Fibromyalgie: à quoi ressemble la vie lorsque la douleur et la fatigue deviennent chroniques

On estime qu’entre 2 et 6% de la population mondiale souffre de cette maladie caractérisée par une douleur généralisée musculo-squelettique, qui se manifeste après 30 à 40 ans et qui affecte principalement les femmes. Pourquoi le diagnostic précoce et le traitement interdisciplinaire sont deux points clés de son approche

“Je vais bien, mais je suis épuisé.” “Ce sont les cervicales, j’ai le cou dur”. “Ma tête se casse.” “J’ai mal partout!”. “Je ne donne pas plus!”.  Cette phrase et beaucoup d’autres associées à la douleur et à la fatigue semblent faire partie de la vie quotidienne de nombreuses personnes soumises aux exigences du monde d’aujourd’hui. Mais quand ceux-ci cessent d’être une simple contrariété et deviennent chroniques, vous pouvez être en présence de quelque chose d’autre.

Depuis 1992, l’Organisation mondiale de la santé (OMS) a reconnu dans sa classification internationale des maladies la fibromyalgie, l’  une des affections les plus courantes de la douleur chronique, neuf fois plus fréquente chez les femmes que chez les hommes .

Quels symptômes devraient être alertes? Le médecin psychiatre et coordinateur de la clinique des patients atteints de fibromyalgie et de fatigue chronique de l’Institut de neurologie cognitive (Ineco), Evangelina Melgar (MN 133.847), a donné des pistes pour comprendre ces pathologies pouvant affecter les activités de la vie quotidienne et les relations. expériences interpersonnelles de ceux qui en souffrent.

 90% des patients souffrent de fatigue, 70 à 80% de troubles du sommeil et jusqu’à 25% d’anxiété ou de dépression

“Bien que les causes des deux maladies soient inconnues, des facteurs génétiques pourraient prédisposer au développement de la fibromyalgie, tandis que pour le syndrome de fatigue chronique (SFC), il existe de nombreuses théories allant de leur relation avec les infections virales au stress psychologique”, a noté le spécialiste.

L’expert a fait remarquer que “la fibromyalgie se manifeste généralement entre 30 et 40 ans, bien que, dans une moindre proportion, elle puisse apparaître dans l’enfance et à l’adolescence.” Le symptôme principal est la douleur musculo-squelettique généralisée, qui s’aggrave à la pression des points sensibles . ” “L’intensité de la douleur varie en fonction des changements climatiques, de l’activité physique, du stress psychologique ou du manque de sommeil. Il commence généralement dans une région du corps et migre à travers différentes régions jusqu’à ce qu’il se généralise avec le temps “, a-t-il expliqué.

La fibromyalgie est une maladie psycho-neuro-immuno-endocrinienne (Getty)
La fibromyalgie est une maladie psycho-neuro-immuno-endocrinienne (Getty)

Et après avoir noté que “90% des patients souffraient de fatigue, 70 à 80% de troubles du sommeil et jusqu’à 25% d’anxiété ou de dépression”, M. Melgar a poursuivi en expliquant qu ‘”une faible tolérance à l’effort est également fréquente; la sensation de lourdeur dans les membres; rigidité généralisée (surtout en se levant le matin); sensation d’inflammation et de picotement mal défini dans les mains et les pieds “. Les symptômes peuvent être associés à des maux de tête, des vertiges, des défaillances cognitives de la mémoire et de l’attention, du bruxisme, des symptômes gastro-intestinaux, tels que le syndrome du côlon irritable, la dyspepsie, les nausées . La présence de ces symptômes ou des syndromes associés varie chez chaque personne.

De plus, des facteurs externes, tels que le froid environnemental, l’humidité, le stress, un excès ou un manque d’activité, exacerbent les symptômes. En revanche, la chaleur, le temps sec, la détente et le repos réduisent leur intensité.

Comme l’a noté le psychiatre Sergio Czerwonko (MN 77456), entre 2 et 6% de la population mondiale est atteinte de fibromyalgie et peut présenter l’unique altération, appelée fibromyalgie primaire, ou associée à d’autres maladies, à savoir une fibromyalgie concomitante.

 La douleur n’est pas le seul symptôme. La difficulté à rendre intellectuellement, appelée fibrofog peut être encore plus grave que la douleur elle-même

La maladie fait partie des syndromes sensoriels centraux, c’est-à-dire des pathologies pour lesquelles aucune donnée n’apparaît dans les analyses de laboratoire ou les radiographies, et seul l’expert du domaine, soumis à un examen approfondi, parvient à obtenir le diagnostic.

“La douleur n’est pas le seul symptôme. La difficulté à rendre intellectuellement appelé fibrofog peut être encore plus grave que la douleur elle-même “, a déclaré le professionnel de l’Institut des neurosciences de Buenos Aires (Ineba), pour qui” un grand défi est que le patient trouve le bon professionnel votre diagnostic et votre traitement. “

La fibromyalgie est une maladie psycho-neuro-immuno-endocrinienne (PNIE) , qui doit être diagnostiquée et traitée par une équipe de traitement de la douleur chronique, car il s’agit d’une affection chronique. “La population la plus touchée par cette maladie est la femme, car toute la vie est celle qui présente les oscillations hormonales les plus importantes et doit faire face à de nombreux traumatismes. Par conséquent, lors d’une période fertile, nous devons faire particulièrement attention aux traitements proposés” Czerwonko a expliqué que “cela peut également se produire chez les enfants et les adultes, en particulier chez ceux qui ont traversé des situations stressantes et traumatisantes. C’est une maladie qui apparaît généralement après des processus viraux, des hospitalisations ou des situations de deuil ou des pertes importantes “.

