning stiffness
Frequent headaches
Irritable bowel syndrome
Tingling in the hands or feet
Mood swings (anxiety, depression)
What are the causes and risk factors?
There is no single cause identified for the onset of fibromyalgia, but there are several factors that can contribute to it.
Genetics and family predisposition
There is evidence that the condition may have a hereditary inclinationand affects several members of the same family.
Physical or emotional stress
Events traumaticFibromyalgia, such as accidents or significant losses, can trigger the onset of fibromyalgia in predisposed people.
Traumas and infections
Infections viral or bacterial, as well as injuries severe physical illnesses are associated with some cases (e.g. Epstein-Barr virus)
The Diagnosis of Fibromyalgia
The diagnosis of fibromyalgia is clinicalnot based on laboratory tests.
One of the great difficulties faced by people with this condition is the feeling of mistrust which, unfortunately, still surrounds it, because it doesn't always present manifestations visible for those who witness it, or registrable in procedures such as medical examinations.
Fibromyalgia is diagnosed by exclusionoften after months or years of research.
Updated diagnostic criteria (ACR)
- Chronic generalised pain for more than 3 months
- Functional impact assessed with specific scales:
- Widespread Pain Index (WPI)score that assesses the number of areas of the body where the patient has felt pain in recent weeks - at least 11 out of 19 points on the body assessed
- Symptom Severity Scale (SS scale)score that assesses the severity of fatigue, non-restorative sleep, cognitive symptoms and other general symptoms
- Exclusion of other conditions (e.g. arthritis, lupus, hypothyroidism)
The importance of early diagnosis
A timely diagnosis allows appropriate interventions to be initiated, preventing the patient's physical and psychological condition from worsening.
It is therefore important to look for specialised professionalsin order to minimise the impact of the condition as soon as possible.
Fibromyalgia and other pathologies
Here are some conditions that are often diagnosed with fibromyalgia:
- Irritable bowel syndrome
- Depression
- Anxiety
- Migraines
- Chronic fatigue
- Multiple chemical sensitivity
The presence of parallel pathologies requires a multidisciplinary approach to treatment.
Fibromyalgia in children and adolescents
Although less commonFibromyalgia can affect young people. Here are some of the frequent reports:
Persistent complaints of pain
Unexplained fatigue
Frequent absence from school
Sudden changes in behaviour
In these cases, early diagnosis and family support are crucial.
Fibromyalgia's impact on daily life
The limitations caused by fibromyalgia are real and often invisible:
- Professional: absences from work, reduced productivity
- Familylack of understanding, feelings of isolation
- Personal / Spirituallow self-esteem, frustration, emotional distress
- Fibromyalgia affects personal appearance, overall movement capacity, mobility...
- Around 75% patients3 out of 4 develop depression or anxiety in their lifetime
- Cognitive: mental confusion, loss of agility, memory
Special focus on women
Does fibromyalgia affect women more?
Studies indicate that around 80% of those diagnosed are women.
Gender differences in diagnosis
Women tend to report more pain and seek more medical support, which may influence the statistics.
Hormones and pain sensitivity
Female hormonal fluctuations, especially during periods such as the menopause, can intensify the symptoms.
How is Fibromyalgia treated?
Fibromyalgia is treatable through an approach of multidisciplinary - integrated between specialities - which combines different therapies. Here are some of the most commonly used:
Pharmacological treatment:
- Antidepressants (duloxetine, milnacipran) to regulate neurotransmitters
- Anticonvulsants (pregabalin, gabapentin) to modulate pain perception
- Muscle relaxants in specific cases
- Conventional painkillers - limited efficacy
Psychotherapy:
- Cognitive Behavioural Therapy (CBT) for chronic pain management
- Mindfulness and acceptance techniques
- Group therapy to share experiences
Therapeutic exercise:
- Gradual and adapted physical activity
- Hydrotherapy and aquatic exercises
- Relaxation and stretching techniques
Neurotherapy:
- Transcranial Magnetic Stimulation (TMS) to modulate pain perception
- Neurofeedback to train the brain to better process pain signals
In NeuroPsyquewe used an integrated matching psychotherapy specialising in chronic pain with advanced neurotherapyIt is customised to the specific needs of each patient. On a case-by-case basis, physiotherapy can be a great help in treatment.
The role of psychotherapy in treatment
Psychotherapy plays an important central role in the treatment of fibromyalgia, helping patients to developing effective strategies for dealing with chronic pain.
