Bordoni Bruno, Escher Allan R
Dipartimento di Cardiologia, Fondazione Don Carlo Gnocchi IRCCS, Istituto di Ricovero e Cura, S Maria Nascente, Milano, 20100, Italia.
Anesthesiology/Pain Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA.
Open Access Rheumatol. 2024 Mar 7;16:55-66. doi: 10.2147/OARRR.S442327. eCollection 2024.
The classification of fibromyalgia (FM) is not always immediate and simple, with the time from the first diagnosis, compared to the onset of symptoms, of a few years. Currently, we do not have instrumental or biochemical tests considered as gold standards; the clinician will make a diagnosis of FM based on the patient's medical history and subjective assessment. The symptoms can involve physical, cognitive and psychological disorders, with the presence of pain of different origins and classifications: nociplastic, nociceptive and neuropathic pain. Among the symptoms highlighted, postural disorders and neuromotor uncoordination emerge, whose functional dysfunctions can increase the mortality and morbidity rate. An alteration of the diaphragm muscle could generate such functional motor problems. Considering that the current literature underestimates the importance of breathing in FM, the article aims to highlight the relationship between motor and diaphragmatic difficulties in the patient, soliciting new points of view for the clinical and therapeutic framework.
纤维肌痛（FM）的诊断并非总是迅速且简单的，从首次诊断到症状出现往往间隔数年时间。目前，我们没有被视为金标准的仪器检查或生化检测方法；临床医生将根据患者的病史和主观评估来诊断纤维肌痛。这些症状可能涉及身体、认知和心理障碍，存在不同起源和分类的疼痛：神经病理性疼痛、伤害性疼痛和神经源性疼痛。在突出的症状中，姿势障碍和神经运动不协调出现了，其功能障碍会增加死亡率和发病率。膈肌的改变可能会导致此类功能性运动问题。鉴于当前文献低估了呼吸在纤维肌痛中的重要性，本文旨在强调患者运动与膈肌困难之间的关系，为临床和治疗框架寻求新的观点。
