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Fibromyalgia is a mysterious disease of civilization that does not appear in laboratory tests. Pain of the whole body, this is what affected people call fibromyalgia. Read the interview with Dr. Agnieszka Zielińska from the Rheumatology Institute.
Fibromyalgiahas been controversial for many years among doctors and patients alike. On the one hand, some doctors who use the "slide-and-eye" methods deny its existence, on the other hand, the number of patients who live in chronic pain and do not find understanding of their surroundings is increasing. 2-10 percent suffer from fibromyalgia. population. The data are imprecise as fibromyalgia is difficult to diagnose. Many people do not know that they are sick. We talk to Dr. Agnieszka Zielińska from the Rheumatology Institute about fibromyalgia.
- Fibromyalgia is a psychosomatic disease?
Dr. Agnieszka Zielińska : It is supposed to be so, although we know little about her. The symptoms of fibromyalgia are non-specific and may mimic other diseases. It is very difficult to make a diagnosis and it consists in excluding individual diseases. The physician's assessment is subjective, as there are no abnormalities in laboratory and imaging tests in fibromyalgia. The problem lies in the nervous system, in the excessive excitability of the pain-conducting structures in the spinal cord and brain. Patients then have a lowered pain sensitivity threshold.
- Although fibromyalgia has been recognized as a separate entity, many doctors doubt its existence.
A.Z .: On the one hand, it is a very complex disease. Everyone gets sick differently, which makes diagnosis even more difficult. How many patients, so many pictures of fibromyalgia. On the other hand, there is insufficient awareness of this disease in the medical community, unfortunately. Our Rheumatology Institute is visited by patients who previously had long and unsuccessful carols for various specialists with a pile of unnecessary tests. It is particularly unpleasant because fibromyalgia largely excludes patients from everyday existence, work and family responsibilities. It significantly reduces the quality of life. The feeling of exclusion and isolation intensifies the stress which makes the disease worse.
- Academic medicine often "cuts" the patient and creates narrow specializations. He forgets that man ispsychophysical unity?
A.Z .: Fibromyalgia clearly shows that soma and psyche should not be considered separately. It is an interdisciplinary disease that can be encountered by various specialists: rheumatologists, neurologists, orthopedists, psychiatrists, endocrinologists, cardiologists, and physiotherapists.
ImportantWhat is fibromyalgia?
Fibromyalgia is a non-inflammatory rheumatic disease of soft tissues. It is characterized by chronic pain in muscles and joints and the occurrence of the so-called tender points, i.e. places sensitive to pressure on the body. The disease may be accompanied by: fatigue, lack of energy, concentration, sleep disorders, depression, symptoms of irritable bowel syndrome, overactive bladder, numbness and tingling of the hands, irregular heart beat, restless legs syndrome, etc.
- How is fibromyalgia treated?
A.Z .: Patients have different symptoms; they are also in different stages of the disease. Some complain only about severe pain, others about pain and sleep disturbances, while others come depressed. The therapy is therefore individual. In general, we combine pharmacological and non-pharmacological methods in the treatment. Even though fibromyalgia is not a psychiatric disease, we use antidepressants by taking advantage of their neurotransmitter-boosting properties. Depression may accompany or appear as a consequence of this disease due to its bothersome chronicity. Painkillers, such as paracetamol and tramadol, as well as non-steroidal anti-inflammatory drugs, which, although considered to be pointless by some, are also recommended in the treatment, in some cases alleviate the pain. Antiepileptic drugs are also effective as drugs that reduce neuropathic pain.
- With what non-pharmacological methods is this disease treated?
A.Z .: Various methods are tried, ranging from he althy lifestyle recommendations, through physical therapy, psychotherapy, to acupuncture and relaxation techniques. It is also recommended moderate physical exertion, exercise, cycling, walking and swimming. In the West, floating sessions in a special relaxation chamber are currently fashionable in the treatment of this disease. In this cabin, the patient rises on the surface of the dense brine without any effort. It has been tested that during a floating session, the patient's production of endorphins, i.e. happiness hormones, increases. His well-being improves significantly, and muscle and joint pains alleviate.
ImportantFibromyalgia: in search of the cause
Genetic susceptibility and factors likely contribute to the development of fibromyalgiamental - severe trauma, trauma, chronic stress. But not only. Recently, there are more and more patients who combine the onset of its symptoms with various infections, e.g. inflammation of the upper respiratory tract or the urinary bladder. And oddly enough, there are infections of varying severity; sometimes mild, sometimes serious - requiring intravenous antibiotic therapy. After their subsidence, the joints and muscles experience severe and chronic pain of unknown origin.
- Is fibromyalgia contractible?
A.Z .: No drugs or treatment of fibromyalgia are 100% effective, but there are cases of remission. Usually, however, there are alternating periods of worsening and alleviation of the disease. It is worth noting that the disease is mild, it does not lead to disability or shorten the life expectancy.
- Contemporary academic medicine is not keeping up with the development of civilization diseases?
A.Z .: Unfortunately, yes. I feel helpless at times, looking, a bit in the dark, for suitable methods that would alleviate this disease. And it is becoming a growing problem. It also frustrates doctors. It is an "unwanted disease" for them due to its complexity and ambiguity.
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