Fibromyalgia neurologist or rheumatologist?

In this post we are going to answer the question ‘’Fibromyalgia neurologist or rheumatologist?’’ We will explain what fibromyalgia is, which specialist is in charge of treating it and what the treatments are.

Fibromyalgia neurologist or rheumatologist

Both. Fibromyalgia can be diagnosed in rheumatology, neurology, and internal medicine units.

A caress, a simple touch, moving or simply doing nothing are things that most people find pleasant and pleasant. In general, we enjoy the sensations that our body transmits to us, unless they cause us some kind of discomfort or pain.

However, this exception is the norm for many people who experience chronic pain in most of their body without any clear disease causing it. These are people with fibromyalgia.

The World Health Organization (WHO) recognised fibromyalgia as a disease in 1992. As of today, 4% of the population is affected by fibromyalgia and the majority, almost 90%, are women.

As it affects all the soft parts of the musculoskeletal system, it is known as the “invisible disease” and cannot be readily detected by medical tests. It is not possible to see fibromyalgia, leave no scars on the skin or inflict wounds that anyone may see or identify themselves. It is a desperate, lonely pain.

The etiology of this disorder is still unclear at the moment, but what we do know is that more people are diagnosed year after year, so we aim to have as globalized an intervention as possible, including how plausible the biopsychosocial component is.

What is fibromyalgia?

Fibromyalgia is a well-known disease that is characterized mainly by the presence of constant musculoskeletal pain spread throughout the body. This pain is diffuse and non-specific and lasts for more than three months of persistence.

It also highlights a hypersensitization of different points of the body, called trigger points, in which there is usually hyperalgesia. The threshold from which perception becomes painful is lowered so that the slightest touch on these points can trigger sensations of great pain.

The symptoms

It has been seen that these people frequently suffer from symptoms of depression and anxiety, symptoms that may be a consequence of the chronicity of their condition and ignorance of the causes of their condition.

However, it has also been indicated that its presence may be part of the symptoms of the disorder. They tend to suffer from sleep problems such as sleeplessness or frequent awakenings, which in turn eases their discomfort and fatigue.

It is also not uncommon for muscle stiffness to appear in the form of cramps, stiffness and even tremors.

It is also common for fibromyalgia sufferers to tend to fatigue easily without having to exert great effort. Sometimes these symptoms are added to the presence of other disorders, but these do not explain the generalized pain

The medical analysis of the patients does not reflect any indication of alterations or injuries that could cause pain. 

In fact, for many years it has come to be considered a somatoform disease, as there are no indications of real injuries even though the perceived pain and suffering are real. 

However, today it is considered a rheumatic disease. It is more common in women than in men.

Causes of this disorder

Fibromyalgia is a condition for which the exact causes are still unclear, even today, and no clear lesions that may cause general pain have been found in this disorder.

However, the research performed point to a defect in the delivery of serotonin and P, which has been altered in many of these patients. Specifically, a decrease in serotonin levels was observed while substance P increased (the latter is highly involved in the perception of pain).

An irregular reaction of the nervous circuits and the pathways connected to the pain sensation could be triggered by the altered levels of these drugs, allowing the body to perceive various stimuli as painful.

Furthermore, it was thought that this could be due to aspects such as nickel or gluten sensitivity (although without intolerance), but there is still insufficient evidence in this regard.

It has also been considered that the occurrence of stressful and/or traumatic events may contribute to the onset and maintenance of the condition, especially if it is taken into account that it occurs regularly along with changes in mood or anxiety.

As we have previously mentioned, this could be due to the fact that the patient feels powerless and hopeless because his condition cannot be clarified.

Who treats fibromyalgia rheumatologist or neurologist?

The lack of answers to many questions, including which doctor treats fibromyalgia, rheumatologist or neurologist, makes those who suffer from it and their families see circuits of chaos and confusion, preventing a rapid treatment of the disease.

The bewilderment of the patients at not finding a specialist “interested” in the disease leads them to a search that is often unsuccessful. Let’s clear up a doubt: which doctor can treat fibromyalgia?

The answer is anyone.

If you want to know what this reasoning is based on, you can continue reading the article written by Paul Ingraham that explains the “absent-mindedness” and “abandonment” that the patient finds when finding a specialist who treats the disease.

What doctor treats fibromyalgia, rheumatologist or neurologist?

Fibromyalgia often resembles the early stages of rheumatological diseases such as lupus or ankylosing spondylitis. In fact, fibromyalgia can coexist with these conditions. This is why fibromyalgia patients are often referred to as rheumatologists.

As a result, many patients and rheumatologists end up frustrated and confused with each other.

Rheumatology is the medical specialty dedicated to arthritis, particularly inflammatory arthritis (autoimmune diseases). Rheumatologists are especially concerned about these very serious and complicated diseases. Many of them subspecialize in just one!

