WHAT IS FIBROMYALGIA?
What is Fibromyalgia?
Fibromyalgia is a common condition characterized by widespread chronic pain, sleeping disturbances, fatigue and cognitive problems (bad memory). The pain can also manifest in the form of several sensitive spots distributed across the body.
This condition is known to be a syndrome associated to the central nervous system, but the precise mechanism behind fibromyalgia is currently unknown. Also, due to the vague nature of our understanding, diagnosis is usually difficult and can take a long time.
How common is Fibromyalgia?
Many studies consider that from 0,5% to 5% of the population of every country suffers from fibromyalgia, and that 7% to 13% of them suffer from frequent episodes of pain.
Interestingly, gender seems to be an important factor for fibromyalgia, Women tend to be up to 7 times more likely to develop the condition than men.
What are the symptoms?
Generalized chronic pain is the main symptom and it can present itself in a number of ways and intensities. Muscle (including face muscles), fatty tissue, bone and joins are common places where patients experience most discomfort.
Other common symptoms include:
- Memory problems
- Posture problems
- Sleep disturbances
- Irritable bowel syndrome
- Paresthesia (numbness, itching or tingling in arms, legs or feet)
- Changes in the severity and frequency of symptoms by the effect of the weather and physical or psychological stress
Diagnosis of Fibromyalgia
Diagnosis of fibromyalgia can be difficult. There are no lab tests or histological finding that can be directly linked to the condition. Many cases stay undiagnosed for a long time because of reasons like: Presence of an underlying condition that is thought to cause the pain, doctors not recognizing the cluster of symptoms, etc. The current guidelines for diagnosing fibromyalgia consider several important elements: Clinical examination, the patient’s history and a questionnaire filled by the patient. A complete medical examination is used to rule out any condition that may be the true cause of the symptoms and the patient’s history is examined to determine if the pain may be caused by any kind of drug abuse.
The questionnaire ultimately provides 2 important values: Widespread pain index (WPI), which measures pain from 0 to 19 and symptom severity (SS) which ranges from 0 to 12.
According to the current standard:
- WPI≥ 7 and SS≥ 5
- WPI (3 to 6) and SS≥ 9
Results in evidence to support a positive diagnosis
Without knowing the precise mechanism behind fibromyalgia is difficult to know exactly how these factors trigger the development of the syndrome. However, based on large studies, we know that:
- Chronic viral infections (Epstein-Barr virus, Parvovirus, etc)
- Any prolonged febrile disorder
- Physical trauma (especially if it affects the spine)
- A predisposition to a low pain threshold.
Can be safely considered as causes. Other cases simply have no apparent cause.
Who is at risk?
Fibromyalgia has a proven genetic component. According to recent studies, people with first degree family members diagnosed with fibromyalgia are 8 times more likely to develop the condition at some point during their lives.
Treatment for Fibromyalgia
There are pharmacological and non-pharmacological treatments. Unfortunately, drugs are not very effective and often need to be paired with other methods to improve quality of life.
Treatments include Cognitive-behavioral therapy, aerobic exercise and an overall increase in physical activity.
All of the following are documented risk factors for fibromyalgia; however, they are not necessary for its development.
- Lack of physical activity
How to prevent Fibromyalgia
There is no known way to prevent Fibromyalgia. Most doctors recommend trying to maintain a healthy, as with other medical conditions (5).
- Häuser, W., Ablin, J., Fitzcharles, M., Littlejohn, G., Luciano, J. V., Usui, C., & Walitt, B. (2015). Fibromyalgia. Nature reviews, 1, 1-16. Retrieved from https://doi.org/10.1038/nrdp.2015.22
- Neumann, L., & Buskila, D. (2003). Epidemiology of Fibromyalgia. Current Pain and Headache Reports, 7(5), 362–368. Retrieved from https://doi.org/10.1007/s11916-003-0035-z
- Rudin, N. J. (2019). Fibromyalgia. Pain, 693-697. Retrieved from https://link.springer.com/chapter/10.1007/978-3-319-99124-5_148#citea
- Clauw, D. J. (2014). Fibromyalgia: A Clinical Review. Journal of the American Medical Association, 311(15), 1547–1555. doi:10.1001/jama.2014.3266
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