Fibromyalgia is a pathology that manifests itself in chronic pain in the muscles and joints. This disease is also called fibrositis. It is characterized by anxiety and depression, poor sleep, a feeling of constant fatigue and disruption of the intestines.
Etiology
Fibromyalgia syndrome is most often registered among women 40-55 years old. In men, this pathology is diagnosed much less often - in only 16% of cases. Pain sensations with fibromyalgia have the ability to disappear and reappear, migrating throughout the body, so the diagnosis is difficult. At the same time, adult fibromyalgia is a common occurrence, as adolescents and children are very rarely affected by this disease, although they may experience periodic pain in the muscles or joints.
The causes of this disease are unknown. Often it develops in patients with concomitant rheumatoid arthritis. Provoking factors are constant stressful situations, overwork and depressive states. In some cases, a genetic predisposition to fibromyalgia is traced.
Features of fibrositis
It was previously believed that fibromyalgia is a pathological condition of inflammatory etiology, but today these assumptions are refuted, since there are no signs of inflammation or manifestations of arthritis. A feature of this disease is that patients record a low level of growth hormone. This can be attributed to the fact that with fibromyalgia, the phase of deep sleep is disturbed, and it is during this period that the pituitary gland is able to synthesize this hormonal compound.
It is also worth noting that patients with fibromyalgia experience pain even on the action of stimuli, which usually cannot be perceived as painful. In addition, patients have a high level of neurotransmitters (the so-called substance P), as well as growth factors in the cerebrospinal fluid (cerebrospinal fluid). If we study the nature of pain, we can assume the presence of hypersensitivity to the central nervous system, as well as the pathological perception of pain stimuli.
Also, patients diagnosed with fibromyalgia, the causes of which are unknown, have a history of severe physical or psychological trauma or a complex infectious disease. They also have a small number of slow eyeball movements during sleep, which leads to a feeling of being overwhelmed or to frequent night awakenings.
Clinic
When fibromyalgia develops, the symptoms of this disease include the following symptoms:
• fast muscle fatigue;
• “goosebumps”;
• sleep disturbance;
• general fatigue;
• frequent headaches;
• temporomandibular disorders in the form of pain in the face and jaw, as well as resonance in the ears.
Patients also have an imbalance in the mental sphere. So, when there is fibromyalgia, the symptoms of this pathology can include poor memory, impaired attention and emotional disorders, which are often described as depression.
Patients also complain of dizziness, pain in the abdomen, especially during palpation. Sometimes prolonged hyperthermia can be observed for no apparent reason. In addition, patients with fibromyalgia are prone to colds and note stiff joints in the morning (after waking up).
It should be noted that the course of the disease is stationary. Manifestations of fibromyalgia can be observed for many years, slightly changing under the influence of certain external factors. Pain, as a rule, are permanent, asymmetric or generalized. If the pain reaches a critical level, then they speak of a "fibrosite storm."
The peculiarity of the pain syndrome with fibromyalgia
When fibromyalgia is diagnosed, the symptoms of this disease in 100% of cases include pain. It has certain features:
• pain in the musculoskeletal system is common and can last more than six months;
• quite often, chronic pain syndrome with fibromyalgia is combined with the symptoms of other diseases;
• pain is accompanied by autonomic disorders and changes in the psychological sphere.
When fibromyalgia develops, symptoms may also include fluid retention, intestinal irritation, vestibular disorders, osteoporosis, and other disorders. Clinical manifestations in each case are individual and require careful diagnosis.
It should be noted that pain occurs in various parts of the body and can focus on both sides. Most often, pain is localized in the neck, shoulders and chest, that is, in the upper body. Areas that have an increased sensitivity are characterized by a clear location. So, when fibromyalgia occurs, the points of pain can act as a specific diagnostic criterion.
Tender Points (TP) - pain points for fibromyalgia
TRs are important modern criteria for the detection of fibromyalgia, although patients do not even know about their existence. These points are characterized by the following properties:
• for pain to occur, a slight pressure is needed;
• on palpation, pain is observed that occurs in the patient spontaneously;
• TRs are placed in strictly defined places, so there are specific maps of these areas.
It should be noted that the exact amount of TP is unknown, although it correlates with the intensity of the clinical manifestations. The most common localization of pain points is the nape of the neck, neck, area of the trapezius muscle, the place of attachment of the second rib to the sternum, the lateral portion of the shoulder, buttocks, as well as the medial fat pad in the area of the knee joint.
Despite the presence of TR, patients with fibromyalgia develop various algic syndromes with different localization. So, pain can be observed not only in the muscles, but also in the abdominal cavity or heart, which complicates the diagnosis. In addition, panic attacks, hyperventilation syndrome, loss of consciousness, and tunnel neuropathies are characteristic.
Features of the diagnosis of fibromyalgia
To date, there are no specific tests or examinations that would help to identify this disease. They are prescribed only to exclude other pathologies. Diagnosis is based on medical history and physical examination. It is with the identification of specific pain points and in the absence of other diseases that fibromyalgia can be detected.
