Fibromyalgia is a chronic disease characterized by widespread pain and hypersensitivity to pressure. The name comes from the Greek word “Fiber” which means “fibrous tissue”, Myo means “muscle” and algea which refers to “pain”. It is estimated that up to eight percent of the population is affected by this disease. However, the majority of them go undiagnosed. Women are twice as likely to have the disease as men, and it's most commonly diagnosed between the ages of 35 and 45. Although it can be diagnosed at any age.
Symptoms
The main symptoms of this disease include:
1) Chronic generalized pain
2) Increased pain in response to tactile pressure, called allodynia
3)Fatigue
4) Cognitive impairment or brain fog
5) Sleep disorder
There are several other possible symptoms of this
disease, including anxiety and depression, muscle spasms called paresthesias,
nausea, and dysmenorrhea in women.
Weight gain and sensitivity to cold are also possible
conditions, and irritable bowel syndrome, temporomandibular joint disorders,
and chronic fatigue syndrome appear to be linked to fibromyalgia. Therefore,
jaw pain and gastrointestinal discomfort may also be Present.
Cause
The cause of fibromyalgia is currently unknown. Some hypotheses include central sensitization, where these patients are thought to be more sensitive to pain, resulting in a lower pain threshold. It is thought that pain-sensing neurons are over-excited and pain-inhibitory pathways are under-active. Often there is emotional or physical stress that acts as a trigger, and as said, fibromyalgia is associated with conditions that have a stress component like irritable bowel syndrome, temporomandibular joint disorder and chronic fatigue syndrome, and a manifestation of sleep appear to be another risk factor, along with smoking, obesity, and physical inactivity.
Researchers don't know exactly what causes
fibromyalgia. Genetics may play a role. Fibromyalgia is a long-lasting or
chronic disease. The etiology and pathogenesis of fibromyalgia are not yet
fully understood. Several factors such as central and autonomic nervous system
dysfunctions, neurotransmitters, hormones, immune system, external stressors,
psychiatric aspects and others seem to be involved.
However, current thinking in the field of rheumatology
suggests that fibromyalgia results from a problem with pain processing in the
central nervous system (CNS).
Diagnosis
There is no specific test used to diagnose fibromyalgia, and in most cases the tests performed are normal. In 1990, the American College of Rheumatology created diagnostic criteria for fibromyalgia based on tender points. There were a total of 18 points and the pain was expected to be widespread, affecting all four quadrants of the body and lasting over three months.
In 2010 these were revised, which included a widely
used pain index based on the parts of the body that have been affected in the
past two weeks. Give one point for each area touched. Provide a range of 0-19
points, then the symptom severity score, which signifies the severity of
fatigue, unrested waking, cognition, and general somatic symptoms. Each scored
between zero and three points, for a total of zero to twelve.
Overall criteria were a generalized pain index of 7 or
more and a symptom severity score of 5 or more, or a generalized pain index of
3 to 6 but with a symptom severity score of 9 or more. more. The symptoms had
to be present for more than 3 months and there could be no other condition to
explain the symptoms.
Some studies suggest that 66 of people diagnosed with
fibromyalgia may have other conditions. Examples include: lupus, non-celiac
gluten sensitivity, polymyalgia rheumatica, hypothyroidism, and nerve
compression syndromes like carpal tunnel syndrome, to name a few.
Subtypes
Four subtypes of fibromyalgia are believed to exist and these are:
1) Extreme sensitivity to pain without psychiatric illness.
2) Fibromyalgia with pain-related depression.
3) Depressionwith concomitant fibromyalgia syndrome.
4) Fibromyalgia due to somatization means showing psychological distress in the form of physical symptoms.
Controversy
There is some controversy with fibromyalgia. The
International Classification of Diseases or ICD-10 lists fibromyalgia only as a
pathological entity and advises that it should be classified as a functional
somatic syndrome, i.e. a chronic disease with no apparent cause rather than a
mental disorder. However, the preliminary ICD-11 characterized fibromyalgia as
chronic, widespread pain.
Treatment
Due to the unexplained nature of fibromyalgia, there is no specific cure or treatment, and treatment is generally aimed at managing symptoms. Non-pharmacological therapies are used alongside medication, with exercise being the most effective and showing significant evidence that it can reduce symptoms of pain and fatigue.
Aerobic exercise is most often recommended, but
therapies like yoga can also help. Cognitive behavioral therapy has been shown
to have a small positive effect on pain relief, and steps should also be taken
to reduce stress levels, which can be the trigger for good sleep.
Hygiene is also recommended, including establishing a
routine of avoiding caffeine and large meals before bed, not using screens in
the hour before bed, and ensuring the room is dark. and comfortable.
In terms of drugs, the United States Food and Drug
Administration has approved three main drugs for fibromyalgia. These include
serotonin and norepinephrine reuptake inhibitors (SNRIs), antidepressants,
duloxetine, milnacipran and pregabalin, a form of anticonvulsants. The
tricyclic antidepressant amitriptyline is also commonly used. Opioid juice is
controversial and is not currently FDA approved for fibromyalgia.
Over-the-counter medications such as acetaminophen and nonsteroidal
anti-inflammatory drugs have not been shown to be effective for fibromyalgia
itself, but are helpful in reducing fibromyalgia pain triggers.
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