From the Guidelines
No, fibromyalgia is not caused by thoracolumbar strain with degenerative arthritis. Fibromyalgia is a complex chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. While back problems like thoracolumbar strain and degenerative arthritis can cause pain that might coexist with fibromyalgia, they are distinct conditions with different underlying mechanisms. Fibromyalgia is believed to involve central sensitization, where the central nervous system amplifies pain signals, leading to heightened pain perception. Research suggests fibromyalgia involves multiple factors including genetic predisposition, neurobiological abnormalities in pain processing pathways, psychological factors, and sometimes triggering events like physical trauma or emotional stress.
Key Points to Consider
- Fibromyalgia is a heterogeneous and complex condition, as noted in the EULAR revised recommendations for the management of fibromyalgia 1.
- The management of fibromyalgia should aim at improving health-related quality of life, balancing benefit and risk of treatment, and often requires a multidisciplinary approach with a combination of non-pharmacological and pharmacological treatment modalities 1.
- Treatment approaches for fibromyalgia typically include multimodal strategies such as medication (duloxetine, pregabalin, milnacipran), physical therapy, cognitive behavioral therapy, and lifestyle modifications, which differ from treatments focused solely on spinal issues.
- Understanding fibromyalgia as a central sensitization syndrome rather than a structural spine problem is important for proper diagnosis and effective management.
- The use of nonsteroidal anti-inflammatory drugs, antidepressants, anticonvulsants, and skeletal muscle relaxants may be considered in the management of chronic pain, but their efficacy and safety profiles vary, as discussed in the context of chronic pain management 1.
Recommendations for Management
- Aerobic and strengthening exercise is strongly recommended for the management of fibromyalgia, with a high level of evidence and grade A recommendation 1.
- Cognitive behavioral therapies and multicomponent therapies are also recommended, although with a weaker strength of recommendation compared to exercise.
- Pharmacological management may include amitriptyline, duloxetine or milnacipran, tramadol, and pregabalin, among others, with varying levels of evidence and recommendation strength 1.
In conclusion is not allowed, so: Fibromyalgia management should be tailored to the individual patient, taking into account their specific needs, preferences, and comorbidities, and should involve a multidisciplinary approach to address the complex nature of the condition, as emphasized by the EULAR recommendations 1 and other studies on chronic pain management 1.
From the Research
Fibromyalgia and Thoracolumbar Strain with Degenerative Arthritis
- Fibromyalgia is a chronic condition characterized by widespread pain, fatigue, sleep disturbances, and functional symptoms 2.
- The etiopathogenesis of fibromyalgia is still debated, and it is believed to be influenced by multiple factors, including genetic predisposition, personal experiences, emotional-cognitive factors, and biopsychological ability to cope with stress 2.
- There is no direct evidence to suggest that fibromyalgia is caused by thoracolumbar strain with degenerative arthritis.
- However, fibromyalgia is often associated with other chronic pain conditions, such as chronic low back pain, which may be related to degenerative arthritis 3.
- The treatment of fibromyalgia typically involves a multi-modal approach, including pharmacologic and non-pharmacologic interventions, and may involve addressing underlying conditions such as degenerative arthritis 4, 5.
- Studies have shown that physical treatment modalities, such as exercise and cognitive-behavioral therapy, can be effective in reducing pain and improving function in patients with fibromyalgia 6.
- Pharmacologic treatments, such as pregabalin, duloxetine, and milnacipran, have also been shown to be effective in reducing pain and improving symptoms in patients with fibromyalgia 4, 5.