Fibromyalgia, characterized by widespread pain, chronic fatigue, sleep disorders, among other associated symptoms, presents significant challenges in both diagnosis and treatment, often leading to a reducedquality of life for sufferers. Traditional treatments focus on managing symptoms without addressing the underlying causes. The Fibromulheres® treatment, based on the Fibromyalgia Method Without Pain and Without Medicine (MFDR), proposes an innovative and holistic approach, integrating psychosomatic and phenomenological therapies, and integrative practices. This article explores the fundamental principles of the FDR Method, the effectiveness of the Fibromulheres® treatment evidenced by the SAFE® method, and discusses the revolutionary potential for fibromyalgia care.

Keywords: fibromulheres®, fdr method, fibromyalgia treatment, holistic approach, psychosomatic therapy, safe® method

MFDR, painless, medicine-free fibromyalgia method; SAFE®, integrative functional health

Fibromyalgia, characterized by diffuse pain and associated symptoms that significantly affect quality of life, has been a constant challenge for healthcare professionals and patients. Traditionally, fibromyalgia treatment focuses on relieving symptoms through medications, physical therapies, and lifestyle changes.

According to the Brazilian Society of Rheumatology, fibromyalgia is a condition characterized by widespread, chronic muscle pain (lasting more than three months), but without evidence of inflammation at the sites of pain. It is accompanied by symptoms such as unrefreshing sleep and tiredness, and may include mood disorders, such as anxiety and depression, and changes in concentration and memory (Brazilian Society of Rheumatology). The cause of fibromyalgia is not yet fully understood, but the main hypothesis is that patients with fibromyalgia present an altered perception of the sensation of pain, supported by studies that visualize the brain of these patients in functioning. Some develop the condition after a specific trigger, such as mistreated localized pain, physical trauma, or a serious illness (Brazilian Society of Rheumatology).

Healthcare professionals face a range of challenges when caring for patients with fibromyalgia, a complex and often misunderstood condition that requires a multidisciplinary and personalized approach. The enigmatic nature of fibromyalgia, combined with the variability of symptoms among patients, creates a challenging scenario for diagnosis, treatment, and emotional support.

Patients facing fibromyalgia deal with a series of challenges that go beyond the complexity of physical symptoms, encompassing diagnostic, emotional, social and treatment difficulties. This condition, characterized mainly by generalized pain, fatigue, sleep disturbances and sensitivity in specific points of the body, can also be associated with psychological symptoms such as anxiety and depression, in addition to cognitive difficulties known as "fibrofog". Some of the main challenges faced by patients when treating fibromyalgia are the time-consuming and challenging diagnosis, stigma and disbelief, difficulties in managing pain and fatigue, side effects of treatments, emotional and psychological impact, and social isolation.

These challenges underscore the need for a holistic, individualized treatment approach to fibromyalgia that not only alleviates physical symptoms but also addresses the emotional, psychological, and social complexities faced by patients. Recognizing and validating the patient's experience with fibromyalgia is a crucial step toward improving their quality of life and overall well-being.¹

When delving deeper into fibromyalgia, we understand it to be a psychosomatic illness. The term "psychosomatic"

refers to the intrinsic connection between the mind (psyche) and the body (soma), recognizing that emotional and psychological aspects can influence physical conditions. In the context of fibromyalgia, this approach is particularly relevant, as the condition is often associated with stress factors, trauma, and unresolved emotional aspects.

The concept of psychosomatics dates back to Hippocrates, the father of medicine, who already recognized the influence of the emotional on the physical. He argued that health depends on the balance between mind, body and environment. This holistic view of health was fundamental to the later development of psychosomatic medicine.³

At the beginning of the 20th century, Georg Groddeck reinforced these principles by introducing the concept that all illnesses have a psychosomatic aspect, suggesting that unconscious conflicts can manifest themselves in the form of physical symptoms. Groddeck argued that "It" (the unconscious) plays a central role in the etiology of disease, an idea that profoundly influenced psychoanalysis and the psychosomatic approach. Fibromyalgia is often difficult to diagnose due to its wide range of symptoms that can overlap with other medical conditions. There is no specific laboratory test or image to diagnose fibromyalgia, which leads to a process of eliminating other possible causes. This delay in diagnosis can be frustrating and exhausting for patients, prolonging their suffering without an adequate treatment plan.²