“Nous devons comprendre que c’est une condition qui existe malgré la résistance dans certaines zones d’incrédulité en son existence, car à l’époque, il était douteux de crises de dépression ou de panique. Aujourd’hui, nous savons qu’il ne s’agit pas d’une maladie psychiatrique, ni traumatologique, ni rhumatismale, ni neurologique ni psychologique, mais qu’elle dispose d’une clinique précise et qu’elle doit être assistée par une équipe multidisciplinaire englobant toutes ces spécialités “, a souligné le spécialiste.

Diagnostic précoce et traitement interdisciplinaire, deux points essentiels

Le traitement  doit être complet et coordonné par un expert et une équipe qualifiée (Getty)
Le traitement doit être complet et coordonné par un expert et une équipe qualifiée (Getty)

Bien que la cause, comme indiqué, de la pathologie soit inconnue, des facteurs génétiques pourraient prédisposer au développement de la fibromyalgie.

“Le diagnostic est éminemment clinique. À l’heure actuelle, aucune étude complémentaire ne le confirme, il est établi lors d’un entretien avec le professionnel, dans lequel le patient décrit les symptômes. Certaines échelles sont utilisées: des questionnaires sur la douleur dans les différentes régions du corps et sur la sévérité des symptômes, où la présence d’altérations cognitives, de sommeil, de fatigue et d’autres symptômes somatiques est  évaluée – décrit Melgar-. Il est en outre recommandé de faire appel à un rhumatologue pour écarter les pathologies associées ou partageant des symptômes similaires “.

Et il a estimé que “le diagnostic précoce est le principal défi présenté par ces maladies, éviter leur chronicité et un impact plus important sur la fonctionnalité de la personne, améliorant ainsi sa qualité de vie”.

 Il existe un consensus sur le fait que les programmes d’exercice physique devraient être l’un des traitements de base pour tous les patients atteints de fibromyalgie.

“Le traitement doit être complet et coordonné par une équipe experte et qualifiée. Aucune donnée ne doit être laissée au hasard, excluant les problèmes rhumatismaux, neurologiques, psychiatriques et cliniques. Cela nécessite de la patience de la part du professionnel traitant et de la compréhension de la part de la famille et de la société. Par conséquent, il est très important de faire rapport sur la pathologie et de sensibiliser le public “, a déclaré Czerwonco.

Melgar a en revanche observé qu ‘”informer correctement de ces pathologies doit constituer la première étape du traitement”. “Le patient doit connaître dès le départ les caractéristiques de la maladie, son évolution, ainsi que les attentes positives et réalistes qui renforcent sa collaboration avec les thérapies, faisant confiance à une amélioration probable”, a-t-il ajouté.

Et après s’être assuré qu’il “existe un consensus sur le fait que les programmes d’exercice physique devraient être l’un des traitements de base pour tous les patients atteints de fibromyalgie”, le spécialiste a indiqué que ” la raideur matinale, symptôme caractéristique, est due à des altérations de la microcirculation qui génèrent sensation d’engourdissement et cause de la difficulté et de la douleur en bougeant  après de longues périodes d’immobilité “. À cet égard, il a souligné que “les exercices quotidiens d’étirement et d’oxygénation (tels que le tai-chi et le yoga) sont indiqués, ainsi que les activités physiques aérobiques et non intenses (marche, danse, cyclisme, exercices aquatiques). Les anaérobies ne sont pas recommandables car ils aggraveraient la sensation de lourdeur et de douleur “.

Les exercices d'étirement et d'oxygénation quotidiens tels que le tai-chi et le yoga sont fortement recommandés dans le traitement de la maladie (Getty)
Les exercices d’étirement et d’oxygénation quotidiens tels que le tai-chi et le yoga sont fortement recommandés dans le traitement de la maladie (Getty)

” La conscience et la thérapie cognitivo-comportementale ont démontré leur efficacité dans l’amélioration de l’humeur, la régulation émotionnelle et la gestion du stress . Ceci est d’une importance vitale pour éviter une aggravation de la douleur et contribuer à la capacité fonctionnelle “, a déclaré Melgar.

Et il a conclu: “Parmi les traitements pharmacologiques de la fibromyalgie, certains antidépresseurs approuvés permettraient de réduire efficacement la perception accrue de la douleur. Il n’existe pas de médicament qui élimine tous les symptômes à lui seul, mais certaines combinaisons de médicaments peuvent aider à réduire la douleur et la fatigue, ainsi qu’à améliorer le sommeil. Mais, de même, les soins susmentionnés sont essentiels pour parvenir, dans l’ensemble, à l’amélioration et au contrôle des symptômes. Peu à peu, vous pouvez réaliser ces changements jusqu’à ce qu’ils deviennent des habitudes. “

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