Fibromyalgia is the second most prevalent rheumatic disease, second only to osteoarthritis. On the occasion of World Fibromyalgia Day, Dr. Mayoral Rojals, coordinator of the Teknon Pain Clinic in Barcelona and member of Top Doctors, reflects on this disease that affects between 2 and 8% of the population.
The main characteristic of fibromyalgia is diffuse and chronic musculoskeletal pain, not attributable to joint pathology. The pain is more pronounced at certain points known as “tender points”, which help in its diagnosis according to the criteria of the American College of Rheumatology (ACR) published in 1990, although revised and modified in 2011. These latest diagnostic criteria incorporate other long-known symptoms that help to complete the diagnosis: chronic fatigue, cognitive disturbances (difficulty concentrating and memory problems), insomnia or unrefreshing sleep, lower abdominal pain, depression and headache.
It is a complex syndrome for which no specific diagnostic test or reliable marker is available.
Who is affected by fibromyalgia?
This pathology does not respect age groups, socioeconomic groups or ethnicities. There seems to be a familial association, with a greater predisposition in first-degree relatives. On the other hand, it is clearly more frequent in women, which reinforces the theories of a genetic basis.
Patients with repetitive episodes of severe pain with an organic basis, for example arthritis or whiplash, conditioned by a stressor, are also more likely to suffer from fibromyalgia.
People suffering from fibromyalgia are affected in their routine, both by pain and by the rest of the symptoms. There are patients whose pain only interferes with their work or instrumental activities, but there are others in whom the most basic activities of daily living are clearly affected. Fibromyalgia can be a truly disabling disease.
Unfortunately, in more than a few patients pain, fatigue, insomnia and memory disorders become the focus of their lives.
Treatment of fibromyalgia
Once the diagnosis is made, it makes sense to address all the symptoms of fibromyalgia that impair the patient’s quality of life, not just the pain.
Not all pain units are specialized in the treatment of fibromyalgia. Thus, when the severity requires specialized care, it requires a multidisciplinary approach that should always include cognitive-behavioral treatment and other psychological therapies performed by expert pain psychologists. Multidisciplinary therapy in a pain unit has the highest degree of scientific evidence, obtaining clear and surprising improvements both in pain and in the emotional and cognitive spheres. In earlier and less severe stages, pharmacological treatment and simple aerobic exercise accompanied by proper nutrition may be sufficient. Alternative therapies such as acupuncture are especially useful in this multidisciplinary therapy, especially in those patients who cannot tolerate pharmacological treatment or are unable to maintain an aerobic exercise program.
Teknon Pain Clinic Fibromyalgia Unit
Clínica del Dolor Teknon, a multidisciplinary center that aims to diagnose, manage and treat chronic pain, has recently created its Fibromyalgia Unit. It involves professionals from different specialties (Rheumatology, Pain, Endocrinology, Nutrition, Psychology, Acupuncture and Physiotherapy, among others) to provide the best guarantees of a correct diagnosis and also coordinate the different personalized treatments for each patient, since they take into account that there is no universal treatment.
Pain is a holistic and multidimensional phenomenon, so all potentially modifiable factors must be analyzed and addressed. Not only pain has to be treated, but also underlying diseases associated with fibromyalgia such as rheumatoid arthritis, lupus, irritable bowel disease, insomnia, chronic fatigue, depression or generalized anxiety disorder, among others.
In this Fibromyalgia Unit, the patient will find an empathetic environment with professionals motivated to offer the best treatment, provide clear information and accompany him/her in the process until he/she gets better.