Fibromyalgia
"The future of treatment for this disease is hopeful, as research on fibromyalgia is progressing rapidly. It is only a matter of time before these advances are translated into more effective treatments.
DR. JAVIER NICOLÁS GARCÍA GONZÁLEZ
SPECIALIST. INTERNAL MEDICINE DEPARTMENT
Fibromyalgia syndrome (FM) is a chronic and complex condition that causes widespread pain and profound exhaustion, as well as a variety of other accompanying symptoms. It is often described as a headache.
It primarily affects the soft tissues of the body. It does not cause joint pain or swelling.
The mechanisms by which it occurs are not well known and therefore no alterations are found in the analyses or in the image studies that allow establishing the diagnosis.
Fibromyalgia shares some characteristics with chronic asthenia syndrome or chronic fatigue or, as it has recently been called, systemic disease from exercise intolerance.
What are the symptoms of fibromyalgia?
In addition to pain and exhaustion, fibromyalgia can also cause one or more of the following typical symptoms:
- Sleep disorders: Despite getting enough sleep, you may wake up and still feel tired.
- Stagnation: Stiffness of the body.
- Increased headaches or face pain.
- Abdominal discomfort: digestive disorders, abdominal pains, meteorism, constipation and/or diarrhea.
- Genitourinary problems: increased frequency or greater urgency to urinate, typically without a bladder infection.
- Paresthesia: numbness or tingling (e.g., in the hands or feet).
- Temperature sensitivity.
- Skin problems: Unpleasant symptoms, such as itching, dryness or blotchiness.
- Chest symptoms: Pain in the chest or upper body.
- Imbalance: Dizziness and/or balance problems.
- Cognitive disorders: difficulty concentrating, "mental slowness", memory loss.
- Sensations in the legs: "restless leg syndrome" (uncontrollable urge to move your legs, especially when you are resting or lying down).
- Environmental sensitivity: hypersensitivity to light, noise, odors and weather changes.
- Depression and anxiety.
Learn what fibromyalgia is and how it is treated (only in spanish)
The most common symptoms are:
- Generalized pain.
- Fatigue.
- Disorders of the dream.
- Depression and anxiety.
Do you have any of these symptoms?
You may have fibromyalgia
What are the causes of fibromyalgia?
Cases of fibromyalgia have been described that begin after specific processes, such as a bacterial or viral infection, an automobile accident, marital separation, a problem with children...
In other cases it appears after another known disease limits the quality of life of the patient (rheumatoid arthritis, lupus erythematosus...).
These triggers do not seem to cause the disease, but what they probably do is to awaken it in a person who already has a hidden abnormality in the regulation of his or her ability to respond to certain stimuli.
Although it is not yet known with certainty, it is likely that an abnormal response to stress-producing factors plays a very important role in this disease.
Low levels of some substances important in the regulation of pain (particularly serotonin) have been detected in the nervous system of people with fibromyalgia.
Who can suffer from it?
It is a common disease, with a clear predominance in women, so that in Spain up to 4.2% of women may suffer from the disease, while it only affects 0.2% of men.
The mechanisms by which it occurs are not well known and therefore no alterations are found in the analyses or in the image studies that allow the diagnosis to be established.
How is fibromyalgia diagnosed?
The diagnosis of fibromyalgia or fibromyalgia syndrome is made in those patients with a picture of generalized musculoskeletal pain, several months of evolution in which other possible causes have been excluded.
The pain is generally associated with other symptoms such as fatigue, headache, dryness of mucous membranes, etc.
In the physical exploration, the doctor identifies pain to the pressure in some determined points of the body. When the painful points are more than 11 of the 18 indicated in a person with generalized pain, the diagnosis of fibromyalgia can be made.
Another alteration is the greater facility for redness of the skin when pressing with the hand in any place of the body.
Tests and x-rays in this disease are normal and serve primarily to rule out other diseases that may be associated with fibromyalgia.
How is fibromyalgia treated?
There is no standard treatment for all patients and it must be adapted to each patient according to their characteristics. The aim of treatment is to try to control the symptoms that accompany the disease (musculoskeletal pain, tiredness ...) trying to avoid the side effects of medication that often suffer patients with fibromyalgia.
It is necessary to avoid the factors that aggravate the symptoms by adapting life habits and customs to the limitations that pain and fatigue can produce. It is advisable to try to achieve a change of mentality, both in the patient and those around him, seeking a relaxed family environment free of constant demands.
Of all the measures that have been used in the treatment of fibromyalgia, physical exercise and adequate muscle strength are undoubtedly the most effective. Massage, muscle stretching exercises, local heat and some types of electrotherapy ("currents"), can be secondarily effective.
Local injections of the painful points with local anesthetics, especially if followed by a local massage, are of great help for intense localized pain.
Painkillers or analgesics can help in a punctual way. There is a group of medicines, which act among other mechanisms of action, increasing the levels of serotonin, and that improve the symptoms in a good number of patients.
In the cases refractory to the pharmacological treatment, the perfusions of lidocaine (local anesthetic) administered in intravenous form can be effective.
Where do we treat it?
IN NAVARRE AND MADRID
The Department of Internal Medicine
of the Clínica Universidad de Navarra
Its integrative vision and polyvalence allow us to provide the best medical assistance to multipathological and multisymptomatic patients, who present a difficult diagnosis or who suffer from prevalent diseases of a hospital nature.
Why at the Clínica?
- State-of-the-art diagnostic technology.
- Quick diagnosis to start the most appropriate treatment early.
- Teamwork with the rest of the professionals in the Clinic.
Our team of professionals
