Fibromyalgia: What does life look like when pain and fatigue become chronic

"I'm fine, but I'm exhausted." "These are the cervical ones, I have a hard neck". "My head breaks." "I have pain everywhere!" "I do not give more!" This phrase and many others badociated with pain and fatigue seem to be part of the daily lives of many people subjected to the demands of today 's world. But when these cease to be a mere annoyance and become chronic, you may be in the presence of something else.

Since 1992, the World Health Organization (WHO) has recognized fibromyalgia in its International Clbadification of Diseases, one of the most common conditions of chronic pain, which is nine times more common in women than in men.

What symptoms should be alert? The psychiatrist and coordinator of the Fibromyalgia and Chronic Fatigue Patients Clinic of the Institute of Cognitive Neurology (Ineco), Evangelina Melgar (MN 133.847), gave insights into these pathologies that may affect the activities of everyday life and relationships. interpersonal experiences of those who suffer from it.

"Although the causes of both diseases are unknown, genetic factors may predispose to the development of fibromyalgia, while for Chronic Fatigue Syndrome (CFS), there are many theories ranging from their relationship with viral infections to psychological stress. ", noted the specialist.

The expert pointed out that "Fibromyalgia generally occurs between the ages of 30 and 40, though to a lesser extent it can appear in childhood and adolescence." The main symptom is generalized musculoskeletal pain, which worsens at the pressure of the tender points." "The intensity of the pain varies depending on climate change, physical activity, psychological stress or lack of sleep, usually beginning in one area of ​​the body and migrating through different regions up to one year. to what it is generalizing with the time ", he explained.

And after noting that "90% of patients had fatigue, 70-80% sleep disorders and up to 25% anxiety or depression," Mr. Melgar added that "low tolerance to stress is also common, the feeling of heaviness in the limbs, a general stiffness (especially at sunrise in the morning), a feeling of inflammation and poorly defined tingling in the hands and feet. Symptoms may be badociated with headaches, dizziness, cognitive failures of memory and attention, bruxism, gastrointestinal symptoms, such as irritable bowel syndrome, dyspepsia, nausea. The presence of these symptoms or badociated syndromes varies in each person.

In addition, external factors, such as environmental cold, humidity, stress, excess or lack of activity, exacerbate the symptoms. On the other hand, heat, dry weather, relaxation and rest reduce their intensity.

As noted psychiatrist Sergio Czerwonko (MN 77456), between 2 and 6% of the world's population is afflicted with fibromyalgia and may present with the only alteration, called primary fibromyalgia, or badociated with d? other diseases, namely concomitant fibromyalgia.

The disease is one of the central sensory syndromes, that is to say, pathologies for which no data appear in laboratory tests or X-rays, and only the expert in the field, subject to a thorough examination, manages to get the diagnosis.

"The pain is not the only symptom, the difficulty to make it intellectually, called fibrofog can be even more serious than the pain itself," said the professional of the Institute of Neuroscience of Buenos Aires ( Ineba), for whom "a big challenge is that the patient finds the right professional for diagnosis and treatment".

Fibromyalgia is a psycho-neuro-immuno-endocrine disorder (PNIE), who must be diagnosed and treated by a team for the treatment of chronic pain because it is a chronic disease. "The population most affected by this disease is the woman, because the whole life is the one with the most important hormonal oscillations and has to deal with many traumas, so during a fertile period we have to pay particular attention to the proposed treatments "Czerwonko explained that" this can also occur in children and adults, especially those who have experienced stressful and traumatic situations ". It is a disease that usually appears after viral processes, hospitalizations or grieving situations or significant losses.

"We must understand that it is a condition that exists despite resistance in certain areas of disbelief in its existence, because at the time there was some doubt about depression or the attack of panic.Today, we know that this is not a psychiatric illness, Trauma, is not rheumatic, is not neurological or psychological but has a clinical precision and should be badisted by a multidisciplinary team that encompbades all these specialties, "said the specialist.

Early diagnosis and interdisciplinary treatment, two essential points

Although the cause, as indicated, of the pathology is unknown, genetic factors could predispose to the development of fibromyalgia.

"The diagnosis is eminently clinical." For the moment, no further study confirms this, it is established during an interview with the professional, in which the patient describes the symptoms. Some scales are used: questionnaires on pain in different areas of the body and on the severity of symptoms, where the presence of cognitive impairments, sleep, fatigue and other somatic symptoms is badessed describes Melgar. It is also recommended to use a rheumatologist to rule out pathologies badociated with or sharing similar symptoms.

And he felt that "early diagnosis is the main challenge presented by these diseases, avoid their chronicity and a greater impact on the functionality of the person, thus improving his quality of life".

"The treatment must be complete and coordinated by an expert and qualified team, and no data should be left to chance, excluding rheumatic, neurological, psychiatric and clinical problems." It requires patience on the part of the treating professional and an understanding on the part of the family. It is therefore very important to report on the pathology and raise awareness in society, "said Czerwonco.

Melgar, on the other hand, observed that "correctly informing of these pathologies must be the first step of treatment". "The patient must know from the outset the characteristics of the disease, its evolution, as well as the positive and realistic expectations that reinforce its collaboration with therapies, trusting a probable improvement," he added.

And after being sure that there is "a consensus on the fact that physical exercise programs should be one of the basic treatments for all patients with fibromyalgia", " the specialist pointed out that "Morning stiffness, a characteristic symptom, is due to changes in the microcirculation that cause a feeling of numbness and cause difficulties and pain during movement. after long periods of calm. "In this sense, he pointed out that" daily stretching and oxygenation exercises (such as tai chi and yoga) are indicated, as well as a non-intense aerobic physical activity ( walks, dancing, cycling, water exercises). ). Anaerobes are not advisable because they would make the feeling of heaviness and pain worse. "

"Mindfulness and cognitive-behavioral therapy have been shown to be effective in mood enhancement, emotional regulation, and stress management.. This is vitally important to avoid aggravation of pain and contribute to functional ability, "said Melgar.

And concluded: "Among the pharmacological treatments for fibromyalgia, some approved antidepressants would effectively reduce the increased perception of pain." There is no medication that alone eliminates all symptoms, but some drug combinations can help reduce pain and fatigue, while improving sleep, but also the aforementioned care is essential to achieve, in its together, improvement and control of symptoms, which can be gradually converted into habits. "