Fibromyalgia is the second most common rheumatic disorder behind osteoarthritis and is still largely unrecognized. It is now believed to be a lifelong disorder of the central nervous system responsible for increasing pain in the body. Daniel Clauw, MD, professor of anesthesiology at the University of Michigan, examined the neurological basis of fibromyalgia in a plenary lecture today at the Pain So American Annual Scientific Meeting.
Clauw explained that fibromyalgia pain comes more from the brain and spinal cord than from areas of the body where a person may experience peripheral pain. This condition is thought to be associated with changes in the way the brain processes pain and other sensory information. He added that physicians should suspect fibromyalgia patients with multifocal (mainly musculoskeletal) pain that is not fully explained by injury or inflammation.
“As whole-body pain tests are amplified in fibromyalgia patients, pain can occur anywhere, such chronic headaches, visceral pain, and sensory hypersensitivity are common in fibromyalgia patients. people with this condition, painful condition,” Clauw said.
“This doesn’t mean that peripheral nociceptive delivery doesn’t contribute to pain in fibromyalgia patients, but they experience more pain than would normally be expected from the degree of peripheral input.” People with fibromyalgia and other painful conditions “feel the pain that relates to them, who hasn’t had the condition described as pressure,” Clauw added.
Because of the central nervous system pain origin in fibromyalgia, Clauw said opioids and other narcotic pain medications are generally not effective because they do not reduce the activity of neurotransmitters in the brain. “These drugs have not been shown to be effective in patients with fibromyalgia, and there are signs that opioids may even exacerbate fibromyalgia and other significant pain,” he said.
Clauw recommends physicians integrate pharmacological treatments such as gabapentin treatments, tricyclic and selective serotonin reuptake inhibitors, non-pharmacological methods such as cognitive behavioral therapy, exercise, and stress reduction .
“Sometimes the amount of therapeutic response to simple, inexpensive medical treatment outweighs the drug,” Clauw said. “The primary benefit is improved performance, which should be the primary goal in treating any chronic pain condition. Most patients with fibromyalgia can see their symptoms improve and live a normal life with proper medication and the extensive use of non-pharmacological therapies. “
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“Fibromyalgia can be considered both a separate disease and a common way of centralizing pain and becoming chronic. Most people with the disease have chronic pain throughout their lives, Clauw said: “The disease can be difficult to diagnose if you don’t know the classic symptoms because there is no single cause or external signs”.