Can’t be diagnosed, can’t be cured?
Sorry, I was stuck in terse mode tonight.
If Fibromyalgia can’t be diagnosed, how can it exist? Do they just tell people with a certain group of symptoms they must have Fibromyalgia and leave it at that?
I’ll give you a brief summary of what I know, hopefully someone will come along to confirm what I say or correct any errors. I talked with some Rheumatologists, GPs and Neurologists about chronic pain as part of my work (market research) and briefly discussed Fibromyalgia as well.
From what I understand the diagnosis of Fibromyalgia is made when there is pain for an extended period of time and this pain must be present in a certain number of areas or joints. I know this is vague but I don’t know the length of time or the number of sites for a diagnosis.
Fibromyalgia is often applied after a “diagnosis of exclusion”. e.g. from this page:
“None of the signs and symptoms of Fibromyalgia show up on diagnostic tools such as blood tests, x-rays and diagnostic scans. This makes diagnosis more difficult than for most other syndromes.”
The diagnosis is made after tests for inflammation, spinal injury, neurological causes etc. are all negative. It is generally accepted that the patient is feeling pain - with no known cause there is no way to actually remove the pain so the goal is pain management.
Within the medical field there are also differences of opinion about whether it is a psychological disorder or physical disorder and if it is physical is it in the nerves or brain?
To answer your questions:
If it can’t be diagnosed but there is a group of patients exhibiting similar symptoms why not put a label onto it? People want to talk about the patients in journals, to colleagues. if there was no label they would just say “chronic pain with no known cause.” Some doctors i spoke to didn’t like using the term though as it legitimises a condition that might not be real. Some people object to the label ADHD for the same reasons.
The treatment generally consists of maintaining quality of life, exercise, better diet etc. The disorder is sometimes be associated with workers’ compensation claims and also people who might gain secondary benefits from having a disease e.g. lonely people who have appointments to keep with all types of professionals they would not normally meet and gain attention from family who might otherwise visit less often or can continue to be paid for staying off work.
I am not saying this is intentional and this moves the disorder into the area of unconcious motivations and hypochondria. This is what doctors sometimes suspect but they accept that they might be worng. Depression is also a common co-morbidity. But are they depressed because they are pain or more sensitive to pain because they are depressed? Or both in a vicous cycle? I think anti-depressants can be precribed for Fibromyalgia but that can lead to dependence on the drugs.
This turned out to be a little more IMHO than I intended because I’m not a doctor, i just spoke to some! This relates to Australia and may differ to Europe and North America.
I just found another page with some good information, it is from the government in Victoria’s health department:
Victoria Health Department page
It confirmed a few other things for me as well …
“Fibromyalgia affects mostly women, between the ages of 35 to 60 years, from all nationalities and culture groups. It can also affect children.”
"There are key signs that may cause the doctor to make a diagnosis of fibromyalgia. These are:
* A history of widespread pain for three months or longer
* Abnormal tenderness in specific parts of the body."
One of the main symptoms targeted is lack of sleep so mild painkillers are sometime prescribed at night.
Also I think Fibromyalgia is similar or even the same disorder that used to be called Chronic Fatigue Syndrome. It might have been renamed to avoid some of the stigma associated with this name and the press coverage that resulted from it.
I’ve had time to read through the page I referenced in my first post and it confirms much of what I said and adds more details. Here it is again
Thanks 4thMonkey, I’m hoping that my symptoms are brought on by allergies and not this stuff.
I don’t think it’s anywhere near widely accepted yet, but there’s some evidence that fibromyalgia is associated with thyroid problems. Here’s one study, and you should be able to find more by poking around Pubmed.
What does that mean for treatment? Probably not much right now, but it is cause for hope.