What diseases cause pain throughout the body?

By definition, diffuse pain affects the entire body or several parts. She may be acute or chronic, when it lasts more than three months. “Pain is defined as an unpleasant sensory experiencewithout necessarily having an anatomical link“, explains Professor Thomas Hügle, Head of Department, Rheumatology Department at the Vaud University Hospital of Lausanne. The medical terminus for pain is -algia, this is why professionals can use the term diffuse polyalgia syndrome in case of diffuse pain. Fibromyalgia is one of the main causes of widespread pain, but it is far from being the only reason. The pain may be difficult for the patient to place or localize. “The causes are very broadindicates Professor Hügle. Our job is to exclude different diseases that could be rheumatism, spondylitis, psoriasis, rheumatoid arthritis or lupus which are common causes of diffuse pain. However, they are very rarely caused by a serious illness such as cancer“.

Fibromyalgia: pain “everywhere all the time”

When a patient suffers from fibromyalgia (pain in the muscles and fibrous tissues – tendon, ligaments -), we often say that he“He hurts everywhere, all the time.” Pain is the main symptom, which can decrease with rest and intensify after exercise. Fibromyalgia is associated with significant fatigue linked to sleep disorders and non-restorative sleep. “Other body systems are disturbed, such as the digestive system. The patient may have abdominal cramps or constipation. At the neurological level, dizziness can appear just like migraines“, continues our interlocutor. The precise cause of fibromyalgia is not yet well defined and several hypotheses exist.

The pain can be different from one person to another: difficulty concentrating, photosensitivity, etc.

“The most accepted is a problem with the central nervous system, spinal cord or brain, which explains the different types of pain and symptoms. Moreover, there is not a single clinical picture concerning fibromyalgia, but several subtypes depending on the symptoms.“, describes the rheumatologist. Indeed, the pain can be different from one person to another: concentration problems, photosensitivity (discomfort to light), discomfort to noise, etc.

Neurological diseases: Parkinson’s, Lyme, Multiple Sclerosis

Lyme borreliosis, Parkinson’s disease or multiple sclerosis are neurological diseases that can cause pain in the body. It can also be toxic neuropathies, linked to certain medications or the consumption of certain drugs.

Psoriatic arthritis: pain especially in the joints

Psoriatic arthritis is an inflammatory joint disease caused by psoriasis. The pain mainly affects damaged skin and nails, joints and the spine.

Rheumatoid arthritis: swollen wrists and hands

This disease manifests itself by pain in several joints, often swollen in the wrists and hands. Affected joints feel stiff, especially at night and in the morning.

Ankylosing spondylitis: flare-up pain

Ankylosing spondylitis is a chronic inflammatory joint disease. The pain is mainly lumbar and sacroiliac (pelvis). This disease causes painful flare-ups interspersed with periods of calm.

Vitamin D deficiency can lead to bone pain

Certain metabolic diseases, caused by a lack of vitamin D for example, can be the cause of chronic diffuse pain in the muscles or bones.

A muscle disease

Inflammatory or congenital muscle diseases or myopathies can cause widespread pain throughout the body. Myositis manifests itself very differently from one form to another and, for the same form, from one person to another.

Somatoform disorders after trauma

Somatoform disorders are not defined as persistent physical complaints caused by pain of psychosomatic origin. “We understand the somatoform part of pain better and better. They can occur years after trauma, psychological post-traumatic stress or even sexual abuse. The functional link has been proven in different studies. Trauma that occurred during childhood and adolescence can lead to the occurrence of physical pain, like an imprint left on brain activity.“, describes the rheumatologist.

Pre-menopause: 1 in 2 women have joint pain

Peri or pre-menopause is another common cause of diffuse pain, but underestimated. The period before menopause can last several years. “With the decrease in estrogen, the body begins to hurt. These hormones being natural anti-inflammatories, women gradually lose their protection against inflammation. Losteoarthritis of the back, of the heel pain (talalgia) or epicondylitis are all forms of pain that can appear during peri-menopause. We qualify them as pseudo-rheumatism. This is a frequently visible phenomenon in the profession of rheumatologist: 50% of women, during this period, may have joint pain. The women most often affected are those aged between 50 and 53, rather obese and sedentary,” describes Professor Thomas Hügle.

Which doctor to consult in case of diffuse pain?

In case of persistent diffuse pain, the general practitioner can already provide many therapeutic solutions to the patient. The attending physician can prepare the history and prescribe medical examinations. If necessary, the doctor refers the patient to a specialist in pain and musculoskeletal disorders such as the rheumatologist. The diagnosis is a diagnosis of exclusion. Diseases are excluded one after the other to find the one causing the pain.

“We evaluate muscles and vitamin D possibly”

“The medical history is essential, as is the clinical examination. A blood test is prescribed to exclude inflammation. We assess muscle and possibly vitamin D. An ultrasound of the joints is prescribed to exclude arthritis.” Classically, for fibromyalgia, nothing is visible in medical imaging exams. The diagnosis for this disease is mainly made after a complete and rigorous investigation as well as negative test results.

How to relieve diffuse pain?

Treatment depends on the etiology of the diffuse pain, which is difficult to assess. “Medications can improve pain in fibromyalgia by approximately 20-30%, often no more. Support must be multidisciplinaryincluding medication, physiotherapy and psychological treatment, indicates the rheumatologist. Fibromyalgia is treated with antidepressant medications or anticonvulsants, such as Gabapentin or anti-inflammatory medications. At the same time, physical exercise with a physiotherapist can relieve widespread pain.” Professor Hügle also recommends fight against a sedentary lifestyle by practicing regular physical activity. Weight loss in cases of obesity also has its benefits in combating chronic pain. Cognitive-behavioral therapy (CBT) is also recommended to reduce the stress of living with this pain. Finally, improving sleep quality is very important to avoid exhaustion, because the pain is already tiring for the patient. “What gives the best result is multimodal treatment. We try several therapies at the same time, in conjunction with the multidisciplinary team, especially with a psychiatrist. Finally, patient care must be comprehensive to effectively reduce widespread pain.“

Thanks to Professor Thomas Hügle, Head of Department, Rheumatology Department of the Vaud Lausanne University Hospital Center