Vous entendez parfois la fibromyalgie appelée « diagnostic à la mode » ou « nouvelle maladie » , mais la vérité est que la fibromyalgie est loin d’ être nouvelle. Il a des siècles d’histoire, avec de multiples changements de nom et théories mis au rebut le long du chemin.
Bien qu’il n’a pas toujours été acceptée par la communauté médicale, et aujourd’hui son acceptation n’est pas universel, la fibromyalgie a parcouru un long chemin et la recherche actuelle continue d’apporter la preuve qu’il est une maladie physiologique très réelle.
Le récit historique plus souvent cité de la fibromyalgie provient d’un document de 2004 par des chercheurs et Muhammad Fatma Inanici B. Yunus. Cette histoire a été compilée à partir de leur travail, ainsi que de nouvelles informations de la dernière décennie. (Toutes les sources sont citées à la fin de l’article.)
Retour au début – 1592-1900
Dès le début, les médecins ne disposaient pas des définitions distinctes pour toutes les conditions de la douleur que nous connaissons aujourd’hui. Les descriptions et la terminologie commencé large et ont été rétrécis progressivement.
En 1592, le médecin français Guillaume de Baillou a introduit le terme « rhumatisme » pour décrire la douleur musculo – squelettique qui ne proviennent pas d’ une blessure. Ce fut un terme qui aurait inclus la fibromyalgie ainsi que l’ arthrite et de nombreuses autres maladies. Finalement, les médecins ont commencé à utiliser des conditions douloureuses qui, comme la fibromyalgie, ne provoquent une déformation « rhumatisme musculaire ».
Deux cents ans plus tard, les définitions étaient encore assez vague.
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Cependant, en 1815, le chirurgien écossais William Balfour a noté des nodules sur les tissus conjonctifs et émis l’ hypothèse que l’ inflammation pourrait être derrière les deux nodules et la douleur. Il a également été le premier à décrire les points d’appel d’offres (qui sera plus tard utilisé pour diagnostiquer la fibromyalgie.)
Quelques décennies plus tard, le médecin français Francios Valleix a utilisé le terme « névralgie » pour décrire ce qu’il croyait être douleur référée de points sensibles qui voyagent le long des nerfs .
D’ autres théories du jour comprenaient les terminaisons nerveuses hyperactives ou des problèmes avec les muscles eux – mêmes.
En 1880, le neurologue américain George William Beard a inventé les termes neurasthénie et myelasthenia pour décrire la douleur généralisée ainsi que la fatigue et des troubles psychologiques. Il croyait que la condition a été causée par la création stress.The d’ une terminologie plus spécifique vraiment explosé au début du 20ème siècle. Différents noms pour la maladie comme la fibromyalgie inclus:
Myogeloses
durcissement musculaire
aponévrite
Fibrosite, inventé en 1904 par le neurologue britannique Sir William Gowers, est celui qui est resté. Les symptômes mentionnés Gowers vous semblera familier à ceux qui ont la fibromyalgie:
La douleur spontanée,
Sensibilité à la pression,
Fatigue,
Perturbations de sommeil,
Sensibilité au froid,
Aggravation des symptômes par le muscle surutilisation.
En tant que traitement, il a suggéré des injections de cocaïne, comme la cocaïne a ensuite été utilisé en médecine comme anesthésique topique.
Médicalement, « fibro » signifie le tissu conjonctif et « itis » signifie l’ inflammation. Peu après Gowers mis en avant le nom, un autre chercheur a publié une étude semblant confirmer un grand nombre de théories de Gowers sur les mécanismes de l’ inflammation dans l’état. Cela a contribué à cimenter le terme fibrositis en langue vernaculaire. Ironie du sort, cette autre recherche a été trouvé plus tard défectueux.
Dans les années 1930, l’ intérêt accru dans la douleur musculaire mentionné des points d’appel d’offres / déclenchement et graphiques de ces modèles ont commencé à apparaître. Les injections locales de l’ anesthésie ont continué à être un traitement suggéré.
Fibrosite n’a pas été un diagnostic rare à l’ époque. Un document 1936 a déclaré le fibrositis était la forme la plus courante de rhumatisme chronique sévère. Il a également dit que, en Grande – Bretagne, elle représentait 60 pour cent des cas d’assurance pour les maladies rhumatismales.
En outre , à cette époque, le concept de la douleur musculaire mentionné a été prouvé par la recherche. Une étude sur les voies de la douleur profonde douleur et mentionné hyperalgésie (réponse de la douleur accrue) et peut avoir été le premier à suggérer que les systemwas nerveux central impliqués dans la maladie.
En outre, un document sur les points de déclenchement et douleur irradiée mis en avant le terme « syndromes de douleur myofasciale » pour une douleur localisée.
