# Is fibromyalgia a real condition? **URL:** \ **Category:** Factual Questions\ **Created:** [September 18, 2013, 8:08pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172 "2013-09-18T20:08:28Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![MichaelQReilly](https://avatars.discourse-cdn.com/v4/letter/m/df705f/32.png) [@MichaelQReilly](https://boards.straightdope.com/u/MichaelQReilly)\ **Post date:** [September 19, 2013, 2:07am UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/21 "2013-09-19T02:07:32Z")
> [@The Great Sun Jester](#): > > According to a fair percentage of plaintiff attorneys I deal with, the most common cause is being involved in a low-speed rear-end motor vehicle collision. I know you meant this in jest, but as someone who does a fair amount if PI work, I can tell you that we don’t touch fibromyalgia claim because no one (judges, juries, worker’s comp) thinks it’s legit. ---
**Author:** ![Dorjan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dorjan/32/12440_2.png) [@Dorjan](https://boards.straightdope.com/u/Dorjan)\ **Post date:** [September 19, 2013, 2:08am UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/22 "2013-09-19T02:08:30Z")
> [@Hari\_Seldon](#): > > My family doctor sure thinks so. My wife went to see him with some vague complaint. He said it might just be fibromyalgia. He didn’t think so, but there was a simple test. He prescribed something–I think it was prednisone. He said that if it really were fibromyalgia, the symptoms would disappear overnight. They didn’t, she stopped taking the drug and the symptom gradually dissipated. > > From this I drew the following conclusions. He thinks it is a real disease with a real treatment. My wife’s symptoms, while undiagnosed, were caused by some real disease, presumably some kind of infection that she fought off. And she isn’t nuts. I suspect your wife’s doctor prescribed a placebo. ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [September 19, 2013, 2:19am UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/23 "2013-09-19T02:19:47Z")
Of course it is real. I have two close relatives–father and cousin–who suffer from it. Otherwise completely normal people who don’t have a history of physical complaints, attention-seeking behavior, or hypochondria. I have no doubt that their pain is very real and I feel very sorry for them. I think its association with a swath of psychiatric conditions is not a coincidence. But rather than assuming this means the disorder is “mental”, I lean towards the idea that the problem is systemic. This is underscored by the fact that there are also cormorbid physical problems too–such as migraines and IBS. While googling fibromyalgia just a few minutes ago, I stumbled across websites authored by sufferers who had a long list of other diagnoses. I know that when I encounter people like this, I tend to mentally label them as “crazy”, because how in the hell can you be “normal” and have accrued so many different diseases, disorders, and conditions? But maybe these people shouldn’t be written off as hypochondriac wackjobs. If a person has a systemic malfunction, affecting different body systems all at once, you would expect their symptoms to be all over the place too. Why should the flu virus make your muscles ache, your nose run, and your energy zero? Because it’s a bad-ass virus. Duh. There’s some speculation that it’s an auto-immune disease (similar to rheumatoid arthritis). Which I find interesting, since my mother’s got really bad RA. It took years for doctors to stop telling her the pain was “all in her head”, despite the tell-tale signs. Just because doctors don’t understand something doesn’t mean it’s not “real”. ---
**Author:** ![Inigo\_Montoya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/inigo_montoya/32/124_2.png) [@Inigo\_Montoya](https://boards.straightdope.com/u/Inigo_Montoya)\ **Post date:** [September 19, 2013, 2:32am UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/24 "2013-09-19T02:32:35Z")
> [@MichaelQReilly](#): > > I know you meant this in jest, but as someone who does a fair amount if PI work, I can tell you that we don’t touch fibromyalgia claim because no one (judges, juries, worker’s comp) thinks it’s legit. Well FFS come and practice your arts in Denver! Between fibromyalgia and…wotsit…“Traumatic Convergence Insufficiency Disorder”, also caused by tiny bumper dents, I’m about ready to lose my shit. ---
