By Writing Allodocteurs.fr
Widespread pain in muscles, joints, tendons, intense fatigue … The symptoms of fibromyalgia can be extremely debilitating. In France, the treatment of this disease remains unknown varies from one patient to another. A parliamentary inquiry will look at this disease in order to develop recommendations for better management of patients.
Points highly targeted pain
In France, fibromyalgia affects more than a million and a half people. In 90% of cases, it is women. Fibromyalgia is characterized by widespread pain, sometimes felt like burns and affect the muscles, tendons, joints …
Fibromyalgia is a malfunction in the modulation of pain. When bumps for example, nerves transmit electrical messages to the brain which converts it to feel pain. In case of fibromyalgia, pain circuit is disturbed. He is hyperactive. The brain can no longer decode the sensations, which leads to continuous and diffuse pain.
If there is no significant biological marker of fibromyalgia, it is possible to make a clinical diagnosis. In fibromyalgia patients, 18 pressure points are particularly sensitive to the touch, such as the neck, trapezius, elbows, the hip joint or knee. When 11 of the 18 points are painful, this is called fibromyalgia.
Continuous fatigue and disturbed sleep may also be part of the symptoms. The origins of fibromyalgia are still unclear. It has also long been considered an imaginary or psychological illness. Since 1992, fibromyalgia is now recognized by the World Health Organisation and listed in musculoskeletal diseases.
Before being recognized in 1992 as rheumatic disease by the World Health Organization, fibromyalgia was considered a psychiatric disorder by doctors. Laboratory tests are normal patients and those around often difficult to believe that they are really suffering, making it difficult for doctors to put a name to this pathology.
Viral? Psychological? For over a quarter century, several theories have been advanced to explain it. Some speak of a viral origin, such as herpes or shingles, which could also be triggering factors. Others have thought of biochemical disorders or psychological disturbances. But what is certain is that people with fibromyalgia are hypersensitive to pain.
Poor transmission of sensations. Normally, pain is perceived through a nerve that acts as a receptor and which conveys this feeling as an electric message. Then, the brain decodes this information and the module and it is only at this point that we actually perceive the sensation of pain. In fibromyalgia, this circuit is very active, the brain no longer able to properly analyze the pain messages, it is deregulated and therefore the patient has trouble constantly.
Fibromyalgia affects much the quality of life of patients. To further accompany the pain treatment center of Cochin Hospital in Paris offers therapeutic education workshops. Called “Fibroschool”, they allow small groups of patients to share their experiences and develop cognitive behavioral therapy strategies to better manage the disease and to fight against pain.
Relaxation therapy: learning to manage pain
Roselyne is 57 years old. She suffers from fibromyalgia and practice relaxation therapy, sessions that allow them to better manage muscle pain.
Fibromyalgia: the therapeutic role of sport
Patients with fibromyalgia often arrested sport for fear of having more pain after exercise. But at Grenoble University Hospital, the Sports Rehabilitation division has taken this issue against the foot and offers patients to gradually resume a sporting activity to fight against fatigue and pain.
Before starting the sports program, patients undergo a stress test to assess possible against-indications but also to see the patient’s level of fitness. On the program: spa, relaxation and bicycles apartment … These workouts are designed to increase muscle tone in patients, to give them confidence in the motion and so improve their quality of life.
Each year, 80 patients following this 6 month internship. 50% of them find a significant reduction in pain and fatigue and 25% moderate improvement.
Fibromyalgia can it be cured?
There is currently no cure for fibromyalgia. The treatment is intended only to relieve pain and other symptoms such as sleep disorders.
Although psychological cause is not always the cause of fibromyalgia, psychotherapy is often associated with treatment. Chronic pain affects seriously indeed the quality of life and often has an impact on mood.
Fibromyalgia: cryotherapy to relieve pain
In the long term, the analgesic intake can cause problems. An alternative for pain relief is cryotherapy, ie the use of cold.
Cryotherapy is a technique of exposing the cold, to -160 ° C, the body of patients with chronic pain. “Patients spend three minutes in the cold inside a cabin. This is the maximum time which can be left inside knowing that we won first therapeutic effects at -110 ° C. It is in survival mode in the cold and our brain releases mediators that allow us to protect ourselves, including analgesics, anti-inflammatories and antioxidants, “explains Vincent Jacquet, physiotherapy. But this intense cold is hard to bear.
There are cons-indications for cryotherapy and this practice should be tightly controlled. The cons-indications are especially cardiovascular order (no pacemaker, heart failure, arterial problems …). Kidney problems are also an against-indication. It is therefore imperative to consult a doctor before cryotherapy session.
Under the effect of the cold, the blood rushes to the vital organs which drains muscles of their toxins. And to warm the body intensifies the blood circulation which relaxes the muscles, eliminates fatigue and reduces pain.
A total of ten consecutive sessions are necessary to reduce the pain that causes fibromyalgia. Generally, the benefits of this treatment may last up to six months.
Fibromyalgia: the interest of osteopathy in the study
To mitigate the very specific pain of fibromyalgia, patients often resort to drugs but also various manual therapies. The Assistance Publique – Hôpitaux de Paris has recently launched a study to assess the interest of osteopathy in the management of fibromyalgia patients.
A clinical study is currently underway on the interest of osteopathy in the treatment of fibromyalgia. Each participant completes a detailed questionnaire: medical history, pain intensity and impact on quality of life … Many parameters are evaluated. “Unfortunately in pain, there is no biological element or a radiological examination to assess improvement. The only way we have is these questionnaires. At the end of each questionnaire is obtained a score and an interpretation of the score. this allows us to make a comparison between two groups, “says Terkia Medcour attached clinical research.
This is indeed a double-blind study. One group will receive supported osteopathy sessions and the other lighter handling. The objective is to measure the effects. Patients ignore what osteopathic treatment concerns.
Mechanically working pressure and stretching, the doctor seeks to reduce muscle tension due to fibromyalgia: “There is a complete disruption of the nervous system pain, which on the one hand that the perception threshold is very depressed, people experience pain in situations that are not normally painful. and secondly, this disorder is such that in some cases can make your own pains that have no logical reason to exist. with manual processing, there is a part of stimulations is exerted on the joints, muscles, bones … that can act on the nervous system and inhibit somehow making this pain. C ‘ is what we hope so, “warns Dr. Jean-Yves Maigne, rheumatologist. Protocol requires the patient has 48 hours to describe his feelings about his liaison book.
To participate in the study, diagnosis of fibromyalgia must be made for at least one year. 150 patients will be recruited. The team hopes to publish the results of the study stream in 2018.