Psychological HealthCare, P.L.L.C.

The Frustration of Fibromyalgia

Fibromyalgia occurs in about 3% of the population. About 15% of the patients seen in a rheumatology practice and about 10% of the patients in general internal medicine clinics are diagnosed with fibromyalgia. The term "fibromyalgia" was first used by Hench in 1977. In 1990 the American College of Rheumatology developed guidelines for the classification and diagnosis of fibromyalgia. The diagnosis is made by physician palpation at certain characteristic sites located in bilaterally symmetrical areas along the body. Diagnosis is made when palpation produced pain in at least 1l of 18 of these tender points. The term "tender points" was first used by Smythe and Moldofsky in 1972; tender points cause local pain when pressed, but in contrast to trigger points, do not refer or generalize pain.

There is widespread pain and muscle stiffness in fibromyalgia. The pain is often widespread and generalized. It is felt as very "deep" pain, in the muscles, as though the person has a bad case of the flu. Fatigue and nonrestorative sleep are the two other common symptoms. If the person with fibromyalgia is able to fall asleep, when she awakens, she often does not feel refreshed.

At this point there is no widely known or agreed-upon cure for fibromyalgia; treatment is at best palliative, meaning that it can address some symptoms. Fibromyalgia is a mystery to most physicians. Physicians prescribe pain medications, antidepressants, and sleep aids with varying degrees of success.

With patients suffering and turning to their health care providers for answers, well-meaning doctors and motivated patients often get frustrated with each other because of the limits of current medical knowledge about fibromyalgia.