FIBROMYALGIA: THE INVISIBLE BEATING.

M. Ruth Álvarez Quintillán

1º E.U.E. Meixoeiro

CONTENTS:

• What is «Fibromyalgia»?• Epidemiology.• Historical memory of Fibromyalgia.• Signs and symptons of this disease.• What causes this?• How can it be diagnosed?• Is there a treatment for it?• Video: a real testimony.• Bibliographic references.

WHAT IS FIBROMYALGIAFIBROMYALGIA?• «Fibromyalgia» comes from the Latin term «fibro»

(conective tissue) and Greek «mio» (muscle) + «algia» (pain).

• Also called «Fibrositis».

• Non-inflammatory chronic rheumatic disease.

• Prolonged pain and hypersensitivity in bones, joints, muscles, tendons and other soft tissues.

• There aren´t demonstrable organic disorders.

EPIDEMIOLOGY:

• Affects 2-5% of the world population (in Spain 2,4% of the total population).

• It is assumed that only 10% of sufferers are diagnosed.

• Appears in people between 20-50 years old.

• To a lesser extent it affects children and elderly people.

• 10 women per man.

HISTORICAL MEMORY OF FIBROMYALGIA:

• It was mentioned for the first time in 1750 by Sir Richard Manningham (physician) in his publication: «Symptoms, nature, causes and cure of the low-grade fever or small fever: commonly called nervous or hysterical fever».

• In 1843 Robert Floriep (anatomist) described "the sensitive points", in his treatise of pathology and therapy of rheumatisms.

• In 1881 George Beard (doctor) wrote a book called «American Nervousness» describing patients with neurasthenia who showed the presence of painful points and hyperalgesia.

• In 1904 Sir William Gowers called “fibrositis" the pain caused by the inflammation of the fibrous tissue of the muscle. After that, the definition of fibrositis was “an inflammatory change of fibrous interstitial tissue of the striated muscle”.

• In 1936 all the theories about the disease were denied and developed different ones about a psychological origin, which would endure many decades later.

• In 1963 appears the concept of “self-feeding pain”:

A special personality causes a

constant tension generated by

muscle spasms which turn into

pain. MUSCLE SPASMS

PAIN

STRESS

• In 1976 Philip Kahler Hench (doctor) defined “Fibromyalgia” as a “form of non articular rheumatism”.

In 1992, the WHO recognized «Fibromyalgia»

as a disease.

Classified with the code M79.7 of International

Statistical Classification of Diseases (ICD).

ICD-10 review classified it within rheumatisms.

SIGNS AND SYMPTONS:

-Diffuse, slight, intense, sharp, stabbing, burning...

-In many parts of the body at the same time.

-Starts in a particular area and then spreads to the rest of the body.

-Depends on the time of the day, activity, climate, levels of stress… -Muscle stiffness, spasms and tingling in hands and feet.

-Insomnia.

-Light sleep, waking up several times at night.

-Apnea, or moments where the person stops breathing.

-Paroxysms of sleep, sudden movements.

-Bruxism, or teeth grinding.

PAIN

FATIGUE AND SLEEP

DISTURBANCES

• Irritable Bowel Syndrome (constipation, diarrhea, gas, and nausea)

• Dysmenorrhea or painful periods in women.• Raynaud's disease (narrowing of hand/feet

blood vessels that reduces the blood flow).

WHAT CAUSES FIBROMYALGIA?

It´s SUPPOSED to be related with:•Stressful or traumatic events.•Diseases such as rheumatoid arthritis or hypothyroidism.•Infectious diseases.•Hormonal changes.•Excess of stimulants (coffee, alcohol, tobacco).•Anaemia and deficiencies in vitamin B12 and B6.•Obesity.•Genetic predisposition.•Malfunction of the immune system.•Can happen on its own.

Abnormalities in the Central

Nervous System.

SEROTONIN (Controls the intensity

of pain and sleep).

SUBSTANCE P(controls the

perception of pain)

DIAGNOSIS:

• Chronic pain in all four quadrants of the body and axial skeleton for 3 months.

• Easy blush of skin by pressure (bad blood flow).

• Feel pain at 11 from 18 “tender points” when they´re pressed:

Urine tests.Blood tests.

Radiographs.

ANAMNESIS + EXPLORATION.

TREATMENT:• Analgesics.

• Non steroidal anti-inflammatory drugs (NSAIDs).

• Antidepressants

• Anticonvulsants.

• Antiepileptic drugs.

• Teach the patient and family about the disease.

• Psychological therapy.• Physiotherapy or

chiropractic treatments.

• Acupuncture.• Yoga.• Aerobics.

• Aquatic exercises.• Meditation and

breathing techniques.• Strict sleep routines.• Healthy diet (avoid

alcohol, coffee and tobacco).

• Support groups.

A REAL TESTIMONY:

THANKSTHANKS FOR FOR YOUR YOUR

ATTENTION! ATTENTION!

BIBLIOGRAPHIC REFERENCES:

• http://www.nlm.nih.gov/medlineplus/spanish/ency/article/000427.html• http://www.arthritis.org/espanol/general/fibromialgia/• http://www.institutferran.org/fibromialgia.html• http://www.niams.nih.gov/portal_en_espanol/Informacion_de_salud/Fibro

mialgia/default.asp• http://www.unobrain.com/que-es-fibromialgia-sintomas-tratamiento-

natural-la-fibromialgia• http://www.rheumatology.org/Practice/Clinical/Patients/

Diseases_And_Conditions/La_Fibromialgia/• https://www.msssi.gob.es/profesionales/prestacionesSanitarias/

publicaciones/Fibromialgia.htm• http://www.webmd.com/fibromyalgia/default.htm?names-dropdown=FL• http://www.nhs.uk/Conditions/Fibromyalgia/• http://www.fmnetnews.com/fibro-basics/fibromyalgia-faqs