This Saturday, 12 in May, marks the World Day of Fibromyalgia, a chronic pain condition mainly located in the locomotor system, which is accompanied by multiple clinical manifestations that affect other organs and systems such as cardiovascular, intestinal, neurological, etc.
This disease affects in Spain to 2,4% of adults and between 1 and 2% of the child population, especially girls. Dr. Alejandro San Martín Álvarez, rheumatologist of the newly renovated HLA San Carlos, Explain, "that perhaps, the controversy is because of the refusal to see it as a defined entity. It is considered a continuous process, without a clear cut-off point that separates it from the healthy state of the patient and, erroneously, the pathology is thought almost as an artificial grouping of a set of very frequent symptoms (joint pain, tiredness, headaches ...) ".
Fibromyalgia causes chronic pain located in various parts of the locomotor system, being "the most frequent symptom, often the most important and the one that leads the patient to consult his doctor", says the professional and clarifies that "It is a changing process that in the morning can present discomfort in the arms and throughout the day feel that the pain is moving towards the lower limbs. In addition, other symptoms are added such as intense tiredness, sleep disturbances, morning stiffness with feeling of lack of night rest, alterations of the cognitive sphere (lack of memory and concentration), digestive disorders (diarrhea, abdominal pain, dyspepsia), headaches and anxiety or depression. "
Causes that trigger fibromyalgia
Although the causes of the disease are not known exactly, the most accepted theory is a deregulation of the neurotransmitters of the nervous system. "There have been numerous alterations in the molecules involved in the transmission of the nervous stimulus and, what is more suggestive, some drugs that act on certain neurotransmitters raising their values, or that maintaining their action for a longer time improve the clinical picture", declares the rheumatologist of HLA Denia, and continues that "This translates, on the one hand, into an alteration of the mechanisms of pain processing, responsible for one of the most relevant symptoms of this disease and, on the other, acting on other systems, leads to the emergence of multiple clinical manifestations of the clinical picture ".
As for the triggers, they are counted "any situation of physical or emotional stress such as infections, surgeries, trauma". On the root or psychological consequences of fibromyalgia, Dr. San Martín recognizes that "This question remains unanswered today: chronic pain and fatigue cause depression and anxiety; and it is also true that a subgroup of these patients is previously diagnosed with anxiety or depression.".
The road to diagnosis
"The prevalence of Fibromyalgia in the Spanish population older than 18 years is 2,4%, with a female-male ratio of 20: 1", says San Martín and adds that "The average age of the diagnosis is around 47 years, but from the beginning of the symptoms until the diagnosis is made, it can take up to 7 years. There is also a risk of suffering the disease up to 8 times higher among the relatives of the patients already diagnosed".
For the HLA rheumatologist San Carlos Office "The delay in diagnosis is due, in part, to the fact that there is no proven clinical test since the disease usually begins with nonspecific symptoms that are complicated and associated with more complex ones over months or years, which causes that the full expression of the disease takes time to establish ".
For all this, the diagnosis is made exclusively through the clinical study of the patient, where "The aforementioned symptoms are coincident in most of them on their first visit that, in addition to the characteristic painful pressure in certain areas of muscle and ligament insertion, cannot be proven to be pathognomonic fibromyalgia with any analytical or imaging test. today".
Women and girls, the main affected
Different statistics on fibromyalgia indicate that up to 80% of those affected are women. Dr. San Martin explains that this high incidence: "The studies show the role of hormones, especially the neuroendocrine system through the hypo-thalamus-pituitary-adrenal axis and female hormones, which have shown certain alterations that may be related to their greater expression in sex female".
The doctor warns that "The disease can also be expressed in children, with an estimated prevalence of 1-2% of the child population, according to some studies. Female predominance also occurs in Pediatrics, in up to 93% of cases, with an age of appearance between the 11,5 and the 15 years ".
While there is currently no curative treatment, medical strategies are aimed at improving symptoms and keeping the process under control. "They are fundamentally based on three therapeutic modalities: some drugs, aerobic exercise and cognitive behavioral therapy (CBT). The simultaneous combination of these, in the form of multidisciplinary treatment, is being imposed as the option that brings greater benefits to the patient".
