Fibromyalgia: the invisible pain that has an explanation

Fibromyalgia: the invisible pain that has an explanation

Fibromyalgia remains one of the most difficult to diagnose and, at the same time, one of the most misunderstood diseases. It mainly affects women and usually takes years to be identified. We spoke with Dr. Jorge Orduña to clarify the keys to diagnosis, debunk myths and explore effective treatment options to improve patients’ quality of life.

Why is fibromyalgia so difficult to diagnose?

Unlike other diseases, fibromyalgia does not show up in blood tests or imaging tests. This can be frustrating for both patients and healthcare professionals. Diagnosis is based on clinical criteria, medical experience and ruling out other causes of chronic widespread pain, which requires a global and sensitive view. In addition, the lack of historical recognition has hindered its visibility in the healthcare system.

Common myths: more harm than help

One of the most common misconceptions is that fibromyalgia “does not exist” or that it is “only psychological”. Although emotional factors may play a role, this does not negate the fact that there is a clear neurophysiological basis. People with fibromyalgia have increased sensitivity to pain due to alterations in sensory processing. Another harmful myth is that patients exaggerate. In reality, the pain is real, constant and widespread.

What happens when the patient is not believed?

The lack of medical and social credibility generates profound consequences: anxiety, sadness, isolation and a worsening of the general condition. Validating the patient, listening to his or her story and providing clear information has a real and positive therapeutic impact.

Is there a common profile among fibromyalgia sufferers?

There is no “fibromyalgic personality” as such, but there are shared traits in many patients: self-demanding, responsible, emotionally sensitive individuals who have lived through prolonged stressful situations. These traits do not cause the disease, but they can influence its evolution and how pain is coped with.

Labor impact: a little visible reality

Fibromyalgia directly affects occupational performance. Chronic pain, fatigue and cognitive difficulties can lead to absenteeism or even loss of employment. Therefore, it is necessary to talk about work adaptations, flexible schedules and the official recognition of this condition as a cause of partial disability.

New therapeutic approaches: there is hope

Although there is currently no definitive cure, there are effective tools to improve quality of life. Some of the emerging treatments that are showing good results include:

  • Personalized and adapted physical exercise

  • Mindfulness techniques and stress management

  • Psychotherapy with a focus on chronic pain

  • Education in pain neuroscience

  • Multidisciplinary approaches

  • Neurostimulation in selected cases

 

The approach must be individualized and person-centered, with an integrated view of the person’s physical, emotional and social situation.

Central sensitization: the neurological key to pain

People with fibromyalgia present a phenomenon known as central sensitization, in which the nervous system amplifies normal signals, interpreting them as painful. This explains why pain is perceived without visible lesions: the origin lies in how the brain and spinal cord process sensory information.

Stress as a trigger

Although not the sole cause, sustained stress is a factor that can act as a trigger in predisposed individuals. Sleep disturbances, emotional trauma or mental overload may contribute to activate this state of hypersensitivity.

Underdiagnosis: a worrisome situation in Spain

In our country, many people remain undiagnosed, often after years of medical pilgrimage. This is due to several factors: scarce specific training on chronic pain, overload in primary care, lack of specialized units and a fragmented view of the patient’s symptoms.

A message for those who have just received the diagnosis

Dr. Orduña sums it up in a sentence that may mark the beginning of a new stage:

“Your pain is real, you are not alone and there are ways to get better.”

Seeking reliable information, staying active within one’s means and surrounding oneself with specifically trained professionals can make a big difference in prognosis and well-being.

Doctor Jorge Orduña

Medical Director MIVI Salud and Doctor in MIVI Valencia