Diseases, Fibromyalgia (English)

Update on clinical features, aetiopathogenesis, and therapy for fibromyalgia

Chronic widespread pain, fatigue, sleep disturbances, and functional symptoms are all symptoms of fibromyalgia.
Fibromyalgia’s etiopathogenesis, diagnosis criteria, and classification criteria are still being discussed, as are the treatment methods for this disorder.
Fibromyalgia is the third most common musculoskeletal disorder, and its prevalence rises as people get older.
Despite the fact that diagnosis has progressed as a result of the development of more precise diagnostic criteria, a significant number of physicians still fail to identify the syndrome.

Genetic predisposition, personal experiences, emotional–cognitive influences, the mind–body relationship, and a biopsychological capacity to cope with stress are all factors that lead to the development of fibromyalgia in a particular way. A multi-modal treatment approach is needed due to the multiple components of the pathogenesis and management of the disease. With the growing understanding that various fibromyalgia subgroups exist with different clinical characteristics, individually personalized care is becoming more important.

As a result, while an evidence-based approach to fibromyalgia management is often preferable, physicians’ approaches must ultimately be observational, with the intention of forming a close alliance with the patient and formulating mutual, practical therapeutic objectives.

Key points

  • Fibromyalgia is a relatively common condition in the general population, with a global prevalence of 2–3%.
  • Fibromyalgia’s complex polysymptomatology includes autonomic abnormalities, cognitive dysfunction, hypersensitivity to external stimuli, somatic symptoms, and psychiatric conditions, in addition to chronic widespread pain, exhaustion, and sleep disturbances.
  • Because of the subjective nature of symptoms and the lack of biomarkers, diagnosis is highly clinical, and diagnostic criteria are continually changing; early detection and prevention remain elusive objectives.
  • A variety of composite measures may be used to assess the degree of fibromyalgia and its development or improvement.
  • The pathogenesis of fibromyalgia is unknown; theories suggest that genetic predisposition, traumatic life events, peripheral (inflammatory) and core (cognitive–emotional) mechanisms all interact to trigger pain dysperception due to neuromorphological changes (‘nociplastic pain’).
  • The treatment should be multimodal and focused on four pillars (patient education, health, pharmacotherapy, and psychotherapy); it should be individualized, symptom-based, and stepwise, with the patient setting mutual objectives.

Leave a Reply

Your email address will not be published. Required fields are marked *