Cognitive Behavioural Therapy (CBT):
- Identifying and modifying thought patterns that amplify pain
- Development of adaptive coping strategies
- Management of stress and anxiety associated with the condition
Acceptance and Commitment Therapy (ACT):
- Acceptance of the condition without resignation
- Focus on personal values and quality of life
- Reducing the internal struggle against pain
Pain education:
- Understanding the mechanisms of chronic pain
- Demystifying limiting beliefs
- Empowerment through knowledge
A solid therapeutic relationshipbased on trust and proximityis fundamental to the success of the treatment.
Medicines used for treatment
Pain perception modulators:
- Pregabalin: effective in reducing pain and improving sleep
- Gabapentin: alternative to pregabalin with a similar profile
Antidepressants:
- Duloxetine: acts on pain and associated depressive symptoms
- Milnacipran: specific for fibromyalgia in some countries
- Amitriptyline: can help with sleep and pain in low doses
Other medicines:
- Cyclobenzaprine: muscle relaxant for stiffness
- Tramadol: analgesic in selected cases
ImportantConventional anti-inflammatory drugs (ibuprofen, diclofenac) have limited efficacy in fibromyalgia, as there is no typical inflammation.
Pharmacological treatment should always be individualised and closely monitored by a specialised doctor.
When to seek professional help
Seek support when:
- Pain interferes with work, social life or sleep
- Constant feeling of "flu that won't go away"
- Unrefreshing sleep even with many hours of sleep
- Persistent physical and emotional exhaustion
- Symptoms persist for more than 3 months
- Quality of life is seriously compromised
How to deal with Fibromyalgia in everyday life?
In addition to specialised medical care, there are practical strategies that can improve significantly quality of life:
Energy management:
- Plan activities during periods of high energy
- Alternate demanding tasks with moments of rest
- Learning to say "no" when necessary
Sleep hygiene:
- Keeping regular bedtimes and getting up times
- Create an environment conducive to rest
- Avoid screens before bed
- Relaxation techniques to help you fall asleep
Adapted physical activity:
- Start gradually with low-impact exercises (ideally physiotherapy with specialised professionals)
- Short walks, swimming or yoga
- Listen to your body and adjust the intensity as necessary
Stress management:
- Deep breathing techniques
- Meditation or mindfulness
- Pleasurable activities and relaxing hobbies
- Learn about Fibromyalgia and its manifestations, and about mental health practices
Social support:
- Maintaining genuine contact with family and friends
- Participate in support groups
- Communicate your needs clearly and sincerely
Food and Fibromyalgia
Diet can play an important role in managing symptoms.
Foods that relieve symptoms
A diet rich in fruit, vegetables, oily fish and whole grains can help reduce inflammation and improve general well-being.
Avoid inflammatory foods
Avoid inflammatories such as sugar, o gluten, o alcohol, a lactose, and the omega-6 present in highly processed vegetable oils.
Supplementation
Supplements such as magnesium, vitamin D-3 and omega-3 can be beneficial, always with medical advice.
Myths and Truths about Fibromyalgia
The mysticism associated with Fibromyalgia gives rise to misconceptions of what it's like to live with the condition, and it's essential spread knowledge to stimulate understanding. Here are some common myths:
Myth | Truth |
| "Fibromyalgia is just an excuse for people who are lazy" | Fibromyalgia is a serious condition - it's not a "way of being". This condition can bring a lot of suffering, especially if those around us don't know how to deal with it. |
"Fibromyalgia is a psychological illness" | Fibromyalgia involves real changes in pain processing in the central nervous system. The psychological component can aggravate symptoms, but does not explain the origin of the condition. |
"Fibromyalgia only affects women" | Although it is more prevalent in women, it can also affect men and children. |
| "Fibromyalgia has no treatment" | Although there is no cure, there are effective treatments that help control symptoms and significantly improve quality of life. |
Fibromyalgia - Rights and labour context
Fibromyalgia rights in Portugal
Although fibromyalgia is not explicitly listed in isolation in the National Table of Disabilities (TNI)This can be recognised as a disabling condition if its effects are proven to be limiting.
Recognition of disability equal to or greater than 60% gives access to:
- Exemption from user charges
- Priority in booking appointments
- Tax benefits (e.g. IUC exemption, IRS reduction)
- Social support as a dependency supplement
This degree is awarded for Social Security Medical Boardsby means of a medical report and functional assessment.
Sick leave and job protection
People with fibromyalgia are entitled to:
- Medical leave (long-term illness) issued by the family doctor
- Protection against dismissal due to illness (Article 351 of the Labour Code)
- Possibility of job reassessment in the event of partial incapacity for work
In the event of prolonged sick leave, the employee can't be sacked, for this reason, without an opinion from the occupational doctor.
