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FibroCOVID



This blog references an August 2021 research paper in The British Medical Journal: Rheumatic and Muscular Diseases titled "Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey" by Professor Francesco Ursini et al.

I consider myself with my particular Long Covid one of the lucky ones. Apart from the occasional overwhelming headache in the evening, burning in my feet at night and pain in my intercostal rib muscles after carrying anything I do not suffer from constant and unmanageable pain. Widespread pain is a sequelae for many of those with Post-acute Covid Syndrome/ Long Covid (PACS/LC).


For those with Brain Fog their key messages are:



What is already known about this subject?

  • PACS/LC is emerging as a complex condition with a wide range of clinical manifestations.

  • Clinical features of PACS/LC include musculoskeletal pain, fatigue, cognitive impairment and sleep disturbances.


What does this study add?

  • Our study suggests that up to 30% of patients with PACS may satisfy criteria for fibromyalgia (FM).

  • Obesity and male gender represent the strongest risk factors for post-COVID-19 FM.


How might this impact on clinical practice or further developments?

  • It is reasonable to expect that rheumatologists will soon face up with a sharp rise of cases of this new entity that we defined ‘FibroCOVID’.


What is Fibromyalgia?

From the Fibromyalgia Action UK - the name fibromyalgia is made up from “fibro” for fibrous tissues such as tendons and ligaments; “my” indicating muscles; and “algia” meaning pain.


"Fibromyalgia is a chronic condition of widespread pain and profound fatigue".

The pain tends to be felt as diffuse aching or burning, often described as head to toe. It may be worse at some times than at others. It may also change location, usually becoming more severe in parts of the body that are used most.




What are the symptoms of fibromyalgia?

As well as widespread pain, people with fibromyalgia may also have:

  • increased sensitivity to pain

  • extreme tiredness (fatigue)

  • muscle stiffness

  • difficulty sleeping

  • problems with mental processes (known as "fibro-fog"), such as problems with memory and concentration

  • headaches

  • irritable bowel syndrome (IBS), a digestive condition that causes stomach pain and bloating


What are the causes of fibromyalgia?

The exact cause is unknown but it is thought to be related to abnormal levels of certain chemicals in the brain and changes in the way the central nervous system (the brain, spinal cord and nerves) processes pain messages carried around the body.

It is also thought that there is a strong genetic link with a increase risk of developing fibromyalgia inherited from our parents.

There can also be triggers such as bereavement, divorce, operations and infections.


Who is affected by fibromyalgia?

It is thought to affect 1 in 20 people with it being 7 times more common in women ( there has been a recent paper on FMS being an autoimmune disease).

The condition typically develops between the ages of 30 and 50, but can occur in people of any age, including children and the elderly.


How can I be tested for fibromyalgia?

There is, as yet, no specific test for FM.

Fibromyalgia is not new, but for most of the last century it was difficult to diagnose. Part of the problem has been that the condition could not be identified in the standard laboratory tests or x-rays. Moreover, many of its signs and symptoms are found in other conditions as well – especially in chronic fatigue syndrome (CFS).

Two Canadian doctors developed a way of diagnosing fibromyalgia in the 1970s and in 1990 an international committee published requirements for diagnosis that are now widely accepted. Once other medical conditions have been ruled out through tests and the patient’s history, diagnosis depends on two main symptoms:

  • pain in all four quadrants of the body for at least three months together with

  • pain in at least 11 out of 18 tender point sites when they are pressed. The “tender points”, or spots of extreme tenderness, are rarely noticed by the patient until they are pressed.

Recently this has been updated with the new ACR 2010 criteria to include more emphasis on the patient's history and the need for tender points removed.


2010 RA classification criteria: domains, categories and point scores


What is the treatment for Fibromyalgia?

Treatment is currently limited to helping with pain and improving sleep. For more information on this and other aspects of FM see the UK's National charity for Fibromyalgia https://www.fmauk.org and follow https://www.throughthefibrofog.com , https://www.instagram.com/through.the.fibro.fog/ on Instagram.


References

Fibromyalgia as an autoimmune disease - https://www.medicalnewstoday.com/articles/fibromyalgia-more-evidence-of-links-to-immune-system

NHS website - https://www.nhs.uk/conditions/fibromyalgia/

Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey - https://rmdopen.bmj.com/content/7/3/e001735

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