Fibromyalgia and chronic fatigue syndrome: when fatigue and pain become chronic

Pain and exhaustion are some common symptoms that if they become chronic can cause concern.

It is estimated that between 2 and 10% of the population in general can be affected, with more cases occurring in women. Early diagnosis is important

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Since 1992, the World Health Organization (WHO) has recognized Fibromyalgia , one of the most common conditions of chronic pain, within its International Classification of Diseases . Between 2 to 10% of the general population can be affected, being nine times more frequent in women.

What symptoms should we attend to? What progress is there in your diagnosis and treatment? What is your relationship with Chronic Fatigue Syndrome? The Dra. Evangelina Melgar (MN 133,847), medical psychiatric and coordinator of the clinic patients with fibromyalgia and chronic fatigue INECO , provides keys to understanding these pathologies that can affect activities of daily living and interpersonal relationships of those who suffer .

Generally, fibromyalgia manifests as of 30-40 years although, in smaller percentage, it can appear in childhood and adolescence. The main symptom is generalized musculoskeletal pain, which worsens at the pressure of tender points. The intensity of pain varies influenced by climatic changes, physical activity, psychological stress or lack of sleep. It usually starts in one region of the body and migrates through different areas, until it becomes generalized over time.

90% of patients experience fatigue, 70-80% sleep disorders and up to 25% anxiety or depression. Poor tolerance to effort is also common; the feeling of heaviness in limbs;generalized rigidity (especially when getting up in the morning); feeling of inflammation and ill-defined tingling in the hands and feet. It may be associated with headaches, dizziness, cognitive failures in memory and attention, bruxism, gastrointestinal symptoms, such as irritable bowel syndrome, dyspepsia, nausea. The presence of these symptoms or associated syndromes varies in each person.

Fatigue itself is a symptom that can be found in multiple tables, but Chronic Fatigue Syndrome (CFS), also called myalgic encephalomyelitis, is a clinical entity recognized by all international medical organizations and by WHO . Only 8% of the time fibromyalgia is associated with CFS .

The syndrome can appear at any age, even in childhood, but it is more frequent in women between 20 and 40 years old. In many cases, it begins abruptly after an infectious episode, or a physical or psychic trauma, such as surgery, accidents or the death of a loved one. In others, it appears gradually. It can last many months and even years; only a small percentage recovers completely.

The SFC is characterized by extreme fatigue lasting more than 6 months and not relieved by rest, associated with another group of symptoms that are also constant for more than 6 months. Among them: sleep disorders, muscle or joint pains, headaches, sore throat, concentration and memory failures, the feeling of being dizzy or sick. The severity of symptoms varies from day to day.

Early diagnosis is the key to success

While the causes of both pathologies are unknown, genetic factors could predispose to the development of fibromyalgia, while for Chronic Fatigue Syndrome (CFS) there are many theories, ranging from their relationship with viral infections to psychological stress.

The diagnosis of both pathologies is eminently clinical. At the moment, there are no complementary studies that confirm them, it is established in an interview with the professional, in which the patient describes the symptoms. Some scales are used: questionnaires about the pain in the different regions of the body and about the severity of the symptoms, where the presence of cognitive alterations, of sleep, fatigue and other somatic symptoms is evaluated. It is also recommended the evaluation of a rheumatologist specialist to rule out associated pathologies or those that share similar symptoms.

Early diagnosis is the main challenge presented by these diseases, to avoid their chronicity and greater impact on the functionality of the person, improving their quality of life.

Properly reporting on these pathologies should be the first step of treatment. The patient must know from the beginning the characteristics of the disease, its evolution, as well as the positive and realistic expectations that enhance its collaboration with the therapies, trusting in a probable improvement.

There is consensus that physical exercise programs should be one of the basic treatments for all patients with fibromyalgia . For example, morning stiffness, characteristic symptom, is due to alterations in the microcirculation that generate the sensation of numbness and cause difficulty and pain when moving after long periods of stillness.

In this sense, daily stretching and oxygenation exercises are indicated, as well as aerobic physical activity, not intense. The anaerobic ones are not recommended, since they would worsen the sensation of heaviness and pain.

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