Fibromyalgia Syndrome

By | 2017년 11월 21일

The location of the nine paired tender points that comprise the 1990 American College of Rheumatology criteria for fibromyalgia.


며칠동안 집에 머물고 있는 동생이 아침에 일어나자마자 큐티를 하고 있는 내게 이렇게 이야기한다. “혹시 fibromyalgia가 아닐까요?”라고 말이다. 그 말을 듣는 순간, 정신이 아찔했다. ‘맞다. 왜 그 생각을 하지 못하고 있었을까?’라는 생각이 머릿속에 가득했다. 지금까지 통증을 호소하였던 모든 시간들을 다시금 되짚어 보았다.

섬유근육통(fibromyalgia)일 가능성이 매우 높다. 물론, 무릎의 반달(meniscus)의 손상이 있었던 것은 사실이고, 궁둥주머니염(ischial bursitis, 좌골낭염)이 있었던 것도 사실이다. 그러나 지금까지 가장 아내의 통증의 원인은 fibromyalgia에 의한 것이었다고 생각된다. 이제 아내의 통증치료에 조금 더 방향성을 찾게 되었다.

쉽지 않은 시간들이 되겠지만, 최선을 다해 치료에 전념하려고 한다. 여기에 월요일부터 대상포진(herpes zoster)이 발견되었다. 이것도 좀 더 적극적으로 치료를 해야 할 듯 하다. 불행하게도 관련된 많은 의사들은 이 진단을 내리지 않는다. 환자를 노이로제(neurosis) 환자로 몰고가기도 한다. 왜냐하면 류마티스 관절염은 아닌데, 그 만큼 통증을 호소하기 때문이다.

섬유근육통(fibromyalgia)에 대한 위키페디아의 자료(그림 포함)를 가져왔다.

Fibromyalgia (FM) is a medical condition characterised by chronic widespread pain and a heightened pain response to pressure. Other symptoms include tiredness to a degree that normal activities are affected, sleep problems, and troubles with memory. Some people also report restless legs syndrome, bowel or bladder problems, numbness and tingling, and sensitivity to noise, lights or temperature. Fibromyalgia is frequently associated with depression, anxiety, and posttraumatic stress disorder. Other types of chronic pain are also frequently present.

Widespread Pain Index (WPI) Areas

The cause of fibromyalgia is unknown; however, it is believed to involve a combination of genetic and environmental factors with half the risk attributed to each. The condition runs in families and many genes are believed to be involved. Environmental factors may include psychological stress, trauma, and certain infections.

The pain appears to result from processes in the central nervous system and the condition is referred to as a “central sensitization syndrome”. Fibromyalgia is recognized as a disorder by the US National Institutes of Health and the American College of Rheumatology.

There is no specific diagnostic test. Diagnosis involves first ruling out other potential causes and verifying that a set number of symptoms are present.

The treatment of fibromyalgia can be difficult. Recommendations often include getting enough sleep, exercising regularly, and eating a healthy diet. Cognitive behavioral therapy may also be helpful. The medications duloxetine, milnacipran, or pregabalin may be used. Use of opioid pain medication is controversial with some stating their use is poorly supported by evidence and others saying that weak opioids may be reasonable if other medications are not effective. Dietary supplements also lack evidence to support their use.

While fibromyalgia can last a long time, it does not result in death or tissue damage. Fibromyalgia is estimated to affect 2–8% of the population. Women are affected about twice as often as men. Rates appear similar in different areas of the world and among different cultures.

Fibromyalgia was first defined in 1990 with updated criteria in 2011. There is controversy about the classification, diagnosis, and treatment of fibromyalgia. While some feel the diagnosis of fibromyalgia may negatively affect a person, other research finds it to be beneficial.

The term “fibromyalgia” is from New Latin, fibro-, meaning “fibrous tissues“, Greek μυώ myo-, “muscle“, and Greek άλγος algos, “pain“; thus the term literally means “muscle and fibrous connective tissue pain“.

[사진출처 : 영문 위키페디아]