**Author:** ![drewtwo99](https://avatars.discourse-cdn.com/v4/letter/d/d07c76/32.png) [@drewtwo99](https://boards.straightdope.com/u/drewtwo99)\ **Post date:** [September 19, 2013, 3:26am UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/25 "2013-09-19T03:26:04Z")
Yarster, for what it’s worth, my mom is a fibromyalgia sufferer and the type you threw out matches her almost to a T. I do believe it is a real thing but am just as clueless as to everyone else as to what it really is, what causes it, and so forth. It may be entirely mental but that doesn’t make it any less real. ---
**Author:** ![TimeWinder](https://avatars.discourse-cdn.com/v4/letter/t/bcef8e/32.png) [@TimeWinder](https://boards.straightdope.com/u/TimeWinder)\ **Post date:** [September 19, 2013, 3:39am UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/26 "2013-09-19T03:39:02Z")
> [@Dorjan](#): > > I suspect your wife’s doctor prescribed a placebo. Isn’t that against the AMA code of ethics? I don’t think you can do that, any more. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [September 19, 2013, 3:42am UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/27 "2013-09-19T03:42:23Z")
> [@nearwildheaven](#): > > I also believe that some of the people who think they have this actually have rhabdomyolysis (muscle destruction) from certain drugs, most commonly Evista and statin anti-cholesterol meds. Good to know. Thanks for that. > [@HoneyBadgerDC](#): > > M.S. is another one I have my doubts about. Again, good to know. Thanks. ETA: I realized I didn’t take my turn…ok, let me see, hmm. Well I am pretty skeptical about that whole “diabetes” thing myself. I mean, _two_ types?? C’mon. Shit’s not real. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [September 19, 2013, 4:52am UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/28 "2013-09-19T04:52:03Z")
> [@HoneyBadgerDC](#): > > M.S. is another one I have my doubts about. Are you sure you’re not mixing up MS (multiple sclerosis) and MCS (multiple chemical sensitivity)? MCS, like CFS (chronic fatigue syndrome) is a controversial and poorly understood disorder that often co-presents (as I think the whitecoats call it) with fibromyalgia and similar conditions. Multiple sclerosis, on the other hand, as other posters have noted, is a disease involving actual physical damage to the nerves. We’re talking visible lesions on the nerve fibers here. Yes, a lot of aspects of MS are still not fully understood, but the symptoms are definitely not only subjective or of psychological origin. ---
**Author:** ![Inigo\_Montoya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/inigo_montoya/32/124_2.png) [@Inigo\_Montoya](https://boards.straightdope.com/u/Inigo_Montoya)\ **Post date:** [September 19, 2013, 11:57am UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/29 "2013-09-19T11:57:20Z")
> [@HoneyBadgerDC](#): > > M.S. is another one I have my doubts about. Ok now that shit’s funny. Because it really was just 2 days ago at work one of my coworkers was going through some med records while working on a settlement and she turns to me and says, “Jester, can a car accident make MS worse?” Using my best deadpan I told her, “Sure. Might also cure it. MS is a myth.” I defended the position for a while before referring her to half a dozen well-documented cases I’d worked in the past where, yes indeedy, it sure looks that way. But I think I will have a go at diabetes next, or maybe pregnancy. ---
**Author:** ![Chief\_Pedant](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)\ **Post date:** [September 19, 2013, 12:02pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/30 "2013-09-19T12:02:13Z")
Fibromyalgia is a diagnosis given to patients who have tenderness at certain touch points, generalized pain of various descriptions lasting at least a few months, and no definable physical/laboratory abnormality associated with other known diseases. Its treatment includes anti-depressant agents, along with some trials of other centrally-acting (brain receptor) drugs, and analgesics. It is associated with general fatigue, anxiety disorders, depression, and similar sorts of conditions. Is it a real “condition”? Of course it is. Is it associated with real (albeit, undefined) physical things that happen? Of course it is; every physical and emotional state is a consequence of something happening somewhere in the body as a result of physiochemical events. For me as a physician, the most remarkable thing about patients with fibromyalgia