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Vertebral Spine Institute
Istituto Della Colonna Vertebrale
Fibromyalgia
Fibromyalgia
Dr. Pablo Dias, Specialist in Trauma-orthopedics and also in Chiropractic at COFFITO.
Patients typically feel severe pain throughout the body and joints, often associated with tiredness, unrefreshing sleep and changes in mood. Other common symptoms are excessive tiredness, fatigue and sleep disturbances. This is a common problem, accounting for around 5% of patients who go to a Medical Clinic and 10 to 15% of patients who go to a Rheumatology office.
Around 30% of fibromyalgia patients are men and that is why we consider this to be a “female” disease, but there is no scientific data to justify this prevalence. As this syndrome is present both before and after menopause, there is no relationship with hormonal changes that would justify the higher incidence in women.
It is believed that patients with fibromyalgia are more sensitive to pain than other people and, in general, on physical examination it is clear that these patients are more sensitive to touch when palpating soft tissues.
There does not appear to be a relationship with hormones, as fibromyalgia affects women both before and after menopause. Perhaps the criteria used today to diagnose FM tend to include more women. The age at which fibromyalgia appears is generally between 30 and 60 years old. However, there are cases in older people and also in children and adolescents.
We can consider that Fibromyalgia is a clinical syndrome, as it presents a set of typical manifestations, but in general it manifests itself with pain throughout the body, mainly in the muscles, associated with tiredness, a sleep that does not repair and causes the person to wake up right away. very fatigued due to “non-refreshing sleep”. Other common symptoms are related to changes in memory and attention, anxiety, depression and intestinal changes.
There are no blood tests or imaging tests that can prove the existence of fibromyalgia, which is why it is common for patients with fibromyalgia to seek specialists in the musculoskeletal field with many tests, as if the patient were searching for the cause of their problem.
I must mention that it is common to request diagnostic tests to rule out some pathologies and by exclusion reach the diagnosis of Fibromyalgia.
Of course, there are musculoskeletal conditions that are more common in patients with fibromyalgia, such as carpal tunnel syndrome and subtrochanteric bursitis, but the diagnosis of fibromyalgia is based on the history of the disease, the manifestation of signs and symptoms, and finally, based on the patient's clinical condition.
The diagnosis of fibromyalgia according to current guidelines should not be based on the number of points, but rather through specific questionnaires that are scientifically validated, associated with clinical assessment and monitoring. We know that in general, patients present with pain for more than three months throughout the body and the presence of painful points in the muscles. Important points must be considered in the diagnosis, such as depression, sleep disturbances (95% of patients) and fatigue. Patients also experience diffuse body pain and some complain of pain even when being hugged and low tolerance to physical exercise. Patients' sleep tends to be superficial and is related to changes in the REM phase, (Rapid Eye Movements), or rapid eye movement phase.
Pain in fibromyalgia involves mechanisms that are difficult to understand and is not mainly linked to inflammatory events, but rather related to perception, history and learning related to each individual's painful experience. We do not understand all the mechanisms involved in this pathology, but it is certainly related to changes in the perception of painful stimuli in interaction with the central nervous system.
Below I mention some possible impairments of patients with fibromyalgia.
1. Memory
2. Muscle strength, mobility, changes in performance in physical and work activities
3. Attention and learning
4. Relationships with family, people at work and social life
5. Changes in mood, in the sense of becoming more withdrawn, more prostrate and less interactive with people.
6. Demonstrates being in physical and/or mental suffering.
Treatment
Here at the Spine Institute, we have developed, through 20 years of clinical experience, a multimodal protocol combining different resources and very special clinical management to achieve the best results in Fibromyalgia. Make an appointment with us!