(Caracas, August 17. News24) – We try to capture research and the correct opinions of Dr. Manuel Martínez Lavin, author of the book “Fibromyalgia misunderstood pain”. Fibromyalgia, being a complex but common disease, affects 2% to 4% of the world population. The vast majority of those affected are women in 80% or 90%.
Dr. Martínez Lavin studied at the Autonomous University of Mexico (UNAM), post-graduate in the United States. He currently directs the department of Rheumatology at the UNAM, is a member of the National Academy of Medicine in Mexico and a researcher.
It is characterized by a generalized, diffuse chronic pain in the four quadrants of the body, which in the patient manifests with extreme sensitivity to the palpation of different areas of the body. Among its primary symptoms include: fatigue that does not improve with rest, sleep disturbances, diffuse numbness of the body, tingling or cramps in arms and legs, headache, irritable bowel, anxiety and depression.
Some considerations are important to differentiate pain in general, short-term or acute pain and long-term or chronic pain. The latter is divided into two major phases: the one associated with persistent damage in the physical body, identified by the medical community as nociceptive. Which is common in patients suffering from arthritis or cancer.
And the pain that is due to an intrinsic alteration of the nerve fibers responsible for transmitting the painful impulses. This type of pain is called neuropathic, which is characterized by no real damage to the physical body, but it does occur in the nerve fibers; which transmit impulses to the brain, interpreting that the body was inflamed or beaten.
This is fundamentally due to the fact that the nerves responsible for transmitting pain secrete an excess of substances known as the substance “P”, glutamate and aspartate. On the other hand, through the calcium channels, being pain drivers alike, neuropathic pain is identified. When neuropathic pain is present, abnormal connections between the sympathetic nervous system and the painful pathways can develop.
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Pain and placebo effect
By accepting that human beings are body, mind and spirit, we understand better how we can mediate and in some cases forget the pain. A chronic pain to feel, we could condition our mind, so that through willingness and faith, achieve improvement. This is not mere popular philosophy, if we approach to understand the placebo effect of the organism.
This is recognized by scientists around the world, as a beneficial effect, which can act on chronic pain. By ingesting pills or being injected with substances that do not contain active ingredients, called placebo, our body could react, or our mind accept the beneficial action of such procedures, having the conviction as patients, that the substance ingested, we will palliate the pain.
The placebo effect is very common, it is estimated that approximately one third of people around the world, who ingested an inactive substance, tend to improve their pain, to a greater or lesser degree, believing that this will help them. It is so amazing that it multiplies, the more ostentatious the therapeutic intervention.
A good example of this is the famous study carried out in arthroscopic knee surgery, published in the scientific journal New England Journal Medicine, in 2002. To 180 patients who participated in the study, a subgroup was submitted without they knew, to a simulated intervention (they only used sedative), and to another group the operation was really practiced. Both groups showed relief in pain, even in some cases, those not really intervened, relief and mobility lasted up to two years.
In spite of the above, the characteristics of the placebo should be emphasized: It is not an effect that can necessarily last months or even years. Its beneficial action is felt by any type of people, not just the “suggestible ones”. It is a real effect in which our powerful natural painkillers or endorphins are released. So real is its effect that when a patient is given drugs or drugs to block endorphins, the placebo effect does not occur. This increases and complements the action of drugs, is ultimately our therapeutic weapon.
The Autonomic Nervous System … our internal pain regulator
Like animals, as human beings we have a system that allows us to adapt to the constant changes in the environment. This through its wonderful performance, exercises among multiple functions, be the reginternal ulator and adaptation to the environment, I write about our Autonomous Nervous System, now well what is this relationship with chronic pain and fibromyalgia?. The Autonomous Nervous System, this intricate network of nerves, from the brain to the organs, is responsible for keeping our vital signs in harmony, monitors the correct functioning of all our organs, responds to stress, works closely with the Endocrine System and the Immune System. Its center is located in the brain stem and in the areas of the brain. brain called hypothalamus and thalamus. It is composed of two branches, the accelerator or the Sympathetic Nervous System; which deals with putting the body on alert, ready for the fight or flight. I work with what we know as adrenaline secretion and its congeners, composed in turn by repinephrine and dopamine. On the other hand, the parasympathetic system, which has antagonistic actions, favors sleep and digestion. It works predominantly by the secretion of acetylcholine. The Autonomic Nervous System, having a Cicardian rhythm, that is, that the activity of its two branches complement each other between day and night, and be interconnected in the cerebral cortex, with consciousness, emotions and between them with pain. For a next installment I will touch the manifestations of Fibromyalgia in depth, genetic predisposition to Fibromyalgia, diffuse pain, frequent manifestations of Fibromyalgia, diagnosis and diseases that can be confused with Fibromyalgia.