What is fibromyalgia, the disease that suffers Lady Gaga?

Since 1992, the World Health Organization (WHO) has recognized in its International Clbadification of Diseases Fibromyalgia, one of the most common conditions of chronic pain. Between 2 and 10% of the general population can be affected and is nine times more common among women.

What symptoms should we expect? What progress has been made in your diagnosis and treatment? What is your relationship with Chronic Fatigue Syndrome? The doctor Evangelina Melgar, psychiatrist and coordinator of INECO's Chronic Fibromyalgia and Chronic Fatigue Clinic, provides clues to understanding these pathologies that can affect the activities of daily living and the interpersonal relationships of those who suffer from them.

Although the causes of these two diseases are unknown, genetic factors could 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. .

In front of what signs is it necessary to consult a doctor?

Usually fibromyalgia It occurs between 30 and 40 years of age but, to a lesser extent, it can appear during childhood and adolescence.. The main symptom is the Generalized pain of skeletal muscles, which worsens at the pressure of sensitive points. The intensity of the pain varies with climate change, physical activity, psychological stress or lack of sleep. It usually starts in one area of ​​the body and migrates through different regions until it becomes generalized over time.

90% of patients suffer from fatigue, 70 to 80% of sleep disorders and up to 25% of anxiety or depression. They are also frequent poor tolerance to effort; the feeling of heaviness in the limbs; generalized rigidity (especially when getting up in the morning); feeling of inflammation and poorly defined tingling in the hands and feet. It can be badociated with headaches, dizziness, cognitive failures of memory and attention, bruxism, gastrointestinal symptoms such as irritable bowel syndrome, dyspepsia, nauseaas. The presence of these symptoms or badociated syndromes varies in each person.

External factors such as environmental cold, moisture, stress, excess or lack of activity, exacerbate the symptoms. From another side heat, dry weather, relaxation and rest reduce their intensity.

Fatigue itself is a symptom that can be found in several charts, but Chronic Fatigue Syndrome (CFS), also known as myalgic encephalomyelitis, is a clinical entity recognized by all international medical organizations and by the 39; WHO. Fibromyalgia is badociated with CFS in only 8% of cases.

The syndrome can appear at any age, even during childhood, but is more common in women between 20 and 40 years old. In many cases, it begins abruptly after an infectious episode or physical or psychological trauma, such as a surgical operation, an accident or the death of a loved one. In others, it appears gradually. It can last several months and even years; only a small percentage recovers completely.

The SFC is characterized by Extreme fatigue that lasts more than 6 months and is not relieved by rest, badociated with another group of symptoms also constant for more than 6 months. Between them: sleep disorders, muscle or joint pain, headache, sore throat, impaired concentration and memory, feeling dizzy or sick. The severity of symptoms varies from one day to the next.

Importance of early diagnosis

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.

The diagnosis of both pathologies is eminently clinical. At the time, there are no further studies that confirm them, 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. It is also recommended the evaluation of a specialist in rheumatology to rule out pathologies badociated with or sharing similar symptoms.

The early diagnosis The main challenge posed by these diseases is to avoid their chronicity and a greater impact on the functionality of the person, improving their quality of life.

Interdisciplinary treatment

An adequate report on these pathologies should be the first step in 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 possible improvement.

There is consensus that Exercise programs should be one of the basic treatments for all patients with fibromyalgia. For example, Morning stiffness, a characteristic symptom, is due to changes in the microcirculation that cause a numb sensation and cause difficulty and pain when moving after long periods of immobility. In this sense, daily stretching and oxygenation exercises are indicated, as well as a mild aerobic physical activity. Anaerobes are not recommended because they will make you feel heavy and painful.

• Aerobic exercises with repeated movements: walks, dancing, cycling, exercises in the water.
• Stretching exercises or flexibility, whose goal is to improve flexibility: Tai Chi, yoga.

The Attention and cognitive-behavioral therapy have been shown to be effective in mood enhancement, emotional regulation, and stress management. This is essential to prevent aggravation of pain and contribute to functional ability.

Among the pharmacological treatments for fibromyalgia, some antidepressants are approved to effectively reduce the increased perception of pain. There is no medication that eliminates all the symptoms alone, but some drug combinations can help reduce pain and fatigue, as well as improve sleep.

In case of chronic fatigue syndrome, the most effective treatment is a dual approach combining cognitive training with a program of gradual exercises. In this case, the drug would also be indicated for sleep disorders, pain and badociated psychiatric illnesses.

Latest scientific studies on pain

There is evidence of abnormal sensory processing in the central nervous system that increases the perception of pain. In the face of repetitive stimuli, instead of generating addiction, an increase in painful sensitization is provoked. These neuroplastic changes include neurochemical and electrophysiological changes generating increased perception of pain stimuli (hyperalgesia) and painful perception of pain-free stimuli, such as cold, heat, or a simple hug (allodynia).

Recently, new neuroimaging studies performed by functional magnetic resonance imaging, allow to visualize the brain activation of regions responsible for the treatment of pain, both emotional and sensory, documenting an increase in connectivity in the transmission pathways pain. , decrease antinococeptic pathways, as well as abnormalities of neurotransmission.

Fibromyalgia and chronic fatigue syndrome pose a dual challenge: to sensitize the general population to this disease and to adequate professional training to help the affected population.