Les chercheurs ont suggéré que la douleur généralisée de fibrositis peut venir d’une personne ayant de multiples cas de syndrome de la douleur myofasciale.
La Seconde Guerre mondiale a apporté un regain d’ intérêt lorsque les médecins ont réalisé que les soldats étaient particulièrement susceptibles d’avoir fibrosite. Parce qu’ils ne montrent des signes d’inflammation ou d’une dégénérescence physique, et l’ apparition des symptômes liés au stress et à la dépression, les chercheurs ont étiqueté « rhumatisme psychogène. » Une étude 1937 a suggéré que la fibrosite était un « état psychonévrotique chronique. » Ainsi, le continu débat entre physique et psychologique est né.
Fibrosite a continué à se faire accepter, même si les médecins ne pouvaient pas d’ accord sur exactement ce qu’il était. En 1949, un chapitre sur la condition paru dans un livre de texte Rhumatologie bien considéré appelé l’ arthrite et les conditions alliées. On pouvait y lire « [T] ici ne peut plus y avoir de doute quant à l’existence d’une telle condition. » Il a mentionné plusieurs causes possibles, y compris:
Infection,
Traumatisante ou professionnelle,
Les facteurs météorologiques,
troubles psychologiques.
Pourtant, les descriptions étaient mish-purées vagues que nous reconnaissons maintenant comme incluant plusieurs types de conditions de douleur très différentes. Ils interviennent généralement la fatigue, des maux de tête, et la détresse psychologique, mais un mauvais sommeil n’a pas été mentionné.
La première description de fibrositis qui ressemble à ce que nous reconnaissons aujourd’hui que la fibromyalgie est venu en 1968. Chercheur document de Eugene F. Traut mentionné:
La prédominance féminine,
courbatures et raideurs Généralisée,
Fatigue,
Maux de tête,
Colite,
Mauvais sommeil,
Être « Worts Worry »
Les points sensibles découverts par examen physique,
Un important lien corps-esprit.
En plus de la douleur généralisée, il a reconnu certaines d’entre elles régionales qui semblaient être communs, y compris ce que nous savons maintenant que le syndrome du canal carpien. Il a mentionné « différents niveaux de l’axe de la colonne vertébrale, » que vous pouvez reconnaître à partir des critères de diagnostic modernes: la douleur dans le squelette axial (os de la tête, la gorge, la poitrine et la colonne vertébrale) et dans les quatre quadrants du corps.
Quatre ans plus tard, cependant, chercheur Hugh A. Smythe a écrit un chapitre de manuel sur fibrositis qui ont eu une influence considérable sur les études futures et conduire à son être appelé le « grand – père de la fibromyalgie moderne. » Il croit être le premier à décrire exclusivement en tant que condition répandue, il distinguant ainsi du syndrome de douleur myfascial.
Smythe non seulement inclus un mauvais sommeil dans la description , mais a décrit ce que le sommeil était comme pour les patients et a également fourni électroencéphalogramme non publié (étude du sommeil) des résultats qui ont montré un dysfonctionnement au stade 3 et le sommeil stade-4. En outre, il a déclaré que le sommeil non réparateur, le traumatisme et la détresse émotionnelle tous pourraient entraîner des symptômes accrus.
Des recherches ultérieures ont confirmé des anomalies du sommeil ainsi que de montrer que la privation de sommeil peut entraîner des symptômes semblables à la fibromyalgie chez les personnes en bonne santé.
Smythe a ensuite été impliqué dans une étude que l’ amélioration des points d’appel d’offres précis et proposé leur utilisation dans le diagnostic. Il douleur chronique également fourni , troubles du sommeil, la raideur matinale et la fatigue des symptômes qui pourraient aider à diagnostiquer la maladie.
Alors que les chercheurs ont fait des progrès, ils avaient toujours pas découvert des preuves de l’ inflammation – la « ite » dans fibrosite. Le nom a ensuite été changé à la fibromyalgie: « fibro » signifie les tissus conjonctifs, « mon » qui signifie le muscle, et « algie » la douleur signifie.
Pourtant, beaucoup de questions restent. Les principaux symptômes sont vagues et courants dans la population. Les médecins n’avaient toujours pas une poignée sur ce que la fibromyalgie était.
Ensuite, une avance d’étude séminale par Muhammad Yunus est sorti en 1981. Il a confirmé que la douleur, la fatigue et les troubles du sommeil sont significativement plus fréquents chez les personnes atteintes de fibromyalgie que chez les sujets témoins en bonne santé; que le nombre de points d’appel d’offres était significativement plus élevé; et que plusieurs autres symptômes étaient beaucoup plus fréquents et. Ces symptômes supplémentaires inclus:
Gonflement subjective,
paresthésie (Les sensations anormales nerveuses),
conditions qui se chevauchent , tels que le syndrome du côlon irritable (IBS), les céphalées de tension et les migraines.
