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Apport de l'ostéopathie aux céphalées

FIBROMYALGIA

DEFINITION 

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas of the body. While the exact cause is unknown, research suggests several factors may contribute to its development:

  1. Genetic Predisposition: Genetics may play a role, as fibromyalgia tends to run in families. Certain genetic mutations may increase sensitivity to pain.

  2. Abnormal Pain Processing: People with fibromyalgia have a heightened sensitivity to pain. Their central nervous system may amplify pain signals, causing normal sensations to be perceived as painful.

  3. Infections or Illnesses: Certain infections or illnesses have been linked to triggering or exacerbating fibromyalgia symptoms.

  4. Physical or Emotional Trauma: Physical injuries, surgeries, or significant emotional stress may act as a trigger for the onset of fibromyalgia.

  5. Hormonal Imbalances: Fibromyalgia may be related to imbalances in neurotransmitters such as serotonin, norepinephrine, and dopamine, which are involved in pain regulation, sleep, and mood.

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Symptoms:

 

Fibromyalgia presents with a range of symptoms that can vary in intensity. The most common include:

  1. Widespread Pain: The hallmark symptom is pain throughout the body, often described as a dull ache that persists for three months or more. It typically occurs above and below the waist and on both sides of the body.

  2. Fatigue: Despite getting sufficient sleep, individuals with fibromyalgia often feel fatigued. Sleep is frequently disrupted by pain or other sleep disorders, such as restless leg syndrome or sleep apnea.

  3. Cognitive Difficulties: Often referred to as "fibro fog," this includes problems with memory, focus, and concentration.

  4. Sleep Disturbances: Many individuals with fibromyalgia have trouble falling asleep or staying asleep due to pain or other related conditions.

  5. Tender Points: Specific areas of the body, such as the neck, shoulders, back, and hips, may be especially tender to touch.

  6. Other Symptoms: Headaches, irritable bowel syndrome (IBS), anxiety, and depression are commonly associated with fibromyalgia.

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TREATMENT

The European League Against Rheumatism (EULAR) published its recommendations for the management of fibromyalgia in 2016, emphasizing a comprehensive approach to treatment. Here are the key recommendations following the diagnosis of fibromyalgia:

  1. Education and Self-Management: Patients should be educated about fibromyalgia, including its symptoms, treatment options, and coping strategies. This knowledge empowers patients to manage their condition effectively.

  2. Multidisciplinary Approach: Treatment should involve a multidisciplinary team, including healthcare professionals such as rheumatologists, physiotherapists, psychologists, and occupational therapists. Collaboration among these experts can address the diverse needs of patients.

  3. Pharmacological Treatments: The use of medications should be considered based on the individual patient’s symptoms. Options may include:

    • Analgesics: For pain relief.

    • Antidepressants: Such as duloxetine or milnacipran, which can help manage pain and improve mood.

    • Anticonvulsants: Such as pregabalin, which may be effective for nerve pain.

  4. Physical Activity: Regular physical activity should be encouraged, as it can help reduce pain, improve physical function, and enhance overall well-being. Tailored exercise programs that consider the patient’s capacity are recommended.

  5. Cognitive Behavioral Therapy (CBT): Psychological interventions, particularly CBT, can be beneficial in addressing the psychological aspects of fibromyalgia. This therapy helps patients manage stress, anxiety, and depressive symptoms, which can exacerbate pain.

  6. Sleep Management: Since sleep disturbances are common in fibromyalgia, it’s crucial to address sleep quality. Strategies may include sleep hygiene education and, if necessary, pharmacological interventions to improve sleep.

  7. Complementary and Alternative Therapies: Some patients may find relief through complementary therapies such as acupuncture, mindfulness, yoga, and massage. These should be considered as adjuncts to conventional treatment, based on individual preferences.

  8. Regular Follow-Up: Continuous monitoring and follow-up are essential to assess the effectiveness of treatment and make necessary adjustments. Regular check-ins can help address emerging concerns and reinforce self-management strategies.

  9. Avoidance of Ineffective Treatments: Patients should be advised against therapies that have not been shown to be effective for fibromyalgia, including certain invasive procedures or unproven medications.

 

 

Mr Charbel Kortbawi, in addition to his osteopathic care, is qualified given his specialization to carry out therapeutic education of the patient, and to help the patient find a physical activity program adapted to his condition.

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