By Iris Joussen
On the occasion of the World Day of Fibromyalgia, May 12, zoom on this disease recognized since 1992 by the WHO as a rheumatic disease.
What is it ?
Fibromyalgia is characterized by the appearance of diffuse muscle pain, chronic and multiple well as fatigue, accompanied by sleep disorders.
That can be achieved?
Fibromyalgia affects about 1-3% of the population and 2 to 3 million French would be achieved. Its distribution is very uneven: it mainly affects people living in Western countries, in urban areas, and women (80%) between 30 and 50 years. However, fibromyalgia has also been diagnosed in children.
What are the causes ?
It is difficult to determine the causes of fibromyalgia are certainly numerous. Sensitization of the nervous system was observed but it is unclear whether this is a cause rather than a consequence of disease. It was also found that fibromyalgia often occurred after a violent emotional shock, a major injury or a viral illness. The frequent association of sleep disorders and depression did consider the possibility of deficiency neurohormones (hormones of the nervous system), including serotonin, the hormone of humor. Furthermore, the existence of hereditary cases ( “mother-daughter”) could suggest the involvement of a genetic factor. Finally, the Massachusetts researchers found that 50% of patients presented to the skin (especially the legs) of damaged nerve fibers, thus evoking a neurological disease called “small fiber neuropathy”, often found in diabetics.
How to recognize fibromyalgia?
There are no recognized test 100% reliable for diagnosing fibromyalgia. Difficult to find objective criteria because the people can have normal laboratory analysis and many of the symptoms are also found in other diseases (rheumatoid arthritis, osteoporosis …). In most cases, there is a diagnosis of exclusion. The most widely accepted classification criteria, developed in 1990 ( “1990 ACR criteria”) by the American College of Rheumatology, define fibromyalgia according to the presence of the following:
– A widespread pain throughout the body for over three months, affecting all of the four quadrants of the body (both sides, above and below the belt),
– At least 11 points painful to pressure among 18 defined points (points Yunus), although pain may also occur in other areas of the body.
Location of nine pairs of tender points that meet the criteria of the American College of Rheumatology for fibromyalgia (ACR 1990).
Note that the location and number of tender points can vary depending on the time and / or circumstances. The most painful areas are close to the spine, such as the neck, shoulders, the area between the two shoulders, shoulder blades, lower back, hips. The pain is localized in the muscles surrounding the joints. Beyond these diffuse or localized pain, the main symptoms are sensitivity of the extremities (dysesthesia, numbness, feeling cold), and muscle contractures (in 90% of cases).
Other symptoms include:
– Sleep disorders (85-90%) as sleep apnea,
– A decrease in physical performance (fatigue, loss of libido …) and intellectual (lack of concentration, loss of short term memory, difficulty in expressing ideation)
– Digestive disorders: chronic colitis (in 70% of cases)
– Of anxiety and depression syndromes (86% of cases)
– Migraines or headaches (40-50%),
– Very painful menstrual cramps, vaginal pain and “dyspareunia” (pain during intercourse)
– Urinary incontinence,
– Hearing problems (hearing loss, ringing or tinnitus) and temporomandibular (bruxism, jaw deviation, difficulty swallowing, dental occlusion) …
100 fibromyalgia symptoms, by the National Association Fibromyalgia SOS.
How can I treat fibromyalgia?
Misunderstood disease, fibromyalgia has been a considerable number of therapeutic attempts often concluded in failure. While some drugs have been effective in testing but it is difficult to extrapolate the results, as the symptoms are varied from one person to another. Thus an ineffective treatment against pain can be useful for its effects on sleep or fatigue, and vice versa.
Treatment of fibromyalgia
• the most frequently prescribed drugs:
– Analgesics against pain
• non-drug Techniques:
– Physical rehabilitation,
– Cognitive and behavioral therapies have proven effective on pain, fatigue and mood,
– Relaxation or hypnosis
What are the consequences ?
The evolution of fibromyalgia is chronic. The tender points remain fairly constant but other symptoms may change. Some symptoms include pain, stiffness and fatigue limit the functional abilities in daily or professional activities. In particular, repeated tasks involving muscular effort or lifting arms are hardly supported. However, despite the significant challenges that the disease imposes on daily life, all people do not become dependent or disabled. The reorganization or re-orientation of the work and the maintenance of physical activity, albeit reduced, are essential. The national medicine recommends a test Academy (QIF quiz) to measure the impact of fibromyalgia on the quality of daily life.