Fibromyalgia

Fibromyalgiais a common disorder, presented by 2.4% of the general population, and is included among the so-called central sensitisation syndromes. It is mainly characterised by widespread pain. Hyperexcitability in the central nervous system and a reduced pain threshold cause pain to appear prematurely and to be more intensive, long-lasting and diffuse. There is a more intense response to painful stimuli (hyperalgaesia) and a painful response to non-painful stimuli (allodynia). Its cause is unknown although there are sometimes clear triggers such as physical or emotional traumas or infections.

It is a chronic condition whose course alternates between periods of improvement and clinical worsening.

Symptoms:

The main symptom is widespread pain, although this is often accompanied by other symptoms such as tiredness, insomnia, a feeling of pins and needs in the limbs, headache, nausea, memory loss and lack of concentration, anxiety and depression.

Who is affected by the condition?

It usually affects middle-aged women, peaking between the ages of 40 and 49, although it can affect people of either sex and all ages.

Diagnosis:

It is diagnosed under criteria based on the patient's clinical history, depending on the presence of the condition’s symptoms and signs.

There is no specific medical test for it.

Analyses and occasionally imaging tests help us to rule out other illnesses that are often concomitant (present at the same time).

Treatment:

Treatment of fibromyalgia rests on four cornerstones: health-care education (general information on the condition and attitude towards it), physical-exercise guidelines according to tolerance, cognitive behavioural therapy, where appropriate, and pharmacological treatment:.

1. General information on the condition and attitude towards it

The condition needs to be explained to patients along with general advice for feeling better.

2. Physical exercise depending on tolerance

There is evidence of its effectiveness for pain, well-being and physical function.

Patients are recommended to start with low-impact aerobic exercise: walking, swimming, cycling, water aerobics, tai chi and pilates.

Such exercise has to be done regularly and progressively.

The recommendation is exercise between 20 and 50 minutes per session, at least three days a week.

Patients with worse tolerance should start with ten minutes per session between four and six days a week and progressively increase the length, frequency and intensity of these sessions, every month, if possible.

3. Cognitive behavioural therapy

Provided by clinical psychologists where there is an accompanying anxiety or depression.

Even though the condition is not psychological, anxiety and depression can be triggered and prolonged by its symptoms.  

4.  Pharmacological treatment

This can help with treating certain symptoms, such as pain, fatigue and sleep disorders, although its effectiveness is reduced in a large percentage of patients.

Several analgaesics, muscular relaxants, anticonvulsants and even several groups of antidepressants are currently used.

An assessment needs to be made of the risk/benefit and potential side effects of the drugs that are used.

Prevention 

The public is advised to have a healthy lifestyle, keeping down their weight through aerobic exercise, according to tolerance, and a balanced diet, and to organise and order their usual tasks, including brief rests, and to avoid physically and emotionally stressful activities.

Health tips for patients with fibromyalgia are attached.

Related departments that treat this condition: Rheumatology

Notable professionals at Vall d’Hebron who treat this condition: Miriam Almirall