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Fibromyalgia is a chronic non-inflammatory rheumatic disease of soft tissues. Behind this complicated medical definition is pain, and it is chronic, exhausting, constantly causing you to feel tired. Simple pain medications don’t work, so doctors look elsewhere for treatment options. What therapy can people struggling with fibromyalgia count on?
- Fibromyalgia is characterized by chronic muscle and joint pain and a feeling of fatigue
- Standard painkillers, such as ibuprofen, are often ineffective, so treatment is based on non-pharmacological methods
- Breathing exercises, relaxation and physical activity soothe pain, stabilize nerve activity and diaphragm movements
- More information can be found on the Onet homepage
What is fibromyalgia?
Fibromyalgia is not easily treated. Certainly, non-pharmacological methods help: breathing exercises, relaxation techniques, aerobic exercises. While fibromyalgia is pain, standard painkillers won’t work here. Find out what methods can be used in this life-difficult condition.
Fibromyalgia is primarily characterized by chronic muscle and joint pain and a feeling of fatigue. Basic imaging studies do not indicate a specific defect. In case of doubt, the doctor orders a chest X-ray, abdominal ultrasound, and a rheumatologist, orthopedist – X-ray evaluation of bones, joints or ultrasound.
When other diseases are suspected, their diagnosis does not differ from general standards and other imaging tests are performed.
– If we do not find any abnormalities in other organs, and the symptoms are associated with fibromyalgia, our task is to stop the pain, influence a number of symptoms so as to improve the patient’s functioning and quality of life. We want to help the patient return to normal functioning – assures Dr. Maria Maślińska, deputy head of the Early Arthritis Clinic of the National Institute of Geriatrics, Rheumatology and Rehabilitation in Warsaw.
The European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) updated their recommendations for the treatment of fibromyalgia in 2019. In the first place, great emphasis was placed on non-pharmacological treatment such as:
- relaxation techniques,
- biofeedback,
- physical activity,
- breathing exercises,
- teaching proper breathing,
- relaxation.
These elements soothe pain, stabilize nerve activity, diaphragm movements, reduce and soothe the so-called hypersensitization. Patient education also plays an important role: it is recommended that they have knowledge about their condition and agree with the doctor about the goals of therapy that can be achieved. Pharmacotherapy is most often used in the case of sleep disorders.
Why are fibromyalgia pain medications not working?
Classic painkillers in the treatment of fibromyalgia are not working. Therefore, drugs known from neurology and psychiatry are used, such as affect the serotonin pathway and affect pain transmission and inhibition of its chronification. Due to the effect on neurotransmitters, the pain is stopped. Therefore, drugs used as antiepileptic drugs, antidepressants or with combined properties appear in treatment. The help of a psychologist is also important.
– If the patient has another disease, we also treat it in accordance with all applicable standards. However, we should never underestimate fibromyalgia, because then we can better assess how much of the pain is, for example, arthritis in RA, and to what extent, after the action of anti-inflammatory drugs that modify the course of the disease, the symptoms of fibromyalgia still remain. If we disregard the existence of fibromyalgia, we may have a situation in which the treatment, e.g. RA, is constantly modified and escalated, we see improvement in laboratory or imaging tests, and the patient still experiences pain He is still tired from areas other than the joints and he does not perceive the treatment of the underlying disease as effective, says Dr. Maria Maślińska.
- Check the causes of the fatigue that often accompanies you. Order Fatigue – a package of tests for people exposed to overload of the body with the possibility of home blood collection.
If to heal, then “non-individually”
Fibromyalgia often comes along with other diseases. According to the specialist, you should pay attention to it, and once it is diagnosed, treat it equally with other diseases. With the use of complex therapy, a significant improvement will be achieved.
– Currently, there is a strong emphasis on non-pharmacological methods – however, the patient should be persuaded to try them, we should consider him to seek help from a psychologist, or encourage him to use pain coping techniques, which may turn out to be sufficient – adds Dr. Maria Maślińska.
The rest of the article is available under the video.
Glucocorticosteroids – a mistake in pain management and the consequences of their use
When the patient says that he has joint or muscle pain, sometimes the doctor, assuming that it is definitely “some” inflammation, without confirming this fact in the physical examination and additional tests (laboratory, imaging) recommends taking glucocorticosteroids, sometimes the patient himself tries to prescribe them .
It happens that a glucocorticosteroid, often simply called a steroid, is prescribed to an elderly person with joint pain and rheumatoid factor present without confirming the inflammatory disease. It is very dangerous.
– Long-term steroid therapy always has its negative consequences, especially unjustified. In clinical situations, when it is necessary to use them, the dose of the drug is carefully selected, the duration of therapy depends on the disease, other concomitant diseases are taken into account (e.g. diabetes, hypertension, coronary artery disease), metabolic disorders such as increased sugar levels or lipid disorders, in addition, fluctuations in blood pressure, eye complications, cataracts or glaucoma, weight gain – explains Dr. Maria Maślińska.
At the beginning of taking steroids, the patient usually states that there is an improvement due to their anabolic effects, but then complications may arise and the analgesic effect diminishes.. In addition, the patient may have osteopenia or develop osteoporosis, which increases the risk of fractures. low-energy, compression fractures of the vertebrae or the neck of the femur.
According to Dr. Maślinska, the use of steroid therapy brings with it consequences and if the doctor consciously recommends such treatment, he must properly monitor it and protect the patient, if possible, e.g. with prophylaxis or treatment of osteoporosis, pain alone is not an indication for the administration of steroids.
The problem is that fibromyalgia still seems to be an unspecified disease to patients, so they want a specific medication for inflammation or a pain reliever. Then there’s the disappointment that diclofenac or ibuprofen didn’t work. The patient still feels a great deal of discomfort and suffers, limiting his daily activity and social contacts, often such a situation has a negative impact on relations with close people. Also for this reason, scientific medical societies put so much emphasis on the proper education of patients suffering from fibromyalgia.
Beata Igielska, Zdrowie.pap.pl
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