2023-05-14 22:00:54
- Currently it is estimated that between 2 and 5% of the population worldwide suffers from fibromyalgia.
- One of the most famous patients with this condition was the creator of the modern model of nursing, Florence Nightingale.
- It is a chronic musculoskeletal pain disease that has no cure but can be treated.
The National Institute of Psychiatry “Ramón de la Fuente Muñiz” provides care to patients diagnosed with fibromyalgia. It is a rheumatological condition that causes chronic pain and fatigue, is disabling, invisible, unpredictable and uncontrollable.
In the institute’s Outpatient Rehabilitation Department, the approach to this condition is comprehensive and multidisciplinary, with the purpose of improving the medical, psychological and psychiatric conditions in which the patient finds himself or herself.
List with its main symptoms
The specialist attached to this department, María Isabel Barrera Villalpando, said that this disease is characterized by widespread pain in any part of the body such as head, joints, muscles or ligaments, fatigue, irritable bowel syndrome, concentration problems and high levels of depression and anxiety.
The person states that the pain is combined with burning and they experience a sensation of cramps and electric shocks; In addition, it causes sleep disturbances and morning stiffness, leading to trouble getting up. Frequently, fibromyalgia crises are exacerbated by heat, humidity, cold and are often very sensitive to noise, lights and certain smells, he explained.
“The characteristic pain of fibromyalgia is neuropathic; It refers to a malfunction in the nerve fibers, without damage to any organ or structure of the body. This neuropathic pain is also shown in people with diabetic foot or herpes zoster; It is a nuisance that burns, which causes them not to tolerate even the rubbing of their clothes”.
How is its diagnosis achieved?
The doctor in Psychology indicated that other criteria to consider that it is fibromyalgia is the hypersensitivity at specific points on the body that lasts for at least six months. There are also problems with concentration and anxiety.
He clarified that there are no laboratory studies for its diagnosis, so it is important that the rheumatology specialist rule out other diseases before confirmation through the clinical interview. Appropriate pharmacological treatment avoids unnecessary or excessive supply of drugs.
The fibromyalgia has a strong genetic predisposition, it is common for members of a family to develop this condition.
He stated that the differential diagnosis should be made with diseases such as rheumatoid arthritis, systemic lupus erythematosus, chronic fatigue syndrome (now called myalgic encephalomyelitis), Sjögren’s syndrome, polymyalgia rheumatica and neuropathies, among others.
He stressed that the fibromyalgia it affects between two and five percent of the population worldwide, generally from the age of 40; of every 100 cases, 90 are women and 10 men.
The specialist highlighted that the psychological treatment for better pain management is based on contextual cognitive behavioral therapy, a model that works with the relationship between thoughts, emotions and behaviors, with emphasis on the triggering and maintenance factors that a patient presents with strong histories of physical, psychological and/or sexual abuse from childhood.
The therapy also contemplates working with psychiatric disorders such as anxiety and depression that maintain or aggravate the fibromyalgia.
The also author of the Stress and mental health manual specified that up to 80 percent of people with fibromyalgia have had a moderate to severe depression problem. While 60 percent have presented some anxiety disorder and the high association with post-traumatic stress is frequent.
More recent works on the disease
Recent research on this disease shows the existence of dysautonomia, that is, a malfunction of the autonomic nervous system that controls automatic responses in the body such as heart rate, blood pressure, temperature, and intestinal motility, among others.
Likewise, increased activity of the sympathetic nervous system has been detected at night, which could explain the unrefreshing rest in patients.
Recent studies by the Department of Rheumatology of the National Institute of Cardiology and the Hospital for Blindness highlight that fibromyalgia is a fine fiber neuropathy. It was found that in the cornea there are fewer of these fibers and they are thinner. Probably in the future it could be considered as a biological marker for the diagnosis of this condition.
The specialist explained that another area of research reports significant dysfunction in the mitochondria, which would explain the lack of energy that characterizes these patients. In this sense, adequate nutrition and good oxygenation are essential so that this part of the cell that provides energy has enough nutrients that help reduce or prevent chronic fatigue.
He indicated that in women an association of certain hormones that influence the fibers that transmit pain has been found.
Among the recommendations for those who suffer from this condition, detailed the scientific advisor, are performing low-impact exercise free of pressure, practicing tai chi, yoga, walking, water aerobics, hydrotherapy in warm water and relaxing swimming.
He advised following the milpa diet, which includes corn, beans, fruits -which provide vitamins-, and vegetables that provide important minerals such as magnesium, zinc and potassium, among others.
He added that for his psychiatric treatment antidepressants (serotonin and norepinephrine reuptake inhibitors) or some tricyclics are used. Pain modulators that relieve neuropathic discomfort are also prescribed.
The National Institute of Psychiatry offers psychoeducational and informative sessions for patients, family members, and the general public to address this little-known condition, not only in Mexico, but throughout the world.
In addition, contextual cognitive behavioral group therapy is provided for fibromyalgia and other painful disorders, in which other health professionals such as nutritionists, biologists, and psychologists and psychiatrists specializing in violence also participate.
He World Fibromyalgia Day was instituted by the World Health Organization (WHO)in tribute to the nurse Florence Nightingale, who suffered from this disease. Nightingale founded the first modern nursing school and was an advocate for the rights of people living with disabilities.
Also read:
Chart of the Day: 10 Celebrities Diagnosed With Fibromyalgia
The importance of a multidisciplinary approach to combat pain
World Pain Day: How should medical care be?
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