Caring for the person with Fibromyalgia

By Ana Maria Canzonieri

Caring for the person with Fibromyalgia, written by Ana Maria Canzonieri, brings a multidimensional and humanized view of the people affected by the disease. Those who get sick need understanding, attention and care, as well as proper guidance to regain their self-esteem and find the healing path.
The text is easy to understand and can be the light at the end of the tunnel for those seeking hope in the midst of pain..

• Language: English
• Publisher: Difusão Editora
• Release date: Nov 6, 2019
• ISBN: 9788578084400

Book preview

recovery.

Chapter 1

ASPECTS OF FIBROMYALGIA

PAIN - has an element of blank; It cannot recollect

When it began, or if there were

A day when it was not.

It has no future - but itself, its infinite realms contain

Its Past, enlightened to perceive

New Periods - of pain."

Emily Dickinson (1830-1896)

Fibromyalgia is defined as a chronic, diffused and generalized non-inflammatory pain syndrome of unknown etiopathogenesis, which may affect the physical and psychological state of the patient. It disrupts social, professional, relational activities and the quality of life of the suffering person, by manifesting in a non-articular way, painful pressure points in the muscles, tendons, and ligaments.

This definition implies that despite many efforts, little is understood about fibromyalgia as a disease, and why people who receive this diagnosis suffer intensely from the pain.

Suffering often starts before the diagnosis, as some people seek the opinion of several doctors in search of a response, thus making for a long therapeutic journey.

The lack of laboratory tests that prove the disease makes diagnosis difficult. Therefore, many patients are referred to psychiatric and/or psychological treatments without a diagnosis, further increasing their suffering because they feel stigmatized.

Even after diagnosis, pain and suffering continue to make it challenging for patients to participate in the treatment. In turn, the patient’s challenges make it difficult for health professionals to provide care.

Based on an understanding of the extent of suffering, it is known, there are gaps in professional training in the health field regarding care for people with chronic diseases.

Historically, Hippocrates voiced the first description of generalized skeletal muscle pain. The word fibromyalgia originates in the Latin fibro, fibrous tissue that surrounds the ligaments, tendons or fascia; Mi, muscle tissue; Algia, pain (Oliveira, 2008), that is, a word that expresses pain that radiates from tendons and muscle tissue, but does not give the dimension of human suffering.

It is documented that the highest prevalence of the disease is among women between the ages of 35 to 60 years and, within in this group, are people with lower education and socioeconomic levels. In the general population, Fibromyalgia targets women up to 10 times more frequently than men.

Cultural issues, how to interpret pain and disease, and the reinforcement of negative responses may explain the prevalence of fibromyalgia in women. Male’s tend to issue more functional responses, whereas, the woman describes a type of cognitive assessment of pain, contextually in relation to domestic activities and effective relationships (Yunnus et al. 2001, Galli, 2008, Amarale Catro, Kotanishi, 2011).

People who participate in manual activities are more likely to have an injury and pain; unpaid work, such as housework, which alone is a risk factor for pain, whether physical or the relationship between a women’s perceived devaluation and their actual devaluation (Cavalcante et al., 2006; Assumpção et al., 2009).

Research has shown there is an association between having a higher educational level and a lower presence of chronic pain and vice versa. There is a greater presence of musculoskeletal symptoms within a lower socioeconomic level and vice versa (Cavalcante et al., 2006; Assumpção et al., 2009).

A diagnosis of fibromyalgia and the identification of a treatment plan are difficult since laboratory tests are usually impaired by the absence of physical alterations or inflammatory processes. Another factor is the aggravation of fibromyalgia by generalized pain. It is common to observe anxiety disorders, and depression together with the pain. Hence, it is common to refer a patient to a psychiatrist or psychologist for an evaluation.

In addition to the fibromyalgia factors, the presence of symptoms over time interferes with the process of a patient becoming ill and restored. The difficulty in diagnosis and identifying a treatment plan generates the patient’s feelings of vulnerability and helplessness. These feelings can trigger emotional changes and depression, thus affecting negatively the family, social and professional context in which it is inserted, interfering in the quality of life.

Many think that the manifestation of pain in an emotionally susceptible person represents, from a psychological point of view, the inadequate response to physical, emotional and environmental stressors. A person with fibromyalgia presents themselves in a constant state of pain, converting emotional pain into physical pain and vice versa.

Research by Fietta, Manganelli (2007) shows that a depressive disorder is the most common psychiatric comorbidity in patients with fibromyalgia, with prevalence rates varying from 20% to 80%. Those with a depressive disorder tend to catastrophize, alter perception, causing the anticipation of pain to become a vicious circle.

Researchers have confirmed, psychological, interpersonal and socio-cultural processes are present in the illness and can contribute to the amplification of the pain and aggravation of the symptoms. Preoccupation with the disease and the catastrophic response can increase anxiety levels, originating somatic symptoms (Matias et al., 2006).

When a professional evaluates a patient’s pain, it is important to understand the origin and magnitude of the pain, as well as, how to treat and meet the needs of the individual. The evaluation is instrumental in helping the patient to understand and to seek internal resources for coping with pain.

A set of neuroticism (chronic level of adjustment and emotional instability) is associated with individuals who are more likely to experience emotional suffering, that is, a certain type of person presents a higher degree of difficulty in dealing with natural aspects of life, including pain and illness.

We know the painful situations present in fibromyalgia modifies patients’ style and quality of life, restricting daily activities and negatively influencing mental health, impairing the capacity for work, family, and social