Fibromyalgia: Causes and Symptoms

Fibromyalgia is a pathological condition accompanied by diffuse musculoskeletal pain, muscle tension and weakness, fatigue and psycho-vegetative phenomena. This disease, which occurs on average in 4% of the population, but is rarely diagnosed, especially in Russia. In recent years, there has been a trend of a 5% increase in the incidence rate. Absence of clear morphological and diagnostic signs, unclear pathogenesis, absolutely "normal" (i.e. e. without pathological changes), all this is the reason that the diagnosis of "fibromyalgia" can rarely be heard within the walls of a conventional clinic or hospital.

In this article I will tell you about the causes and symptoms of fibromyalgia, but once again we recall that the information is provided only for acquaintance, and to put the diagnosis on the basis of the revealed reasons and signs the doctor-neurologist should only.

General information

Until the mid-seventies of the twentieth century, this disease was referred to as "fibrositis." But, as soon as the non-inflammatory nature of the pathological process was elucidated, the term "fibromyalgia" was proposed, which is also used today.

Fibromyalgia is a complex problem affecting many specialists. This disease falls in the field of vision and rheumatologists, and neuropathologists, and traumatologists, and psychiatrists, and general practitioners. In most cases, this diagnosis is made by eliminating all other possible and identified diseases.

Causes

Constant mental stress and frequent intake of drugs contribute to the emergence of fibromyalgia.

To date, the exact cause of this pathology is not established, and views on the pathogenesis are very contradictory. There are several theories explaining pathological changes in fibromyalgia, but none of them has received priority distribution. Most scientists are inclined to unite at this stage of peripheral and central mechanisms of disease development.
Under the influence of any external causes there is a continuous pain (nociceptive) stimulation of the structures of the central nervous system from the periphery. Among the external reasons, the following may possibly matter:

• Sluggish current infectious processes (herpes virus, Epstein-Barr, cytomegalovirus);
• injuries, both acute and chronic (for example, in athletes);
• hormonal imbalance (especially thyroid hormones);
• constant mental stress, i.e. being in a state of stress;
• peripheral pain syndromes;
• constant intake of medicines;
• vaccination.

Under the influence of constant pain stimulation of the posterior horns of the spinal cord, a continuous excitation state is formed in them. Being in this state, the neurons of the spinal cord transmit impulses further to the central nervous system about the presence of pain. And they continue to do this even after stopping the arrival of impulses from the periphery. Those. the sensation of pain begins to appear even in the absence of a direct peripheral stimulus. Often, patients who complain of pain in any part of the body in the absence of damage in this area, detectable with the help of additional methods of research, are considered to be simulators (in fact the real cause of pain is not).

It is believed that the process described above plays a role in the onset of fibromyalgia, as well as a violation of the descending (from the brain) pain control. The decrease in the flow of norepinephrine and serotonin, melatonin, dopamine, substance P from the central nervous system contributes to the chronic existence of a sensation of pain. The pain threshold in patients with fibromyalgia is significantly reduced.

There is also a genetic predisposition (due to the tendency of having several cases among blood relatives), but gene localization has not yet been proven.
There is also the opinion that a certain role in the development of fibromyalgia can play a violation of the phase of deep sleep and at the same time a low level of somatotropin.
Thus, so far, unfortunately, there is no consensus in the world about the likely causes of fibromyalgia. Research in this direction continues.

Symptoms

Such patients are concerned about pain in different parts of the body.

The onset of the disease is gradual, usually 20-30 years, much less often - in childhood. Often a provoking factor is revealed: trauma, stress, surgical intervention. Women are predominantly ill, the ratio of men and women is approximately 1: 8. The course of fibromyalgia is chronic, the periods of remission are replaced by exacerbations.

Isolate fibromyalgia primary and secondary. Secondary develops against a background of a disease, the primary does not have a history of references to a different disease.

We list the main clinical manifestations of fibromyalgia.

1. Pain syndrome: has a great variety. Patients complain about the presence of pain of the most diverse localization, nature and prevalence. Pain is simultaneously disturbing both in the upper and lower parts of the body, left and right, i.е. is diffuse. The duration of pain is at least three months. The tendency to the migration of pain is characteristic. Perhaps a feeling of pain in the joints with their simultaneous swelling and restriction of movements, directly in the muscular arrays, spine or extremities. Pain can occur when performing self-service skills: when washing your hair, combing your hair, brushing your teeth etc. Pain decreases after massage, in a warm room, with little physical activity and after rest. However, prolonged rest or prolonged inactivity can, on the contrary, provoke a worsening of the condition.
2. Hypersensitivity in certain points of the body (the nape, the front surface of the neck at the C5-C7 vertebrae, trapezius muscle, internal surface of the knee, upper-outer quadrant of the buttocks and others). At the same time, visible pathological changes and objective reasons for pain in these areas should not be.
3. Stiffness of movements, most pronounced in the morning. It can appear spontaneously during the day and lasts for 15-20 minutes.
4. Fatigue: a constant sensation that does not pass after sleep or rest, sometimes even the patients wake up more tired than when going to sleep.
5. Paresthesia: burning sensation, crawling, numbness, "unpleasant" (words that can not be described) sensations.
6. Subjective feeling of bursting and tightening of tissues to the touch (more often in the area of ​​hands and knees).
7. A variety of sleep disorders, in any combination. Sleep is shallow and never gives a feeling of recovery.
8. Tension headaches.
9. Nocturnal painful cramps in the legs, or krampi;
10. "Restless legs syndrome": unpleasant, difficult to explain sensations in the legs, causing an irresistible desire to move them.
11. The Raynaud's syndrome can have varying degrees of severity. More frequent manifestations of spasm of blood vessels with cooling and whitening of the fingers.
12. Psycho-vegetative disorders: pain in the heart area without objective reasons, irritable bowel syndrome, imperative urge to urinate, attacks of "panic attacks", fainting, migraine, premenstrual syndrome, impotence.
13. Anxiety-depressive disorders are observed in 90% of cases. Sometimes come to the fore in the clinical picture, and then other symptoms of the disease are "explained" by the presence of the depression itself, which depresses the timing of the diagnosis.
14. Light cognitive impairment: absentmindedness, lack of concentration of attention, sensation of "fog in the head".

Symptoms of fibromyalgia lead to unpleasant sensations, deterioration of the quality of life of the patient, a decrease in the ability to work, a violation of the adaptability of the organism to external conditions. The variety of the clinical picture of this disease makes the diagnostic measures and diagnosis much more complicated. Only a competent and versatile approach to assessing all manifestations of the disease allows the doctor not to make a mistake and not miss this disease.