Is fibromyalgia real, and if so, are drug companies profiting from the uncertainty of the disease?

There is a “real” fibromyalgia syndrome and those who display it’s features are suffering, but the presence of a distinctive disease is unproven.

The concept of the fibromyalgia syndrome has it’s usefulness in relieving suffering, and also potential damage in leading to premature closure in understanding and relieving the patients suffering. Sometimes, just the label alone reinforces a regressed illness mentality that itself leads to lower functioning. Sometimes it leads to a focused effort to minimize dysfunction and leads to better functioning. When to make a syndromal diagnosis like fribromylagia and when to withhold that label is part of the art of medicine and should not be an automatic response to a symptom checklist without considering the psychological state of the patient.

Don’t feel comfortable accessing your patients psychological state and letting that inform your management? Afraid to depart from checklists? Then go into a no-patient contract specialty or administration.

Maybe it’s a tautology, but of course fibromyalgia is “real”.

It is properly called fibromyalgia SYNDROME.

SYN – together, with, united, same, at the same time, together

DROME – Run, course (as in racecourse)

So….running together.

The philosopher-kings of medicine get together, usually in a place with good climate and good food. They create definitions of “X” syndrome.

If you have…..

History of widespread pain that has been present for at least three months

Widespread in turn defined as: Pain in both sides of the body, pain above and below the waist, pain in 11 of 18 tender point sites on digital palpation, with the usual tender points further defined…….and you DON’T have a whole bunch of other conditions that could result in similar complaints…….then you have fibromyalgia SYNDROME.

A whole bunch of historical findings, symptoms, and clinical findings…..RUNNING TOGETHER.

We don’t use the term “myocardial infarction syndrome”, because we have a defined pathophysiologic mechanism. We don’t have that for fibromyalgia, hence it’s defined by the signs and symptoms running together. Those who define such things specify exactly what has to run together to satisfy the definition of the syndrome.

So, maybe a tautology, but “fibromyalgia syndrome” is quite real. What’s not known is the underlying mechanism behind the syndrome. So, maybe it’s a rheumatologic disorder, maybe it’s a neurologic disorder, maybe it’s a paychiatric disorder, maybe it’s a hormonal disorder, maybe it’s a sleep disorder, etc…….

I get disappointed patients from time to time. I say the condition is quite real, but the condition is not treated with opiates, benzodiazepines, “medical” marijuana, SOMA, etc. It’s more properly treated with exercise, sleep hygeine, avoidance of tobacco and alcohol, diet, NSAID’s, maybe trigger point injections, antidepressants, etc.

Too many prople think recognition of the syndrome means you countenance drug abuse and wallowing in a “victim” mentality.

And yes, it’s more than just mental masturbation to recognize the syndrome as “real”. By creating a more precise definition, it facilitates research, helping to make sure the researcher in Paris is really looking at the same type of patient as a researcher in Los Angeles or London.

I actually have fibromyalgia and I can tell you first hand how very real it is. I would literally give my left arm to have this syndrome disappear so I could be the healthy, active person I was just five years ago.
Fibromyalgia is not technically a disease, but a syndrome, meaning it is a collection of symptoms and health problems that when occurring together create a debilitating condition.

Ever go to the gym and work out really hard or do extra work in the yard or any kind of physical exertion that is atypical for you? Do you remember the way your body feels the next day- the achy muscles, the stiffness, the fatigue, the lack of energy, the soreness? Now can you imagine having these symptoms every day? Can you imagine having them without doing anything to cause them? Can you imagine having these problems, plus a myriad of other symptoms? This is what it is like to have FMS.

We don’t ask that you feel sorry for us. We aren’t dying. We aren’t victims. But what we are is in pain and those of us with this condition deserve funding to help us find ways to feel relief and have a better quality of life as do those who suffer from chronic back pain, shingles, or macular degeneration.

