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Monday, October 19, 2009

Fibromyalgia: Is Fibromyalgia Real?

Like many of his colleagues, John Kissel, M.D., used to think that fibromyalgia wasn't a real condition. Dr. Kissel, a neurologist and the co-director of the MDA/ALS Center at Ohio State University, thought it was a wastebasket diagnosis-a dumping ground for malingering, drug-seeking patients with unexplained pain, fatigue, and depression.

Then he saw patients that began to change his mind. He still remembers one woman in her 40s, a professional trial attorney from Columbus, OH. She had developed debilitating fatigue and horrible muscle pain and tenderness about a month after getting over a mild case of the flu.

After performing a number of tests, I went in to speak with her and mentioned fibromyalgia, Dr. Kissel recalls. She asked, 'What's that?' I said, 'You haven't heard of fibromyalgia? People are talking about it all over the place.' She said to me, 'I work 14 hours a day as a trial attorney-I don't do outside reading.' She wasn't depressed. She was still working. But she had all the typical symptoms of fibromyalgia. That was a formative experience in my thinking about the condition.

Today, more and more neurologists are coming around to the idea that fibromyalgia is a real disorder, and one that should be managed, or at least co-managed, by neurologists who care for chronic pain-not only the rheumatologists who originally identified the condition some 100 years ago.

Neurologists have become more educated about the diagnosis and treatment of fibromyalgia. - LYNNE MATALLANA, FOUNDER OF THE NATIONAL FIBROMYALGIA ASSOCIATION

Fibromyalgia has long presented a puzzle for doctors. It's considered a syndrome-a collection of related symptoms and problems without an identifiable cause-rather than a disease. Those related symptoms include:

* Chronic widespread pain, often accompanied by numbness, tingling, and burning

* Multiple tender points throughout the body

* Severe fatigue

* Sleep problems

Pain networks in the brains of fibromyalgia patients seem to be more easily activated than in people without the disorder.

To be diagnosed with fibromyalgia, a person must have had widespread pain in all four quadrants of the body for at least three months, and tenderness or pain when pressure is applied in at least 11 of 18 identified tender points.

Fibromyalgia was originally thought to be a rheumatologic condition because-like diseases such as rheumatoid arthritis-it is characterized by musculoskeletal pain. But research has since shown that there are no abnormalities in the musculoskeletal system in people with fibromyalgia. Instead, the problem appears to lie in the pain processing pathways of our central nervous system-the bailiwick of neurologists. Today, both rheumatologists and neurologists treat fibromyalgia.

The National Fibromyalgia Association estimates that between three percent and six percent of the population has fibromyalgia-mostly women, but some men and children as well. However, with a flimsier body of research than many other chronic conditions and no blood test to diagnose the disorder, controversy has swirled around fibromyalgia for years. It's also easily confused with other conditions, such as rheumatoid arthritis and lupus (in fact, some patients have both).

Lynne Matallana, the founder and president of the National Fibromyalgia Association, originally saw a rheumatologist for her fibromyalgia. Recently she has also been seeing a neurologist to help with the overlapping conditions, such as migraines and restless leg syndrome, that also cause her distress.

Just like everyone with fibromyalgia, I have to deal with comorbid conditions that are often treated by neurologists, Matallana says. When I started experiencing insomnia and daytime sleepiness, for example, I was referred to a neurologist who specialized in sleep disorders. Unlike several years ago, neurologists have become more interested and educated about the diagnosis and treatment of fibromyalgia. As a patient this is extremely exciting because they bring a new perspective. Read the rest of the article here.

1 comments:

The Conscious Life said...

Hi Antonette,

It's believed that fibromyalgia is triggered by chronic inflammation. I've written some articles on inflammation and foods that are anti-inflammatory. I hope they can be of some use to you and your readers.