“Is Fibromyalgia Real?”
Before we start, let me say, that is definitely NOT my question. Imagine my shock when I perused today’s email messages and found one with the subject line “Is Fibromyalgia Real?,” followed by a link to an article by two prominent physicians debating what the author of the email calls a “controversial topic.” The first section of the article concludes:
“…it is clear that ‘fibromyalgia’ is not by itself a distinct condition with a single pathophysiologic mechanism. Rather, it is a common symptom complex that is characteristic of the heightened perception of pain associated with a number of different precipitating factors.” Posted at Medscape Neurology News
As a chronic pain doctor who has spent decades working with fibromyalgia patients, this article made me more than a little upset. I admit, when I first heard about fibromyalgia, I was skeptical. When I first got involved in fibro research about 20 years ago, I was certain our research would prove that fibromyalgia was not a unique condition but just your garden variety chronic musculoskeletal pain by another name. Data don’t lie and I was bowled away by what the data showed — the fibro patients were very different from our typical chronic pain patients, which probably explained why our previous attempts to lump them in with other chronic pain patients for treatment hadn’t worked very well.
In 1990, the American College of Rheumatology produced the first diagnostic criteria of fibromyalgia, which allowed for careful study of this important population. Since then, study after study has consistently shown something very important — fibromyalgia is real and associated with clear changes in biology of the nervous system, pain sensitivity, muscles, hormones, etc. While we still do not know the specific cause of fibromyalgia, we can very definitively say that fibromyalgia results from genuine and reproducible physiological abnormalities.
Articles like this can do a real disservice to the healthcare community and patients struggling with fibromyalgia. I suspect most doctors receiving this email will not take the time to read through the full transcript of the debate. Rather, many will see the headline and, without further education, likely conclude that fibromyalgia is NOT a real condition. While this subject line may be more exciting and a better tickler than something like, “What do we know about the pathology of fibromyalgia,” using it can negatively affect how those unfamiliar with this often disabling condition perceive their patients’ reported symptoms.
Excerpted from The Woman’s Fibromyalgia Toolkit:
Fibromyalgia Symptoms and The Science Behind the Disease
“Fibromyalgia is a complex disorder with a wide variety of disabling symptoms. How can one disorder cause problems with pain, sleep, the digestive system, the bladder, and more? This assorted collection of symptoms is probably part of the reason why it took doctors so long to recognize that fibromyalgia was, in fact, a single disorder. The symptoms characteristic of fibromyalgia could be the result of the abnormalities in physiology that scientists have uncovered in people with this condition. Doctors have not yet discovered what specifically causes fibromyalgia, but they have identified a number of important changes in the body that can explain at least some of the symptoms. Changes in nerves and muscles probably influence pain levels and weakness. Hormonal changes may result in other common symptoms; for example, abnormal melatonin levels may cause sleep problems, and thyroid deficiencies may affect mood and fatigue.
“As scientists learn more about fibromyalgia, research is helping convince people with fibromyalgia and their doctors that fibromyalgia is a real, biological condition. This increased understanding has also helped experts develop new systems for identifying and diagnosing fibromyalgia. Increasing knowledge about the genetics and underlying physiology of fibromyalgia will help improve the ability to diagnose and treat this complex condition.”
The Woman’s Fibromyalgia Toolkit will be available March 15th.
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