Fibromyalgia, a poorly understood disease that hurts – A la une

The 29th World Fibromyalgia Day is celebrated on May 12, 2022.

Firomyagia is a very complex and difficult to understand disease. This is because of its very variable symptoms and its repercussions on various organs. Indeed it is defined as “a syndrome consisting of chronic symptoms of moderate to severe intensity including diffuse pain without apparent cause and sensitivity to pressure, associated with fatigue, cognitive and sleep disorders and numerous somatic complaints. “. It was recognized as a medical entity by the World Health Organization (WHO) in 1992.

According to the report from the Ministry of Solidarity and Health, published on October 08, 2020, the prevalence of fibromyalgia was estimated at 1.6% of the adult population, or approximately 1.2 million people with a female predominance in France. In Canada, the incidence rate of fibromyalgia is between 3.3% and 5%, or 260,000 to 400,000 people only in Quebec, according to the Laval fibromyalgia association.

Fibromyalgia is manifested by preponderant diffuse pain for at least 03 months, generally in the muscles, with burning sensation, stabbing without any apparent cause. These are accompanied by other signs and symptoms which differ according to the different systems and organs affected. Thus, according to the literature we can observe:

The level of musculoskeletal system it is manifested by: generalized stiffness, muscle cramps and chest pain.

The level of the nervous system, there is persistent fatigue, lack of endurance, migraines and headache. The sensory system is marked by hypersensitivity to pain, hyperactivity to noxious stimuli, perceptual and dimensional distortion, burning and swelling sensation, and sensory overload phenomenon. On the cognitive side, there is difficulty managing information, cognitive deficit, concentration disorders, confusion, misuse of words, short-term memory problems. Motor skills and balance are also affected by muscle weakness, lack of balance, clumsiness and a tendency to drop objects, difficulty walking the tightrope walker, numbness or tingling.

Furthermore the sleep disorders are characterized by hypersomnia or insomnia, non-restorative sleep, sleep apnea.

Le neuroendocrine system is marked by a sudden change in weight, heat and/or cold intolerance, mood swings, anxiety and reactive depression.

From visual and auditory disturbances are also identified by changes or pain in the eyes, double, blurred or twisty vision, dry or itchy eyes, photophobia, tinnitus, interference caused by noise.

The level of circulatory systemthere is orthostatic hypotension, fainting or dizziness, palpitations and tachycardia, fluid retention and bruising.

Le digestive system, is marked by lump in the throat, nausea, heartburn, abdominal pain and irritable bowel syndrome. As to urinary system there is a bladder disorder and an overactive bladder.

The level of reproductive systemit can cause endometriosis, an irregular monthly cycle, loss of libido or impotence and anorgasmia.

No laboratory analysis and medical imaging can currently diagnose fibromyalgia. But, it is important to do a simple basic blood test in order to rule out conditions whose symptoms may be similar to those of fibromyalgia. The diagnosis of fibromyalgia is therefore based on the patient’s symptoms.. This is based on the questions and the physical examination, which seek to highlight both the symptoms of fibromyalgia and the associated conditions.

Support involves several parameters such as:

Physical activity adapted and regular to reintegrate movement into daily life. The physical activities most often recommended are walking, which stimulates the bone, muscle and ligament systems. This helps maintain joint flexibility and muscle mass, while training the respiratory and cardiovascular system; stretching exercises that help increase flexibility and reduce injuries; aqua fitness in hot water 1 to 3 times per week. This relaxes the muscles and works the cardiovascular system.

massage therapy which improves blood circulation, reduces muscle pain, releases tension and restores range of motion.

Psychotherapy which aims to improve psychological, physical and functional well-being and quality of life; to promote self-esteem and a sense of self-efficacy; encourage the mobilization of varied adaptive coping strategies and reduce stress.

Therapeutic patient education which aims to allow the patient to become an actor of his health. It aims to help patients and their loved ones understand the chronic disease and its treatments in order to improve their quality of life.

Targeted pharmacological treatment. This uses antiepileptics, antidepressants, nonsteroidal anti-inflammatory drugs, psychotropic drugs.

The recommendations to improve the health course and the quality of life of people affected, by the Ministry of Solidarity and Health in a press kit distributed in October 2020, by the collective expertise of INSERM. These revolve around four axes:

– Better inform health personnel about fibromyalgia and new recommendations to reduce; the general public to understand pain and its management, empower patients and reduce the stigma associated with persistent pain;

– Diagnose earlier by strengthening the capacities of health professionals, by developing the intervention of expert patients with fibromyalgia;

– Better structure chronic pain and fibromyalgia;

– Strengthen research on chronic pain and fibromyalgia.

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