Fibromyalgia Syndrome

Fibromyalgia syndrome


     Fibromyalgia is a musculoskeletal pain syndrome with chronic evolution, characterized by diffuse chronic pain lasting more than 3 months. The intake of antidepressants in the fibromyalgia treatment has been mentioned in literature. Fibromyalgia (fibrosis) is a musculoskeletal pain syndrome with chronic evolution, met more frequently in women of middle age, without a lesion explanation, characterized by diffuse chronic pain lasting more than 3 months, pain caused by pressure of at least 11 points of 18 specific pain points (the American College Rheumatology-ACR criteria).

     In addition to these events other symptoms are present: cutaneous hyperesthesia, paresthesia, contraction, insomnia, non-repairable sleep, feeling of swollen extremities, abdominal pain, abnormal transit, headache, irritable bladder, anxiety, depression, morning fatigue, dizziness.

     Fibromyalgia prevalence is 3.4% in women and 0.5% in men in the U.S.

    

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 In the fibromyalgia syndrome etiopathogenesis are incriminated many factors, including physical or mental trauma. Psychiatric disorders are constant, by reference to a mental over morbidity. Association with depression, masked depression, dysthymic, panic disorder, simple phobias are common, between 68% for depression and 16% for anxiety, obviously contributing to the impaired of the functional capacity and decreased quality of life. The involvement of other psychosomatic syndromes, chronic fatigue syndrome, irritable bowel, confirms that fibromyalgia syndrome is a part of the functional disorder category.


Studies on fibromyalgia syndrome


     Findings of a large study showed that patients with irritable bowel syndrome have an increased risk of developing fibromyalgia syndrome. Previous research that has made the connection between irritable bowel syndrome and the disease were based on data obtained in the findings of some small clinical trials, said the study author Dr. J. Alexander Cole and his colleagues at Boston University.

     Because of methodological difficulties such as the lack of a reference group and the inability of a full control of precipitating factors, there could not been draw a definitive conclusion from these studies. The present study analyzes more than 125,000 patients and does include a reference group. Subjects were drawn from a larger database, those who associated irritable bowel syndrome and those who also were in the reference group.

     The study showed that in comparison with the subjects from the reference group who did not associate the irritable bowel syndrome, those with this disease were 60% more likely to develop fibromyalgia syndrome. The high risk of developing fibromyalgia was of 80%. The authors concluded that the survey results come to confirm previous studies in which these 2 diseases have the same biological mechanism on base.


Fibromyalgia syndrome today


     

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Fibromyalgia was formerly defined as a psychological illness due to absence of clinical signs at physical examination and laboratory tests and imaging. Many doctors still do not accept fibromyalgia syndrome as a disease in its own right. However recent studies and clinical investigations have clarified the neurophysiologic basis for fibromyalgia syndrome that leads to a redefinition of central sensitivity syndrome.

     Today fibromyalgia is considered a neural sensorial disorder characterized in part by the central nervous system abnormalities in pain processing. The increasing understanding the biological basis of fibromyalgia has led to new pharmacological treatments for this condition.


Clinical fibromyalgia syndrome


     Clinical fibromyalgia pain is more than widespread. This overlap over other central sensitivity syndromes: chronic fatigue syndrome, irritable bowel syndrome, chronic pelvic pain syndrome / primary dysmenorrheal, temporal mandible joint pain, headaches, diseases of posttraumatic stress, periodic limb movements, restless leg syndrome, interstitial cystitis, regional pain syndromes and behavioral changes with anxiety.

     Fibromyalgia syndrome development involves elements of vulnerability: the female gender, genetics, the abuse or other traumatic experiences in childhood when the brain is still developing and persistent stress or distress. Predictors of acute pain progression to chronic pain are the high levels of anxiety and distress, slow delivery of pain and a history of trauma.