Fatigue and chronic pain: is fibromyalgia?

“I’m so tired, my body hurts, I hurt all the time …” You may be suffering from fibromyalgia. An unknown disease and poorly supported. What treatments take?

Although Fibromyalgia affects 2 to 5% of the population, mostly women, it is still unclear. “This is a special state of generalized hypersensitivity that results in diffuse musculoskeletal pain and migratory, fatigue and exercise intolerance,” says Dr. Gérard Mick. These people have a different perception of pain perception threshold with a lower than average.

A lot of recognition syndrome

Fatigue and pain are such as to prevent the person from going about their daily business. Too long cataloged psychosomatic illness, pain related to fibromyalgia is not always taken seriously by those around him as a full syndrome.

Recognized as rheumatic disease

It is only since 1992 that the WHO has recognized this disease as rheumatic, while it was previously considered psychiatric. The nonspecific symptoms partly explain wandering patients from one doctor to another because they can not find solutions to their pain.

Causes enigmatic

The cause of fibromyalgia is still unknown, but we see it often appears after trauma (accident, illness, emotional shock) or overwork. It evokes a viral origin as a trigger (herpes, mononucleosis and shingles), as well as biochemical and physiological disorders. Since 2004, researchers are looking to nature immunochemical disorders, neurological and environmental.

Various symptoms

People with fibromyalgia suffer:

  • pain throughout the body, diffuse and variable felt as contractures or voltages, or as burning sensations with tingling in the extremities. These pains of muscles and tendons worsen with stress, cold, pressure and stress.
  • chronic fatigue for at least six months, ranging from fatigue to exhaustion true. People describe a total loss of power causing them to greatly reduce their activity.
  • sleep disorders. Sleep light and fragmented, does not appear repairer. also observed stiffness upon waking.
  • associated signs vary from person to person: headaches, digestive disorders (irritable bowel, irritable bowel syndrome, diarrhea, constipation …), menstrual problems, irritable bladder, impaired memory and concentration, depression and anxiety (a third of people with fibromyalgia), noise sensitivity, restless legs, tinnitus …

Where to direct?

When the pain and fatigue settled, people with fibromyalgia have trouble finding the right person to deal with their pain. It is advisable to consult a rheumatologist, a specialist in internal medicine or the relevant associations that can correctly refer the person.

A difficult diagnosis to ask

Joint pains and morning stiffness can refer initially to a diagnosis of osteoarthritis or rheumatoid arthritis. The problem ? No biological or radiological element (MRI or CT) allows to confirm the presence of fibromyalgia. The diagnosis is based on patient interview confirming suffer from fatigue and widespread pain for at least six months.

Specific pain points

The doctor confirms the diagnosis by applying pressure with his fingers out of eighteen tender points precise location, also called trigger or tender points points. These points are symmetrical and are situated on the front of the body (neck, second side, elbow, hip, knee) and the rear face (occiput to the base of the skull, shoulder, shoulder blade, basin). Eleven of them have to be painful to sit diagnosis.

The problem of support

Fibromyalgia is not recognized as a chronic disabling disease by the Ministry of Health, which means it does not justify the right to support 100%, especially when the person’s condition requires a judgment of job. The associations are fighting for recognition of full syndrome. However, the patient with fibromyalgia may benefit from support 100% of care and treatment under conditions of “off-list” in case of progressive and disabling form and recommendation of the medical service.

A multidisciplinary management

Unfortunately, there is no curative treatment for fibromyalgia. So this is to support the best possible symptoms. Yet too many sufferers are poorly accompanied in their pain. Linking drug and non-drug treatment is a key to improving this state related primarily to hypervigilance.

First objective: drug treatment

It relies on the use of analgesics such as paracetamol or tradamol. Opioids or nonsteroidal anti-inflammatory drugs are not recommended. One can associate relaxants low dose treatments and some of the family of antidepressants or antiepileptics, to reduce hypersensitivity.
According to a report from 2007 by the Academy of Medicine, the antidepressant milnacipran based on the molecule is particularly effective on pain and fatigue, especially among non-depressed people. In case of anxiety, which is the case of two people, one may appeal to background anxiolytics.

Second objective: non-drug approaches

Different therapies can be proposed depending on the person’s needs: these include physiotherapy, massage therapy and sedative therapy, sophrology and hypnosis.

TENS, of sending, through electrodes placed on the skin, a mild electrical current, can have beneficial effects. As for fatigue, acupuncture can provide a solution.

Third objective: learning to control emotions

“The improvement is largely a psychic emotional control,” said Dr Mick. Several studies have shown the interest of the mind-body approaches to better live the disease and understand another way of pain. The approaches most effective mind-body are the “biofeedback” who learns to control muscle tension and breathing through viewing these settings on machines, hypnosis and cognitive behavioral therapies.

Fourth goal: staying active

It is essential not to stop the physical efforts, under penalty of mismatching-muscle and strengthen fatigue and anxiety. The establishment of a program combining individualized exercises, including heated swimming areas, cardiovascular resistance exercises such as cycling and stretching exercises improves symptoms.

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