Fibromyalgia patients often face stigma and disbelief, both from society and healthcare professionals, regarding the validity of their condition. This is because fibromyalgia does not present visible abnormalities in traditional exams, causing some to disregard the reality of the pain and discomfort experienced. This lack of recognition can lead to feelings of isolation and invalidation of patients' experiences. Widespread pain and fatigue are the most debilitating symptoms of fibromyalgia, making daily management a constant challenge. Finding an effective strategy to manage these symptoms varies significantly between patients and may require a multidisciplinary approach, combining medications, physical therapies, lifestyle changes, and psychological support. The chronic nature of these symptoms means that patients need to develop long-term strategies to manage their condition. Although there are pharmacological treatments available to alleviate the symptoms of fibromyalgia, they can be accompanied by a variety of side effects, including weight gain, drowsiness and gastrointestinal problems. These side effects can significantly affect patients' quality of life and, in some cases, dissuade continued treatment.

The physical challenges of fibromyalgia are often accompanied by significant emotional and psychological impacts. Dealing with chronic pain can lead to feelings of anxiety, depression, and stress, which, in turn, can exacerbate the physical symptoms of fibromyalgia. This vicious cycle highlights the importance of treatment approaches that include psychological support and mental health therapies. Additionally, the combined impact of pain, fatigue, and misunderstandings about the condition can lead to socialisolation. Physical limitations can make it difficult to maintain jobs, social activities and hobbies, contributing toa sense of isolation and loss of identity prior to the illness.

The conscious conflicts can manifest themselves in the form of physical symptoms. Groddeck argued that "It" (the unconscious) plays a central role in the etiology of disease, an idea that profoundly influenced psychoanalysis and the psychosomatic approach. Faced with this entire scenario, the Fibromulheres® Treatment based on the MFDR method (Fibromyalgia without Pain and Without Medicine Method), both developed. These challenges highlight the need for a holisticand individualized treatment approach for fibromyalgia, which does not just alleviate the physical symptoms, but also address the emotional, psychological and social complexities faced by patients. Recognizing and validating the patient's experience with fibromyalgia is a crucial step toward improving their quality of life and overall well-being.

When delving deeper into fibromyalgia, we understand it to be a psychosomatic illness. The term "psychosomatic" refers to the intrinsic connection between the mind (psyche) and the body (soma), recognizing that emotional and psychological aspects can influence physical conditions. In the context of fibromyalgia, this approach is particularly relevant, as the condition is often associated with stress factors, trauma, and unresolved emotional aspects.

The concept of psychosomatics dates back to Hippocrates, the father of medicine, who already recognized the influence of the emotional on the physical. He argued that health depends on the balance between mind, body and environment. This holistic view of health was fundamental to the later development of psychosomatic medicine.

At the beginning of the 20th century, Georg Groddeck reinforced these principles by introducing the concept that all diseases have a psychosomatic aspect, suggesting that it was idealized by author Jordana Ribeiro as a revolutionary approach to treating this condition. This method not only promises to effectively alleviate symptoms, but also offers the prospect of treatment without dependence on medications, marking a significant advance in the treatment of fibromyalgia.⁴

MFDR is based on a holistic understanding of fibromyalgia, integrating knowledge from clinical psychology, psychosomatics, humanistic-phenomenological and systemic therapies, and other complementary integrative approaches to treat the condition. The difference between this method lies in its ability to personalize treatment, considering the specific characteristics of each patient, and focusing not only on physical symptoms, but also on the emotional and psychosocial aspects that influence the experience of pain. Fibromyalgia, often misunderstood and undertreated, poses unique challenges for both diagnosis and treatment. The recognition of fibromyalgia as a multifactorial condition, influenced by genetic, hormonal, emotional and environmental elements, highlights the need for a comprehensive approach.

MFDR, by addressing these diverse factors in an integrated manner, promotes not only symptom relief, but also a significant improvement in patients' quality of life, challenging traditional treatment paradigms and opening new paths for the effective management of fibromyalgia. This method, developed based on a deep understanding of the nuances of fibromyalgia, emphasizes the importance of treating the person as a whole, recognizing that chronic pain is influenced by a complex interaction of physical, emotional, psychological and social factors.

