LECCE – Today we are talking about a disease that was ignored and underestimated in the past, but which today also affects many patients in Salento. Let’s address this issue with Dr Gianluigi Megliolagraduated in Bari in Medicine and Surgery, specialist in Anesthesia, Resuscitation, Intensive Care and Pain Therapy (he holds a II level Master’s degree in Pain Therapy), which mainly deals with Intensive Care and Pain Therapywith particular reference to musculoskeletal and neuropathic pain, and is operational at the Calabrian Center of Cavallino, a polyclinic that has been a territorial point of reference for years for the diagnosis and treatment of numerous pathologies. The expert explains how important it is correct and timely diagnosis, otherwise you run the risk of stuffing the patient with NSAIDs, worsening his health conditions.
In recent years there has been more talk of fibromyalgia syndrome: many Italians suffer from it. Diagnosis is very important, also because the symptoms can lead to hypothesize other pathologies, right? In the beginning it’s all about what the patient reveres, right? What are the diagnostic tools to focus on?
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“Fibromyalgia syndrome or fibromyalgia has actually begun to be talked about only in recent years, as it was initially misunderstood and patients were often treated for other pathologies, often presenting non-specific symptoms. Subsequently, it was recognized as a syndrome, i.e. a set of symptoms and clinical signs belonging to a single disease. In Italy alone, the estimated number of patients affected by this syndrome is about 2 million people, mainly females (7 to 1 ratio with males), generally young or middle-aged, even if, given the difficulty in making , there could be many more patients. The peculiarity of fibromyalgia lies in the fact that the symptoms are absolutely non-specific, which is why the syndrome is not easily recognized and therefore patients are subjected to treatments that do not solve the basic problem. These symptoms include tiredness, difficulty concentrating, irritable bowel syndrome, tension headache, sleep disturbances, morning joint stiffness, tingling in hands and feet, bruxism, menstrual pain, dryness and vision disturbances, widespread or localized muscle pain level of the neck, arms, shoulders, feeling of not having enough rest, burning sensation all over, extreme sensitivity to pain, anxiety and depression. In light of these symptoms and clinical signs, the diagnosis is one of exclusion, after excluding rheumatoid arthritis, multiple sclerosis, hypothyroidism, restless legs syndrome, osteoarthritis, autoimmune diseases. Consequently, diagnostic tests aim to exclude these pathologies, since the diagnosis of fibromyalgia is only clinical: the symptoms must have been present for at least 3 months and spread over the whole body (in the past, the diagnosis was made by exploring what were called tender pointsi.e. specific points whose acupressure triggered the pain)”.
Do we have to live with pain by controlling it or can it be defeated? What are the most effective treatments?
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“The fibromyalgia can be controlled by changing your lifestyle habits, making them as healthy as possible and relying on a doctor who deals with fibromyalgia. It is often necessary to administer drugs capable of controlling all the various aspects of the syndrome, paying close attention to prevention”.
What are the causes of this disease? Is there any form of prevention?
“The fibromyalgia can be triggered by various events and it is certainly the result of a combination of factors: an injury, viral infection, childbirth, surgery, breakup of an emotional relationship, mourning and more, but often it is not possible to trace the cause. An alteration of the intestinal microbiota has recently been proposed as a possible trigger. For prevention it is obviously necessary to have a balanced lifestyle, both in terms of sleep, physical activity, avoidance of stressful situations, correct nutrition”.
Is it true that before a correct diagnosis many fibromyalgia patients go through an ordeal of tests without answers, so as to confuse the disease with some psychosomatic pathology?
“Often the fibromyalgic patient initially goes to the doctor for neck pain, cervicobrachialgia, muscle pain, easy fatigue, joint pain, anxiety, headache and insomnia. He is treated for these symptoms with the common NSAIDs which in reality are of little use and thus an ordeal begins which is unlikely to end if attention is not focused on the syndrome. Very often the fibromyalgic patient was and still is defined as an ‘imaginary patient’, to the point of being labeled as a patient with psychiatric disorders, when in reality he is not”.
There is still a long way to go to raise awareness of this issue. This article can also be a contribution. Can we define Fibromyalgia today as a “social disease”, even if we don’t die of this pathology?
“Yes fortunately you don’t die of fibromyalgia, but it can be a disabling pathology, especially from an emotional and social point of view, as well as from a working one. Just imagine that a new mother with fibromyalgia can have difficulty picking up her baby, that any effort can cause pain, anxiety about an event can be such as to trigger a headache that prevents us from participating in it. We can put a stop to all this and see the light again, relying on those who know and recognize fibromyalgia syndrome.
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