Fibromyalgia

Summary about fibromyalgia

Fibromyalgia is a term that we often hear without understanding what it is, without knowing the details of the disease. Many people talk about it and it seems that this is a psychosomatic illness. However, this disease affects many people and is growing. Many fibromyalgia patients are mostly women, but it appears that male cases have increased significantly.

Fibromyalgia patients have been misunderstood and certainly discriminated against. In the past, this disease was thought to be “imaginary”. However, this disease has been recognized by the World Health Organization (WHO) and the American Medical Association since 1987.

The main problem with fibromyalgia is the diagnosis. In fact, the pain is diffuse and often the reasons for the pain cannot be seen, giving the appearance of an “imaginary illness”. However, the pain can be very intense. Although the disease is not serious and rarely leads to serious complications, fibromyalgia can be debilitating for the patient in his professional, social and family life.

Fibromyalgia is a set of symptoms, the main of which is chronic pain (lasting more than three months), pain that is extensive and diffuse, continuous, fluctuating, which increases with effort.

Fibromyalgia treatments are diverse, ranging from pain relievers to antidepressants. Improvement of symptoms through healthy lifestyle is also highly recommended.

In short, to understand how to improve the treatment of the disease, it is important to know fibromyalgia well.

Definition

Fibromyalgia has been recognized as a disease in its own right by the American Medical Association since 1987. Five years later, the World Health Organization (WHO) finally recognized it as a disease. We can say, therefore, that fibromyalgia is a little known and little understood disease.

Fibromyalgia is a rheumatic disease characterized by widespread pain throughout the body, especially in muscles, tendons and ligaments. The etymology of the word is well aware of its magnitude:

– “Fibro” comes from fibrosis.

– “Mio” comes from the Greek and means muscle.

– While “algia” also comes from the Greek and means “pain”.

It is understandable, therefore, that the disease affects the muscles, the main symptom being pain. The disease is also known as “soft tissue rheumatism.”

Other symptoms may coexist, such as extreme fatigue and sleep disturbances.

The pain can be so intense that it prevents daily and professional activities.

Another term used to describe fibromyalgia is SPID or Diffuse Idiopathic Polymyalgia Syndrome. This term, unfortunately, was not selected internationally, even though it describes the disease well.

Causes

One of the reasons why fibromyalgia is unknown and mostly misunderstood is that we don’t know its causes. Furthermore, the pain felt by the patient has no apparent explanation as to its origin. In fact, doctors are not able to attribute painful inflammation to the muscle. They don’t see any damage to the painful area. However, some hypotheses are pointed out as causes of fibromyalgia. It is also possible that it is a combination of several factors that ultimately causes the disease. The most studied assumptions are the following:

– Genetic factors.

– A lowered pain threshold.

– Neurotransmitter deficiency.

– Falta de sono.

– Physical and emotional impact.

– Presence of antibacterial agents.

genetic factors

It seems that fibromyalgia cases are more common in families where there are already people with fibromyalgia. The track must be studied genetically. However, recent studies cannot yet demonstrate the gene or group of genes responsible for fibromyalgia.

Decreased pain threshold

People with fibromyalgia are more sensitive and feel pain more quickly and more intensely. Factors to be looked for by lowering the pain threshold, such as a defect in nerve transmission.

neurotransmitter deficiency

Serotonin neurotransmitters are essentially deficient, as are those of glutamate. This could explain the complications of depressed people with fibromyalgia.

the lack of sleep

Lack of sleep is not just a symptom of the disease but could also be a cause of the disease.

The physical and emotional impact

It appears that physical shocks such as car accidents are one of the triggers for fibromyalgia.

Emotional shocks also seem to cause the illness. It is believed that people who have experienced major shocks such as aggression, including sexual violence, develop the disease more easily.

the infectious agents

Recent research indicates that infectious diseases can cause fibromyalgia. Infectious diseases that are suspected include hepatitis B and C , as well as Lyme disease and HIV .

Groups of risk

Fibromyalgia has no well-defined causes. However, some people are more likely to develop the disease:

– People whose family member suffers from fibromyalgia.

– People whose family member suffers from depression .

– People suffering from sleep disorders.

– People who have suffered physical shock, such as a car accident, for example.

– People who have suffered emotional or major trauma(s) in their lives, such as assault, rape, violence.

– People who suffered from infectious diseases such as hepatitis B or hepatitis C , Lyme disease (beware of tick bites) and people who contracted the AIDS virus (acquired immunodeficiency syndrome).

– Women.

– People with rheumatic diseases such as rheumatoid arthritis or lupus .

Women

It seems that people with fibromyalgia are mostly women. The disease was once described as a disease of hysterical women. It is possible that sex hormones are involved in triggering the disease. Thus, men with the highest levels of testosterone would be better protected against the disease. Testosterone has a protective role in keeping the pain threshold at a higher level than women. Thus, for 10 women, only one man suffers from fibromyalgia. The statistics, however, have increased: now it is one man for 8 women.

People affected by the disease are between 30 and 60 years old. However, some cases have been reported in children.

