“The pain is invisible, but it destroys, isolates, weakens”
This quote, taken from the white Book of pain published in 2017 by the French Society of study and treatment of pain, reflects the daily life of patients with fibromyalgia.
Far from being rare, this disease affects 2 to 5% of the population in western countries, in particular women (8 to 9 out of 10 cases, according to the sickness Insurance).
Yet recognized since 1992 by the world health Organization, the fibromyalgia is still seen by some doctors as the expression of psychosomatic disorders.
Its cause is still unknown to this day. In October 2017, the journalists of le Figaro have reported on this disease in the show Toc Toc Docteur, in the company of professor Françoise Laroche of the Centre for the assessment and treatment of the Hospital Saint-Antoine in Paris.
What is fibromyalgia?This disease is characterized by chronic pain, diffuse and persistent, which may be aggravated by stress, cold or moisture, as well as by burning sensations, added to which is a profound tiredness.
In addition to these symptoms, people with a syndrome fibromyalgique are also likely to suffer from digestive disorders and sleep disorders, cognitive disorders or emotional disturbances.
These events have so far not physiological explanation and are not accompanied by biological abnormalities or visible lesions. Although very restrictive, fibromyalgia is not life-threatening because vital organs are not affected.
In addition, it is neither contagious nor hereditary. How to triggers the disease?An emotional shock or physical (accidents, surgery) may trigger the disease. But it is also possible that other disturbances are at the origin. Thus, the link between pain, sleep disorders, and depression makes it possible to envisage a deficit in neurohormones, including serotonin. “The neurohormones are substances present in very small amount at the level of the nervous system involved in functions such as sleep, mood and pain, but also in various functions of sensory, motor and cognitive”, and fills in the Orphanet encyclopaedia.
But whatever the cause, the disease is not overnight. In fact, before it settles, several symptoms precursor non-specific can occur, such as tingling, abnormal fatigue on exertion, pain in the stomach or an intolerance to cold and heat.
And, once installed, the pain is difficult to reverse. In question? Insomnia chronic, stressful environment, anxiety and bad hygiene of life which maintain the disease. The way in which the disease progresses is variable depending on the person.
Some, for example, can develop a depression that will affect their quality of life, others will experience pain, preventing the physical activity or even the realization of everyday tasks.
Fibromyalgia is, in many cases, a disease heavy, which profoundly affects the daily lives of patients. “READ ALSO – Fibromyalgia: “Learn to live with the omnipresence of pain,” How to diagnose it?The diagnosis is often difficult to establish, because of the absence of signs of organic and / or visible to medical imaging. The diagnostic criteria are based on those established in 1990 by the American College of rheumatology. The patient must feel pain for 3 months or more on at least 11 of the 18 sensitive areas identified (sub-occipital, cervical lower, trapéziens, scapula, second ribs, elbows, buttocks, femurs, and knees). The pain must also be generalized, that is to say, be located on both the right and left sides of the body, but also above and below the waist.
“During the clinical evaluation, the doctor assesses the pain, physical as well as moral, of the patient. He is also seeking a depression associated, pre-existing (unrelated to the fibromyalgia) or secondary (associated with the syndrome).
The doctor also looks for symptoms associated with pain, fatigue, sleep disorders, digestive disorders, concentration disorders, etc”, complete sheet health insurance.
Fibromyalgia can be confused with other diseases?The diagnosis can take a long time to establish, the fact of the resemblance of fibromyalgia with other diseases.
The physician must therefore eliminate the related conditions such as anxiety disorders or depressive, or personality disorders. Fibromyalgia can also be confused with irritable bowel syndrome, chronic fatigue, or Sjögren’s syndrome, responsible for dryness of the mouth, eyes, and mucous membranes of the genital area. What mechanisms?In people with fibromyalgia, the pain control at the level of the brain is altered. The Pr Laroche illustrates this mechanism by the image of the brakes, which would have too much served, and would then be “worn-out and less operational”. On the other hand, the hypersensitivity of the nerves plays a role in the felt painful, according to professor Laroche. But it is possible to mitigate these painful sensations, according to the attention that has been given to these evils.
“The pain is also modulated by the thoughts, emotions, and behavior,” adds the specialist. “READ ALSO – chronic Pain: have you tried electrotherapy? How to deal with it?Each treatment is customized according to the patient. In general, doctors prescribe analgesic drugs, but also of antidepressants, hypnotics and anticonvulsants. “An adapted physical activity is also indicated to combat the effects of the disease,” recalls the Pr Laroche.
Maintenance of the muscles and combat the physical deconditioning are the main benefits.
Because the origin of the disease is not known, there is not, for the time of curative treatment. If a lot of patients are opting for non-conventional medicine, such as acupuncture or osteopathy, “it must not, however, putting aside the approach to drug classic.
It is necessary to think in terms of complementary associations”, says the Pr Laroche.
” READ ALSO – Fibromyalgia: mps have called for its classification as a disease A support difficileLa fibromyalgia is not recognized as a disease by all. While the WHO considers it as such since 1992, the French health authorities consider that it is in fact a syndrome, that is to say a set of symptoms. In France, the national Institute of health and medical research (Inserm) is currently conducting a expertise the results of which should appear in may 2018. Because of this, fibromyalgia does, for the time being, not one of the diseases that are supported 100% by health Insurance.
Patients experience particular difficulties in obtaining the Affection status Long-Term (which avoids the advance of 100% of medical costs) because the treatments are not considered sufficiently costly. However, some may benefit from it. In fact, about 1000 to 2000 requests made each year to the Caisse nationale de l’assurance maladie, 500 are granted. People with fibromyalgia may also try to obtain the recognition of the disability, or the recognition of invalidity, but this remains very rare. The hope is for people suffering from fibromyalgia. Indeed, research on the disease advances, in particular on the role played by stress, genetics or viruses in the disease or its outbreak. In addition, the use of certain drugs, such as pregabalin (antiepileptic drug indicated in the treatment of anxiety disorders and pain due to nerve damage) or anti-vomiting agent bring results “promising”, according to the Orphanet encyclopaedia. . .