is an incredible obsession with “suffering.” It’s all about how “my pain is unbearable.” I don’t see that sort of obsession as widespread in other patients–even ones with things like broken bones or various horrible mechanical causes of pain. Of course, even personalities ultimately have underlying physiochemical events; we are all machines from a biochemical perspective. But there is no doubt that a certain personality type is associated with fibromyalgia, and it’s all about the suffering. Most patients don’t even “have fibromyalgia” the way they “have bony mestastases.” Instead, the “suffer from fibromyalgia.” I, for one, am glad the Mayo Clinic is there to work them up. But that’s another story… I think we’ve had other threads on this before, and they are eventually inundated with sufferers of fibromyalgia presenting their case for how their pain and suffering is real, and how they labor on through it despite the skepticism of others. Of course their suffering is real. ---
**Author:** ![si\_blakely](https://avatars.discourse-cdn.com/v4/letter/s/d9b06d/32.png) [@si\_blakely](https://boards.straightdope.com/u/si_blakely)\ **Post date:** [September 19, 2013, 12:23pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/31 "2013-09-19T12:23:53Z")
> [@brazil84](#): > > I recall reading that unlike other physical conditions, there is no objective diagnostic test for fibromyalgia, which suggests that it is a mental condition. There have been some clear studies that show that FM sufferers respond differently to exercise - more rapid [lactic acid buildup](http://rheumatology.oxfordjournals.org/content/41/7/721.long) and [slower recovery times](http://link.springer.com/article/10.1007%2Fs00296-006-0211-7). This has led some researchers to speculate that a metabolic disorder may be involved. It may be that similar symptoms from different causes are involved. I sort of tend to an autoimmune disorder theory, myself. My wife has arthritis, has been diagnosed with FM, and has subsequently also been diagnosed with another illness that is specifically autoimmune (and has clear diagnostic symptoms). It is not hard to draw a conclusion that they may all be related to an overactive immune response damaging various parts of the body. And one of the cites above points out that FM sufferers under exercise did not respond to analgesic placebos but did to analgesics - so the effects are real. ---
**Author:** ![yellowjacketcoder](https://avatars.discourse-cdn.com/v4/letter/y/4bbf92/32.png) [@yellowjacketcoder](https://boards.straightdope.com/u/yellowjacketcoder)\ **Post date:** [September 19, 2013, 12:43pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/32 "2013-09-19T12:43:03Z")
I dated a girl that had Fibromyalgia once. At least, she claimed to have it. It was amazing how it would flare up when she had an exam she hadn’t studied for, or a friend was moving and wanted help. It was likewise amazing how the symptoms would go away when she wanted to go for a hike or catch a movie with friends. At least in part, this is why we broke up - I couldn’t trust her anymore after seeing her play her friends like that. Now, all the anecdotes like this don’t mean fibromyalgia isn’t real, or doesn’t affect some people. It just means that an unfortunate group of people use the disease as a “get out of work free” card, or a sympathy ploy. Which I’m sure makes it far worse for the people that actually have chronic nerve problems leading to generalized pain. ---
**Author:** ![Anaamika](https://avatars.discourse-cdn.com/v4/letter/a/5f9b8f/32.png) [@Anaamika](https://boards.straightdope.com/u/Anaamika)\ **Post date:** [September 19, 2013, 1:25pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/33 "2013-09-19T13:25:48Z")
I also know someone who has fibromylagia, and she fits all of the above - she’s depressed, chronically, she doesn’t move a lot, she’s an older woman, she’s very lonely, etc. She’s very large, not only thin people get it. Is it a ‘real’ disease? Well, it certainly seems to be affecting her quality of life quite a bit. And I’m sure it’s overdiagnosed, or more likely, self-diagnosed. On the other hand, I am very, very grateful that I am not her. Not even if it’s in her mind. Imagine being in pain all the time, even in your own head. But I have wondered, too. ---