The central focus of the method is the idea of unblocking pain by addressing its emotional and psychological roots. The MFDR confirms that chronic pain, especially in fibromyalgia, often has emotional components. By working to resolve these underlying aspects, the method aims to unblock the pain and symptoms of fibromyalgia and consequently wean the medication, carried out under medical guidance. Unlike approaches that place the patient in a passive role, MFDR emphasizes patient empowerment. Through education about the condition and self-help techniques, the method aims to empower individuals to manage their own health, promoting a sense of control and autonomy over their well-being.

The MFDR highlights the importance of consideration and respect for each patient’s individuality. This includes consideration of factors such as: life history, emotional and social situation – these can influence the experience of pain. Such attention to individuality allows for more precise and effective interventions. Treatment follows the biopsychosocial model, which considers not only the biological aspects of fibromyalgia, but also the psychological and social factors that can affect the patient's health. This integrative approach is critical to effectively treating fibromyalgia, a notoriously complex and multifaceted condition.

The method not only focuses on physical pain, but also addresses mental health conditions commonly associated with fibromyalgia, such as depression and anxiety. In doing so, MFDR seeks to improve the patient's overall quality of life. By equipping patients with tools and techniques to manage their condition, MFDR aims for sustainable results, reducing the likelihood of symptoms recurring and promoting a healthy, active lifestyle.

The MFDR Method represents a breakthrough in the treatment of fibromyalgia, offering hope and a new direction for those who have struggled with the limitations of the conventional approach. By focusing on the whole person and not just the symptoms, it paves the way to a more complete recovery and a pain-free life. The application of MFDR in Fibromulheres® Treatment is designed to meet the specific needs of women living with fibromyalgia. This method is distinguished by its integrated and personalized approach, which considers not only physical pain, but also the psychological, emotional and social aspects that affect the condition.

The innovative approach of the Fibromulheres® Treatment, designed by the author (Jordana Ribeiro, 2020), presents itself as a revolution in the fight against fibromyalgia, especially aimed at women who seek a life free from pain and dependence on medications. This treatment is distinguished by its exclusive methodology, anchored in three fundamental pillars: Nexum, Centrum and Anima, each with its specific focus on neuroscience, emotional and spirituality, respectively. The practical application of the MFDR method (Fibromulheres® Method without Pain and Without Medicine) is broken down as follows within the Fibromulheres® Treatment:

Nexum: Body and Mind Connection through Neuroscience

Nexum aims to establish a harmonious connection between body and mind, employing neuroscience principles to understand and treat the physical pain associated with fibromyalgia. Patients are educated about fibromyalgia, including understanding chronic pain and strategies for managing it. This is essential to empowering patients, allowing them to take an active role in their treatment and recovery.

This pillar emphasizes the importance of considering the impact of the emotional and mental state on the physical manifestation of pain, proposing techniques and exercises that promote neural health and, consequently, alleviate the physical symptoms of fibromyalgia.

Centrum: You at the Center of Care

The Centrum pillar places women at the center of treatment, promoting a deep understanding of the emotional and psychological origins of fibromyalgia. This introspective approach encourages patients to explore their emotions, life experiences, and stressors that may be contributing to the persistence of the condition. Through specific techniques, women are guided to process and release these emotional factors, facilitating a path to recovery.

Anima: Increasing Vibrational Frequency through Spirituality

Anima focuses on the spiritual dimension of being, seeking to raise the vibrational frequency of patients. This pillar confirms the importance of spiritual connection and inner harmony in overcoming fibromyalgia. Practices such as meditation, mindfulness and other spiritual techniques are internal to treatment to promote balance, inner peace and a sense of general well-being.

The implementation of MFDR in Fibromulheres® Treatment is facilitated through an online portal, where patients have access to techniques, exercises and tools to integrate three pillars into their daily routines, as their schedule allows and without the need for transportation to facilitate access treatment, given the limited conditionof most patients with fibromyalgia. Treatment is flexible, allowing adjustments to meet changing patient needs and situations.

Interaction is continuous in the program's therapeutic forum, where the author, Jordana Ribeiro and her team of therapists offer personalized interventions, aimed at reaching and treating the roots of fibromyalgia in each patient. Additionally, live mentoring sessions are held weekly to accelerate results, creating an environment of support and continuous learning. This innovative treatment not only addresses fibromyalgia in a holistic and integrative way, but also empowers women to take control of their health, guiding them to a life free from pain and medication dependence through self-knowledge, personalized care and constant support. Treatment begins with a detailed assessment of medical history, fibromyalgia symptoms, history of previous treatments, lifestyle, and stress factors. This includes a discussion of the fibromyalgia patient's personal journey, their experiences with pain, and any previous treatments, whether occasional or alternative.