In general, it is not fair or reasonable to expect rheumatologists to treat fibromyalgia alone. The only rheumatologists who do it are those who have been interested and have gone out of their way to study it. This is the exception.

In Canada, rheumatologists have been “tipped off” by the professional organization that brings them together: they are not prepared to treat it – technically they are not prepared to help fibromyalgia patients!

Neurology is the other medical specialty that treats fibromyalgia cases, it is probably the most suitable – although neurologists are also prepared and concerned about other serious diseases that they understand much better.

Many of them subspecialize in one disease (multiple sclerosis), or a class of neurological problems such as movement disorders. But some neurologists still take a professional interest in diseases like fibromyalgia.

Other specialists who can treat fibromyalgia

In all cases, any professional can help if they are interested in the subject. But there is simply no specialty that clearly lends itself to that. There simply are no “fibromyalgia doctors.” Here are the closest possible possibilities, after rheumatology and neurology:

Traumatologists “carpenters” of medicine generally focus on surgical repairs of biomechanical problems and sports medicine. They are mostly not a good option for fibromyalgia patients.

Physical medicine and rehabilitation is a recent medical specialty, they are basically advanced, physical therapists.

Pain specialists are typically board-certified anesthesiologists, neurologists, physiatrists, psychiatrists, or oncologists, with additional training in pain management.

They often work in multidisciplinary pain clinics/programs. This may be a good option for fibromyalgia patients, but – once again – the fibromyalgia citizen can be a second-class citizen, overshadowed by notoriously more serious illnesses.

More specialists

Psychiatrists and psychologists are potentially helpful not because fibromyalgia is “all in your head,” but to help rule out (or treat) symptoms caused by anxiety and depression.

Massage therapists have little hope in altering the progression of fibromyalgia, but they reliably offer something almost what no other practitioner can: at least relieve temporary nervous system symptoms.

Calming the central nervous system may be more important than it sounds, more effective than relaxation, inasmuch as it is a very pleasant sensory experience that can actually help reduce sensitization.

Fibromyalgia treatment

Due to the definitive ignorance of the causes of fibromyalgia, the treatment that is applied usually focuses on alleviating its symptoms and improving the quality of life of the patient from a multidisciplinary perspective.

Pharmacological intervention

At a pharmacological level, sedative-hypnotic agents such as benzodiazepines, antidepressants and anticonvulsants have been applied in order to reduce fatigue, possible muscle spasms, and depressive and anxious symptoms.

Analgesics and anti-inflammatories are also commonly used to try to reduce the level of perceived pain.

Psychological intervention

On a psychological level, the use of multimodal programs that take into account a large number of essential factors to improve the condition of the subject in question is recommended.

Within these programs, the use of relaxation, meditation and biofeedback strategies is essential in order to try to reduce the intensity of pain and have a greater capacity to manage it. 

Physical exercise has been shown to be useful in treatment, especially those of the aerobic type that is carried out in the water.

It is necessary for the patient to be able to express his feelings and fears as well as to work on them and the feelings of helplessness that he may have so that the subject perceives himself as more competent and capable of controlling the situation.

It is also helpful for the patient to try to give meaning to pain and reinterpret it, seeking to be able to establish different strategies that allow them to cope with the disorder.

Psychoeducation for the patient and their environment is also essential, since it is reassuring to receive information about the problem in question (it must be taken into account that most subjects do not know what happens to them) and about strategies to apply in order to reduce it.

In addition, the fact that there are no injuries can lead the environment to think that the person may be simulating a disorder.

FAQS: Fibromyalgia neurologist or rheumatologist

Should I see a rheumatologist or neurologist for fibromyalgia?

Neurology is the other medical specialty that treats fibromyalgia cases, it is probably the most suitable – although neurologists are also prepared and concerned about other serious diseases that they understand much better.

Can a neurologist diagnose fibromyalgia?

Yes, a neurologist can diagnose fibromyalgia.

What can a rheumatologist do for fibromyalgia?

Since fibromyalgia is complicated in nature and difficult to diagnose, a complete medical history and a thorough physical examination would be carried out by a rheumatologist. A physical examination may help show symptoms of inflammation in the joints and musculoskeletal system of the body.

What kind of doctor helps with fibromyalgia?

A rheumatologist or neurologist can help you with fibromyalgia.

What is the new name for fibromyalgia?

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

In this post we answered the question ‘’Fibromyalgia neurologist or rheumatologist?’’ We explained what fibromyalgia is, which specialist is in charge of treating it and what the treatments are.

If you have any questions or comments please let us know!

References

Clauw, D. J. (2014). Fibromyalgia: a clinical review. Jama, 311(15), 1547-1555.

Wolfe, F. (1991). Fibromyalgia. Prognosis in the rheumatic diseases, 321-332.

Goldenberg, D. L., Burckhardt, C., & Crofford, L. (2004). Management of fibromyalgia syndrome. Jama, 292(19), 2388-2395.

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