“Fibromyalgia is a disease that is characterized by a particular sensitivity to pain, a pain that shouts out. Professor Carlo Selmi, Head of Clinical Rheumatology and Immunology at Humanitas, spoke about this topic at the Obiettivo Salute microphones on Radio 24.

“Fibromyalgia mainly affects the female sex, especially young women (before menopause), and is also characterized by a number of less obvious manifestations, such as sleep and intestinal disorders.


How is the diagnosis made?

“Fibromyalgia is a syndrome, a set of symptoms and signs that do not actually have a physical counterpart: however, many examinations can be carried out on a patient with fibromyalgia, and they will always be negative.

This disease does not have high inflammatory indices, does not have autoantibodies (such as rheumatoid arthritis), has no radiological tests, no magnetic resonance tests, no CT scan that can show changes that make a diagnosis.

For these reasons, the diagnosis of fibromyalgia is often difficult and delayed,” emphasizes Professor Selmi.


Pain, a key symptom

“The suspicion comes mainly from widespread pain, a key symptom of this disease. Pain affects not only the joints, but all parts of the body and this distinguishes it from arthritic or arthrosic manifestations that can predominantly generate joint pain.

The pain is persistent and has no correlation with physical activity or rest. It can also co-exist with other less immediate symptoms such as deep tiredness that further reduces quality of life, with repercussions in the workplace as well. Then there can be a deficit of concentration and memory and a deficit of rest at night, but not in the sense of insomnia: patients often sleep well for many hours, but in terms of rest after night, the subject often wakes up not rested in proportion to how many hours he has slept,” says the specialist.


How is it treated?

“The therapy must be based on a multidisciplinary approach that includes both cognitive-behavioral management through a psychological path and low-impact physical activity. This is the only approach that can change the management of this condition in the medium term.

It is also necessary not to abuse painkillers and non-steroidal anti-inflammatories, as the use of steroid drugs and cortisone is just as useless.

Fibromyalgia management is a long and difficult process that is based on several mechanisms. Some pain medications can be used at the peripheral level, but they are very specific and different from the ones we use normally. A psychological path, with a cognitive-behavioral therapy, is also indispensable.

However, it must be strongly emphasized that fibromyalgia improves with movement, physical activity and weight loss: this is often difficult to accept for a patient who is accustomed to experiencing pain 24 hours a day and a subsequent inactive life. Starting physical activity in a gradual and low-impact way (such as Thai chi, yoga, pilates, swimming) has a beneficial effect on symptoms,” concluded Professor Selmi.