When other diseases accompany fibromyalgia


By Dr. Javier Rivera | Mar. 1, 2019 | Posts in English

It is common for several diseases to coincide at the same time and this association is called comorbidity. Well, exactly the same thing happens with fibromyalgia and there may be other accompanying comorbidities.

When there are several diseases together, there is always one that is the most relevant, either because it is the most serious, the one that produces the most symptoms, the one that needs a more energetic treatment or the one that limits the patient the most, and then it is said to be the main or important disease.

In this article we are going to see what happens when fibromyalgia is the main disease and in the next one we will see the opposite: when fibromyalgia accompanies another important disease.

The first thing I want to draw attention to is that in a person with fibromyalgia, not all the symptoms they present should be attributed to this disease -as happens with some frequency-, and other diagnoses should be evaluated when the clinical manifestations cannot be clearly attributed to fibromyalgia.

In a study we did recently, we found that people with fibromyalgia have a greater number of associated comorbidities, but these are the same as those of other patients. This means that fibromyalgia patients are well studied and as a consequence more diagnoses of common illnesses are made. So far, everything correct.

But, in the same work we also verified that there is a clear overdiagnosis in these patients and that there are many associated diseases that are irrelevant and that, moreover, are misdiagnosed. In this case, the problem is twofold: on the one hand, the concern generated by a new diagnosis and, on the other, the consequences of the treatment indicated to treat the misdiagnosed disease. This isn’t so good anymore, is it?

Fibromyalgia is a disease with many symptoms and some of them are identical to those of other common diseases. For example, osteoarthritis causes pain in the joints and spine, and when a patient with fibromyalgia also has osteoarthritis, it hurts more. But, in this case, the excessive pain is not because the osteoarthritis is more serious, but because the patient also has fibromyalgia that increases the pain. It is evident that here we will have to treat fibromyalgia more, which is what is really responsible for the pain, and not so much osteoarthritis.

Other frequent symptoms in fibromyalgia such as tiredness, sleep disturbances, digestive disorders or dizziness can also be confused with the symptoms of other diseases and we must be aware of this so as not to look for other diseases that are not there.

In the work that I mentioned before, one of the most surprising findings was that the pharmacological treatment to treat the symptoms of anxiety or depression begins to be given to these people when they have already developed for several years. This data suggests that these symptoms appear slowly and, therefore, psychiatric comorbidity would be a consequence of the suffering caused by fibromyalgia and not its origin.

In summary, when fibromyalgia is the main disease, the risk that exists is the overdiagnosis of other diseases thinking that they are more relevant than they really are. Actually, the really important one, and the one that needs to be treated more aggressively, is fibromyalgia

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