Fibromyalgia

“It’s in the head.” Patients diagnosed with fibromyalgia have often seen their illness more as a mental disorder. Many of them having gone through depressive episodes, the medical profession has for a time considered the symptoms of fibromyalgia as the manifestations of a latent depression. Today, research contradicts this explanation.

Fibromyalgia is a very painful set of symptoms, which causes great fatigue that can go as far as disability. This pain can occur by day and night, It is a rheumatic syndrome characterized by a painful, muscular, diffuse state, evolving chronically, associated with fatigue, morning rustling, sleep disorders. The initial description dates back to the beginning of the 20th century.

It is difficult to determine the causes of fibromyalgia that are surely multiple. A weak nervous system has been linked but it is difficult to know if it is a cause rather than a consequence of the disease. It has also been found that fibromyalgia often occurs after a violent emotional shock, a major trauma or a viral illness. The frequent association of sleep disorders and depression has made the possibility of a lack in neurohormones (hormones of the nervous system), including serotonin, the mood hormone. In addition, the existence of hereditary cases (“mother-daughters”) might suggest the intervention of a genetic factor. Finally, researchers in Massachusetts found that 50% of patients had damaged nerve fibers in their skin (especially their legs), suggesting a neurological disease called “small fiber neuropathy”, often found in diabetics

At the origin of fibromyalgia, certainly, a genetic predisposition combined with unfavorable factors: traumatic, environmental, social, physiological, human. The set generates an unmanaged state of stress, the overloaded neurological system responds poorly, and induces this chronic attack.

Who is concerned ?

Mainly women, between 40 and 60 years because of particular hormonal peculiarities. But it can begin as early as adolescence. This represents 14 to 20% of rheumatology consultations. It affects 4 times more women than men. It usually starts after age 40 but can be observed earlier. Children can present this disease. Sufferers are people with sleep disorders. People who are emotional, anxious, fragile, lacking self-confidence or people who have experienced difficult situations traumatized them.

What is the main symptom and what are its characteristics?

Pain is the constant sign.

It concerns both the region of the cervical spine, upper dorsal or lumbar-gluteal. It can also be found at the pressure points of the shoulders, trapezius, elbows, near the hips and near the knees. These points are located in the same place in the same patient, found from one consultation to another, which makes it one of the characteristics of the disease.

Other disorders that accompany the pain: the feeling of tiredness, of being exhausted, a disturbed and non-restorative sleep.

Are there triggers?

They are not always present. It can be physical trauma such as a whiplash, a fall, but also an emotional shock, a stress mourning or a change in family or professional situation. A history of psychological trauma in childhood is common.

Is it a chronic condition?

It is a chronic pain syndrome that can evolve intermittently, with remissions, be fluctuating, with periods of crises on a permanent painful background.

Other symptoms:

  • Migraine, headaches caused by muscle tension located in the neck.
  • Diarrhea, constipation, or abdominal pain.
  • Depressive episodes or anxiety.
  • Difficulty concentrating and memory problems.
  • Exacerbated sensitivity to noise and light.
  • Abnormal intolerance at temperatures (cold and heat).
  • Dry eye, dry mouth and dry skin (Sjögren’s syndrome).
  • Numbness and tingling at the extremities (hands and feet).
  • Restless legs syndrome.
  • Painful periods.
  • Frequent urination

Treatment

This Illness is poorly understood, fibromyalgia has been the subject of a considerable number of therapeutic attempts often concluded by failures. Certainly, some drugs have been effective in the trials but it is difficult to extrapolate the results, as the symptoms are varied from person to person. Thus, an ineffective treatment for pain may be useful for its effects on sleep or fatigue, and vice versa.

Drugs most often prescribed:

  • analgesics against pain,
  • antidepressants,
  • anti-convulsants.

Non-drug techniques used:

  • physical rehabilitation,
  • the cognitive and behavioural therapies that have shown their effectiveness on pain, fatigue and mood,
  • relaxation or hypnosis,

Fibromyalgia is not a serious illness in the sense that it does not lead to major health complications. It is nonetheless a painful and debilitating disease for people who suffer from it. The pains are chronic and often resistant to different treatments, whether medical, physical or psychological. However, they tend to remain stable over the long term, or to diminish. There is usually no aggravation.

The intensity of pain and fatigue limits daily activities and can sometimes have repercussions on professional activity. However, maintaining one’s professional activity is both psychologically and physically beneficial, as shown by a Swedish study in 2005.62 working time and post adjustments are sometimes necessary when the pain is very severe. .