Fibromyalgia - a form of extra-articular soft tissue lesions characterized by diffuse musculoskeletal pain and the presence of specific tender points or hypersensitivity of points defined at feeling.
The disease predominantly affects middle-aged women.
manifestations of fibromyalgia
A characteristic feature of fibromyalgia is the abundance and variety of complaints and subjective sensations of the patient with a very meager objective evidence of disease.
The main symptom of fibromyalgia - a diffuse musculoskeletal pain. Pain is seen as diffuse, if it is present in different anatomical areas of the right and left half of the body above and below the belt, as well as - in the projection of the spine.
The pain is usually combined with a sense of morning stiffness, feeling of limb edema, fatigue and muscle sensations, "pins and needles" or tingling. Characteristically these gain characteristics when changing weather, fatigue, stress.
In accordance with the diagnostic criteria of the American College of Rheumatology fibromialgicheskih symptom duration must exceed 3 months since the emergence of spilled muscle pain and fatigue can be caused by a viral infection, temporary disturbance of sleep and stress situations.
Significant psychological distress largely determine the manifestations of fibromyalgia and bring the disease to chronic fatigue syndrome.
One of the most common complaints is fatigue, which says 87% of patients. Sleep disturbanceManifested difficult process of falling asleep, restless sleep interrupted and the lack of a sense of recovery after sleep, observed in 79% of patients. Frequent headaches by type migraine It says more than half of patients with fibromyalgia.
For patients characterized by emotional disorders, which can range from small mood to reduce severe depression and alarming-over-anxious state.
Along with psychological disorders in patients with fibromyalgia can be detected by a variety of disorders.
These disorders include symptoms such as Irritable bowel syndrome, premenstrual syndrome, primary dysmenorrhoeaVestibular disorders, joint hypermobility syndrome, irritable bladder syndrome, fluid retention syndrome, Raynaud's syndrome and shegrenopodobny syndrome mitral valve prolapse, Dysfunction of the temporomandibular joint, the detection of livedo.
Diagnostics
Great importance is attached search specific tender points whose presence distinguishes fibromyalgia from other diseases associated with chronic musculoskeletal pain.
When determining the optimal tender points should be considered finger pressure with a force that does not exceed 4 kg. Point is counted as positive if the test says the pain. According to the American College of Rheumatology criteria necessary for the diagnosis of fibromyalgia is the presence of disease 11 out of 18 possible points. Dominated by their localization in the muscles of the shoulder girdle, back, lumbosacral and gluteal region.
The essential point in the diagnosis of fibromyalgia - a search for painful points. To eliminate subjectivity factor must redetermine the number of tender points different persons. Furthermore, the definition of pain sensitivity is required at the control points (in frontal, above the head of the fibula).
fibromyalgia treatment
The presence of pronounced psychological disorders necessitates the inclusion of antidepressants in the treatment of fibromyalgia. The most commonly used amitriptyline, imipramine at a dose of 10-25 mg 1 time at night. Course of treatment 4-6 weeks. Fluoxetine 20 mg administered one time in the morning.
The widespread use in the treatment of fibromyalgia have found non-steroidal anti-inflammatory agents. Prolonged intake of non-steroidal anti-inflammatory drugs is not desirable because of possible side effects. Recently, topical therapy is preferred in the form of ointments, gels, and injections of local anesthetics in combination with, inter alia, lidocaine.
It is considered expedient to include muscle relaxants so-called local action: baclofen at a dose of 15-30 mg dantrolene day or a dose of 25-75 mg a day contribute to reduction of muscle tone, possess analgesic action.
Are reports of the effectiveness of antioxidants (ascorbic acid, alpha-tocopherol).
Of non-drug treatments are widely used various physical therapy procedures, in particular, massage, balneotherapy, cryotherapy.
Much attention in recent years given to physical exercises, namely aerobics as an effective way to eliminate chronic muscle pain and fatigue. Importance is given to the methods and psychological rehabilitation of patients with fibromyalgia - psychotherapy and autogenic training.
