Det uppskattas att mellan 2 och 6% av världsbefolkningen lider av denna sjukdom, kännetecknad av generaliserad muskuloskeletala smärta, som uppträder efter 30-40 år och påverkar främst kvinnor. Varför tidig diagnos och tvärvetenskaplig behandling är två viktiga punkter i sitt synsätt
“Jag mår bra, men jag känner mig utmattning.” “De är cervicals, jag har en hård nacke”. “Mitt huvud bryter.” “Allt gör ont!” “Jag ger inte mer!” Detta och många andra fraser i samband med smärta och trötthet verkar vara en del av det dagliga livet för många människor som utsätts för dagens krav. Men när dessa går från att vara en enkel irritation och bli kronisk, kan du vara i närvaro av något annat.
Världshälsoorganisationen (WHO) har sedan 1992 erkänt inom sin internationella klassificering av sjukdomar fibromyalgi, ett av de vanligaste tillstånden för kronisk smärta, vilket är nio gånger mer frekvent hos kvinnor än hos män .
Vilka symptom ska vara varna? Psykiatrisk medicinsk och koordinator för kliniken patienter med fibromyalgi och kroniskt trötthets Institute of Cognitive Neurology (Ineco), Evangelina Melgar (MN 133.847), under förutsättning att vissa ledtrådar för att förstå dessa sjukdomar som kan påverka verksamheten i det dagliga livet och relationer inter av drabbade.
90% av patienterna upplever trötthet, 70-80% sömnstörningar och upp till 25% ångest eller depression
“Även om orsakerna till de båda sjukdomarna är okända, kan genetiska faktorer predisponerar för utvecklingen av fibromyalgi, medan kroniskt trötthetssyndrom (CFS) Det finns många teorier, från hans förhållande med virusinfektioner till psykisk stress” noterade specialisten.
Om vilka tecken som ska konsultera läkaren påpekade experten att “vanligtvis fibromyalgi manifesterar sig från 30-40 år, även om det i en lägre procentandel kan förekomma i barndomen och ungdomar. Huvudsymptomet är generaliserad muskuloskeletala smärta, vilket förvärras vid tryck av anbudspunkter . ” “Intensiteten av smärta varierar påverkat av klimatförändringar, fysisk aktivitet, psykisk stress eller sömnbrist. Det börjar vanligtvis i en region av kroppen och migrerar genom olika områden, tills det blir generaliserat över tiden “, förklarade han.
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Och notera att “90% av patienterna upplever trötthet, sömnstörningar 70-80% och upp till 25% ångest eller depression , ” Melgar grävde att “är också ofta dålig motion tolerans; känslan av tyngd i lemmarna; generaliserad styvhet (särskilt när man står upp på morgonen); känsla av inflammation och odefinierad stickning i händer och fötter. ” Symtom kan vara associerat med huvudvärk, yrsel, kognitiva misslyckanden i minnet och uppmärksamhet, bruxism, gastrointestinala symptom, såsom irritabelt tarmsyndrom, dyspepsi, illamående . Förekomsten av dessa symtom eller associerade syndrom varierar i varje person.
Dessutom förvärrar externa faktorer, såsom miljöförkylning, fuktighet, stress, överskott eller brist på aktivitet, symtomen. Å andra sidan, värme, torrt väder, avkoppling och vila, minska deras intensitet.
Enligt psykiatern nämnda Sergio Czerwonko (MN 77.456), lider mellan 2 och 6% av världens befolkning av fibromyalgi, och kan förekomma som enstaka förändring-vad som kallas primaria- fibromyalgi eller associerade med andra sjukdomar fibromyalgi samtidigt.
Smärta är inte det enda symptomet. Svårigheten att göra intellektuellt, kallad fibrofog kan vara ännu allvarligare än själva smärtan
Sjukdomen är en del av de centrala sensoriska syndrom, som är de sjukdomar för vilka inga data i labbtester eller röntgenstrålar och endast fackmannen, under noggrann undersökning, förvaltar han för att hitta en diagnos.
