Fibromyalgia Syndrome (FMS) is a musculoskeletal illness (which causes chronic pain) and a chronic

Fatigue disorder. It can also change sleep patterns and cause the following: digestive disorders, chronic

headaches, painful menstrual periods, temperature sensitivity, morning stiffness, numbness or tingling

of extremities, and even cognitive memory problems. The name fibromyalgia comes from "fibro" in Latin

meaning tissue, "my" in Greek meaning muscle, and "algia" meaning pain. Because symptoms are wide –

ranged and studies for treatment of FMS did not begin until the 1980's, it is one of the most popularly

misdiagnosed conditions in the medical world. The main symptoms are widespread pain and fatigue as

well as tender points on the body. The muscular pain often may feel like a pulled muscle and may burn

or twitch. This syndrome is diagnosed with a history of at least three months of widespread pain and

tenderness in eleven to eighteen of tender-point sites. These points include: the neck, the shoulders, the

chest, the rib cage, the lower back, the thighs, the knees, the arms (mainly the elbows), and the

buttocks. The pain in these areas is defined as an overwhelming characteristic of FIBROMYALGIA and is

long standing. Fibromyalgia (FM) is a chronic and debilitating disease that in the U.S.A. has been estimated to affect as many as 5 million individuals, mainly women in a ratio of 3:1.1. Patients with FM are characterized by the presence of chronic widespread pain. Although this pain is the clinical hallmark of FM, patients report a constellation of other symptoms and conditions including sleep disruption, fatigue, depression, abdominal pain, anxiety, and memory and concentration problems (Fibromyalgia-Associated Symptoms and Conditions from a Clinical Perspective: A Step toward Evaluating Healthcare Resource Utilization in Fibromyalgia, pg. 1) FM shows considerable overlap with other chronic pain syndromes, such as irritable bowel syndrome, chronic fatigue syndrome, migraine, and temporomandibular disorder. Like many other chronic pain syndromes FM has no single specific feature, but represents a symptom complex of self-reported or elicited findings. (Clinical management of fibromyalgia: An update: page 109) The treatment of Fibromyalgia should be viewed as a “team approach”. Most chronic pain does not respond to drugs and may require an aggressive use of no pharmacological therapies or “the rehab approach”. This includes a lifestyle change, physically, mentally, and emotionally. This approach should include use of a physician, occupational therapist, physical therapist, massage therapist, chiropractor, an acupuncturist and any specialists, such as a Rheumatologist. (Mondell, D. L., &ump; Wright, P. (2005)) Psychological counseling is recommended early after receiving the diagnosis of Fibromyalgia. Mainly because it takes many years of visiting doctors and having tests results come back negative that an individual will begin to think this is “all in their head”. Then when finally a diagnosis is given like Fibromyalgia and they are told that “the cause is unknown, the treatment is unknown and there is no cure” can be hard to accept. It is recommended that the patient’s loved ones attend sessions, because they, too, will find it hard to understand the diagnosis. In 2007 pregabalin became the first US Food and Drug Administration (FDA) approved drug for the treatment of FM. Pregabalin and its precursor gabapentin play an important role in the treatment of neuropathic pain. These medications have analgesic, anxiolytic, and antiepileptic effects in animals and humans. Some of the most effective pharmacological therapies for FM pain include low doses of tricyclic antidepressants (TCAs) [62]. These medications exert their effects at the serotonin (5-hydroxytryptamine [5-HT]) and NE transporters of the presynaptic terminals of neurons. (Clinical Management of fibromyalgia: An update page: 113) Should physicians medicalize a set of symptoms into a disorder or disease, and attempt to treat the illness, or should they attempt to figure out the underlying causes of the symptoms and try not to medicalize something which doesn’t need medicalization? Both arguments about fibromyalgia are strong, and both are backed up by valid claims, although each does have its positive and negative aspects. The social construction of illnesses in the medical field is an extremely assiduous task and requires years of dedication, time and research before final decisions are made. They must be made carefully, since they will affect millions and millions of people.

Sources:

Staud, Roland. Current Medical Literature: Rheumatology, 2011, Vol. 30 Issue 4, p109-119, 11p, 1 Chart

Mondell, D.L., & ump: Write, P. (2005) Living with fibromyalgia: 4 steps to manage pain and lead a fulfilling life.

Silverman, Stuart L.; Harnett, James; Zlateva, Gergana; Mardekian, Jack. Pain Practice, Nov/Dec2010, Vol. 10 Issue 6, p520-529, 10p, 3 Charts, 3 Graphs; DOI: 10.1111/j.1533-2500.2010.00383.x