Had my ass handed to me that time, didn’t I? :smack:
I’ll concede that point - but I still think it’s beside my own.
Insurance companies, if pressed by frivolous lawsuits over non-existant conditions, will fight against covering these “non-diseases” even if the people clamor for coverage.
Look at vaccine-induced autism. There’s a public clamoring, it’s not a real disease/condition/disorder, and insurance companies don’t pay for it.
Huh? Autism isn’t a real disorder? Sure, it’s not caused by vaccines, but insurance companies very much do cover actual disorders, whether you’re “right” about how you got them or not. If I believe my broken bones were caused by telekinetic space aliens rather than the vehicle that just ran over me, my insurance will still pay to have them set.
Relatively few folks here are arguing that fibromyalgia is “all in the head.” Clearly there’s some sort of (coverable) pathology here. The question is whether there’s an actual specific disease with a specific cause present, or whether folks with a wide variety of underlying conditions are getting a “blanket” diagnosis. Neither should have any effect on whether insurance covers the treatment of the symptoms.
Well do you agree that whether or not there is a public clamor, the insurance companies will pay if the courts and regulators require them to do so?
I’m not sure I see your point here. Are we talking about disability insurance or some other kind of insurance?
I’m not sure I’m following you here.
Some folks are clinically depressed; antidepressants are prescribed. Some folks suffer from anxiety; cue anti-anxiety medication. Health insurance covers those, right?
So why should it be any different if some folks have trouble sleeping while complaining about pain and fatigue – at which point a pill can likewise get prescribed and insurance can likewise cover it? Sure, you could maybe say “it’s all in the head” about that last one – but if you’re not disallowing the first two on those grounds, why bother?
Uh, so far as I can tell, we’re agreeing with each other, except maybe on the “it’s all in the head” line. That was tangential to my point, but I meant it in the sense of “a purely imagined symptom which has no underlying physiology, and is not subject to treatment.”
Uber_the_Goober seemed to be saying that insurance wouldn’t cover effective treatments unless it was known how you got the illness. I’m disagreeing with that, as–I think–are you.
Bluntly, based on the evidence I’ve seen, I don’t think a disease (meaning a specific physiological cause) called “fibromyalgia” exists. I think it’s a catch-all diagnosis for a wide variety of different and unrelated disorders. Some experts agree with me, some disagree.
But importantly: neither side of this debate is saying that people diagnosed with fibromyalgia don’t have symptoms (of something), can’t be treated, and can’t be covered by insurance.
I’m just suggesting their symptoms don’t have the same underlying cause. This is a largely academic distinction when it comes to treatments and the effects of suffering, but it’s critical from a scientific (and hopefully a “cure”) standpoint. Colds and bacterial infections can have roughly the same symptoms, and in some cases be mitigated by the same treatments, but antibiotics will flat-out cure one and have no effect on the other. So finding an answer to the OP’s title question is critical to making progress easing the suffering of those with the symptoms.
Nope, I mis spoke, and conflated two completely unrelated things.
vaccine-induced autism was a poor choice of non-existent disease.
Surely part of the problem is that a disabling condition with no objective test is going to be a huge magnet for malingerers and “crazy and lazy” types. So it’s reasonable to think that some percentage – perhaps even a high percentage – of FM sufferers are faking it either consciously or subconsciously.
I was hoping someone would bring that up. Fibromyalgia is a name given to a group of symptoms that are typically found together, but I doubt that there will ever be a SINGLE cause found for all cases. It seems like dementia or pneumonia in that respect – the same cluster of symptoms could be caused by any of a number of different things or a combination thereof. Head trauma seems to be one, sleep disorders certainly could lead to many of these symptoms (narcolepsy runs in my family and apparently so does fibro – major sleep episode disturbance definitely increases pain, which makes it hard to sleep at night which increases pain, lather rinse repeat), inflammatory diseases, mental illnesses, etc. might be a contributing factor for some people, and so on and so on.
Another possible cause was in the news earlier this year, having to do with blood flow in the skin: New Study Indicates A Cause For Fibromyalgia Pain To Be Found In The Skin. I know mine often manifests as extremely sensitive and painful skin, with maddening itches that can’t be scratched because scratching hurts so much. It hurt so bad during one period a few years ago that I could barely stand to have my clothes touching me, or the air from the fan blowing on me.
The thing about obesity strikes me as similar to the sleep disturbance thing: even if you don’t start out obese, the fact that you’re in constant (or at least frequent) pain that makes it difficult to move may well lead to inactivity-induced weight gain. A lot of medications also cause weight gain, including most of the antidepressants, some of which are used to treat fibro symptoms. I did not start out obese (just look at my wedding photo in the gallery, that was only 2010), but by a lot of doctor’s definitions I am now. I used to be quite fit, and when I’m fit, I do feel a lot better, but when the pain gets too bad, the fitness diminishes and the other symptoms and contributing factors like depression and anxiety come crowding into the chicken/egg feedback loop to make everything just that much more difficult.
