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People with fibromyalgia often complain of cognitive problems; this is known as fibro fog, brain fog, or cognitive dysfunction. These symptoms consist of difficulties affecting complex cognitive processes such as memory, executive functions, and attention or concentration. Pain and fatigue are the main causes of these problems. There is no neuronal deterioration, but the difficulties will vary in intensity depending on the overall symptomatology.
People with fibromyalgia frequently feel very tired and in some patients this symptom is particularly prominent. Fibromyalgia may sometimes give rise to problems such as apathy, lack of energy, demotivation, asthenia, physical tiredness, a disproportional feeling of exhaustion compared to the effort made, etc. This suggests that the fatigue depends on and increases in function of other mechanisms involved in the disease.
The rheumatologist is responsible for diagnosing the condition and the primary care doctor will prescribe the treatment and perform follow-up, so long as the disease is under control and stable. If the symptoms worsen and/or the disease does not improve or is poorly controlled, you will be referred to the corresponding specialist.
You must always tell your doctor and plan your pregnancy to the maximum extent possible in case any of the medications you are taking need to be withdrawn gradually. In most cases, unless contraindicated by any of your healthcare team, you can continue with the rest of your treatment (exercises, relaxation, multidisciplinary treatment, etc.), while adjusting it to each stage of the pregnancy. Some patients report an improvement of their condition during pregnancy, others remain the same and a small percentage endure worse symptoms. Each case is unique.
No, fibromyalgia is not a hereditary disease. Nevertheless, a certain degree of familial aggregation has been observed. First-degree relatives of fibromyalgia patients have a greater risk of developing the syndrome, as occurs with other diseases.
There are currently no medicines available that can definitively eradicate the disease. The aim of treatment is to improve control over the symptoms and reduce their intensity in order to maintain or improve patients’ functional capacity and quality of life. According to the intensity of the pain and the other symptoms, one type of treatment or a combination of treatments may be used, depending on each patient and the state of their fibromyalgia. After agreeing with the patient, the specialist will prescribe one or more medications to control the symptoms. Drug therapy is generally initiated if the symptoms are of moderate to high intensity.
If the drug therapy works well, which is understood to be the maximum, stable therapeutic response to the drug for at least 1 year, the reduction and/or withdrawal of the medication can be considered if the symptoms are mild and, obviously, always following the indications of the specialist. Many patients who reach this situation can maintain their condition for long periods or only need to take a painkiller every now and then.
First of all, you should learn about the disease, familiarise yourself with the resources to help control the symptoms and always complete the necessary treatments with experienced professionals who are trained in fibromyalgia.