Invisible pain called fibromyalgia
There are diseases that cannot be measured on an X-ray, cannot be proven in a blood test, and yet can completely exclude a person from normal life. Fibromyalgia is one of them. For decades, it was labelled a psychosomatic disorder, a fabrication of oversensitive patients, or a manifestation of depression. Today we know that it is a real, biologically conditioned state – and modern science is finally beginning to reveal what is actually happening in the bodies of people suffering from fibromyalgia.
Imagine waking up in the morning feeling as though you have spent the entire night wrestling with a heavy burden. Your joints ache, your muscles are stiff, your head is spinning, and the fatigue is so profound that even coffee doesn't help. Add to that a fog in your mind that makes concentration difficult, and pain that migrates from place to place without any apparent cause. This is precisely how millions of people around the world who live with fibromyalgia describe their everyday lives.
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What is actually happening in the body with fibromyalgia?
For a long time, it was assumed that fibromyalgia was a problem of the muscles or connective tissue. Research in recent years, however, points elsewhere – the cause lies in how the brain and nervous system process pain signals. Experts speak of so-called central sensitisation, a state in which the nervous system amplifies painful stimuli and reacts excessively even to those that would not trouble a healthy person at all. A light touch can be painful, cold or heat unbearable, and even ordinary noise can cause physical discomfort.
Research published in specialist journals, such as Nature Reviews Rheumatology, confirms that patients with fibromyalgia experience measurable changes in brain activity – specifically in the areas responsible for processing pain. This is therefore neither a fabrication nor exaggerated sensitivity. It is a measurable dysfunction of the nervous system with real consequences for a person's daily functioning.
Another important finding concerns the role of neurotransmitters, particularly serotonin and noradrenaline. In people with fibromyalgia, their levels tend to be reduced, which disrupts the body's natural pain-dampening mechanisms. This is precisely why certain antidepressants have proven effective in treatment – not because the patient is "crazy", but because these medications help restore the balance of substances that naturally regulate pain.
Fibromyalgia affects approximately 2 to 4 percent of the world's population, with women being diagnosed significantly more often – according to some studies, they account for up to 80 to 90 percent of all patients. The precise reason for this imbalance has not yet been fully explained, but it is assumed that hormonal factors play a role, as do differences in how the male and female nervous systems process pain.
Diagnosing fibromyalgia is often a lengthy and exhausting process. The average time from the first symptoms to a diagnosis is five to seven years in many countries. A patient typically passes through a series of specialists – a rheumatologist, neurologist, orthopaedist, psychiatrist – and each rules out their own area without offering an explanation. Only when other causes have been excluded and the clinical picture matches the criteria established by the American College of Rheumatology does the patient finally receive a name for what they are suffering from.
As one of the pioneers of chronic pain research, Dr Mary-Ann Fitzcharles of McGill University, once said: "Fibromyalgia is not a diagnosis of exclusion – it is a diagnosis of inclusion, with clear clinical criteria and biological underpinnings." These words are slowly but surely changing the way medicine approaches fibromyalgia.
How does fibromyalgia manifest itself, and why is it so difficult to recognise?
The insidiousness of fibromyalgia lies in the fact that its symptoms are highly varied and change over time. It is not just about pain – even though that is usually the most conspicuous and burdensome manifestation. Widespread musculoskeletal pain lasting more than three months and affecting different parts of the body is the primary diagnostic criterion, but it is accompanied by a whole range of other complaints.
Fatigue that does not subside even after sufficient sleep is among the most frequent complaints. Sleep is often disrupted – people with fibromyalgia wake up unrefreshed, even if they have slept for a sufficient length of time. Research shows that they experience disruption to the deep stages of sleep, which are crucial for the regeneration of both body and mind.
The so-called fibro fog – known in English as fibro fog – is another typical manifestation. It involves difficulty concentrating, forgetfulness, and a sense of mental haziness that can be just as limiting as physical pain. A person who was previously efficient and organised suddenly forgets simple words, misplaces things, and is unable to follow more complex trains of thought.
Headaches, irritable bowel syndrome, sensitivity to light, sound and temperature, tingling sensations in the limbs, and in some cases anxiety or depression also occur – though these are more likely a consequence of chronic pain than its cause.
The story of a forty-year-old teacher from Brno, who wishes to remain anonymous, illustrates well how fibromyalgia can change an entire life. For seven years she visited various doctors, underwent dozens of tests, and repeatedly heard that "everything is fine" or that "it's stress". She lost her job because she was unable to concentrate and the pain prevented her from standing in front of a blackboard all day. Only after a fibromyalgia diagnosis and the beginning of comprehensive treatment did her condition start to improve – and at the same time, her relationship with her own body began to heal, as she stopped perceiving it as an enemy.
This story is not exceptional. It is the reality lived by thousands of people in the Czech Republic and millions around the world. And that is precisely why it is important to speak about fibromyalgia openly and without prejudice.
The path to relief: what actually helps?
Fibromyalgia cannot be cured in the classical sense – that is, with a single pill or an operation. But it can be managed, and very effectively, if it is approached comprehensively. Modern medicine agrees that the best results come from a combination of pharmacological treatment, physical activity, psychological support, and lifestyle changes.
From a movement perspective, regular, moderate physical activity is one of the most effective tools for alleviating symptoms. Research repeatedly confirms that aerobic exercise – such as swimming, walking, or cycling – reduces the intensity of pain and improves sleep quality. The key word here is "moderate" – excessively intense exertion can, on the contrary, worsen symptoms. Yoga and tai chi are proving particularly beneficial, as they combine movement with breathing techniques and relaxation.
Nutrition is playing an increasingly important role in the context of fibromyalgia. Although there is no "fibromyalgia diet" with scientifically proven efficacy, many patients report improvement after reducing their intake of processed foods, sugar, and alcohol. An anti-inflammatory diet rich in omega-3 fatty acids, antioxidants, and fibre can help reduce overall inflammation in the body and support the nervous system. Magnesium is one of the minerals most frequently mentioned in connection with fibromyalgia – a deficiency can worsen muscle tension and sleep quality.
Psychological support, particularly cognitive behavioural therapy, helps patients change the way they perceive and process pain. The aim is not to convince them that the pain "is not real" – it is to teach them strategies for living with it and preventing it from taking over their entire lives. Mindfulness and meditation are proving to be effective complements that reduce the body's stress response and thereby the intensity of painful sensations.
In the area of dietary supplements and natural preparations, it is important to proceed with caution and always consult a doctor. Some studies suggest the potential benefit of vitamin D, a deficiency of which is very common in fibromyalgia patients, as well as coenzyme Q10 or curcumin as a natural anti-inflammatory agent. Certified herbal preparations and adaptogens, such as ashwagandha or rhodiola, may help the body cope better with stress, which significantly worsens fibromyalgia symptoms. When selecting any supplements, it is advisable to look for products with transparent ingredients and verified quality.
An important part of self-care is also sleep quality. A regular sleep routine, limiting blue light before bedtime, a cooler bedroom, and rituals that induce calm – all of this can significantly improve recovery. Some patients have also found natural aids helpful, such as lavender pillows, magnesium baths, or soothing herbal teas.
Fibromyalgia changes lives – but it does not have to destroy them. The more it is discussed, the more doctors take it seriously, and the more patients gain access to comprehensive care, the better. Science is moving forward, and with it, hope for those who battle this invisible pain every day. Accepting a diagnosis is not surrender – it is the first step towards learning to live differently, but still fully.