The Unique Pain Of Fibromyalgia Syndrome

The experience of pain appears to be a complex phenomenon with humans. The reason for the occurrence of pain can be physical, psychological, or a combination of both of these causes. And how one defines or describes the intensity of the pain they experience varies as much as the types of pain that exist. Although the origin may be the same from one person to another, the experience of pain is, in fact, a subjective emotional response to the sensation and perception of the pain itself.
This is why the syndrome of Fibromyalgia is so difficult to define objectively and treat for health care providers, who are usually primary care physicians. Rheumatologists have said that Fibromyalgia Syndrome is the second most common musculoskeletal diagnosis after osteoporosis.
Fibromyalgia is a very controversial syndrome. Some doubt it is as prevalent as others believe (3 to 6 percent of the population, some have determined). About 80 percent of the sufferers that are diagnosed with fibromyalgia are women. Furthermore, fibromyalgia is not a disease- it is a syndrome. A syndrome is what you call something that has multiple symptoms that occur together. A disease, however, is an actual dysfunction of one’s physiology in some manner.
Fibromyalgia syndrome is considered a muscle condition that involves varying intensities of chronic pain for a prolonged period of time. As a result of this pain which is rather brutal with many sufferers, their physical function becomes limited. In addition, the location of the pain associated with fibromyalgia is determined by the health care provider according to at least 11 of 18 defined tender points at various locations on the human body.
Regardless, fibromyalgia is misunderstood by the medical community overall. To further complicate the subject of fibromyalgia syndrome, some have suggested that the pharmaceutical companies that make the only two medications actually approved for the treatment of fibromyalgia, which are the drug giants Pfizer with their drug Lyrica, and Eli Lilly, the maker of Cymbalta, have conducted what is known as disease mongering.
Disease mongering is when others expand the diagnostic criteria for a particular medical issue though various ways of informing the public of the potential undetected cases of such an issue through advertising, primarily.
Also, another method of disease mongering is though the funding of various related associations and societies through educational grants to be the voice for those who conduct disease mongering with deliberate intent to increase the profit of their medications. There is evidence to support this claim- with more funds from these companies dedicated to advertising much more than grants.
Yet it is clear that fibromyalgia syndrome exists, as there are so many diagnosed with this medical issue that share the same symptoms, which include other symptoms besides pain alone. And it often takes a great deal of time for a patient that has fibromyalgia to receive the correct diagnosis due to the absence of any objective diagnostic testing to assess this syndrome. The fibromyalgia patient often goes through numerous other diagnostic testing, such as blood work and X-Rays, as their doctor orders such tests to rule out other diseases and disorders that may be present with the symptoms expressed with fibromyalgia syndrome.
Variables associated with those diagnosed with fibromyalgia syndrome include those patients with a history mental illness. They also tend to be overweight and live an inactive lifestyle, overall. Also, there seems to be an association with those diagnosed with fibromyalgia and these patients being in a state of low socioeconomic status.
Also in over 50 percent of those diagnosed with fibromyalgia, the patients are experiencing mental stress, emotional distress, as well as some sort of family conflicts as well. In fact, this stress amplifies the symptoms of fibromyalgia if these emotions are expressing themselves in the fibromyalgia patient. Insomnia is associated with fibromyalgia as well. It appears that mean age of onset of Fibromyalgia is around 40 years old, yet fibromyalgia syndrome can occur at any age.
Aside from systemic pain of varying degrees with the fibromyalgia patient, the patient experiences affective disorders typically. Since the symptoms of fibromyalgia also could indicate other disease states in 25 percent of the patients, usually X-Rays and blood work are examined to rule out other possible causes for the symptoms.
The Journal of the American Medical Association gave these symptoms the name of Fibromyalgia in the mid 1980s, as well as this association publically acknowledging that it is a disabling illness
There is evidence the cause is neurological. Upon examining the spinal fluid of a fibromyalgia patient, their serotonin levels are low, which is a neurotransmitter that has multiple emotional functions, as well as elevations of the neuro-chemical protein called substance P, which is the catalyst for pain. The patients also have elevated levels of what is called nerve growth factor (NGF). NGF is a protein molecule that, when elevated, is also associated with Alzeimer’s disease, and, believe it or not, one falling in love.
Furthermore, some fibromyalgia patents have had their brains scanned for abnormalities that may be present, and their brains in fact have shown varying degrees of structural dysfunction with their brains due to fibromyalgia.
So some suspect not only the cause may be some sort of central nervous system injury, but also there is evidence the syndrome is from some sort of viral infection, it has been reported.
Treatment of the fibromyalgia patient includes not only the drugs mentioned earlier, but also other medications for pain, anxiety, and insomnia in particular. Lifestyle changes are recommended for the fibromyalgia patient, as well as many other treatment methods in order to relieve their discomfort. Physical exercise is appropriately recommended for the fibromyalgia patient as well.
What is perhaps not recommended enough is cognitive or behavioral therapy for the fibromyalgia patient. There seems to be a strong association between fibromyalgia syndrome and psychogenic or psychophysiological causes for their symptoms.
Or, perhaps the fibromyalgia patient is suffering from some sort of guilt for some reason that is amplifies the unfortunate syndrome they are forced to tolerate.
Mea Culpa is Latin, meaning, ‘my fault’.
Pain is a Latin word as well. Its meaning: a fine or penalty.
Further research, however, is needed regarding this unfortunate syndrome experienced by so many others for no solid reason defined yet.
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Dan Abshear

To Throckmorton–it is very real! There are some biophysiological labs which do testing to prove it definatively.
I went through 2 days of extensive biophysiology testing with a nurse by my side. I was hooked up to all sorts of monitor wires and made to do things such as go up and down stairs, walk, do resistance machines, do fine motor work with fingers etc…..On the second day…all I wanted to do was lie down on the floor and sleep.

This kind of testing proves beyond a reasonable doubt how Fibromaylgia effects a person’s performance and ability to sustain performance.