Ce document assez mis en place d’un groupe de symptômes constants pour désigner officiellement la fibromyalgie syndrome, ainsi que les premiers critères éprouvés pour différencier ceux qui ont la fibromyalgie des autres.
Une richesse de la recherche a depuis confirmé que ces symptômes et les conditions qui se chevauchent sont en fait associée à la fibromyalgie.
Yunus puis cimentation a conduit la recherche de l’idée de plusieurs conditions qui se chevauchent, dont la dysménorrhée primaire (période douloureuse) avec IBS, la céphalée de tension et la migraine.
Alors qu’il croyait que la fonction unificatrice était des spasmes musculaires, mais ce qui suggère plus tard céder la place à la théorie de la sensibilisation centrale.
Depuis ce point, nous avons eu une énorme quantité de recherches publiées et des progrès réalisés. Nous n’avons pas encore toutes les réponses, mais nous avons acquis une bien meilleure compréhension de ce qui peut se passer dans notre corps.
Des progrès importants comprennent:
1984 – Première étude publiée lien entre la prévalence de la fibromyalgie plus élevée chez les personnes atteintes d’ arthrite rhumatoïde;
1985 – première étude contrôlée de la fibromyalgie juvénile a été publié;
1986 – Médicaments influençant la sérotonine et la noradrénaline ont d’ abord été montrés pour être efficace;
1990 – American College of Rheumatology établit criteriaof diagnostic officiel douleur généralisée et de tendresse dans au moins 11 des 18 points spécifiques, la standardisation ainsi des critères d’inclusion de la recherche dans le monde entier;
1991 – Fibromyalgie impact Questionnaire développé pour les médecins pour évaluer la fonction;
1992 – Découverte des niveaux bas hormone de croissance;
1993 – Les études démontrent des anomalies sensibilisation centrale et de l’ axe HPA (régulation du stress);
1994 – Confirmation de la substance P élevée (messager de la douleur) dans le liquide céphalorachidien;
1995 – Première étude de la prévalence américaine montre la fibromyalgie dans 2% de la population;
1995 – Première SPECT (imagerie cérébrale) montrant des modèles anormaux de flux de sang dans le cerveau;
1999 – Première étude démontrant composante génétique pour expliquer pourquoi il fonctionne dans les familles;
2000 – Examen des pièces de preuve le terme des syndromes de sensibilisation centrale;
2005 – American Pain Society publie des lignes directrices pour le traitement de première douleur de la fibromyalgie;
2007 – Lyrica (prégabaline) devient le premier traitement approuvé par la FDA aux États – Unis (Cymbalta (duloxétine) et Savella (milnacipran) suivi, en 2008 et 2009, respectivement;)
2010 – American College of Rheumatology libère des questionnaires criteriausing diagnostic alternatifs au lieu des points sensibles.
La recherche a continué à consolider ces résultats, ainsi que proposer de nouveaux facteurs et mécanismes de causalité possibles. Au début de 2014, certaines lignes d’enquête comprennent:
L’ inflammation du fascia: Certaines recherches ont suggéré que la douleur généralisée de la fibromyalgie peut en effet être inflammatoire, mais dans le corps à l’ échelle extrêmement mince bande de tissu conjonctif appelé fascia.
Nerfs supplémentaires sur les vaisseaux sanguins: Une étude très médiatisée montre la température supplémentaire et les nerfs de détection de la douleur dans le système circulatoire.
Neuropathie petite fibre: La recherche émergente montre que certains nerfs spécialisés peuvent être endommagés.
Système immunitaire Malformations: Certaines lignes de recherche montrent une activité anormale dans le système immunitaire qui peut suggérer l’ activation ou l’ auto – immunité système immunitaire chronique. Une étude suggère une réaction auto – immune à la sérotonine. Un autre propose un test de diagnostic possible basé sur un profil immunitaire.
Plusieurs chercheurs travaillent également à établir des sous-groupes de la fibromyalgie, estimant qu’il est la clé de clouer les mécanismes sous-jacents et les meilleurs traitements. Des traitements sont toujours à l’étude, et un objectif majeur a longtemps été l’identification et l’établissement des outils de diagnostic objectifs comme un test sanguin ou scan.Fibromyalgia n’a pas encore trouvé l’acceptation universelle dans la communauté médicale, mais il est plus proche que jamais. Comme la recherche continue de démontrer qu’il est à la fois réel et physiologique, cette condition gagne en crédibilité et ceux d’entre nous avec elle gagner la compréhension, le respect, et, surtout, de meilleures options de traitement afin que nous puissions récupérer notre avenir.
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