Fibromyalgia is a complex chronic disease characterized by generalized musculoskeletal pain, intense fatigue, stiffness, insomnia and often accompanied by cognitive impairment (memory and concentration problems) and mood disorders such as anxiety and depression. Other less frequent symptoms, but which can also appear, are digestive disorders, pelvic floor pain, sensory hypersensitivity (to light, noise, smells, etc.) or dizziness and vertigo. This disease affects 2.5% of the adult population, although it is diagnosed more in women than in men -9 out of every one.
This set of symptoms has a considerable impact on the quality of life of people who suffer from it, in many cases affecting the work, family and social spheres. Faced with this evidence, the Fibromyalgia Unit of Parc Taulí, formed by the Rheumatology service and the Physical Medicine and Rehabilitation service, launched the multicomponent treatment in 2022, led by the physiotherapist and psychologist, Ariadna Álvarez.
The therapy combines therapeutic physical exercise, education in the science of pain, cognitive behavioral therapy and mindfulness training, to reduce the impact of the disease.
These four strategies are worked on in groups and reinforced at home with materials that are sent to them online. First, education is provided in fibromyalgia and the science of pain, to better understand the disease and the different mechanisms of the nervous system that may be altered and responsible for the symptoms. “Knowing all the symptoms of the disease well helps patients to go through a process of acceptance and adaptation to the disease itself. This knowledge prevents feel lost and can adopt more appropriate coping strategies”, explains Ariadna Álvarez.
This is followed by cognitive behavioral therapy, which works on managing thoughts, emotions and behaviors. The second part begins with a therapeutic exercise session. This is a type of rehabilitation exercise, progressive and adapted for patients. The session ends with mindfulness practices, which work on focused attention in the present moment and help to become aware of the body and calm the mind.
The multicomponent treatment lasts 12 weeks and there is one two-hour session per week, with four in-person groups, two virtual groups and one online.
The Fibromyalgia Unit considered it necessary to include the possibility of doing therapy virtually and online, to ensure that patients can access all documentation and videos through a digital platform. “It is a disease with an unpredictable evolution and there are patients who cannot attend in person due to their situation. In this case, the treatment is the same, but it is done from home.”, emphasizes the person responsible for the treatment.
Since the launch of the therapy in 2022, around 500 people have been able to benefit.
"Patients are very satisfied with this therapy and appreciate feeling supported and listened to. Their evolution varies depending on the severity of the disease, the social factors surrounding it and the degree of adherence to therapy. However, people who"Those who actively involve themselves and come to all sessions can experience improvements in different variables such as the level of functionality, mood, level of physical activity or quality of sleep", explains Ariadna Álvarez.
However, he warns that once treatment is finished, they must persist, “We strongly urge them that everything they learn about the disease, the strategies, the exercises, they must continue to do because it is a chronic disease and these habits and knowledge acquired can be positive for them”. At this point, the professional recalls that it is very important to link patients with the activities carried out by primary care and patient associations.
To complement behavioral therapy, four sessions with the family are also offered to improve understanding and facilitate the process of adapting to the disease, because “People with fibromyalgia feel very misunderstood. Having a close environment that understands the disease and supports the person will help them cope. In addition to offering information, it is also a space where family members can express themselves.”Assures Álvarez.
This May, new sessions of multicomponent treatment have begun with ninety patients.
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