Being diagnosed with fibromyalgia can be a relief for some, but also a cause for concern for others. Fibromyalgia is a condition in which the central nervous system is very sensitive, and the immune systems (sympathetic, endocrine, and motor) are overreactive. Fibromyalgia can also be described as a disease of the pain system, with the body’s alarm system malfunctioning.
Additionally, this causes the body to overprotect itself. Over time, this overprotection leads to changes in the tissues, which changes the amount of danger messages sent to the central nervous system.
Fibromyalgia affects 5% of the general population. It is a diagnosis of exclusion, meaning that all other possible causes of pain have been ruled out before arriving at this diagnosis.
As a result, people with fibromyalgia can experience pain anywhere in their body, and the number of signs and symptoms experienced varies from person to person.
The pain system in fibromyalgia
Here are 5 particularities of the pain system in people with fibromyalgia:
- The pain detector is more sensitive: these people can feel pain for a stimulus that is not painful in people who do not have an alteration of their pain system.
- The volume of all sensory inputs is increased. There is therefore an increase in sensitivity to cold, heat, noise and chemicals.
Sensitization of the brain regions:
- Mood
- Sleep
- Concentration
- Memory
It is not uncommon for people with fibromyalgia to suffer from anxiety, lack of concentration, memory problems or fatigue.
- Presence of too many endogenous opioids in the brain of people with fibromyalgia.
- Inability to activate the descending pathways of the brain to reduce pain, due to a lack of serotonin. The brain’s descending pathways are dependent on serotonin.
fibromyalgia treatment
Can we cure fibromyalgia? No
It’s like diabetes or high blood pressure: we have it forever, but there are several ways to control the symptoms.
The treatment approach is a holistic one, which considers the well-being of the person as a whole. Thus, the overall goal is to get the person to love and enjoy their life.
Education
It is important for people to understand fibromyalgia. Many people with fibromyalgia have been told that they are making up their pain because there is nothing wrong with their body. This is not true. Although the dysfunctions are invisible, people are really in pain.
Self-management strategies
To teach patients how to manage their own symptoms:
- Exercise
- Sleep hygiene
- Good nutrition
- Energy management
- Having realistic goals
- Having fun
- Mindfulness
- Socialization
- Work: how to manage work in life balance
Physical activity
Physical activity is an excellent method to retrain the pain system. In fact, people with fibromyalgia with pain need 4 types of exercises:
- Stretching
- Strengthening
- Aerobic exercises
- Relaxation
Moving allows you to retrain the body to not feel pain when it is not supposed to feel pain. It is important to start at a low intensity and gradually increase the intensity. Your physiotherapist can prescribe an exercise program specific to your condition.
Psychology
It is recommended to always combine physical activity with psychological therapy, which can help with mood, anxiety, sleep, lack of concentration and fatigue problems. Cognitive behavioral therapy has been shown to be effective.
Medication
Doctors can prescribe adequate pharmacological treatment to help manage the symptoms of fibromyalgia. Being an impairment of the central nervous system, medications that act on this system are usually necessary. In addition, to counteract the hypersensitivity to pain due to glutamate, the use of medications that block its action is possible.
Furthermore, since the inhibitory nerve pathways of pain are altered by the lack of serotonin, the use of medications that increase serotonin may be recommended. They promote an increased concentration of serotonin in the brain, thus facilitating the inhibition of pain. An optimal approach to treating fibromyalgia and preventing its progression involves the combined use of different treatment modalities. Maximizing our toolbox is essential for comprehensive care.
Your physiotherapist can help you live better with fibromyalgia.
Visit the clinic nearest you:
- Physiotherapy – Chelsea Gatineau (secteur Hull)
- Physiotherapy – Vaudreuil-Dorion
- Physiotherapy – Mirabel
- Physiotherapy – Valleyfield
- Physiotherapy – Québec
- Physiotherapy – Boucherville
- Physiotherapy – Trois-Rivières
Dr. Andrea Furlan, MD, PhD, parle de la fibromyalgie dans une vidéo disponible à cette adresse : Lien vers la vidéo (consultée le 16 septembre 2023).
“Fibromyalgie”, Physiopedia. Consulté le 22 janvier 2024. Lien vers la page
Mosely, G.L. et Butler, D. (2015), “The Explain Pain Handbook Protectometer”, Moigroup Publications.
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Private: Lori-Frédérique Landry
Physiotherapist