In Western populations, the prevalence of the disease is about 4%.

Symptoms

The main symptom of fibromyalgia is pain. This pain is felt in particular, as its name suggests, in the muscles, but also the ligaments and tendons. Neck, shoulder pain points are in the first place, followed by the back, chest, not forgetting the arms and legs. This pain is diffuse and symmetrical (both sides of the body). The pain usually lasts for months or years, for example, a person complains of diffuse pain (pain on both sides of the body and above and below the waist) for more than 3 months, this could be a sign that the person has fibromyalgia.

Generally speaking, 18 points on the body are most sensitive. A person with fibromyalgia will feel pain in at least 11 of these points. This is a difficult factor to assess and identify, since fibromyalgia pain is different from one person to another and also depends on the circumstances: weather, time of day, patient tension, etc. We can say that the aggravating factors are humidity, cold and stress (including emotions).

The other symptoms of fibromyalgia are:

– Sleep disorders.

– Mood swings, often with a tendency to anxiety and depression . The patient may also have difficulty concentrating.

– Fatigue that persists during the day despite rest (sufficient night’s sleep). Sleep apnea and restless legs syndrome can also accompany fibromyalgia.

– Touch sensitivity. A simple touch can be felt as a painful signal. This feature of the disease is called allodynia.

Other less characteristic symptoms of fibromyalgia may occur, such as:

– Headaches and even migraines .

– Very painful menses and strong premenstrual symptoms.

– Abdominal pain with constipation or diarrhea .

Some illnesses may be associated with irritable bowel syndrome .

Stress can make fibromyalgia symptoms worse.

Diagnosis

The diagnosis of fibromyalgia is difficult because the symptoms are not characteristic and can suggest other illnesses. In fact, the main symptoms of the disease are widespread pain, persistent fatigue and depressed mood.

Lupus and chronic fatigue syndrome are two other illnesses that can be confused with fibromyalgia.

Thus, the diagnosis of fibromyalgia is based mainly on the patient’s clinical history, palpation of tender points and the exclusion of other diseases through laboratory tests. It would exclude, for example, thyroid disease and other rheumatic diseases.

In order to make a diagnosis of fibromyalgia, the doctor will use two criteria issued by the American College of Rheumatology. These criteria are internationally recognized and are as follows:

– The patient experiences widespread pain throughout the body for at least three months. These pains are present bilaterally and horizontally from left to right, up and down (compared to a seat belt).

– Pain affects at least 11 of the 18 features of fibromyalgia.

Again, given the vastly different sensitivity among people with fibromyalgia, it’s not easy to diagnose fibromyalgia. In fact, not all patients experience pain in the 11 points. Sometimes they feel it in 8 or 9 points. Secondly, the pain is felt differently depending on the time of day, weather, season.

There are (to our knowledge) no specific tests or exams to diagnose fibromyalgia.

However, in October 2016 researchers at the University of Colorado Boulder in the United States claimed to have discovered a brain signature that identifies people suffering from fibromyalgia with an accuracy of 93%. To arrive at these conclusions, the North American researchers carried out magnetic resonance imaging in 37 patients with fibromyalgia and in 35 individuals who did not suffer from this disease. This study was published in the specialized journal PAIN .

Complications

Although fibromyalgia is a chronic rheumatic disease, there are no serious complications because it does not affect the functions of vital organs. However, the presence of pain, sometimes very severe, can be disabling for patients in their daily activities.

The intensity of pain varies from one patient to another. Sometimes people with fibromyalgia may have periods of pain, and other periods where symptoms are mild or non-existent. But, in general, the symptoms reappear anyway. Remember, fibromyalgia is a chronic illness.

Once seen as a disease of hypochondriacs, it is essential to take these people’s pain seriously, even without any detectable cause or injury. The life of people with fibromyalgia is usually very affected by the disease, resulting in a long period of psychological complications, since the person feels so much pain that he cannot lead a normal life (socially and professionally speaking). Therefore, it is essential that the patient maintains a professional activity. This will keep the patient socially active and also improve their physical and mental state.

Thus, we can say that the main complication of fibromyalgia is the reduction in quality of life, with implications for physical (pain) and mental comfort (depressive tendency).

Treatments

Fibromyalgia treatment is based on pain relief with analgesics and anti-inflammatories, muscle relaxants, and mood improvement of patients with antidepressants. It appears that some anti-epileptic drugs have beneficial effects on people with fibromyalgia.

Non-drug treatments are also necessary, such as physical activity, psychotherapy, in addition to a healthy lifestyle.

Analgesics and anti-inflammatories

The most commonly used pain medications are ibuprofen, paracetamol or acetaminophen. When the pain is very severe and is not relieved by analgesics (against pain) called first line, we prescribe drugs with central effects, derivatives of morphine, such as tramadol.

muscle relaxants

Muscle relaxants allow relief from muscle pain. Tensions are reduced, as well as pain.

antidepressants

The main drug used in fibromyalgia is amitriptyline . This molecule is particularly interesting because it improves the patient’s sleep, so it also has a beneficial effect on fatigue.

