A caress, a simple touch, moving or simply doing nothing are things that most people find pleasant and enjoyable. We usually enjoy the sensations that our body transmits to us, unless they cause us some kind of discomfort or pain .

However, this exception is the rule for many people who feel pain chronically over most of their body without any clear disease causing it. These are people who suffer from fibromyalgia .

What is fibromyalgia?

Fibromyalgia is a well-known disease that is mainly characterized by the presence of a constant musculoskeletal pain spread throughout the body . This pain is diffuse and non-specific and lasts for more than three months.

It also highlights a hypersensitization of different points of the body, called trigger points, in which there is usually hyperalgesia. The threshold above which a perception becomes painful is lowered , so that the slightest friction at these points can trigger sensations of great pain.

The symptoms

It has been seen that these people frequently suffer from symptoms of depression and anxiety , symptoms that may be a consequence of the chronicity of their state and the lack of knowledge about the causes of their condition. However, it has also been indicated that their presence may be part of the symptoms of the disorder. They tend to suffer from sleep problems such as insomnia or frequent awakening, which in turn facilitates their discomfort and fatigue.

It is also not uncommon for muscle stiffness to appear in the form of cramps, stiffness and even tremors. It is also common for those suffering from fibromyalgia to tend to fatigue very easily without having to make much effort to do so. Sometimes these symptoms are added to the presence of other disorders , but these do not explain the generalised pain.

The medical analysis of the patients does not show any signs of alterations or injuries that could cause pain. In fact, for many years it has been considered a somatomorphic disease , since no signs of real injuries are found despite the fact that the perceived suffering and pain are real. However, at present it is considered a rheumatic disease. It is more frequent in women than in men.

Causes of this disorder

Fibromyalgia is a disorder for which the exact causes are still unknown, as no specific lesion that could generate generalized pain has been located in this disease .

However, research points to a malfunctioning transmission of serotonin and substance P, which is altered in many of these patients. Specifically, a decrease in serotonin levels has been detected while there is an increase in substance P (the latter is highly involved in the perception of pain).

Altered levels of these substances may cause an abnormal reaction of the nerve circuits and the pathways linked to the sensation of pain, causing the body to interpret different sensations as painful.

In addition, it has been considered that this may be due to aspects such as sensitivity to nickel or gluten (although without reaching intolerance), but there are still not enough data on this.

It has also been considered that the presence of stressful and/or traumatic events may contribute to the onset of the disorder and its maintenance, especially when taking into account that it is frequent to present it together with mood or anxiety disorders . This, as indicated above, may be due to the fact that the patient feels helpless and desperate as he cannot explain his condition.

Treatment of fibromyalgia

Due to the lack of definitive knowledge about the causes of fibromyalgia, the treatment applied is usually focused on alleviating its symptoms and improving the patient’s quality of life from a multidisciplinary perspective.

Pharmacological intervention

On a pharmacological level, sedative-hypnotics such as benzodiazepines, antidepressants and anticonvulsants have been applied with the aim of reducing fatigue, possible muscle spasms and depressive and anxious symptoms.

Analgesics and anti-inflammatories are also commonly used in an attempt to reduce the level of perceived pain.

Psychological intervention

At the psychological level, the use of multimodal programs is recommended, which take into account a large number of essential factors to improve the state of the subject in question.

Within these programs, the use of relaxation, meditation and biofeedback strategies is essential in order to try to decrease the intensity of the pain and have a greater capacity to manage it. Physical exercise has been shown to be useful in the treatment, especially those of an aerobic nature performed in water.

It is necessary for the patient to be able to express his sensations and fears as well as work on these and the feelings of helplessness he may have, so that the subject perceives himself as more competent and able to control the situation.

It is also helpful for the patient to try to give meaning to the pain and reinterpret it , seeking to establish different strategies that allow him/her to confront the disorder.

Psychoeducation for the patient and his/her environment is also fundamental, since it is reassuring to receive information about the problem in question (it must be taken into account that most subjects do not know what is happening to them) and about strategies to apply in order to reduce it. Furthermore, the fact that there are no injuries may lead the environment to think that the person may be simulating a disorder.

Bibliographic references:

  • Clariana, S.M. and De los Riós, P. (2012). Health Psychology. CEDE PIR Preparation Manual. CEDE: Madrid.
  • Smith, H.S.; Harris, R. & Claw, D. (2011). Fibromyalgia: An Afferent Processing Disorder Leading to a Complex Pain Generalized Syndrome. Pain Physician; 14.