Workplace adaptation (Law no. 38/2004)
This law establishes the rights of people with disabilitiesincluding:
- Adapting the workplace
- Flexible working hours
- Reduced working hours (when justified)
- More frequent breaks for rest or pain relief
- Reorganisation of tasks (avoid prolonged or repetitive physical effort)
These adaptations should be discussed with the labour doctor and appear in the Occupational Health and Safety Plan.
Advances in scientific research
Science continues to study ways to improve the diagnosis and treatment of fibromyalgia.
New treatments under study
Several clinical trials are exploring innovative therapies:
NeuromodulatorsDrugs that act on the neurotransmitter systems involved in chronic pain, such as serotonin, dopamine and glutamate. (study*) (study**)
Digital therapiesApplications and online platforms based on artificial intelligence and cognitive-behavioural therapy, which help patients manage symptoms such as pain, fatigue and insomnia. (study*) (study**)
Non-invasive brain stimulationTechniques such as Transcranial Magnetic Stimulation (TMS) (study*) (study**) and Transcranial Direct Current Stimulation (tDCS) (study*) (study**) show promising results in modulating pain and mood.
Medicinal cannabinoidsThe following have been studied for their potential to relieve pain, improve sleep and reduce anxiety, although the scientific evidence is still limited and controversial. (study*)
Future prospects
With more recognition, more investment is going into research into the condition. The next few years could bring good news for fibromyalgia sufferers.
Resources and support available in Portugal
Resource | Description |
SNS - National Health Service | Rheumatology, neurology and psychology consultations |
SNS 24 line | Telephone support: 808 24 24 24 |
Support organisation for patients and families | |
Resources and support groups | |
University Hospital Pain Centres | Specialised chronic pain consultations |
Information and support on chronic pain |
In NeuroPsyque we treat patients with Fibromyalgia through a approach tailored to the individual, integrated between specialities such as Neurology, a Neuropsychology and Physiotherapythat allow us to offer you the greater expectation of eliminating the suffering caused by this disorder.
We have the most specialised equipment and specialists in therapies such as NeuroFeedback, a Transcranial Magnetic Stimulation, a Transcranial Electrical Stimulation, and the Clinical Pilates, which have proved important in the treatment of fibromyalgia. Book your appointment with us!
Conclusion
Fibromyalgia is a complex condition that ranges from far beyond physical painIt's a serious problem, affecting multiple dimensions of the life of those who experience it. Although there is no definitive cure, there is real hope through effective treatments that can significantly transform quality of life.
The growing recognition of this condition by the medical community and society represents a important step to reduce the stigma associated with it, and enables promoting access to appropriate solutions. With a combination right e aligned with medical treatment, psychological support, lifestyle changes and social support, it is possible to live well with fibromyalgia.
It's vital not to give up. Each person is unique, and finding the ideal therapeutic combination can take time and require failuresBut it's worth persevering. Fibromyalgia is not a final judgement!
In NeuroPsyquewe work to give best possible expectation of improvement to our patients, utilising all the resources at our disposal in a truly comprehensive approach. integrated e designed for those who come to us. Book your appointment with us!
FAQ's about Fibromyalgia
1. Is Fibromyalgia curable?
There is no definitive cure, but the symptoms can be very well controlled with appropriate treatment, allowing for a normal and fulfilling life.
2. Can Fibromyalgia get worse over time?
Without treatment, symptoms can intensify. With proper monitoring, many people experience significant improvement.
3. What causes Fibromyalgia?
The exact cause is unknown, but it involves genetic factors, alterations in pain processing by the nervous system and environmental factors such as stress or trauma.
4. Does cold make the symptoms worse?
Yes, many people report increased pain and stiffness with low temperatures and humidity.
5. Can it affect men?
Yes, although it's more common in women (around 80% of cases).
6. Is it possible to work with fibromyalgia?
Yes, with appropriate adaptations in the workplace and effective treatment, it is perfectly possible to work with the condition.
7. Can children get fibromyalgia?
Yes, it can manifest itself in adolescence and early diagnosis is important to prevent any impact on development.
8. Does exercise help or harm?
Adapted and gradual exercise is beneficial, but it must be designed for each person's individual condition.
9. Does food influence symptoms?
Yes, an anti-inflammatory diet can help reduce symptoms, while processed foods can aggravate the condition.
10. Is neurotherapy effective in treating fibromyalgia?
Yes, therapies such as Transcranial Magnetic Stimulation have shown promising results in modulating pain perception.
11. Are there any support groups in Portugal?
Yes, there are online associations and groups that offer support and share experiences.
12. How do I explain fibromyalgia to others?
It's important to educate family and friends about the reality of the condition, emphasising that the pain is real even without visible external signs.
