Fibromyalgia is the second most common rheumatic disorder behind osteoarthritis and, but still widely misunderstood, is now considered a permanent disorder of the central nervous system that is responsible for the increase in pain caused by the body. who suffers Daniel Clauw, MD, Professor of Anesthesiology at the University of Michigan, has analyzed the neurological basis for fibromyalgia at the plenary conference today at the annual scientific assembly of the American Pain So
Clauw explained that the pain of fibromyalgia comes more from the brain and spinal cord than from the areas of the body where anyone can experience peripheral pain. The condition is believed to be associated with alterations in the way the brain processes pain and other sensory information. He said doctors should suspect fibromyalgia patients with multifocal pain (mainly musculoskeletal) that is not fully explained by a wound or inflammation.
“Because pain pathways throughout the body are amplified in fibromyalgia patients, pain can occur anywhere, so chronic headache, visceral pain and sensory hyperresponsiveness are common in people with this condition. painful condition, “said Clauw.
“This does not mean that peripheral nociceptive input does not contribute to the pain of patients with fibromyalgia, but they feel more pain than would normally be expected from the degree of peripheral input.” People with fibromyalgia and other pain conditions, characterized by hypersensitivity to ‘pain experience than those who do not have the condition describe it as a touch, “added Clauw.
Because of the origin of fibromyalgia central nervous system pain, Clauw said that opioid and other narcotic analgesics are usually not effective because they do not reduce the activity of neurotransmitters in the brain. “These drugs have not proven effective in fibromyalgia patients, and there is evidence that opioids can even worsen fibromyalgia and other centralized pain conditions,” he said.
Clauw advises physicians to integrate pharmacological treatments, such as gabapentineides, tricyclics, and selective serotonin reuptake inhibitors, non-pharmacological approaches such as cognitive behavioral therapy, exercise, and stress reduction.
“Sometimes the size of the treatment response for a simple and inexpensive medical treatment outweigh the drugs,” said Clauw. “The biggest advantage is a better performance, which should be the main goal of treatment of any chronic pain condition. Most fibromyalgia patients can see symptoms improve and lead a normal life with the appropriate medication and the extensive use of non-pharmacological therapies. “
“Fibromyalgia can be seen both as a discrete disease and as a common end path for the centralization of pain and becomes chronic. Most people with this condition have chronic pain stories throughout their whole body life, “said Clauw. “The condition can be difficult to diagnose if you are not familiar with the classic symptoms because there is not a single cause and there are no external signs.”