La fibromyalgie est la deuxième maladie rhumatismale la plus fréquente derrière l’arthrose et,
bien que toujours très mal compris, est maintenant considéré comme un trouble du système nerveux tout au long de la vie du centre, qui est responsable de la douleur amplifiée qui tire à travers le corps chez ceux qui en souffrent.
Daniel Clauw, MD, professeur d’anesthésiologie à l’Université du Michigan, la base neurologique pour la fibromyalgie dans une allocution plénière aujourd’hui à la réunion scientifique annuelle de l’American Pain Society analysé.

“La fibromyalgie peut être considérée à la fois comme une maladie discrète et aussi comme une voie finale commune de la douleur de la centralisation et de la chronification.

La plupart des personnes atteintes de cette maladie ont des histoires de douleur chronique tout au long de leur vie “, a déclaré Clauw. “La condition peut être difficile à diagnostiquer si l’on ne connaît pas les symptômes classiques car il n’y a pas une seule cause et il n’y a pas de signes extérieurs.”

Clauw a expliqué que la douleur de la fibromyalgie vient plus du cerveau et de la moelle épinière que des zones du corps où quelqu’un peut ressentir une douleur périphérique.
La condition est censée être associée à des altérations dans la façon dont le cerveau traite la douleur et d’autres informations sensorielles.

Il a déclaré que les médecins devraient soupçonner chez les patients souffrant de fibromyalgie multifocale (principalement musculo-squelettique) une douleur qui n’est pas entièrement expliquée par une blessure ou une inflammation.

“Parce que les voies de la douleur dans tout le corps sont amplifiées chez les patients atteints de fibromyalgie, la douleur peut se produire n’importe où,

les maux de tête chroniques, la douleur viscérale et l’hyperréaction sensorielle sont fréquents chez les personnes atteintes de cette maladie douloureuse », a déclaré Clauw.

“Cela n’implique pas que l’apport nociceptif périphérique ne contribue pas à la douleur ressentie par les patients atteints de fibromyalgie,
mais je ressens plus de douleur que ce qui serait normalement attendu du degré d’entrée périphérique.
Les personnes souffrant de fibromyalgie et d’autres états douloureux caractérisés par une sensibilisation éprouveront de la douleur à cause de ce que les personnes qui ne sont pas atteintes de cette affection qualifieraient de toucher », a ajouté M. Clauw.

Parce que les origines de la douleur du système nerveux central de la fibromyalgie,
Clauw dit traitements opioïdes ou d’ autres analgésiques narcotiques ne sont généralement pas efficaces parce qu’ils ne réduisent pas l’activité des neurotransmetteurs dans le cerveau.
“Ces médicaments ne se sont pas révélés efficaces chez les patients atteints de fibromyalgie,
et il existe des preuves que les opioïdes peuvent même aggraver la fibromyalgie et d’autres états douloureux centralisés”, a-t-il dit.

Clauw conseille aux médecins d’intégrer les traitements médicamenteux, tels que gabapentinoïdes, tricycliques et inhibiteurs sélectifs du recaptage serotonoin,
avec non – approches pharmacologiques telles que la thérapie cognitivo – comportementale, l’ exercice et la réduction du stress.

“Parfois, l’ampleur de la réponse au traitement des thérapies non pharmacologiques simples et peu coûteuses dépasse celle des médicaments”, a déclaré M. Clauw. “Le plus grand avantage est la fonction,
qui devrait être l’objectif principal du traitement pour toute condition de douleur chronique améliorée. La majorité des patients atteints de fibromyalgie peuvent voir une amélioration de leurs symptômes et mener une vie normale avec les médicaments appropriés et un usage intensif de thérapies non pharmacologiques. “


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