Hyperthermia plays a central role in the treatment of fibromyalgia syndrome
The chronic condition known as fibromyalgia syndrome (FMS for short) is considered the second most common symptom observed by rheumatologists and at the same time the most poorly defined and researched to date.
The concept of fibromyalgia syndrome was developed in rheumatology - in distinction to the proven inflammatory rheumatic forms. The term "fibromyalgia" was first used by Yunus* in 1981. The exact causes of "fibromyalgia syndrome" (the term in use today) are not yet clearly understood.
Patients complain of diffuse, generalized pain in various parts of the body without physical findings, usually near joints as well as in muscles and at tendon insertions, the so-called "tender points". The spine is almost always affected. In addition to chronic pain, insomnia, physical and mental exhaustion and even depression are the main symptoms.
Fibromyalgia syndrome affects almost all areas of life and greatly impairs quality of life, ability to work, and productivity.
Until a few years ago, fibromyalgia syndrome was considered an "imaginary" disease, a pain condition that could be explained purely psychologically. Today, fibromyalgia syndrome is classified as a functional somatic syndrome consisting of altered central pain processing, changes in central nervous neurotransmitters, sympathetic nervous system dysfunction, and small fiber pathology.
Psychological factors continue to play a role in the diagnosis, but only accompanying the onset of the disease. 80 percent of all affected persons are women, and 50 percent of patients also have symptoms of small-fiber polyneuropathy.
The Symptoms
Diffuse whole body pain
Increased sensitivity to pressure pain, tension headaches, migraines
Difficulty sleeping through the night
Reduced performance, rapid exhaustion, fatigue
Orthostatic hypotension
Stomach sensitivity
Intestinal problems, Urinary tract problems, pelvic pain
Palpitations
Restless legs syndrome
Vision problems
Hearing problems (sensitivity to noise, tinnitus)
Reduced resilience to stress and external stimuli
Memory impairment, thought disorder, concentration disorder
Anxiety, depressive mood
Sensitivity to cold, shivering, occasionally sweating
Strong sensitivity to the weather
The Diagnosis
Due to the wide range of symptoms, diagnosis and treatment represent a challenge for doctors and patients. In a detailed anamnesis, the main influences that have led to the development of the whole-body pain are first worked out. When the diagnosis of fibromyalgia syndrome is made, it is in most cases a lifelong condition.
Treatment Possibilities
The complexity of the disease requires a multimodal therapeutic approach. Despite a number of concomitant medications, no generally recommended standard drug therapy has emerged to date; drug treatment shows positive effects in only 30 to 40 percent of patients.
Instead, the following measures have proven effective: Exercise therapy, for example strength training and endurance sports, conversion to a healthy lifestyle with appropriate nutrition, and psychotherapeutic support. Patients learn to actively influence their pain and establish mindful forms of exercise (including meditation and yoga).
Complementary, naturopathic and integrative forms of therapy have been used with great success for some time.
Whole-body hyperthermia with water-filtered infrared A radiation is currently the focus of current studies on its effectiveness in the treatment of fibromyalgia syndrome.
Whole-Body Hyperthermia for Fibromyalgia
Whole-body hyperthermia is now an established and successful form of therapy in the treatment of a variety of mild and severe diseases. However, it is still a treatment option that has hardly been scientifically evaluated.
Fortunately, in recent years there are more studies on hyperthermia. Hyperthermia - the artificially generated increase in temperature - can provide lasting pain relief. Undesirable side effects are rarely, if ever, observed.
In addition to pain relief, treatment with hyperthermia in fibromyalgia also has an antidepressant effect by producing immunological and neuroendocrine stimuli.
Plus: After the first hyperthermia treatments, patients can improve the localization of pain, which facilitates further treatment.
Specifically, whole-body hyperthermia causes arterial hyperemia (a significant increase in blood flow to regions of the body) with an increase in metabolism (increased transport of oxygen, nutrients, antibodies, phagocytosis, removal of metabolites).
Longer-lasting heat effects provide pain relief and muscle detonation (relaxation), thereby improving the elasticity of connective tissue structures and increasing mobility. The patient's hormonal system and immune system are stimulated and histological changes occur in the lymphatic organs.
Since the updated “S3 guidelines on fibromyalgia” from 2008, naturopathic and complementary therapy methods have become an integral part of the treatment of fibromyalgia syndrome. In fact, these are used in up to 98 percent.
Why the Disease Occurs
Eighty percent of patients are female. Because of the pain, they often lead very secluded lives with lack of exercise and may be overweight. Updated guidelines recognize physical abuse and sexual abuse in childhood and adulthood as associated factors, as well as depression and lifestyle factors such as smoking, obesity and lack of exercise.
Genetic predispositions are also discussed. However, psychosocial stressors in occupational or family situations as well as experiences of violence and abuse in childhood and adolescence are considered to be the main causes.
*Yunus MB, Masi AT, Kalabro JJ, Miller KA, Feigenbaum SL (1981) Primary fibromyalgie: clinical study of 50 patients with matched controls. Semin Arthritis Rheum 11: 151–171
**See also: A randomized controlled trial on the effectiveness of mild water-filtered near infrared whole-body hyperthermia as an adjunct to a standard multimodal rehabilitation in the treatment of fibromyalgia. Treatment of Fibromyalgia by Whole-body Hyperthermia. Randomized Controlled Trial. By: Thomas Brockow, Andreas Wagner, Annegret Franke, Martin Offenbächer, Karl L Resch. https://pubmed.ncbi.nlm.nih.gov/17277647/