Fibromyalgia: a diagnostic and therapeutic challenge

Fibromyalgia is a complex chronic condition, characterized by a combination of symptoms that significantly affect patients' quality of life. A thorough understanding of this condition is essential to ensure a correct diagnosis and an effective treatment plan.

The Elytis, internists take a comprehensive approach to fibromyalgia, given the complexity of symptoms and the need for a multidisciplinary approach.

Fibromyalgia symptoms: a diverse range

The symptoms of fibromyalgia are varied and can differ significantly from patient to patient. The main manifestations include:

• Chronic generalized generalized pain: this is the defining characteristic of fibromyalgia, the pain is often described as a deep, diffuse, burning or throbbing sensation. It can affect multiple areas of the body and can vary in intensity.
• Severe fatigue: patients experience persistent exhaustion that is not relieved by rest. This fatigue can interfere with daily activities and significantly affect quality of life.
• Sleep disturbances: insomnia, fragmented sleep or sleep deprivation are common. These sleep disturbances can contribute to fatigue and worsen pain symptoms.
• Cognitive dysfunctions: the term 'fibrocystic fibrosis' describes concentration difficulties, memory problems and mental confusion. These symptoms can affect the patient's ability to carry out daily activities.
• Affective disorders: anxiety, depression and irritability are common in patients with fibromyalgia. These symptoms can be both a consequence of the chronic pain and a contributing factor to its worsening.
• Sensitivity to touch: hyperalgesia (increased sensitivity to pain) and allodynia (pain to stimuli that are not normally painful) are common.

Diagnostic difficulties

Diagnosing fibromyalgia can be challenging because:

• There are no specific laboratory or imaging tests to confirm the diagnosis.
• Symptoms overlap with other conditions such as rheumatoid arthritis or systemic lupus erythematosus.
• Chronic pain can be difficult for patients to quantify and describe.

In the past, the diagnosis was based on the identification of pain points, but today's criteria emphasize the severity of symptoms and their impact on the patient's functionality.

Multidisciplinary approach at Elytis

The Elytis, internists take a multidisciplinary approach to the management of fibromyalgia, collaborating with other specialties such as rheumatology, psychiatry and physiotherapy. This approach includes:

• Thorough clinical assessment: the internist takes a detailed history and performs a complete physical examination to assess the severity of symptoms and identify any comorbidities.
• Paraclinical investigations: although there are no specific tests for fibromyalgia, blood tests and other investigations may be needed to rule out other conditions.
• Personalized treatment plan: fibromyalgia treatment is individualized and may include:
  • Pharmacologic therapy: medicines can help reduce pain, improve sleep and manage affective disorders.
  • Physical therapy: tailored exercise, physiotherapy and relaxation techniques can help relieve pain and improve functionality.
  • Psychological therapy: cognitive behavioral therapy (CBT) and other forms of psychotherapy can help patients cope with chronic pain and manage stress.
  • Lifestyle changes: adopting a healthy lifestyle with a balanced diet, restful sleep and stress management can have a positive impact on symptoms.

Pain management

Pain control is a priority in the treatment of fibromyalgia. Effective methods include:

• Pain relievers: prescription painkillers can be used to reduce pain, but their long-term use requires medical monitoring.
• Adjuvant drugs: antidepressants and anticonvulsants can be used to modulate the transmission of pain signals in the central nervous system.
• Relaxation techniques: meditation, yoga and deep breathing can help reduce muscle tension and relieve pain.
• Massage therapy: massage therapy can help relax muscles and reduce pain.

At the internal medicine practice Elytis, we understand the complexities of fibromyalgia and are committed to providing patients with high quality medical care. Through an integrated approach and collaboration across specialties, we strive to improve patients' quality of life and provide them with the support they need to cope with this chronic condition.

Latest medical review:

13.02.2025, Dr. Alexandra Luncă - Specialist