**Author:** ![misling](https://avatars.discourse-cdn.com/v4/letter/m/3ab097/32.png) [@misling](https://boards.straightdope.com/u/misling)\ **Post date:** [September 19, 2013, 2:25pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/34 "2013-09-19T14:25:50Z")
I was diagnosed with fibromyalgia approximately 7 years ago. I am extremely skeptical that it actually exists as a single disease, but SOMETHING was causing my muscles to ache, constantly, for about 4 months straight. I had a ton of tests and they turned up nothing. I was sent to a rheumatologist who specializes in this & related. He prescribed some excercises (ouch) and, after finding out I’ve had intermittent sleep patterns all my life, sleep therapy. His theory is that the problem is with the secondary nervous system overreacting to normal stimuli with pain (he is researching this, it is not a conclusion). I have no idea if he’s right, but after getting good sleep for about 6 months, the symptoms faded. Now they occur only when I’m overtired or overstressed, and not too bad even when they do. Who knows if the treatment did it, or it just resolved itself. Comment: I did get a bit depressed at the time. Aching all the time will do that. Once my symptoms improved, I stopped being depressed at all. ---
**Author:** ![HoneyBadgerDC](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/honeybadgerdc/32/1033_2.png) [@HoneyBadgerDC](https://boards.straightdope.com/u/HoneyBadgerDC)\ **Post date:** [September 19, 2013, 2:33pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/35 "2013-09-19T14:33:43Z")
> [@The Great Sun Jester](#): > > Ok now that shit’s funny. Because it really was just 2 days ago at work one of my coworkers was going through some med records while working on a settlement and she turns to me and says, “Jester, can a car accident make MS worse?” Using my best deadpan I told her, “Sure. Might also cure it. MS is a myth.” > > I defended the position for a while before referring her to half a dozen well-documented cases I’d worked in the past where, yes indeedy, it sure looks that way. But I think I will have a go at diabetes next, or maybe pregnancy. I do believe MS is real, I know lupus is real, I have just found certain hard to diagnose deseases attract people looking for a disease. FM the same thing, I would imagine a percentage really have something wrong but a fairly large percentage are just looking for a convenient disease. ---
**Author:** ![brazil84](https://avatars.discourse-cdn.com/v4/letter/b/8491ac/32.png) [@brazil84](https://boards.straightdope.com/u/brazil84)\ **Post date:** [September 19, 2013, 2:54pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/36 "2013-09-19T14:54:29Z")
> [@si\_blakely](#): > > There have been some clear studies that show that FM sufferers respond differently to exercise - more rapid [lactic acid buildup](http://rheumatology.oxfordjournals.org/content/41/7/721.long) and [slower recovery times](http://link.springer.com/article/10.1007%2Fs00296-006-0211-7). I clicked on your first link; it appears that the word “lactic” does not appear in the article so I’m not sure I understand your point. The second is paywalled. Anyway, if it’s really about lactic acid, then why hasn’t anyone developed a test for fibromyalgia which measures lactic acid buildup after exercise? > [@](#): > > And one of the cites above points out that FM sufferers under exercise did not respond to analgesic placebos but did to analgesics - so the effects are real. I suppose we need to define what is meant by “real.” If FM is the result of a psychological tendency to obsess over aches and pains which most people ignore, it’s real in the sense that it’s a real mental problem, but it’s not real in the sense that there is something physically wrong with the body. ---
**Author:** ![Inigo\_Montoya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/inigo_montoya/32/124_2.png) [@Inigo\_Montoya](https://boards.straightdope.com/u/Inigo_Montoya)\ **Post date:** [September 19, 2013, 2:59pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/37 "2013-09-19T14:59:35Z")
> [@HoneyBadgerDC](#): > > I do believe MS is real, I know lupus is real, I have just found certain hard to diagnose deseases attract people looking for a disease. FM the same thing, I would imagine a percentage really have something wrong but a fairly large percentage are just looking for a convenient disease. Yeah, I was unclear (again) I’m afraid. MS is totally real–the mechanism has been identified and understood for years. You’d have to be a special kind of…special…to disbelieve it. And it can be made worse with physical trauma. FM is poorly understood and often used as a medical term for, “I dunno what your problem is.” But there are tests that can be done to elicit subjective symptoms which, if you’re simply a malingerer, can make it a difficult diagnosis to receive. So in consensus: FM is likely a real thing, but as it is entirely subjective in nature it’s difficult sometimes to not think a sufferer is simply looking for narcotics and/or attention. ---
