Fibromyalgia is the second most common rheumatic disorder behind osteoarthritis and is still largely unknown. It is now considered a permanent disorder of the central nervous system responsible for the increase in pain caused by the body. Daniel Clauw, MD, professor of anesthesiology at the University of Michigan, examined the neurological basis of fibromyalgia at a plenary conference today at the American Pain So Scientific annual meeting.
Clauw explained that the pain of fibromyalgia stems more from the brain and spinal cord than from areas of the body where a person may experience peripheral pain. It is thought that this disease is associated with changes in the way the brain treats pain and other sensory information. He added that doctors should suspect that patients with fibromyalgia have multifocal pain (mainly musculoskeletal) that is not completely explained by injury or inflammation.
“Since pain tests throughout the body are amplified in patients with fibromyalgia, pain can occur anywhere, such as chronic headaches, visceral pain and sensory hypersensitivity are common in patients with fibromyalgia. people with this condition, painful condition, “said Clauw.
“This does not mean that the peripheral nociceptive supply does not contribute to pain in patients with fibromyalgia, but they experience more pain than is normally expected from the degree of peripheral entry.” Fibromyalgia and other painful conditions “feel the pain that worries them, that has not described the disease as a pressure,” Clauw added.
Because of the origin of central nervous system pain in fibromyalgia, Clauw stated that opioids and other narcotic analgesics are generally not effective because they do not reduce the activity of neurotransmitters in the brain. “These medications have not proven effective in patients with fibromyalgia and there are signs that opioids can even exacerbate fibromyalgia and other major pain,” he said.
Clauw recommends that physicians integrate pharmacological treatments such as gabapentin, selective and tricyclic serotonin reuptake inhibitors, non-pharmacological methods such as cognitive behavioral therapy, exercise and stress reduction. .
“Sometimes, the amount of therapeutic response to simple and inexpensive medical treatment outweighs the medication,” Clauw said. “The main benefit is the improvement of performance, which should be the main goal of treatment for any chronic pain condition. Most patients with fibromyalgia can see how they improve their symptoms and lead a normal life with appropriate medications and the intensive use of non-pharmacological therapies. “
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“Fibromyalgia can be considered as a separate disease and as a common way of centralizing pain and becoming chronic. Most people with this disease have chronic pain throughout their lives, said Clauw: “The disease can be difficult to diagnose if you do not know the classic symptoms because there is no single cause or external signs.”