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Treatment Plans

Fibromyalgia

At Dr. Pallanti's Istituto di Neuroscienze, we offer personalized diagnostic and treatment plans designed to detect and treat the complexity and individuality of fibromyalgia syndrome, which is often associated with other disorders such as ADHD.

Fibromyalgia ― Symptoms, Causes and Treatments

Fibromyalgia is a chronic syndrome that can have a significant impact on the quality of life of those who suffer from it and is characterized by a varying number of signs and symptoms among which it is possible to find: widespread muscle pain, chronic fatigue and tiredness, mood and anxiety disorders, sleep disturbances, muscle rigidity, and balance disorders. The specific cause of fibromyalgia is not known, but it is believed to be the result of a combination of genetic and environmental factors. Although there is no specific cure, several treatments can provide significant help in improving symptoms.

Symptoms of fibromyalgia

Symptoms of fibromyalgia can vary widely from person to person, but the most common include:

  • Widespread muscle pain, which can be described as a dull, deep or burning pain;

  • Fatigue;

  • Sleep disturbances, such as insomnia, hypersomnia or frequent night awakenings;

  • Depression, Anxiety or Irritability;

  • Cognitive disorders, such as concentration or memory problems;

  • Gastrointestinal problems, such as nausea, diarrhea or constipation;

  • Sensitivity to pain, which can be caused by stimuli such as skin contact or temperature changes;

  • Joint problems, such as joint rigidity or pain.

The causes of fibromyalgia

The cause of fibromyalgia is unknown, but the syndrome is believed to be due to a combination of genetic and environmental factors.

Genetic factors seem to play an important role in fibromyalgia. In fact, there is a growing scientific evidence that people with fibromyalgia may have a higher prevalence of genes associated with symptoms such as pain, mood and sleep alterations.

Environmental factors may contribute to the onset and maintenance of fibromyalgia. In this direction, some studies have suggested that events such as infection, trauma, or a stressful event (e.g., bereavement) may evoke typical symptoms of the disease.

Overall, it is considered unlikely that fibromyalgia can be caused by a single factor easily identified as responsible for the onset of the disorder. More frequently, it is possible to find in the individual's life history a set of elements of different types that combine to make the individual more vulnerable to the onset of the syndrome. For this reason, it is of fundamental importance to be able to reach a Precision Diagnosis capable of guiding the person to the specialized treatment option best suited for him or her.

Treatment options for fibromyalgia

Fibromyalgia represents a chronic syndrome, so there is no specific treatment that can lead to recovery from the disorder. However, there are a number of treatments that can be of great help in improving symptoms significantly.

Fibromyalgia treatments must be carefully selected by specialized medical team and "tailored" to the single person based on the specific symptom profile. The most common treatments that can help with symptom management include:

  • Physical therapy: Physical therapy can help improve muscle flexibility and strength, leading to a reduction in pain and improving the patient's quality of life.

  • Pain therapy: Pain therapy can help control the pain typical of fibromyalgia and improve the patient's physical function.

  • Pain medications: Pain medications can help relieve the pain experienced by the person with fibromyalgia and sometimes also help in improving sleep quality.

  • Psychological support and psychotherapy: Psychological support and Cognitive-Behavioral Psychotherapy (CBT) can prove to be of great help in helping people manage pain and environmental stressors.

Neuromodulation Therapies

In recent years, the use of Neuromodulation Therapies for the treatment of Fibromyalgia has received increasing interest given the growing body of evidence regarding their efficacy in treating the disorder.

Neuromodulation therapies use physical, magnetic, electrical and light stimuli that act by promoting Neurogenesis, increasing the neuronal plasticity and the creation of new neural connections (synapses).

These therapies represent an advantageous alternative to medical treatments: Transcranial Magnetic Stimulation (TMS), for example, is indicated by numerous international guidelines as an effective treatment in cases of unsatisfactory response to pharmacological treatments. Moreover, Neuromodulation techniques have the great advantage that they can be combined with each other and easily associated with additional medical and psychological therapies, thus providing the possibility of acting simultaneously on multiple mechanisms involved in the disease.

➜ One of the most promising neuromodulation therapies for the treatment of fibromyalgia is Transcranial Magnetic Stimulation (TMS), a technique that uses a magnetic field to stimulate or inhibit specific cerebral areas of interest. Numerous studies have demonstrated the effectiveness of TMS in reducing pain and improving quality of life in patients with fibromyalgia. Dr. Stefano Pallanti is a pioneer in the use of this technique to manage the symptoms of fibromyalgia syndrome: in fact, during his long clinical experience, he has frequently found TMS to be effective in reducing muscle pain and fatigue related to the disorder, through its ability to stimulate the brain tissues responsible for the symptoms. In addition, TMS may prove to be particularly useful because of its great effectiveness in managing the psychological symptoms of fibromyalgia such as Depression, Anxiety and Irritability.

Fibromyalgia and ADHD ― The frequent connection

A research conducted by Dr. Stefano Pallanti uncovered an interesting connection between Fibromyalgia Syndrome (FMS) and Attention Deficit/Hyperactivity Disorder (ADHD). This study revealed that 24.5 percent of subjects with FMS also had ADHD and that this percentage of cases was associated with greater severity of FMS symptoms and more significant functional impairment, particularly in work and school life settings.

In addition to this finding, the research also showed that patients with FMS and ADHD also exhibited a Substance Use Disorder more frequently than those with only FMS (with rates of 38.5 percent versus 3.8 percent). More specifically, the most common substance within this group of people was opioids.

Overall, Dr. Pallanti's research findings underscore the importance of identifying and treating ADHD in patients with Fibromyalgia, as ADHD can significantly increase the disability burden of the disorder, negatively and specifically affecting the person's work life and social activities. More specifically, given the tendency to overuse pain medications such as opioids, the detection of ADHD symptoms ― both in the neurodevelopmental period and in the current life context ― is particularly recommended, especially in patients prone to increase the dose of pain medications.

The results of this study support the existence of a true comorbidity between Fibromyalgia and ADHD, suggesting that these two conditions should be managed in an appropriate and integrated manner. In addition, there is preliminary evidence suggesting that ADHD medications may have a positive effect on the pain and fatigue associated with Fibromyalgia, opening up new treatment perspectives. This pioneering research by Dr. Stefano Pallanti offers substantial clinical implications for prevention and monitoring of the condition, providing innovative insights to improve the quality of life of Fibromyalgia patients.