Fibromyalgia: the management should be multidisciplinary

Fibromyalgia is a chronic disease with still mysterious causes. The diagnosis is difficult to establish, and often long to get support. A multidisciplinary approach is essential to improve the lives of patients.

In France, 1 to 3 million people suffer from fibromyalgia. This chronic disease affects mostly women (3.4% of women against 0.5% of men). It is expressed in the form of pain and of varying severity, which can gradually expand in the joints and / or muscles. These pains are often associated with other symptoms: fatigue, sleep disturbances, mood swings. The disease can range from simple discomfort to a significant handicap.

A disease still controversial …

Although recognized since 1992 by the World Health Organization as a rheumatic disease, fibromyalgia remains controversial by the medical profession because its causes are misidentified. Many doctors fail to recognize the symptoms of this syndrome in patients because they were not sufficiently trained and sensitized to this puzzling disease.

Difficult to diagnose and treatment

Diagnosis is more difficult to establish that the patient does not show any abnormality in radiological studies, clinical and biological. On average, a person waits for 2.7 years in France and sees about three doctors that the diagnosis is made.

Once diagnosed fibromyalgia, accompanying the person is too often unsatisfactory, due to the ignorance of the syndrome by doctors. Even today, medical care is sometimes left to the sole judgment of medical officers. “Disparate treatment prescribed by these practitioners only accentuate the feeling of injustice and abandonment already experienced by people facing this invisible disease and debilitating,” says Carole Robert, president of the association Fibromyalgia France.

A targeted treatment according to the patient profile

Although there is not date specific treatment for fibromyalgia, individualized management of patients can improve the effects of the disease.

The diagnosis of fibromyalgia

Some criteria used to diagnose fibromyalgia. When the patient’s examination, it often described:
– sleep disturbances
– bloating with abdominal pain
– the operation sphincter disturbances
– changes in blood pressure (often drop across it upon standing)
– of heart rhythm disturbances
– increased or decreased sweating
– diarrhea.

During the physical examination, the doctor performs a pressure with a finger on specific points of the body of the patient (among them: base of the skull, scapula, shoulder, buttock, hip, inside the knee). According to the patient’s general status, number of painful areas can be variable: if lack of sleep, these points can be more.

Neurological examination will show that the autonomic nervous system (it controls guts, heart, muscles and skin some elements) is disturbed. It is also necessary to take into account some other symptoms exhibited by the patient (fatigue, sleep disturbances, headaches, anxiety, tingling in the extremities …).

Each patient treatment

“The pain of fibromyalgia is different each, and it is the patient profile that defines the molecules that the doctor will assign” says Carole Robert, president of the association Fibromyalgia France. Treatment of the disease is complex to implement; the role of the practitioner, their listening and investment from the patient, then capital.

“The main medical actors of fibromyalgia are: rheumatologist posing, generally, diagnosis and eliminate the underlying pathologies; the neurologist, the pain specialist, psychologist and other practitioners of complementary therapies (relaxation, relaxation therapy, acupuncture, physiotherapy …), “says Carole Robert.

Relieve pain as best as possible with a multidisciplinary approach

The most comprehensive treatment of fibromyalgia requires a multidisciplinary approach combining drug treatment (or allopathic) and non-drug (or complementary). It adapts to the intensity of pain and the importance of the associated symptoms.

Allopathic treatments

Overall, the most commonly used medication, with a long-term variable effectiveness, are:
– certain painkillers, against pain
– antiepileptics, in some cases, against the intense pain
– antidepressants to calm sleep disorders, of mood and fatigue
– tranquilizers or hypnotics, to relax muscles and aid sleep.

Complementary treatments

In addition to medication, several techniques are available to people with fibromyalgia to try to overcome their symptoms 
– treatment in water, with practice exercises (aerobics, swimming) or without (Thalassotherapy, hydrotherapy) 
– cognitive behavioral therapy 
– a sport adapted including endurance exercise (jogging, aerobics) and muscle building 
– other techniques such as electrotherapy, application of heat, gentle massage, acupuncture, relaxation therapy, relaxation, physiotherapy, meditation …

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