Fibromyalgia is the second most common rheumatic disorder behind osteoarthritis and is still largely unknown, it is now considered a permanent disorder of the central nervous system responsible for the increase in pain caused by the body. Daniel Clauw, MD, professor of anesthesiology at the University of Michigan, examined the neurological basis of fibromyalgia at a plenary conference held today at the annual scientific meeting of American Pain So
Clauw explained that the pain of fibromyalgia comes from more of the brain and spinal cord than in areas of the body where someone can feel peripheral pain. It is believed that the condition is associated with changes in the way the brain treats pain and other sensory information. He said doctors should suspect that patients with fibromyalgia have multifocal pain (mostly musculoskeletal) that is not fully explained by injury or inflammation.
“Since pain tests throughout the body are amplified in patients with fibromyalgia, pain can occur everywhere, such as chronic headaches, visceral pain and sensory hyperresponsiveness are common in patients with fibromyalgia. people with this condition, painful condition, “said Clauw.
“This does not mean that peripheral nociceptive delivery does not contribute to pain in patients with fibromyalgia, but they feel more pain than is normally expected from the degree of peripheral entry.” People with fibromyalgia and other painful conditions “experience pain in relation to them”. who did not have the disease described as a pressure, “Clauw added.
Because of the origin of central nervous system pain in fibromyalgia, Clauw said that opioids and other narcotic analgesics are generally not effective because they do not reduce the activity of neurotransmitters in the brain. “These medications have not been shown to be effective in patients with fibromyalgia, and there are signs that opioids can even exacerbate fibromyalgia and other key pain conditions,” he said.
Clauw recommends that physicians integrate pharmacological treatments such as gabapentin times, tricyclic and selective serotonin reuptake inhibitors, non-pharmacological methods such as cognitive behavioral therapy, exercise and stress reduction.
“Sometimes, the amount of treatment response to simple and inexpensive medical treatment outweighs the medication,” Clauw said. “The main benefit is better performance, which should be the main goal of treatment for any chronic pain condition. Most patients with fibromyalgia can see how symptoms improve and lead a normal life with the right medications and the intensive use of non-pharmacological therapies. “
“Fibromyalgia can be considered both a discrete disease and a common way of centralizing pain and becoming chronic. Most people with this disease have chronic pain stories throughout their lives, Clauw said, “the condition can be difficult to diagnose if you are not familiar with classical symptoms because there is no single cause and there are no external signs “