That raises a few interesting possibilities.
Does obesity cause fibromyalgia? (Perhaps extra fat mass puts more strain on muscles and nerves?)
Another possibility is that fibromyalgia causes obesity. (Perhaps increasing muscle pain causes people to become less active?)
And perhaps there is a third factor which causes both obesity and fibromyalgia. For example, a psychological or personality problem which promotes weight gain and extreme sensitivity to pain.
For what it’s worth, I was not obese when I developed Fibromyalgia. I was the thinnest I have ever been in my life. I was in a relationship. I was probably the fittest I’ve ever been in my life because I didn’t have a car and had to walk everywhere. I did not have an interest in Wicca, beanie babies or cats. I have never been diagnosed with a mental illness except depression, which set in as I became increasingly despondent about living with chronic pain with no known cause or cure. About the only part of the profile I fit is “female”.
That’s not really a fair thing to add to the conversation, is it? It only invites confirmation from those who share your bias, and pre-emptively belittles the contributions of those who don’t fit the stereotype. I mean, I know plenty of people with FMS too. Most of them are married. Their weight variances are representative of the general population. In fact, when I briefly belonged to a local Fibromyalgia Support Group, none of the attendees were morbidly obese. None (to my knowledge) were schizophrenic, and as for anxiety and depression… well, aren’t those fairly understandable reactions to living with a chronic pain condition that is dismissed as fantasy by just about half the world?
As for your observation that they all suffer sleep disorder… Sleep disorder is a recognised component of FMS, and Fibromyalgia-like symptoms can be induced in otherwise healthy people by interrupting their deep sleep phase over several nights. Studies have found people with Fibromalgia have a high frequency of sleep dysfunction, with alpha-delta sleep being commonly detected in sleep studies.
I did worry for years that Fibromyalgia was psychosomatic. Things weren’t going so well in my life when I first got sick (after a bout of Glandular Fever, aka Mono). However, over the course of the next decade it became obvious that the severity of my symptoms did not correspond in any way with what was going on in my life. The most stressful and unhappy time in my life - the breakdown of my marriage - actually coincided with the most dramatic improvement in my health. My theory? I was no longer sleeping with a snorer. Given the known links between Fibromyalgia and deep sleep disturbance, it makes some sense… although, it doesn’t explain the onset and first three years of the syndrome, before I met the snorer in question. It’s just my personal, unqualified theory but I can’t substantiate it in any way.
Ya think? If only I were in such a population to begin with.
The logic here is 100% wrong, and just to clear (most people have identified the correct issues in these posts):
Two errors in the same statement:
A. If objective tests–> must be “physical”
B. If none –> non-“physical,” ie mental
Reason: [Only?] alternative to “physical” is “mental”
Wrong, mental is physical. Brain is pretty physical and is loaded with chemicals.
A. If objective tests–> must be “physical”
B. If none –> non-“physical,” ie mental
Reason: “Mental” has no objective diagnostic tests
Wrong.
Not to mention the fact that many clearly organic (ie physical) disorders have no diagnostic tests. Many types of headaches (ocular, migraine, cluster), pinched nerve (can happen without a bulging disk, for example), soft tissue damage etc.
So you feel there is no distinction at all between what are normally referred to as mental or psychological problems and other kinds of health problems, for example a broken leg?
If that’s the case, then why have mental health professionals at all?
Are you sure of that? I did a google search and found this:
Objective medical evidence generally refers to observable signs or laboratory findings. The problem with fibromyalgia is that the diagnostic criteria are based in part on the patient’s self-reportedy subjective complaints of pain, something which is not verifiable by objective means.
Yes, I’m sure about that. You can google all you want, but that doesn’t tell the tale of diagnostic medicine.
I’ve been diagnosed multiple times for the (same) pinched nerve in my neck, even in the absence of test results, or positive test results. I’ve had doctors perform no tests and some tests with negative results. The fact that the treatments were effective and the symptoms were consistent were enough even if my reflex tests weren’t impaired etc (there are additional tests that can be performed not listed on the Mayo clinic site) was enough to make the diagnosis.
Not all tests are black and white. Some tests give good information, when positive, but don’t add to the discussion when negative. Even positive tests aren’t always diagnostic, as many have very high false positive rates.
The point being that having a test is not the defining characteristic of a physical disease. Some have no tests at all and some have such poor ones, they might as well have none.
I agree but from what you are saying it sounds like pinched nerves are different from fibromyalgia. The former has objective tests which are imperfect. The latter lacks objective tests. Right?
I would agree with that and have never said otherwise.
I never said pinched nerves were the same. It was one among a list of physical conditions with no diagnostic tests.
This quote suggests that you were making the statement that in the absence of a diagnostic test it must be a mental condition.
Slight hijack: I heard a respected doctor recently say:
“The three most dangerous words out of a Physician’s mouth are: ‘In my experience…’”.
J.