It’s a ‘forgotten’ and little known pain, but after the pandemic, cases of fibromyalgia are constantly growing. In Italy there are an estimated 2 million cases.
Fibromyalgia is still not included in the ministerial lists of chronic pathologies and therefore is not in the Essential Levels of Assistance. Experts therefore ask to put the spotlight on this syndrome, so that a timely diagnosis is facilitated and therefore adequate care management is guaranteed, in centers with experience. This was discussed on the occasion of the XII Advanced training course on acute and chronic pain, from research to clinic organized by the National Cancer Institute IRCCS Pascale Foundation of Naples, from 9 to 11 March.
Attention to the syndrome and its diagnosis is even more important today, in light of the data collected by researchers at the Sheba Medical Center in Israel and recently published in PLOS One*: analyzing about 200 patients hospitalized for Covid-19 in 2020, it is found that 87% had at least one symptom related to fibromyalgia after recovering from the infection, 15% developed the syndrome in the following five months. Among women, the incidence was 26%, six times higher than in the general population; the most common symptoms, each present in more than one out of two cases, are tiredness, sleep disturbances and muscle and joint pain.
“These data are also valid for our country, confirmed by ‘real life’, and demonstrate the importance of keeping the attention on fibromyalgia high, especially in those who have been hospitalized for Covid-19, but not only – he observes Marco Cascella, head of Pascale’s Pain HUB and Scientific Head of the Conference –. We know, for example, that juvenile fibromyalgia affects 2-6% of children and adolescents, especially girls, and in these cases it is even more essential to intervene to ensure a good quality of life and to avoid consequences on psychological well-being: recent research has shown in the brain areas responsible for pain processing and in the frontal cortex, in areas connected to the regulation and processing of emotions. It is therefore important to take charge of these patients in order to prevent them from developing psychic and emotional discomfort due to the negative experience induced by the syndrome”.
“In the Pascale Pain Therapy Centre, as well as in all similar highly specialized Italian centres, particular attention is paid to the overall management of patients suffering from chronic pain, including fibromyalgia, by intervening not only on the physical component but also on the also on the psychological aspect, thanks to a multidisciplinary team – resumes Cuomo –. Today we know, for example, that depression can be a consequence of fibromyalgia. Ma for a long time patients were considered ‘imaginary patients’, who somatised psychological discomforts. This is not the case and the efficacy of some antidepressants in selected patients with fibromyalgia and depression also demonstrates it. Therapy may also include muscle relaxants and painkillers, but the treatments are mostly non-pharmacological and above all personalized, with lifestyle, educational and psychotherapeutic interventions.
Unfortunately fibromyalgia is not included in the list of chronic pathologies and therefore in the LEA: patients are not entitled to exemptions for visits, examinations and therapies and this greatly complicates the management of the syndrome, for which it would be important to create adequate pathways so as to reduce the time for diagnosis and ensure adequate care management in centers with experience in the field”, conclude Cuomo.