Fibromyalgia is a very common disease, which is characterized by widespread and persistent musculoskeletal pain, the presence of sensitive points to choices in certain anatomical sites ( “tender points”) and marked asthenia (fatigue).
Who is concerned?
Fibromyalgia is a common disease in the population, because it seems to suggest 2-4000000 Italians, especially women, with a ratio of 5: 1 to 20: 1 compared to men.
What are the symptoms?
IMPORTANT: It is said that all fibromyalgia patients have these symptoms, you can various combinations only – so some are missing (the doctor is able to recognize that associations “minimum”, the diagnosis will be able to make).
- Pain is the symptom Prince, distributed throughout the body. It varies depending on the time of day, activity, stress, weather, sleep patterns.
- Burning, stiffness, contractures, muscle tension, can often be associated with pain.
- Asthenia (fatigue), reduction of resources “energy” of the patient, fatigue, even with minimal effort.
- sleep disorders of various types (nell’addormentamento problems, frequent awakenings during the night, no sleep by muscle tension).
- The presence of sensitive points: the painful pressure points near the tendon insertions occur in different parts of the body, usually the bones. (See unfavorable figure)
- Central nervous system disorders: lack of concentration, decreased ability to concentrate, mood swings, depression, anxiety disorder.
- Other associated symptoms, including the headache most common Sopo (certain forms such as migraine or tension headache type, in particular) and irritable bowel syndrome to.
What is the reason?
The causes are multiple and often causes the disease expression are involved (which is a multifactorial disease).
- In some cases, the syndrome of rheumatic diseases in which chronic inflammation of some connecting structures (such as structures, tendons and muscles). This condition is usually concludes with a blood test that should be imposed when the clinical suspicion of some of these diseases.
- In most cases, the problem is neurological change. Some genetic factors (constitution) and environmental triggers (trauma, psychophysical stress, …) changes in the central nervous system to determine certain neurotransmitters (chemicals in the basis for signal transmission and information our brain circuits) of the brain involved in the perception of pain. Some of these neurotransmitters (such as serotonin and noradrenaline) are also involved in the control of energy, concentration, in the regulation of mood and anxiety. And ‘for this reason that there are many symptoms of fibromyalgia entirely due to central nervous system. Recent data show that there is a decrease in the ability of the energy metabolism of specific cell populations, including, not surprisingly, the serotonergic and noradrenergic neurons.
In support of this, the Italian group study of fibromyalgia (Italian Network Fibromialgia) recently accepted the following definition of fibromyalgia syndrome “central sensitization is characterized by dysfunction in the neural circuits feed the perception, transmission and the treatment of nociceptive stimuli participation main manifestations of pain in the musculoskeletal system. as part of the apparatus of musculoskeletal pain, you can have many symptoms (insomnia, fatigue, abdominal pain, sore head, etc.) manifest, which are common to other central sensitization syndromes “.
How is he?
Before treatment is crucial that you have an accurate diagnosis. It is good, it is by a physician experienced in the material (usually a neurologist or rheumatologist) is the exclusion of other diseases can have similar symptoms.
Once the diagnosis is, for cases where Fibromyalgia is a rheumatic problem the first thing to do, it is associated to treat properly. In most cases, however, the staff and the multidimodale approach is what produces the best results. education appropriate patients, cognitive-behavioral approach, “low impact exercise schedule should be combined with drug treatment.
Among the substances are used or drugs, natural substances that act centrally restoration and / or neurotransmitter levels of stabilization have been reduced due to the disease (serotonin and norepinephrine), and cause symptoms. Other natural substances that improve the performance of energy metabolism, help control some symptoms.
If evidence arises during the visit, the doctor may also involve muscle relaxants, drugs or the regulation of the sleep-wake cycle, while the anti-inflammatory drugs (NSAIDs) or corticosteroids (steroids) have proved very effective for fibromyalgia is not associated with rheumatic diseases …….