The Place of Interventional Blocks in the Treatment of Pain Due to Fibromyalgia in Hashimoto's Disease

Abstract

Introduction: The exact cause of the hashimoto thyroid is unknown. The most important cause of the thyroid gland deficiency (hypothyroid) is the Hashimoto type thyroid gland inflammation. While there is a slight goiter and an antiTPO elevation at baseline. TSH. T3 and T4 are normal. Thyroid growth usually occurs silently without complaints. These patients are usually referred to the doctor for complaints such as exhaustion. prostration. swelling of the hands and face. hoarsening of the voice caused by goitre or thyroid hormone deficiency. There is no treatment method in the disease. Here. we are presenting a case of the use of
interventional blocks in the treatment of pain due to fibromyalgia in a patient with Hashimato's disease.
Case: 25 years old female patient. She is being monitored for Hashimato's disease for 2 years. There was pain spreading in the back and sleep disturbance for 5 years due to fibromyalgia. In this case. for Hashimoto. TSH. T3. T4 was normal and anti-TPO was 100. She was not using any medication for this. She was just being controlled in three-month periods. She was using pregabalin 75 mgX2 for fibromyalgia. VAS was 8-9 when she came to us. We told her to continue the previous treatment and planned for the application of interventional blocks. We applied bilateral suprascapular block. and bilateral suprascapular block + paraservical block 15 days later. and we added trigger point injections to 2 blocks 15 days later. In the control after 15 days. VAS was 1-2. We applied the previous 3 blocks after this and we asked her to come to control 1 month later. VAS was 0-1 in the control; anti TPO value was 5; and TSH. T3. T4 values were normal. After
that. we ended the treatment with control to be performed 3 months later.
Conclusion: Interventional blocks have an important role in the treatment of pain due to fibromyalgia. With the application of interventional block. sympathetic block. parasympathetic activity. vasodilatation and oxygen increases in the damaged area. We think that the decrease in the pain of fibromyalgia and the low anti-TPO in Hashimoto's thyroiditis are due to this.