Lyme, Charcot, fibromyalgia ... these diseases that come out of the shadows
In our society, hyper-connection has a definite advantage. It helps to make known disorders that we spoke little or nothing, and sometimes even remained nameless. "Several elements explain this phenomenon," says Professor Serge Perrot, rheumatologist *. "Thanks to the information they have, patients ask for more, they are in a relationship of equality with medicine. They are more involved in their health and need a label on their disease. But mediatising these affections does not necessarily mean healing them. Update on these new "epidemics".
Musculoskeletal disorders (MSDs) result in pain, stiffness, loss of dexterity or strength, often caused by recurrent movements in everyday work. They have certainly existed since the dawn of time, but they have only really been recognized since the early 1990s. In a few decades, they have gone through an explosion. 87% of occupational diseases are now attributable to MSDs, including carpal tunnel syndrome (34%), shoulder tendinitis (29%) and elbow (20%), as well as low back pain. They are expensive because they generate more than 10 million days off work each year. "In my opinion, the reason for this increase is to look for more global suffering. Not only are people gradually being replaced by machines, but they are now also evaluated by machines, "says Pr Perrot.
What treatments? Psychological support for patients, optimizing the ergonomics of their workstation. Against pain, we prescribed painkillers, osteopathy, physio or surgical procedures in the most severe forms.
And tomorrow ? The virtual may come to prevent the occurrence of MSDs. Thanks to simulation software that reconstructs the work environment and the gestures to be performed using infrared sensors, we will be able to study the possible improvements in order to avoid creating points of weakness.
It is manifested by a feeling of intense fatigue, disturbed sleep and diffuse pain throughout the body. But because no medical imaging exam can testify to its presence, fibromyalgia, which would affect 1.4 million people in the Hexagon of which 80% of women, has long been perceived as a harm only psychosomatic. Thanks to advances in research, we now know that it has its source in a disorder of the nervous system. Scientific advances that have led to the recognition of the disease status on September 3, 2017. Fibromyalgia is not "in the head", even if, as Serge Perrot explains, "people develop it. frequently after a psychological shock.
What treatments? It is based on powerful analgesics, such as tramadol, an opiate derivative that can lead to dependence and sometimes on antidepressants, not always satisfactory solutions.
And tomorrow ? The path of targeted gene therapies is being considered.
The third most common neurodegenerative condition behind Alzheimer's and Parkinson's was until recently little known to the general public, if not through Stephen Hawking, the famous astrophysicist who died in 2018. This amyotrophic lateral sclerosis causes progressive destruction of motor neurons, nerve cells driving voluntary muscles. The situation changed thanks to the Ice Bucket Challenge in 2014, a challenge of pouring a bucket of ice water over the head: it raised a hundred million dollars for the cause to help the research.
What treatments? They are limited for the moment to a single drug, riluzole, which can slow down (a little) the mechanics of the disease.
And tomorrow ? Scientific research explores various pathways: gene therapies that counteract the mutation of the SOD1 enzyme that causes this degeneration and the design of a molecule that "nullifies" the action of glutamate, a neurotransmitter that helps accelerate this degradation.
Fatty liver disease
It first resonated with the United States as NASH. In late France, since 2017, thanks in particular to the journalist Pierre Ménès who has confessed to suffer from this affection, we hear about the ravages of "foie gras disease" or "soda disease". Estimates indicate that about 12% of the inhabitants of France should cope with this disease. This inflammation of the liver caused by excess fat in this organ, often develops in obese, diabetic or hypertensive individuals. It can progress to cirrhosis or cancer.
What treatments? Many pharmaceutical companies are testing anti-NASH molecules around the world, but there is currently no drug to eradicate them. Like musculoskeletal disorders, it is a corollary of our modern way of life and a symptom of what needs to change so that we can live better and longer.
As early as 1959, the French psychiatrist Claude Veil defined his concept. In the 1970s, psychiatrist Herbert J. Freudenberger described in detail the state of some people who lose all energy, as if they were "consumed from within", and give the name of burn-out to the evil they suffer. . As for fibromyalgia, the path was long before he could claim, under certain conditions and thanks to a decree of June 7, 2016, as a "occupational disease". According to the French Institute for Public Health Surveillance (INVS), 7% of the 480,000 employees suffering psychological damage because of their work would be burned out. And it does not reach that assets since more and more seniors are subject, especially among those who play the role of caregivers.
What treatments? The care is based on long-term psychotherapeutic work and rest, often associated with anxiolytics and antidepressants.
The narcissistic perversion
Very fashionable today, to the point that a magazine like The Obs termed it "evil of the century", this psychopathology, theorized by practitioners like Paul-Claude Recamier and Alberto Eiguer, consists in gaining the affection of its "target" to better manipulate and devalue it until it breaks it. completely. The term is used in everyday language and is often misused: any cyclothymic, egocentric or conflict-prone individual does not fall into this category.
What treatments? "To repair oneself" usually means consulting a psychoanalyst or a psychologist.
According to the INVS Sentinel Network, it reaches nearly 27,000 more people each year. Despite its extreme media coverage, this disease transmitted by ticks carrying Borrelia bacteria suffers from a lack of consensus within the medical community. If among the specialists, no one contests the evolution of the symptoms in the absence of treatment (with the cutaneous manifestations can succeed neurological and rheumatological attacks), they are divided on the materiality or not of a chronic form of this one . However, it seems indisputable in the eyes of Professor Christian Perronne, despite the difficulties posed by his diagnosis. "Chronic Lyme is complicated by the fact that it is essentially expressed by subjective signs, that is to say, only perceptible by the patient but which can be disabling. And the objective signs that it generates are not much more enlightening because they can be attributed to other diseases ", explains the one to whom we owe The truth about Lyme disease (Odile Jacob ed.)
What treatments? Long-term antibiotic therapy when confronted with so-called "late phase" Lyme diseases.
* Author of The pain, I'm getting out (In Press)
Thank you to Professor Serge Perrot, rheumatologist at the Center for the Study and Treatment of Pain at the Hôtel-Dieu in Paris, and Professor Christian Perronne, infectious disease doctor at the Raymond-Poincaré Hospital in Garches.
⋙ Lyme disease: 80% of misdiagnosed patients take antibiotics unnecessarily
⋙ Fibromyalgia: what are the symptoms?
⋙ Narcissistic pervers: how to recognize it?