Special attention is paid to identifying possible emotional, psychological and environmental triggers that may be contributing to the manifestation and intensification of symptoms. Based on the initial assessment, a personalized treatment plan is developed, incorporating a range of interventions, including psychological therapies, relaxation techniques, mindfulness practices, and other complementary approaches.

The implementation of MFDR in Fibromulheres® Treatment represents a hopeful path forward for women struggling with fibromyalgia, offering a more holistic and empathetic approach that addresses both the symptoms and underlying causes of the condition.

The Fibromulheres® approach employs a comprehensive, multidisciplinary methodology to rehabilitate both the mental and physical health of patients with fibromyalgia. Using the SAFE® method for quantitative analysis, this study compares the health outcomes of Fibromulheres® participants with a control group, measuring functional health status across a spectrum of biomarkers to assess the impact of treatment.

The SAFE® method (functional health analysis) provides a framework for evaluating the effectiveness of Fibromulheres® treatment. This method considers a wide range of health indicators, including pain, fatigue, sleep quality and cognitive function, offering a comprehensive view of the impact of treatment on patients' quality of life.

A comparative cross-sectional analysis of 63 patients with fibromyalgia was carried out. Group 1 (G1: practitioners of the Fibromulheres® method for 12 weeks) and control group 2 (G2). All participants used the SAFE® Platform application. The result is obtained by a classification percentage from 0 to 100% and has five classification zones. Zone 1 (Z1): 0 to 24% of approved SAFE® biomarkers (worst health level); Zone 2 (Z2): 25 to 49% of approved SAFE® biomarkers; Zone 3 (Z3): 50 to 74% of approved SAFE® biomarkers; Zone 4 (Z4): 75 to 89% approved SAFE® biomarkers and improved level of functional health Zone 5 (Z5): 90 to 100%approved SAFE® biomarkers. In cases where normality was not observed in both groups, the non-parametric Mann-Whitney test was used (a significance level of 5%).

Participants in the Fibromulheres® treatment showed significant improvements in mental and functional health, as indicated by their progression into higher functional health zones within the framework of the SAFE® method. The group presented results (mean and standard deviation): 49.01±9 years; functional mental health of 64.81±20%; body functional health of 67.31%±20%; mind and body balance of 65.06%±14 (classification of functional health level in zone 3). One patient in Zone 1 (Z1), one patient in Zone 2 (Z2), 18 patients in Zone 3 (Z3), 4 patients in Zone 4 (Z4), 2 patients in Zone 5 (Z5) - (Figure 1). More than 93% of patients have their health restored to normal to excellent. These results suggest a notable improvement in both physical symptoms and overall quality of life for fibromyalgia sufferers undergoing Fibromulheres® treatment.

Figure 1 Bar Chart of the Evolution of the General Health of Women with Fibromyalgia after Fibromulheres® Treatment.

One of the most challenging aspects for therapists and healthcare professionals who treat patients with fibromyalgia is providing tangible results that improve patients' quality of life. Fibromyalgia is a complex condition, with a variety of symptoms that vary significantly between patients, which can cause major limitations for patients when not treated correctly. However, the Fibromulheres® Treatment has been shown to be effective in remitting pain and improving quality of life, as evidenced by studies and reports from patients who experienced significant improvements, and consequently, the weaning of medications, under medical guidance.

MFDR and the Fibromulheres® treatment, designed and built by author Jordana Ribeiro, representa significant advance in the treatment of fibromyalgia, offering a holistic and integrative path to healing. The empirical evidence provided by the SAFE® method underscores the method's effectiveness not only in alleviating the physical symptoms of fibromyalgia, but also in addressing its psychosomatic roots, paving the way for a comprehensive approach to fibromyalgia care that promises to improve the quality of life of those affected carriers, providing a life free of fibromyalgia pain and without medication.

The development and validation of the Fibromulheres® treatment is attributed to the collaborative efforts of Jordana Ribeiro and the team of healthcare professionals dedicated to pioneering holisticand effective approaches to treating fibromyalgia.

The authors declare no conflicts of interest.

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