Fibromyalgia is an important health problem that deserves recognition. The Health Council comes to this conclusion an advice.
Patients with fibromyalgia have chronic pain complaints that can vary in location and intensity, and may be accompanied by burning, tingling and/or numbness. The pain is further characterized by hyperalgesia (an increased sensitivity to painful stimuli) and allodynia (feeling pain to stimuli that are not normally painful). Other symptoms, according to the advice, include fatigue, sleep problems, stiffness, nausea, diarrhea, dizziness and cognitive and/or emotional complaints such as concentration and memory problems and mood disorders. The complaints and severity may differ between individuals, but also vary per individual over time.
Enhanced stimulus transmission
According to the Health Council, various biological, psychological and social factors play a role in the development and continuation of the complaints. The dominant theory is that fibromyalgia is the result of central sensitization, that is, enhanced stimulus transmission in the central nervous system, which can cause pain hypersensitivity. But other mechanisms have also been suggested as an explanation, such as disruptions of the two stress systems in the body: the hypothalamic-pituitary-adrenal axis (HPA) and the autonomic nervous system, (neuro)inflammation, autoimmunity and changes in the microbiome of the body. intestine. However, most of it is theory, the council emphasizes.
According to the council, doctors must make their diagnosis based on the so-called ACR-2016 criteria (ACR stands for: American College of Rheumatology) and the results of an extensive biopsychosocial analysis. This means that they look for the degree of ‘widespread pain’ and various other symptoms, such as the presence and severity of fatigue, unrefreshing sleep and cognitive symptoms in the week leading up to the consultation and for the presence of headaches, pain or lower abdominal cramps and depressive symptoms in the past six months. The basis for the biopsychosocial analysis are conversations with the patient, combined with physical and, if necessary, additional examination.
Energy
The council recognizes that fibromyalgia can negatively affect the ability to work. Not all insurance doctors reach that conclusion. According to the council, when assessing disability, they should focus on functioning and limitations due to illness, and less on the cause of the illness. Because a consistent and logically connected set of disorders, limitations and handicaps, such as in the case of fibromyalgia, can make someone (partly) unable to work, the council concludes.
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