La fibromyalgia, or fibromyalgia syndrome, is a chronic pathology striking about 2 million Italians, with a net prevalence of women. It is characterized by widespread pain musculoskeletal, sleep disturbances, chronic fatigue, neurocognitive changes and many other symptoms, such as headache or irritable bowel syndrome. Precisely because of his symptoms, common to many other diseases, formulate one diagnosis it is often difficult and requires the intervention of a specialist.
Fibromyalgia: when it appears and why
Usually the disease appears in the third or fourth decade of life, but it can manifest itself at any age. It has a chronic course and symptoms can persist even all of life, but they are not always present in the same intensity or with the same level of severity. There may, in fact, be exacerbations of more or less recurrent symptoms, which significantly impact on the life quality of those with fibromyalgia. There genetic predisposition seems to play a fundamental role, to which are added environmental factors (physical trauma such as car accidents, illnesses, traumas of a psychic, physical, sexual nature, etc.) e individual predisposition linked to one’s resilience (the ability to adapt to chronic stress situations) and to psychological aspects (anxiety, depression, obsessive compulsive disorder and post-traumatic stress disorder). All this causes modifications of the somatosensory nervous system, which lead to an altered threshold of the pain perception, and is expressed clinically with allodynia and hyperalgesia. Allodynia is the perception of one stimulus not painful as painful; hyperalgesia is the perception of one painful stimulus as excessively painful.
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Problems related to the disease
«While being one chronic pathology it is not recognized by the Italian State. We are looking forward to the law decree so that it can be inserted into LEA (essential levels of assistance) to help patients, who would finally be chronically ill. A further problem is that it does not have a biomarker. To formulate a diagnosis it is necessary to “assemble” a series of clinical manifestations. We need to collect the patient’s history, his own sleep disturbance, the fatigue which warns during the day, the neuro-cognitive disorder. Self-administration tests are of great importance. A further difficulty consists in the fact that the doctor is normally oriented towards the search for organic damage. Sure there differential diagnosis it is important if the symptoms have recently been present, but if they have persisted for years it is good to contact a rheumatologist it’s a algologo, expert in pain therapy », explains the Professor Piercarlo Sarzi Puttini, Full Professor of Rheumatology at the University of Milan and President of the AISF Italian Association of Fibromyalgia Syndrome.
The care of the fibromyalgia patient
«It is very important to improve the relationship between human resources and number of patients, so that each of these can also be followed in the public sphere, without necessarily having to resort to the private sector. Despite being a chronic disease, there is no single therapy. The patient must be the actor of his own therapeutic strategy under the guidance of the doctor. What is needed for fibromyalgia needs to be identified. But it is a journey that must be done together and that takes time. And time is often lacking in public structures: they are there very long waiting lists», Concludes the expert.
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