The importance of treating chronic fatigue syndrome and fibromyalgia from various disciplines

Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS), together with Multiple Chemical Hypersensitivity (intolerance to chemical agents), and Electrohypersensitivity (excessive response to electrical stimuli), are grouped under the term ‘Hypersensitization Syndromes’. Central. In these cases there is a generalized increase in brain activity due to the involvement of some neurotransmitters, which gives rise to an increased perception of the sensory information received.

Specifically, fibromyalgia is a disease that is characterized by having multiple symptoms, such as widespread chronic pain, intense fatigue, sleep disturbances, cognitive disturbances, or mood disorders, among the most frequent. “Since 1992, FM has been included in the catalog of diseases of the World Health Organization (WHO),” says Dr. Francisco Javier Mengíbar Torres, specialist in Rheumatology at the Quirónsalud del Vallès Hospital.

In Spain, it is estimated that 3-4% of the population may be affected by fibromyalgia, as detailed by this expert and, more specifically, he indicates that especially women are the main affected, given that it is estimated that they are between 75% and 90% of people diagnosed.

Multiple signs

Fibromyalgia is characterized by symptoms such as chronic widespread pain, intense fatigue and sleep disturbances.

“This greater female prevalence, in general, may be related to hormonal factors, how they respond to stress, gender roles and associated expectations that can influence the perception and management of pain and of fatigue”, highlights this specialist.

Clinical diagnosis

Currently, this rheumatologist regrets that there is no specific test, neither analytical nor imaging test, that helps diagnose fibromyalgia, so the diagnosis is fundamentally clinical.

For this, Dr. Mengíbar says that the new criteria of the American Academy of Rheumatology (ACR) from 2010 are currently used. “It must be taken into account that the presence of fibromyalgia does not rule out the existence of other diseases. , nor vice versa. Although it does not have a clear genetic basis, there is a component of family aggregation, which can affect up to 8%, especially among first-degree relatives,” he highlights.

Furthermore, the Quirónsalud del Vallès expert highlights that fibromyalgia has a chronic course with phases of improvement and flare-ups. “These would be related to physical efforts, stressful situations, and seasonal changes, which worsen the quality of life of patients.”

Meanwhile, in the case of chronic fatigue syndrome, this expert emphasizes that fatigue predominates over pain in this phenomenon. “It is characterized by fatigue, sometimes extreme, that does not improve with rest and that sometimes worsens with physical or mental activity.” Furthermore, Dr. Mengíbar mentions that chronic fatigue syndrome can include symptoms of permanent fatigue, as well as post-exertional discomfort, sleep problems, pain, and cognitive and emotional alterations.

This expert refers to its diagnosis, apart from the aforementioned diagnostic tests, and given that there is no specific test as such for chronic fatigue syndrome, it is usual that a prior medical evaluation is required to rule out another series of processes that can cause chronic fatigue. “Fundamentally, there must be persistent chronic fatigue for at least 6 months at least, or in an unexplained and recurrent manner, which does not improve with rest, and which seriously reduces the health and quality of life of those who suffer from it,” adds this specialist.

Complex diagnosis

As they do not present ‘visible’ symptoms, patients with this type of pathology often suffer from problems of misunderstanding

These pathologies, as recognized by Viviana Fiszson Herzberg, psychologist at the Hospital Quirónsalud del Vallès, often suffer from a certain misunderstanding, as they do not present “visible” symptoms, and because they entail a complex diagnosis, given that initially they seek to rule out other diseases. diseases.

“In addition, by presenting a great symptom variability, added to the significant impact on mental health (anxiety and depression), it can lead to social stigmatization, a lack of understanding even in their family environment, and not infrequently also in the healthcare environment. These characteristics lead the person to isolation and hopelessness,” laments this specialist.

Currently, it highlights that treatments for these diseases focus on relieving symptoms and improving quality of life, including pharmacological therapy, improving physical condition, psychological approaches, sleep hygiene, balanced diet and adequate stress management, in particular. an interdisciplinary context. “In our hospital we work with the Rheumatology Service that receives, evaluates, diagnoses and refers patients to the area of ​​Psychology, as well as to other specialties involved, given the need for a multidisciplinary approach.”

Multidisciplinary

The treatment is multiple and includes pharmacological therapy, improvement of physical condition and psychological approaches, among others.

With this, this psychologist from the Quirónsalud del Vallès Hospital highlights that, once the patients arrive at Psychology, they are enrolled in a group workshop that consists of four sessions, where they work from an innovative approach in Neuroscience of Pain and Therapy. Information Reprocessing and Desensitization through bilateral stimulation (EMDR technique).

“This psychological technique, recognized by the WHO in 2013 for the treatment of post-traumatic stress, phobias, anxiety and related pathologies, is based on the idea that traumas and negative experiences can remain blocked in the brain, affecting the mental and emotional health. The evidence shows that its use, together with psychoeducation in Neuroscience, are of great interest for people who are included in the Central Hypersensitization Syndrome,” he highlights.

That is why it stands out that its main objectives include the understanding of pain and the nervous system, stress management, emotional regulation and planning for activities that promote changes. “Once the group stage is over, it is important to continue with individual psychological assistance,” considers Viviana Fiszson Herzberg.

“Our medical-psychological approach adds group psychoeducation based on neuroscience and EMDR to medical treatment, with individualized care, to provide a more comprehensive and effective approach to pain and fatigue. This care model improves the understanding of the pathology, and offers tools to facilitate its management, thus improving the quality of life of patients,” concludes the rheumatologist from Quirónsalud del Vallès.