Knowledge about fibromyalgia syndrome and daily precautions for patients
With the accelerated pace of modern life, people need to endure more and more mental stress, which also results in the increasing incidence of some physical and mental diseases. Some patients come to the hospital with the usual complaints of prolonged generalized pain and other related symptoms, such as poor sleep quality, easy fatigue, depression, etc., but no abnormalities in related tests. This group of patients may be suffering from a specific condition called fibromyalgia syndrome. The diagnosis of fibromyalgia has been controversial for a long time, and many scholars have questioned whether fibromyalgia can be considered as a separate disease. However, one thing is certain, namely that the above symptoms do exist in patients with fibromyalgia. However, the mechanisms by which fibromyalgia occurs are not yet well understood.
What is fibromyalgia and what is its incidence?
In daily practice, fibromyalgia is diagnosed if the patient has a history of chronic pain that is widespread, with pressure pain in multiple muscle areas visible on examination or symptoms such as fatigue, cognitive dysfunction, or sleep disturbance. For some patients, there may be a combination of muscle pressure and symptoms associated with the above. Chronic widespread pain (chronic widespreadpain) is epidemiologically defined as pain that persists for at least 3 months, is distributed on both sides of the torso, and involves at least above and below the wrist. Epidemiological data from several countries indicate that widespread chronic pain is a relatively common problem, with a prevalence of about 10%. It is important to note, however, that not all patients with widespread chronic pain have fibromyalgia disease.
Two statistical analyses completed according to diagnostic criteria developed by the American College of Rheumatology (ACR) found that the population prevalence of fibromyalgia was around 2.1% in Germany and 6.4% in Minnesota, USA.
Who is at risk for fibromyalgia syndrome?
Fibromyalgia usually occurs in women, and a minnesota population survey found that about 7.7% of women and 4.9% of men met the ACR 2010 diagnostic criteria for fibromyalgia, but a concurrent analysis of medical records found that in the same population, only 27% of patients who met the ACT 2010 diagnostic criteria were diagnosed with fibromyalgia, which is a proportional This is inconsistent with the actual findings, as the prevalence was calculated to be only 2% for women and 0.15% for men.
It is also worth noting that most of the patients in the medical records were diagnosed with fibromyalgia at a young age, but the actual survey found that the incidence of fibromyalgia increased with age, with the highest incidence over 60 years of age, which may be due to the fact that in elderly patients, multiple limb pains are often diagnosed as arthritis rather than fibromyalgia. Suli Wang, Liangjing Lu
How does fibromyalgia syndrome occur?
The exact pathogenesis of fibromyalgia is not yet understood. These patients do not have persistent structural or functional abnormalities in their muscles, but their pain transmission and disposition mechanisms in the central nervous system are impaired. A recently completed review found that amplification of nociceptive transmission signals in spinal cord segments plays a very important role in the development of chronic pain in patients.
Psychological and sociological factors also have an impact on pain amplification mechanisms, and demographic studies have shown that the aforementioned factors are associated with the onset and persistence of the fibromyalgia process. However, not all psychosocial stresses of the same magnitude in the normal population lead to the development of fibromyalgia, and therefore genetic factors also play a role in its development. A study of family genetic genealogy of fibromyalgia patients in the United States found that patients with fibromyalgia were 13.6 times more likely to have siblings with fibromyalgia than the normal population. The association with fibromyalgia has been found to be in a region of chromosome 17.
Despite these findings, it is too early to say if this is the specific mechanism of fibromyalgia pathogenesis.
Treatment of fibromyalgia
There are a number of hot topics in the treatment of fibromyalgia.
1. Non-pharmacological treatment of fibromyalgia
Non-pharmacological treatments for fibromyalgia can be psychological or physical. Physical methods of treatment include active and passive modalities.
Physical therapy (active)
Functional exercise is recommended for all patients with fibromyalgia. A systematic review analysis found that regular aerobic exercise (20 min/day, 2-3 times/week for at least 2.5 weeks) improved patients’ clinical symptoms. Strength training can also reduce pain and tenderness and bring pleasure to the patient.
Physical Therapy (Passive)
A systematic analysis and two clinical studies provide moderate clinical evidence to support the use of bathing therapy for fibromyalgia. Other passive physical therapies include massage, equine therapy, electrotherapy and ultrasound therapy. However, there is less evidence to support the application of the above clinical measures
Psychological treatment
In addition to exercise, fibromyalgia can be treated through education and psychology, and behavior. Education can relieve the patient’s tension and anxiety due to the location, while behavioral cognitive therapy can improve the patient’s pain perception.
There is strong evidence to support the significance of disease education in improving the functional prognosis of patients with the disease. Most clinical treatment programs for fibromyalgia also use disease advocacy as an effective treatment tool.
2. Pharmacological treatment of fibromyalgia
Medications used to treat fibromyalgia include analgesics, opioids, and antidepressants. Some drugs, such as pregabalin, gabapentin, serotonin and adrenaline reuptake inhibitors (milnacipran, duloxetine), can alter neurotransmitter transmission. Different drugs have different effects on the treatment of the disease.
Daily precautions for patients with fibromyalgia syndrome.
Relief of all kinds of mental stress is of paramount importance.
In general, patients are more or less affected by stress from themselves, their families and society, such as divorce, widowhood and work tension, often accompanied by insomnia, dreaminess, easy awakening and fatigue, so it is very important to relieve all kinds of stress and distress. We should realize that this disease is not a major disease and can be relieved to a normal state; secondly, we should be broad-minded, not to bother about some trivial matters, communicate with friends and confide in them more often, and see a psychiatrist if necessary, which can reduce the patient’s pain and fatigue symptoms, improve the bad mood, adjust the body’s function, and reduce the adverse drug reactions. Usually, you should get good and sufficient sleep.
Physical exercise is also very important.
You can do walking, swimming and ball games, etc. It is recommended to choose one or more kinds of sports that are most interesting for your age group. Of course exercise should be gradual, should not suddenly increase the amount of exercise, generally 3 times a week training, each time about 30 minutes. Exercise before going to bed should be avoided to avoid aggravating insomnia.
Take medication as prescribed by the doctor.
Take the medication regularly for a period of time, and after the symptoms improve, you can gradually reduce the dosage until you stop using it under the guidance of your doctor. Regular check-ups and medical appointments.