Pain, tiredness, memory loss … why fibromyalgia has no cure

“It’s terrible that no one believes you. That nothing appears in the x-rays, neither in the resonances nor in the analytics, and that they tell you that the pain you are complaining about is psychological. For this reason, it was essential for me to be able to name my disease ”. Mari Carmen is 57 years old and has suffered from chronic pain for almost two decades. During the first years, she felt completely misunderstood : they did tests and more tests, but they blamed it all on lumbago and a deviated spine. It wasn’t until his visit to the rheumatologist that he got an answer, an explanation. “They told me I had fibromyalgia.”

Today, talking about fibromyalgia is not a rarity and is considered one of the most frequent causes of chronic pain . In fact, it is estimated that it affects 2.7% of the world population (2.4% in Spain); more common in women aged between 40 and 49 years. But, until 1991, fibromyalgia was not considered a disease by the World Health Organization. These episodes, characterized by bodily pain, fatigue, memory loss , difficulty concentrating and mood disturbances, were considered so nonspecific, so subjective, that patients suffering from them were quickly referred to mental health services .

Despite the fact that, in recent decades, the investigation of this disease has been deepened, it still remains a great unknown, as acknowledged by Dr. Manuel Romero , head of the Rheumatology service at the Quirónsalud Córdoba Hospital: “We still do not know what it is. exactly what causes this disease , but the most accepted theory is the one that indicates that there is a problem in the mechanism of pain transmission at the level of the central nervous system. This problem is known as the central sensitization phenomenon.. Patients perceive stimuli that come from outside, such as heat, cold or pressure, in a quite painful way, and, in addition, the response to control this pain (the body’s analgesic system) is also deficient ”. Central sensitization is much more common among women; in fact, it is estimated that 90% of people with fibromyalgia are women. In addition to genetic or female predisposition, other risk factors are family history, the presence of common headaches or back pain.

Before fibromyalgia came to be considered a disease and began to be taken into account, its symptoms were often identified with depressive problems. And it is true that chronic pain is very complex, that there are many factors that influence its perception and that vicious circles are frequently established in which the physical, emotional and mental planes intermingle, with obsessive thoughts, muscular tension, anxiety … It is important to understand that it is a multifactorial disease , in which psychological, environmental and organic factors are combined, as well as traumatic childhood experiences.

A disease that hides

Another problem traditionally associated with this disease is that it cannot be diagnosed or detected with any specific test. It does not show up on X-rays, tests, or a scan . It must be a specialist who assesses the symptoms —which, as we have already said, range from generalized pain and fatigue to joint stiffness, brain fog, depression and anxiety— and make a differential diagnosis from them.

Research, however, continues, and the latest advances are already showing clinical signs of this disease. Thus, explains Dr. Romero, “ changes have been detected in the field of pain transmission from the peripheral receptors in the joints, muscles or other organs, to the brain. These changes are produced as a consequence of imbalances in the concentration of certain neurotransmitters in the central nervous system ”.

Regular aerobic exercise, such as walking, cycling, or swimming, has been beneficial in improving pain and fatigue

While researchers continue their efforts to unravel the mechanisms of this disease, the idea is that the patient is able to cope with quality of life. The guide ‘ Learning to live with fibromyalgia ‘ , edited by the Spanish Society of Rheumatology, collects in a simple and affordable way information about the disease, diagnosis, treatment and advice on how to act on a day-to-day basis. This guide, says Dr. Romero, “is based on reliable and proven information, which helps the patient not to get carried away by myths and comments without scientific basis.”

Because, certainly, myths abound around fibromyalgia . One of the most common is that patients should not exercise; nothing is further from the truth: in fact, regular aerobic exercise, such as walking, cycling or swimming, has been beneficial in improving pain, fatigue and physical function in these patients. Of course, both the type of exercise and its intensity must be individualized.

No cure, but with treatment

Another belief that circulates is that fibromyalgia has no treatment. It is true that it is a chronic pain syndrome and that it has different causes in different affected patients, but there are approved medications that can help relieve symptoms . In the most serious cases, Dr. Romero points out, “the most advisable thing is to carry out a multidisciplinary and individualized approach, which includes medical treatment, psychotherapy and supervised physical exercise, in addition to the cooperation of other specialists, such as rehabilitators, physiotherapists, psychologists and psychiatrists. “.

Even when there is treatment and the patient can improve, it is important to remember that it is a chronic disease, for which there is still no cure available and that it will persist throughout the patient’s life and that it will evolve through outbreaks. These flare-ups are usually related to triggers, such as physical exertion, stressful situations, and seasonal changes . Among the lifestyle recommendations, experts advise a balanced diet — poor in sugars and saturated fats—, avoiding the consumption of toxins such as alcohol or tobacco, exercising and, very importantly, trying to avoid stressful situations.

Finally, it must be remembered that the success of a favorable evolution in the treatment of fibromyalgia lies in carrying out a comprehensive and personalized approach to each patient.

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