Diagnostic criteria, treatment and education in fibromyalgia

Fibromialgija je kronični bolni sindrom mišićnog i fibroznog tkiva koji karakteriziraju difuzni bolovi na palpaciju tipičnih muskuloskeletnih lokalizacija nazvanih bolnim točkama. Takvo stanje prati kroničan umor, poremećaj sna, glavobolja, depresija ili ankioznost, dismenoreja i iritabilni kolon. Češće obolijevaju žene, s najvećom učestalošću između 20. i 60. godine života. Fibromialgija je i socioekonomski problem jer do 50% bolesnika ima smanjenu radnu sposobnost. Godišnja prevalencija je do 2% u populaciji zdravih. Dijagnoza se postavlja na osnovi klasifikacijskih kriterija Američkoga reumatološkog društva (ACR), donesenih 1990. godine. Prvi je kriterij difuzna bol koja traje najmanje tri mjeseca, prisutna na obje strane tijela, iznad i ispod struka te zahvaćanje aksijalnog skeleta. Drugi je kriterij bolnost 11 od 18 specifičnih bolnih točaka. Liječenje je multidisciplinarni izazov. Uključuje farmakološko liječenje, fizikalnu medicinu, psihološku potporu te edukaciju bolesnika. Kako je fibromialgija kronična bolest, liječenje katkad traje godinama, a samo se kod četvrtine bolesnika postigne remisija u prve dvije godine liječenja.Fibromyalgia is a chronical pain syndrome of muscle and fibroid tissue, based on characteristic diffuse pain on palpation of typical muscle-skeletion localisations, which we call pain spots. This condition is followed chronical fatigue, sleeping problems, depression or neurosis, menstruation disorders and irritable colon. The illness more often affects females between 20-60 years of age. Fibromyalgia is also social and economical problem, because 50% pationts have lower working potential. A year prevalence is up to 2% in a healthy population. The diagnose determined on the basis of criteria set by American College of Rheumatology (ACR), developed in 1990. First criteria is diffuse pain lasting more than 3 months on both sides of the body, above and below waiste and affecting axial skeleton. Second criteria is pain in 11 out of 18 specific pain spots. The treatment presents a multidisciplinary challenge. It includes pharmacoloical therapy, physical medicine, psycholocical support and patient education. However, fibromyalgia is a cronical disease whose treatment continues through many years with only a quarter of pationts in remission in first two years