Fibromyalgia is a rheumatic disorder second most common behind osteoarthritis and although still widely misunderstood, is now considered a disorder of the central nervous system to life, which is responsible for the pain amplified that shoots through the body at those who suffer.
Daniel Clauw, MD, Professor of Anesthesiology, University of Michigan, analyzed the neurological basis of fibromyalgia at a plenary session today at the annual scientific meeting of the American Pain Society.
“Fibromyalgia can be considered both as a discrete disease and also as a final common pathway of centralization and chronology of pain. Most people with this condition have a history of long-term chronic pain in their bodies, “said Clauw. “The condition can be difficult to diagnose if one does not know the classic symptoms because there is no single cause and no external sign.”
Clauw explained that the pain of fibromyalgia is more the brain and spinal cord that areas of the body in which a person suffers from peripheral pain. The condition is considered to be associated with disturbances in the way the brain processes pain and other sensory information. He said doctors should suspect fibromyalgia in patients with multifocal pain (primarily musculoskeletal) that does not fully explain by injury or inflammation.
“Because the pain pathways throughout the body are amplified in fibromyalgia patients, pain can occur anywhere, so that chronic headaches, visceral pain and sensory hypersensitivity are common in people suffering from this painful condition, “said Clauw.
“This does not imply that the peripheral nociceptive input does not contribute to the pain suffered by fibromyalgia patients, but they feel more pain than what would normally be expected from the degree of peripheral contribution. People with fibromyalgia and other states of pain characterized by awareness will feel the pain From that those whose condition does not describe as touch, “said Clauw.
Due to the origin of the central nervous system of fibromyalgia pain, Clauw said that treatment with opioids and other narcotic analgesics are generally not effective because they do not reduce the activity of neurotransmitters in the brain . “These drugs have never been considered effective in patients with fibromyalgia, and there are signs that opioids might even worsen fibromyalgia and other states of central pain,” he said.
Clauw advises clinicians to integrate pharmacological treatments, such as gabapentinoids the trycycliques and inhibitors of serotonin reuptake, with non-pharmacological approaches such as cognitive behavioral therapy, exercise and stress reduction.
“Sometimes the scale of the response to treatment for simple and inexpensive non-drug therapies exceeds that of pharmaceutical products,” said Clauw. “The biggest benefit is the improved function, which should be the main goal of treatment for any chronic pain. The majority of fibromyalgia patients can see an improvement in their symptoms and live a normal life with the right medications and intensive use of non-drug therapies. “
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