"Fibromyalgia" and "Long COVID-19" as a chronic compartment-like syndrome of the whole body (Nineveh, the Shadow is in the Fascia)

ABSTRACT

Background: The Coronavirus pandemic has impact on our community far beyond the acute phase, "Long COVID-19" is recognized as a new medical entity and resembles "fibromyalgia" which, likewise, lacks a clear mechanism. "Fibromyalgia" is a prevalent and misunderstood condition with significant burden and morbidity. "Central sensitization" and biopsychosocial theories describe "fibromyalgia" as the misfortunate neurological fate of traumatized and stressed individuals that have behavioral, cognitive, social, and/or genetic predisposition for an "infinite-positive- feedback of pain with no peripheral organic lesion/injury". Diagnostic criteria seem biologically arbitrary, treatments are insufficient, and physicians are frustrated. This work suggests a theoretical model with an organic mechanical mechanism to help explain "fibromyalgia", "long COVID-19" and "functional psycho/ somatic syndromes", based on cross-disciplinary empirical studies. A practical evidence-based treatment arsenal, which is derived from this model, is discussed briefly. Method(s) Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro, and medRxiv, majority with no time limit. Inclusion/exclusion based on title and , then full-text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. Result(s) 831 records included. The theory of "facial-armoring" suggests fibromyalgia-like entities may be a disease of connective-tissue driven by myofibroblast-generated- tensegrity- tension. This mechanism may explain fibromyalgia's pain, distribution of pain, decreased pressure-pain threshold, tender spots, fatigue, cardiovascular and metabolic abnormalities, autonomic abnormalities, absence of clear inflammation, silent imaging investigations, and other phenomena (e.g., complete resolution soon after surgery). "Long-COVID- 19" is predicted to involve fascial armoring. Conclusion(s) "Fibromyalgia" is a mild-moderate- chronic- compartment- like- syndrome- of- the- whole- body. Treatment should focus on lifestyle and non-pharmacological modalities. Early detection is key. The body and the mind are one being.