Other antidepressant molecules are used like duloxetine or fluoxetine.

Milnacipran is a drug used in the United States, specifically indicated against fibromyalgia. Milnacipran belongs to the family of serotonin-noradrenaline reuptake inhibitors (IRSNa, IRSN or SNRI in English for Serotonin-norepinephrine reuptake inhibitor inhibitor).

Antiepileptics

Antiepileptics or anticonvulsants also have a beneficial effect on fibromyalgia, relieving pain and improving sleep quality. The main drugs used are gabapentin, topiramate and pregabalin.

EULAR treatment recommendations

In 2016, the European League Against Rheumatism (EULAR) published updated recommendations for the management of fibromyalgia and highlighted regular physical exercise as the most effective measure, compared to drugs or alternative therapies (yoga, tai chi, qi gong, spas, etc.).

– For EULAR scientists, physical exercise is recognized as significantly effective against pain and functional disability. EULAR recommends “with low effectiveness” or as second-choice treatments after physical exercise, other alternative therapies such as yoga, tai chi, qi gong, meditation, acupuncture and spa treatments. A detail about yoga, tai chi and qi gong is that they have a positive effect on sleep, fatigue and quality of life. Meditation affects quality of life and pain, but the effect seems small. Acupuncture can improve pain and fatigue. Thermal treatments seem to have an effect on quality of life and pain. On the contrary, chiropractic care is not recommended due to the risk to the patient.

– Regarding the use of drugs, the recommended EULAR as well as for alternative therapies, use as a second choice treatment. In case of pain, 3 molecules (drugs) stand out from these analyses: duloxetine, pregabalin and tramadol. In cases of sleep disorders, doctors may prescribe: amitriptyline , cyclobenzaprine and pregabalin.

– To reach these conclusions, EULAR experts selected 107 reviews or meta-analyses. The study was published in the online version of EULAR’s Annals of the Rheumatic Diseases on 4 July 2016.

Check out this detailed report (in English)

Tips

Fibromyalgia is characterized by severe pain and can lead to excessive consumption of painkillers, which can cause gastric ulcers, for example. To prevent stomach ulcers from occurring, take your pain medicine after a meal or ask your doctor to prescribe a drug that also protects your stomach, such as omeprazole.

When strong analgesics are used for central effects (opioid derivatives), consumption can lead to dependence. Therefore, do not abuse drugs for pain.

Regarding muscle relaxants, you should pay attention to their main side effect, drowsiness. This is especially important when planning to drive.

Fibromyalgia is a little known disease. We therefore have to inform the patient’s surroundings so that it is understood and supported. The pain is sometimes so intense that it can diminish the patient’s social life. Fibromyalgia can be a very debilitating disease. So, to avoid social distancing and withdrawal, the person must feel supported by his family, friends and colleagues.

Although fibromyalgia can be debilitating to the point of jeopardizing work, it is essential that the patient maintain their activities for social and moral well-being, even if their pace is changed.

Prevention

It is difficult to avoid fibromyalgia since the causes of the disease are not known. We can still pay attention to lifestyle, and limit risk situations, especially to prevent viral diseases.

Lifestyle

It is recommended to lose weight in cases of overweight. This relieves the knees of weight overload. Knees are among the 18 characteristic points of fibromyalgia.

It is also possible to improve the lifestyle, when someone has a relative with fibromyalgia, because the disease has a genetic cause.

For lifestyle, we think about the following factors:

– A healthy diet avoiding excess weight.

– Regular physical activity (30 minutes a day to stay in shape). Moderate intensity is sufficient. There is no need to practice a high level sport. Fun is a key factor. So don’t feel forced to play the sport. Thus, a good walk in the fresh air is very beneficial for physical and mental health.

– Regular and peaceful sleep. Good quality sleep is essential, as it appears that lack of sleep is not just a symptom of fibromyalgia, but could also be a trigger.

– Relaxation exercises such as yoga.

– Stress management exercises.

– Avoid stimulants such as nicotine and coffee.

viral diseases

As viral illnesses seem to trigger fibromyalgia (Lyme disease, hepatitis B and C, HIV) prevention is essential.

Lyme disease is transmitted by tick bites. It is therefore necessary to protect yourself against tick bites. There are also protective insecticides against tick bites. So after every possible contact with ticks, inspect the body for any parasites. Even if a person is bitten by a tick, it takes several hours for the infection to develop.

Hepatitis B is transmitted biologically through sex or by blood transfusion. It is recommended to protect yourself during sexual intercourse and take the vaccine against hepatitis B.

HIV is transmitted through unprotected sex with people infected with HIV or living in risky situations, such as sharing needles.

Glutamate and Fibromyalgia

It is estimated that glutamate can provoke or aggravate the symptoms of fibromyalgia, as well as aspartame (artificial sweetener). That is why it is advisable to consume certain foods such as fruits and vegetables, rich in vitamin C, which reduce glutamate toxicity.

News: Against fibromyalgia, movement first and foremost

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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