Perfectionist women may face higher fibromyalgia risk

By Ahmet Taş | Wise News Press
ISTANBUL, TÜRKİYE — Fibromyalgia may be more common among active women with perfectionist personality traits, according to Dr. Asiye Gülsüm Kakı, a physical therapy and rehabilitation specialist at Üsküdar University NPİSTANBUL Hospital.

Speaking as part of May 12 Fibromyalgia Awareness Day, Dr. Kakı said fibromyalgia should not be understood only as a condition of physical pain. She emphasized that sleep problems, chronic fatigue, cognitive difficulties, stress, lifestyle patterns and emotional burden may all shape the course of the disease.

Fibromyalgia is a chronic and multidimensional pain syndrome

Dr. Kakı said fibromyalgia has become one of the health problems seen more frequently in modern life. The condition is commonly known as “muscle rheumatism” among the public, but experts say this definition does not fully reflect the complexity of the disease.

Fibromyalgia is characterized by widespread musculoskeletal pain, fatigue, sleep disturbance, reduced cognitive function and increased central pain sensitivity. According to Dr. Kakı, the condition can significantly reduce a person’s quality of life and may progress for a long time without being fully recognized.

Patients may wake up tired, experience persistent low energy, report pain in the head, neck and back, and struggle with concentration during daily activities. In many cases, the symptoms affect not only physical functioning but also work performance, family life and social relationships.

Dr. Kakı said fibromyalgia should therefore be evaluated not only as a pain disorder but as a chronic syndrome involving the body, mind and social life.

Women between 30 and 55 are more often affected

Fibromyalgia is most commonly seen in active women between the ages of 30 and 55, Dr. Kakı said. Although a clear genetic transmission has not been proven, having a family history of fibromyalgia may increase a person’s predisposition.

She said biological factors alone are not enough to explain the condition. Clinical observations and psychosocial assessments suggest that people with perfectionist personality traits may experience fibromyalgia more frequently.

According to Dr. Kakı, women who carry intense responsibilities in professional life, family life and social roles may be particularly vulnerable. The pressure to constantly “keep up,” difficulty setting boundaries and the expectation of fulfilling multiple roles can increase chronic stress.

This stress may affect the body’s pain perception and overall resilience, potentially triggering or worsening fibromyalgia symptoms.

Perfectionism can become a chronic stress burden

Dr. Kakı described perfectionism as a personality structure marked by very high personal standards, a strong need for control and difficulty tolerating mistakes. She said perfectionism may provide motivation when it remains at a balanced level, but can become physically and psychologically exhausting when it becomes excessive.

“When it reaches an excessive level, this trait can turn into a chronic stress burden and become wearing both psychologically and biologically,” Dr. Kakı said.

Perfectionist individuals may be highly self-critical, may struggle to rest and may feel guilty when they cannot meet their own standards. Over time, this can create a cycle of stress that affects sleep, muscle tension and the nervous system’s response to pain.

According to experts, stress in fibromyalgia should not be treated merely as an emotional issue. It can also be a biological factor that increases pain sensitivity. Poor sleep, chronic muscle tension and emotional overload may make the body more reactive to pain signals.

Pain may be accompanied by fatigue and brain fog

Widespread musculoskeletal pain is the leading symptom of fibromyalgia. Dr. Kakı said patients frequently present with head, neck and back pain, although more localized pain may also be seen in some cases.

The condition, however, is not limited to pain. Sleep problems, chronic fatigue, attention and concentration difficulties, forgetfulness and the mental cloudiness commonly described as “brain fog” are also among common symptoms.

These symptoms may make daily life more difficult. A person may have trouble completing work tasks, maintaining social routines or managing household responsibilities. Even when pain is not severe, fatigue and cognitive difficulties can reduce functionality.

Dr. Kakı also said additional somatic complaints such as migraine, irritable bowel syndrome and abdominal pain may accompany fibromyalgia. For this reason, patients should be evaluated not only for pain but also for sleep quality, digestive complaints, emotional state and overall quality of life.

A single treatment model is not enough

Dr. Kakı said there is no single treatment approach that is sufficient for fibromyalgia. Since biological, psychological and social factors may all play a role in the development of the disease, treatment should be multidisciplinary and personalized.

The patient’s psychosocial condition, sleep pattern, exercise habits, nutrition style and vitamin levels should be assessed together, she said.

Sleep regulation is one of the basic steps of treatment. Dr. Kakı noted that a person who cannot get quality sleep is unlikely to feel energetic and healthy during the day. For this reason, patients should be informed about sleep hygiene and supported in building regular sleep habits.

Exercise planning is also important. Instead of heavy activities that strain the muscles, light-paced aerobic exercises, relaxation practices and breathing exercises are recommended. Dr. Kakı said it may be more beneficial to spread movement throughout the day rather than limiting exercise to a single time period.

Psychological support may improve quality of life

Dr. Kakı said a patient’s personality structure should also be considered during treatment. This is especially important for perfectionist individuals who may need to recognize and manage their self-critical thinking patterns.

Psychological support methods such as cognitive behavioral therapy may help patients improve quality of life. These approaches can support stress management, boundary-setting, emotional regulation and healthier interpretation of body signals.

Such support may also help patients cope with negative thought patterns linked to pain. When combined with physical therapy, sleep regulation, exercise and lifestyle changes, psychological support may contribute to a more effective treatment plan.

Nutrition is another important factor in fibromyalgia management. Dr. Kakı said a balanced and healthy diet is recommended instead of a diet heavily based on carbohydrates. She added that vitamin D, magnesium and omega-3 may be evaluated to support energy metabolism when appropriate.

Dr. Kakı emphasized that fibromyalgia is not limited to physical pain. It also affects the person’s emotional and social life. For this reason, treatment should not focus only on pain but should also address lifestyle, stress levels and emotional burden through a holistic perspective.

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