“Smärta är inte det enda symtomet. Svårigheten att utföra intellektuellt kan kallas fibrofog bli ännu allvarligare än smärtan i sig, “Professional Institute of Neurosciences Buenos Aires (INEBA), för vilken” en stor utmaning är att patienten ger rätt professionella för diagnos och behandling. “
Fibromyalgi är en psyko-neuro-immuno-endokrin sjukdom (PNIE) , som måste diagnostiseras och behandlas av ett kroniskt smärtlag, eftersom det är ett kroniskt tillstånd. “Den befolkning som är mest benägen för denna sjukdom är kvinnan, eftersom hela livet är den med större hormonella svängningar och står inför många traumatiska fall och när det sker under en bördig period måste vi vara särskilt noga med de föreslagna behandlingarna” , förklarade Czerwonko, som sa att “det kan också förekomma hos barn och vuxna, särskilt hos dem som har gått igenom stressiga och traumatiserande situationer. Det är en sjukdom som vanligtvis uppträder efter virala processer, sjukhusvistelser eller situationer av sorg eller viktiga förluster “.
“Du måste förstå att det är ett tillstånd som råder trots motstånd i vissa områden för att tro på deras existens som vid tidpunkten han tvivlade depression eller panikattacker. Idag vet vi att inte en psykiatrisk sjukdom, inte trauma, inte reumatiska, neurologiska eller psykologiska inte men har en exakt klinisk och måste biträdas av en tvärvetenskaplig grupp som omfattar alla dessa specialiteter “betonade specialist.
Tidig diagnos och tvärvetenskaplig behandling, två huvudpunkter
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Även om orsaken, som anges, av patologin är okänd, kan genetiska faktorer predisponera utvecklingen av fibromyalgi.
“Diagnosen är ytterst klinisk. För närvarande finns inga kompletterande studier som bekräftar det. Det är upprättat i en intervju med den professionella, där patienten beskriver symtomen. Vissa vågor används: frågeformulär på smärta i kroppens olika delar och på svårighetsgraden av symtomen, där förekomsten av kognitiva förändringar, sömn, trötthet och andra somatiska symptom utvärderas – beskrivs Melgar-. Det rekommenderas dessutom att utvärdera en reumatologspecialist för att utesluta patologier som är associerade eller som delar liknande symptom “.
Och han ansåg att “tidig diagnos är den största utmaningen som presenteras av dessa sjukdomar, för att undvika deras kroniskhet och större inverkan på personens funktionalitet, förbättra livskvaliteten”.
Det finns enighet om att träningsprogram bör vara en av de grundläggande behandlingarna för alla patienter med fibromyalgi
“Behandlingen måste vara omfattande och samordnad av en expert och ett kvalificerat team. Ingen data ska lämnas till en slump, utesluta reumatiska, neurologiska, psykiatriska och kliniska problem. Det kräver tålamod från den behandlande professionella och förståelsen av familjen och samhället, så rapportering om patologin och ökad medvetenhet är mycket viktigt, säger Czerwonco.
Samtidigt konstaterade Melgar att “korrekt informerade om dessa villkor bör vara det första steget i behandlingen.” “Patienten kommer att veta från början egenskaperna av sjukdomen, dess utveckling, samt positiva och realistiska förväntningar som ökar sitt samarbete med terapier, att förlita sig på en trolig förbättring”, tillade han.
Och efter anger att “det är enighet om att utöva program bör vara en av de grundläggande behandlingar för alla patienter med fibromyalgi , ” specialisten noterade att ” morgonstelhet karakteristiska symptom beror på förändringar i mikrocirkulationen som genererar känslan av nummenhet och orsaka svårighet och smärta när man rör sig efter långa perioder av stillhet “. I detta avseende betonade han att “dagliga sträcknings- och syrgasövningar (t ex Tai Chi och yoga) är angivna, såväl som aerob, icke-intensiv fysisk aktivitet (promenader, dans, cykling, vattenövningar). De anaeroba är inte rekommenderade, eftersom de skulle förvärra känslan av tyngd och smärta “.
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” Mindfulness och kognitiv beteendeterapi visade effekt i humörförbättring, emotionell reglering och stresshantering . Detta är avgörande för att undvika episoder av förvärrad smärta och bidra till funktionell kapacitet, säger Melgar.
Och han slöt slutsatsen: “Inom de farmakologiska behandlingarna för fibromyalgi godkänns vissa antidepressiva medel som skulle vara effektiva för att minska den ökade uppfattningen av smärta. Det finns ingen medicin som i sig eliminerar alla symtom, men vissa läkemedelskombinationer kan bidra till att minska smärta och trötthet, samt förbättra sömnen. Men likväl är den ovannämnda vården avgörande för att i helhet uppnå förbättring och kontroll av symtom. Gradvis kan du uppnå dessa förändringar tills de blir vanor. “
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