Tarihçe ve Epidemiyoloji
Özet
Fibromiyalji Sendromu (FMS), yaygın kas-iskelet sistemi ağrısı, halsizlik, uyku bozuklukları, bilişsel fonksiyon bozuklukları ve spesifik anatomik bölgelerdeki hassas noktalarla karakterize, etiyolojisi tam olarak bilinmeyen kronik bir patolojidir. Tarihsel süreçte "Kas Romatizması" ve "Fibrözit" olarak adlandırılan hastalık, inflamatuar bir süreç içermediğinin anlaşılmasıyla 1976 yılında fibromiyalji adını almıştır. Tanı kriterleri zaman içinde evrilmiş; 1990 yılındaki 18 hassas noktadan en az 11'inin varlığına dayanan kriterlerin yerini, klinik pratikteki zorluklar nedeniyle 2010, 2011 ve 2013 yıllarında yayınlanan ve yaygın ağrı indeksi ile semptom ciddiyet skorlarını esas alan daha kapsamlı kriterler almıştır. Epidemiyolojik olarak osteoartritten sonra en sık görülen romatizmal hastalık olan FMS'nin küresel prevalansı kullanılan kriterlere göre %2-8 arasında değişmektedir. Hastalık her yaşta ortaya çıkabilmekle birlikte, özellikle 40-60 yaş arası kadın nüfusu daha yoğun etkilemektedir. Türkiye'de yapılan bölgesel çalışmalarda prevalansın Trabzon'da %3,6, Denizli'de tekstil işçilerinde %7,3 ve Diyarbakır'da %8,8 olduğu, kentsel alanlarda kırsala göre daha yüksek oranlarda görüldüğü ve ileri yaş, kadın cinsiyet ile düşük gelir seviyesinden etkilendiği saptanmıştır.
Fibromyalgia Syndrome (FMS) is a chronic musculoskeletal pathology of unknown etiology, characterized by widespread pain, fatigue, sleep disturbances, cognitive dysfunction, and painful tender points in specific anatomical regions. Historically referred to as "Muscular Rheumatism" and "Fibrositis," it was renamed fibromyalgia in 1976 after demonstrating the absence of an inflammatory process. Diagnostic criteria have evolved significantly over time; the 1990 criteria based on the presence of at least 11 out of 18 tender points were replaced in 2010, 2011, and 2013 by comprehensive systems focusing on the widespread pain index and symptom severity scores due to clinical limitations. Epidemiologically, FMS is the most common rheumatic disease after osteoarthritis, with a global prevalence ranging between 2-8% depending on the criteria applied. Although it affects individuals of all ages and genders, it predominantly targets women aged 40-60. Regional studies in Turkey report prevalence rates of 3.6% in Trabzon, 7.3% among textile workers in Denizli, and 8.8% in Diyarbakır, showing a 2.3-fold increase in urban areas compared to rural areas, heavily influenced by advanced age, female gender, and lower income levels.
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