Is Fibromyalgia A Real Disease?
Fibromyalgia is a label that is ascribed to a large number of patients who describe chronic pain. Some of these patients have distinct tender points around their body, while others don’t have this at all but describe more of a diffuse pain that really isn’t specific to one particular anatomical region.
Fibromyalgia is not a distinct condition with a single pain generating mechanism. It is a common complicated condition that is characterized by a heightened pain perception with a number of precipitating factors. What is often seen is a wide variety of presenting complaints, such as headaches, shooting pains in the extremities, irritable bowel syndrome, generalized aching, and other endocrine problems.
No one knows the cause of fibromyalgia. University professors busy researchers, and experienced clinicians simply do not know the exact reason that people end up with the diagnosis of fibromyalgia. Often times patients have a disturbed sleep pattern, one may see restless leg syndrome, vitamin and mineral deficiencies, but there really is just not an established and definitive cause that can be pinpointed.
There have been some research studies looking at a relationship between a diagnosis of fibromyalgia and pre-adolescent sexual abuse. Pre-adolescent sexual abuse can lead to numerous medical problems down the road such as fibromyalgia, chronic migraine headaches, along with the potential for autoimmune diseases and hypertension. What needs to be explored in the patient physician relationship is whether or not a history of such a tragedy exists.
Since we do not know the cause of fibromyalgia we can say that depression is not necessarily the cause of the disease, but it often goes along with fibromyalgia. There are multiple antidepressant medications that have shown excellent results in fibromyalgia so we do know that depression is a common comorbidity that is seen.
Fibromyalgia is a very frustrating disease. It presents with a constellation of symptoms that do not have a single cause and for which we do not understand how the disease comes about. We do know that there is often times mental health comorbidities. Fortunately in the current medical treatment era, there are numerous medications that have been shown to help dramatically with patients symptoms of fibromyalgia. Some of these are FDA approved, while others are not but still work exceptionally well for the condition. These medications include duloxetine, tricyclic antidepressants, tramadol, milnacipran, and pregabalin. Opioid medications are currently falling out of favor for fibromyalgia due to their ineffectiveness and multiple side effects.
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