Global Health Asia-Pacific May 2022 May 2022 - Page 53

Fibromyalgia is mostly defined by chronic widespread pain that can affect every part of the body and tends to move around .
minor or no health problems for most people , such as the Epstein-Barr virus , can lead a minority of patients , say one to 10 percent , to develop chronic illnesses characterised by non-specific symptoms like fatigue , sore throat , achy muscles and joints , and brain fog in the weeks or months after the infection has resolved . But since the majority of patients don ’ t get tested for common infections or don ’ t even see doctors , these connections aren ’ t picked up .
This hypothesis has been reinforced by the massive number of people who have developed long-term symptoms after COVID-19 infection , some of whom meet the criteria for ME / CFS and offer a unique research opportunity to disentangle some of the mysteries surrounding post-viral chronic problems , including chronic fatigue .
“ The reason long COVID is different is that COVID is under the microscope ,” said Dr Bateman . “ Everybody goes in and gets tested , so we can watch carefully how many people don ’ t get better and track the disease since the beginning .”
With fibromyalgia , a different and more nuanced understanding of pain has emerged , lending credibility to the condition .
“ The traditional view of pain is that it ’ s a warning symptom and that you have some sort of underlying injury , inflammation or disease ,” explained Dr Kosek . “ Today , however , we understand fairly well that actually a lot of chronic pain is due to altered pain signalling , meaning that pain is not just a symptom any more , but it ’ s a disease of its own ,” she said .
She added , however , that this was a fairly new concept that would take some time to gain currency in the broader medical community , especially among those who weren ’ t expert in pain problems .
According to this advanced notion , referred to as nociplastic pain , fibromyalgia is a disease of pain dysregulation where the nervous system abnormally turns into pain signals many activities that most people do without feeling any pain .
Women fill the ranks of sufferers One aspect that is still unclear is why women make up most of the patients with both ME / CFS and fibromyalgia .
“ Though there are plenty of men who get it , ME / CFS is two to three times more common in women , and this may be true in all post-viral syndromes ,” said Dr Bateman .
Fibromyalgia also fits this pattern as 70 to 80 percent of patients are female , said Dr Kosek . She explained , however , that this could be at least partially due to diagnosis bias , meaning physicians don ’ t expect men to have fibromyalgia and therefore require them to have more symptoms than women before diagnosing them with the condition .
On top of that , Dr Kosek thinks that sex differences in the immune system could contribute to higher
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