The National Institute of Psychiatry “Ramon de la Fuente Muniz” provides care Diagnosing Patients With Fibromyalgia, It is a rheumatological condition that causes chronic pain and fatigue, is disabling, invisible, unpredictable and uncontrollable.
In the outpatient rehabilitation department of the Institute, the approach to this condition is comprehensive and multidisciplinary, aimed at improving the medical, psychological and psychiatric conditions in which the patient finds himself.
List its main features
Maria Isabel Barrera Villalpando, an expert attached to this department, said that the disease is characterized by Widespread pain in any part of the body such as the head, joints, muscles or ligaments, fatigue, irritable bowel syndrome, concentration problems, and high levels of depression and anxiety.
The person states that the pain is combined with a burning sensation and that they experience cramping and electric shock sensations; In addition, it causes sleep disturbances and morning stiffness, which makes it difficult to wake up. Oftentimes, fibromyalgia crises are exacerbated by heat, humidity and cold, and they are very sensitive to noise, light and certain odors, he explained.
“The typical pain of fibromyalgia is neuropathic; It refers to the malfunctioning of nerve fibers without causing damage to any organ or structure of the body. This neuropathic pain has also been shown in people with diabetic foot or herpes zoster; It is an irritation that burns, because of which they cannot tolerate even the rubbing of their clothes.
How is it diagnosed?
The doctor of psychology indicated that there are other criteria to consider that it is fibromyalgia. Hypersensitivity at specific points on the body that lasts for at least six months. There are also problems with concentration and anxiety.
He explained that there is no laboratory study to diagnose it, so it is important that rheumatology specialists rule out other diseases before confirming through a clinical interview. Appropriate pharmacological treatment avoids unnecessary or excessive supply of drugs.
fibromyalgia There is a strong genetic predisposition, it is common for family members to develop the condition.
He added that differential diagnosis should be made with diseases such as rheumatoid arthritis, systemic lupus erythematosus, chronic fatigue syndrome (now called myalgic encephalomyelitis), Sjogren’s syndrome, polymyalgia rheumatica, and neuropathies.
he insisted that fibromyalgia It affects two to five percent of the population worldwide, usually by the age of 40; For every 100 cases, 90 are females and 10 are males.
The expert highlighted that psychological treatments for better pain management are based on contextual cognitive behavioral therapy, a model that deals with the relationship between thoughts, feelings, and behaviors, with an emphasis on triggering and maintenance factors. The patient who presents with a strong history of physical. Psychological and/or sexual abuse since childhood.
Therapy also considers working with mental disorders such as anxiety and depression that perpetuate or exacerbate the condition. fibromyalgia.
The authors of the Stress and Mental Health Manual also noted that 80 percent of people with fibromyalgia also have moderate to severe depression. While 60 percent presented some anxiety disorder and high association with post-traumatic stress is frequent.
Recent works on disease
Recent research on this disease suggests the presence of dysautonomia, that is, a malfunction of the autonomic nervous system that controls automatic responses in the body such as heart rate, blood pressure, temperature, and intestinal motility, among others.
Similarly, increased activity of the sympathetic nervous system has been detected at night, which may explain restlessness in patients without refreshment.
Recent studies from the Department of Rheumatology at the National Institute of Cardiology and the Hospital for the Blind suggest that fibromyalgia is a fine fiber neuropathy. It was found that the number of these fibers in the cornea is less and they are thinner. Possibly in the future it may be considered as a biological marker for the diagnosis of this condition.
The expert explained that another area of research reports significant dysfunction in the mitochondria, which would explain the lack of energy that characterizes these patients. In this sense, adequate nutrition and good oxygenation are essential so that this part of the cell that provides energy has enough nutrients to help reduce or prevent chronic fatigue.
They indicated that there is an association of certain hormones affecting the pain-releasing fibers in women.
Among the recommendations for people suffering from this condition, detailed scientific advice, are doing low-impact exercise free of pressure, practicing tai chi, yoga, walking, water aerobics, hydrotherapy in warm water, and relaxing swimming. have been
He recommends following a Milpa diet, which includes corn, beans, fruits—which provide vitamins—and vegetables that provide important minerals such as magnesium, zinc and potassium.
He is said to have used antidepressants (serotonin and norepinephrine reuptake inhibitors) or some tricyclics for his psychiatric treatment. Pain modulators that relieve neuropathic discomfort are also prescribed.
The National Institute of Psychiatry provides psychoanalytic and informational sessions for patients, family members and the general public to address this little known condition not only in Mexico, but throughout the world.
In addition, cognitive behavioral group therapy relevant to fibromyalgia and other pain disorders is provided, in which other health professionals such as nutritionists, biologists, and psychologists and psychiatrists with expertise in violence also participate.
He world fibromyalgia day was founded by the World Health Organization (WHO) in tribute to the nurse Florence Nightingale who were suffering from this disease. Nightingale founded the first modern nursing school and was an advocate for the rights of people with disabilities.