**Author:** ![The\_Other\_Waldo\_Pepper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/the_other_waldo_pepper/32/12370_2.png) [@The\_Other\_Waldo\_Pepper](https://boards.straightdope.com/u/The_Other_Waldo_Pepper)\ **Post date:** [September 19, 2013, 3:18pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/38 "2013-09-19T15:18:08Z")
> [@HoneyBadgerDC](#): > > I have just found certain hard to diagnose deseases attract people looking for a disease. FM the same thing, I would imagine a percentage really have something wrong but a fairly large percentage are just looking for a convenient disease. Hmm. When you put it like that, I’m a bit curious. Imagine a woman goes to see a doctor. _“I believe I have fibromyalgia,”_ she says; _“I’ve thought so for the better part of a year. I came to see you because the symptoms cause me persistent distress, and interfere with personal functioning in daily living. What can you tell me?”_ After examining her, the doctor replies: _“Well, I can find no adequate physical cause for the symptoms you mention: pain, fatigue, trouble sleeping.”_ Is that, by definition, fibromyalgia? Is that also, by definition, hypochondria? ---
**Author:** ![Yarster](https://avatars.discourse-cdn.com/v4/letter/y/7c8e57/32.png) [@Yarster](https://boards.straightdope.com/u/Yarster)\ **Post date:** [September 19, 2013, 3:19pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/39 "2013-09-19T15:19:27Z")
And perhaps these are all the reasons the OP would question whether it is real. Some people are really suffering from it, and have legitimate symptoms. Unfortunately, as with many diseases that don’t have an outward and obvious appearance to others, there will always be a very vocal and nutty sub-population of patients who use it as a synonym for “I’m crazy and also lazy”. I see this with depression as well. It seems that a good third of the people I meet these days are depressed. The way I distinguish the “real” ones from the “fake” ones is when an enjoyable activity comes up. When it is something unpleasant, like work, both the real and fake ones will either not show up at all, or show up late. When it is an enjoyable activity, only the real one will not show up or show up late. The fake ones are always on time and are unusually overly happy. Sure that could be a manic depressive, but the consistency sends up all kinds of red flags. It really struck a cord with me when **yellowjacketcoder** mentioned the girl he was dating because I see this quite a bit. My wife has a friend who misses an average of one workday a week due to depression, but has never once missed a party, Comic-Con, or other fun event and is often the first one to arrive to help set the event up. ---
**Author:** ![IvoryTowerDenizen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ivorytowerdenizen/32/17937_2.png) [@IvoryTowerDenizen](https://boards.straightdope.com/u/IvoryTowerDenizen)\ **Post date:** [September 19, 2013, 3:26pm UTC](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172/40 "2013-09-19T15:26:24Z")
> [@HoneyBadgerDC](#): > > I do believe MS is real, I know lupus is real, I have just found certain hard to diagnose deseases attract people looking for a disease. FM the same thing, I would imagine a percentage really have something wrong but a fairly large percentage are just looking for a convenient disease. MS is not a convenient disease. You have to have at least two episodes to be considered (my sister had 6 most of double vision and then years later another neurological incident, so they backtracked and looked at the vision issue as incident 1). Lumbar punctures and MRIs to document brain lesions and specific proteins in the CSF (which can be absent but does need to be looked for). It is not trivial to show up claiming MS and have to go through many painful procedures to rule it in or out. [Previous page](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172.md?page=1) [Next page](https://boards.straightdope.com/t/is-fibromyalgia-a-real-condition/669172.md?page=3)