It is worth remembering that many pathologies have a clinical course resembling fibromyalgia syndrome:
• hypothyroidism;
• vitamin D deficiency;
• hyperfunction of the parathyroid glands, which is accompanied by an increase in calcium levels;
• polymyositis or other lesions of muscle fibers;
• bone disease;
• oncopathology;
• infectious diseases.
As a rule, to exclude other lesions, the levels of thyroid hormones, alkaline phosphatase, creatine phosphokinase, as well as ESR, C-reactive protein, antinuclear factor and sialic acid are determined. With fibromyalgia, these indicators are within normal limits.
What are the criteria for making the correct diagnosis?
Fibromyalgia can be suspected in the following cases:
1. The patient has diffuse and symmetrical pain, which occurs spontaneously and is chronic (observed for 6 months or longer).
2. During the examination, 11 pain points from 18 generally accepted, which are characteristic of fibromyalgia, are revealed.
3. The absence of symptoms of any primary pathology.
It should be noted that in clinical practice it is not always possible to detect these criteria, but it is they who are guided by specialists in making the diagnosis. A combination of depressive disorders and chronic muscle pain is also taken into account. Often psychological disorders are considered as a consequence of a constant pain syndrome.
When diagnosed with fibromyalgia, many other pathological conditions are detected. As a rule, depression, bulimia nervosa and sleep disturbances, chronic illogical syndrome are simultaneously observed. Also pay attention to the level of serotonin, which with this disease is reduced.
Fibromyalgia and menopause
After 45 years, involutional changes in the female body begin, which include a decrease in the level of sex hormones, as well as in the suspension of the ovaries. During this period, the functioning of organs and systems functionally changes, and the relationship of the hypothalamus, pituitary and ovaries is disturbed.
Typically, the manifestations of menopause are typical, although they may have individual characteristics, since each organism responds to hormonal failure in its own way. The most common symptom of menopause is hot flashes. They represent a sudden sensation of heat in the area of the face, neck and chest, accompanied by palpitations, excessive sweating and redness of the skin.
It should be noted that there are no clear diagnostic techniques with which to detect the end of the reproductive period. Fibromyalgia with menopause is a fairly common occurrence, as women suffer from insomnia and pain throughout the body. In addition, they are emotionally unbalanced, so the symptoms of this disease in this period are more pronounced.
Fibromyalgia Therapy
When fibromyalgia develops, the symptoms and treatment depend on the characteristics of the course of this pathology, but the most effective is therapy that combines pharmacological and non-drug methods.
As a rule, patients are prescribed tricyclic antidepressants, which improve sleep, relieve muscle pain and eliminate fatigue. Most often, Amitriptyline and Doxepin, as well as Lyric or Neurontin are used for therapeutic purposes. In addition, drugs that increase the concentration of serotonin and norepinephrine (Simbalta, Savello), non-steroidal anti-inflammatory drugs, analgesics can be used.
Among non-pharmacological methods of treatment, massage, acupuncture and exercise therapy are used. It is useful for patients to swim (hydrotherapy), walk, ride a bicycle, do aerobics. Attention is paid to improving sleep. Patients should also avoid stressful situations that can trigger an exacerbation of the clinic.
When fibromyalgia is diagnosed, treatment with folk remedies also gives good results. As a rule, natural adaptogens are used, which activate the immune system and muscle tissue (infusion of Schisandra chinensis, ginseng, St. John's wort).
Herbal medicine helps to neutralize intoxication, has antibacterial and antiviral effects, and also causes a calming effect. Herbs, which are usually used in the treatment of fibromyalgia, oxidize pyruvic acid and lactic acid - the main toxins of fatigue.
It is worth noting that herbal remedies should be taken under the strict supervision of a physician. Only the right dosage can improve appetite, calm and mobilize the functional activity of the body.
Diet for fibromyalgia
To date, there are no clearly established principles of dietary nutrition for this disease, however, there are a number of substances that are recommended to be limited in the diet of patients:
• Aspartame, which is often found in sweeteners. It was found that this compound exacerbates the clinical manifestations of fibromyalgia, since it stimulates the response of pain receptors.
• Nutritional supplements, which include glutamine sodium and nitrates, as they determine the increase in pain.
• Simple carbohydrates - patients are advised to limit their intake of sugar and bread.
• Caffeine. With fibromyalgia, you should not drink coffee, tea, a lot of chocolate. With their limitation, the condition of patients improves in just a week.
• Various pastries that contain yeast and gluten.
• Scientists believe that dairy products of any fat content can negatively affect the dynamics of fibromyalgia.
• Solanaceous - peppers, potatoes, tomatoes and eggplant. These products are capable of exacerbating both arthritis and fibrositis.
If fibromyalgia develops, the symptoms and treatment of this pathology depend on the duration of the pathological process and the presence of other concomitant diseases. With timely diagnosis and therapy, the prognosis is favorable.