Fibromyalgia a cause of pilgrimage through various medical specialties: about a case various medical specialties: about a case

Abstract

Introduction: Fibromyalgia is a disease characterized by chronic musculoskeletal pain; Without evidence of
joint involvement that mainly affects women between 30 and 50 years old, there are no specific data for Ecuador,
but according to researchers' calculations, the phenomenon behaves the same as it does worldwide; 3%
to 5% of the population, the exact causes of FM are uncertain, epigenetic mechanisms and genetic factors are
thought to be involved. Its ignorance favors the pilgrimage of people by different specialists. The new 2019
diagnostic criteria consider the presence of chronic pain> 3 months, 6 areas of body pain out of the 9 proposed,
and are associated with sleep disturbances and fatigue. There is no single treatment, so a multidisciplinary
approach is the best, the pharmacological treatment with the greatest clinical evidence is based on amitriptyline,
pregabalin, milnacipran and duloxetine.

Objective: To describe a clinical case of Fibromyalgia, an underdiagnosed clinical entity.

Material and methods: Retrospective descriptive study, presentation of a clinical case of fibromyalgia, a cause
of pilgrimage through various medical specialties.

Results: The case of a 45-year-old woman with a history of 1 ½ years of generalized muscular pain accompanied
by paresthesias in upper and lower limbs, generalized rigidity, decrease in generalized muscular strength fatigue, emotional lability and insomnia is presented. , with a long history of pilgrimage with several professionals
without finding a clear diagnosis, the diagnosis of fibromyalgia is concluded after multiple evaluations
and non-pharmacological treatment (psychotherapy + physical rehabilitation) and pharmacological treatment
(tricyclic antidepressants, neuromodulators and anxiolytics) are indicated with evident clinical improvement.

Conclusions: The nonspecific clinical characteristics of Fibromyalgia, the general physician's lack of
knowledge of the disease and the low level of suspicion have led to underdiagnosis, which has led to a long
pilgrimage of the patient through various medical specialties and therefore a deterioration in the quality of life
of the same, fact that makes it vitally important to address their clinical characteristics and treatment.