“It’s all in your head” or “just learn to live with it” are the two most frequently heard phrases, from the medical profession, by sufferers of Fibromyalgia Syndrome or FMS [Rona; Casura; Nye, pg. 7].Most of us have an understanding, especially these days, that research in the medical field is occurring at, and coming up with results at a fast and furious pace. Most people also understand that not every doctor can, or even should, be responsible for staying abreast of every new discovery. Without a specific need or interest in a given area, alot of what is learned never gets to the desk of most doctors. This is one explanation, then, as to how such a large number of medical professionals are still unaware of, misinformed about, or in complete denial of the existence of such a common disorder as fibromyalgia [Smith; AT; NBC].HistoryFar from being a new discovery, FMS symptoms were first recorded in the 18th century [Kaplan], and recognized as a specific set of symptoms in the 1860’s. It took more than 100 years, in the late 1980’s, before the official name Fibromyalgia Syndrome was designated by the American Arthritis Foundation and the national Center for Disease Control (or CDC) [Rona]. Prior to that time, FMS was known by at least 100 different names including, fibromyositis, fibrositis, and the old-time familiar, rheumatism [Kaplan].Despite the apparent familiarity with this disorder, many doctors remain reluctant to make a FMS diagnosis. Maria Shriver reported a statement by Dr. Thomas Bohr on the January 4, 2000 airing of NBC Dateline. In this report, a neurologist at Loma Linda Medical Center in California, Dr. Bohr stated, “…. there is a portion of the medical establishment that contends fibromyalgia is not just over-diagnosed, it downright doesn’t exist [NBC].” His opinion does not appear to be echoed by the majority of doctors. Still, there are enough like him that it sometimes makes diagnosis and treatment difficult to find. Even with doctors that are familiar with FMS, the diagnostic process often exceeds five years [Rona; Casura; AT]. DescriptionLiterally defined, fibro refers to fibrous or connective tissues. Myalgia means pain in one or more muscles [Webster]. Therefore, fibromyalgia means pain in the connective tissues and muscles. It is often referred to as a soft tissue musculoskeletal condition [Sahley, et al, pg. 7].While this may be literal, it is hardly fully descriptive. It is often described as feeling like one has the perpetual flu [Starlanyl]. This is not quite enough, either. Today, it is the second most prevalent rheumatic illness [Goldenburg; Sahley, et al, pg. 5] and ten million people, in the USA alone [Casura], share the plight of this intensely painful disorder. Among the 1.5-6% [Murray, 1998, pg. 459; Roderick; Sahley, et al, pg. 7; Kaiser] of the world’s population with a positive diagnosis for fibromyalgia, there is a broad range of descriptions. This holds true for the symptoms of FMS, as well. They are as varied and individual, as are humans. The more frequently experienced symptoms are insomnia, extreme exhaustion and/or fatigue, hormonal dysfunction, irritable bowel and bladder, blurred vision, thermal regulation dysfunction, dysmenorrhea, TMJ, food and environmental allergies, unrefreshing sleep, mitral valve prolapse, muscle pain and spasms, (apparent) joint pain, myofascial pain, depression, anxiety, sugar cravings, excessive thirst, confusion, memory loss, chest pain, irritability, acne, diarrhea, gum disease, oral inflammation, and headaches [Starlanyl; Casura; Yue; Roderick]. The list goes on and on, yet, comparing one patient to another will produce two entirely different sets of symptoms [Yue]. This, in itself, can impede the diagnostic process as numerous illnesses and disorders share these symptoms.DiagnosisIn 1990, the American College of Rheumatology established diagnostic criteria [S of W], which aids in distinguishing FMS from other disorders. This criteria must include, but is not limited to [et al]:Widespread, generalized, persistent muscle/joint pain, not explained by an inflammatory or degenerative musculoskeletal disorder, for 3 or more months (though many doctors insist on 6 months)Ongoing fatigue for a similar time periodTenderness in at least 11 or 12 of https://clicdanstaville.fr/ 18 tender points, referred to as (TrPs), on digital palpation:

suboccipital muscle insertions at occiput

lower cervical paraspinals

trapezius at midpoint of the upper border

supraspinatus at its origin above medial scapular spine

2nd costochondral junction

2 cm distal to lateral epicondyle in forearm

upper outer quadrant of buttock

greater trochanter

knee just proximal to the medial joint line

(Goldenburg)

Some clinicians also specify the degree of palpative pressure applied, varying between two & 10 pounds.This diagnostic criteria is beneficial, yet FMS continues to be misdiagnosed and confused with illnesses such as Chronic Fatigue Syndrome, Myofacial Pain Syndrome, Lupus, Epstein-Barr, and many, many others. The chronic nature of each of these, demographics, and similar therapies adds to the confusion [Goldenburg].Comparative tests by researchers to distinguish between multiple chemical sensitivities (MCS), fibromyalgia (FMS), and chronic fatigue (CFS) were conducted in the early 1990’s, using patient questionnaires to evaluate symptoms. The results showed that 70% of those previously diagnosed with FMS, and 30% of those diagnosed with MCS, met criteria for CFS established by the Center for Disease Control (CDC) [Rona; Murray, et al, pg. 363].Many of the symptoms mimic such illnesses and initial diagnosis is usually something other than FMS until ruled out by imaging studies, blood tests, or other clinical tests. To date no such tests for positively identifying FMS exist, though a February 1999 news release has named the Anti-polymer Antibody Assay (APA assay, a patented blood test) as appropriate for FMS testing on the basis that researchers have discovered anti-polymer antibodies in the blood of FMS patients [AT].