Although the condition has been around for centuries, the term “fibromyalgia” was coined in 1976. Some sources claim that it can be traced back to Biblical times with the life of Job. They reference Job 7:3-4, which states, “so I have been allotted months of futility, and nights of misery have been assigned to me. When I lie down I think, ‘How long before I get up?’ The night drags on, and I toss till dawn.” They also reference Job 30:16-17, which states, “And now my life ebbs away; days of suffering grip me. Night pierces my bones; my gnawing pains never rest.”[i] Having studied the book of Job, I am not sure I believe that Job was suffering from fibromyalgia. However, I am sure many fibromyalgia patients can relate to some of Job’s suffering.
Another person who is believed to have reportedly suffered from fibromyalgia-like symptoms was Florence Nightingale. Florence Nightingale served as an English army nurse during the Crimean War and was a pioneer in the International Red Cross. Nightingale became sick working the front lines during the war and never recovered. She was bedridden the rest of her life with pain and fatigue until her death in 1910.[ii]
In the early 1800’s, doctors wrote about a condition they called rheumatism or muscular rheumatism where the patients experienced symptoms of fatigue, stiffness, aches, pain, and disturbed sleep.[iii] In 1816, Dr. William Balfour, a surgeon at the University of Edinburgh gave the first real description of the condition we now call fibromyalgia. He followed that up in 1824 by describing the tender points anyone who deals with this debilitating condition knows so well. Then in 1880 a United States psychiatrist wrote about a collection of symptoms consisting of fatigue, widespread pain, and psychological disturbances that he termed neurasthenia. He attributed these symptoms to the “stress of modern life”.[iv]
In 1975 the first electroencephalogram sleep study was performed identifying the sleep disturbances that accompany fibromyalgia. Then the first controlled clinical study with validation of known symptoms and tender points was published in 1981. The important concept that fibromyalgia syndrome and other similar conditions are interconnected was proposed in 1984. However, it wasn’t until 1990, when the American College of Rheumatology developed a diagnostic criteria for doing fibromyalgia research, that the term “fibromyalgia” gained wide usage.
Fibromyalgia is like any other Latin medical term, the word itself is its definition. When you break the word down: “fibro” means fiber, “myo” means muscle and “algia” means pain. So the definition of fibromyalgia is basically “Fiber Muscle Pain”. In the medical world, fibromyalgia is actually defined as “an increasingly recognizable chronic illness condition that is characterized by widespread pain, tenderness, fatigue, stiffness, and sleep disturbances to name just a few symptomatologies.” Fibromyalgia is all encompassing in its definition; some people can have only part of that definition and still have fibromyalgia.
It’s estimated that 3-7 million Americans have fibromyalgia. The average person is a 20-40 year old female. However, it can affect anyone whether male or female at any age. There are case studies of an 11-year-old boy with the condition and an 80-year-old female. However, because fibromyalgia has such a debilitating nature, it not only affects the person who has it but everyone around them. It affects the patient’s family, employers, co-workers, friends, and dependents. Because fibromyalgia affects everyone in the patient’s circle of influence, fibromyalgia is a condition that can affect whole portions of a population.
[i] New International Version of the Bible
[ii] Small, H (1948). Florence Nightingale: Avenging Angel. London: Constable.
[iii] Williamson, Fibromyalgia: A Comprehensive Approach, (New York: Walker and Company, 1996).
[iv] Williamson, Fibromyalgia. More
In my treatment of patients with Fibromyalgia, I have discovered there is a lot of confusion about this condition. Some people who have it are never diagnosed and others who do not have it have been told that is the reason for their fatigue or aches and pains. What makes the diagnosis of Fibromyalgia so complicated is there is no known test to confirm a patient has it. This is why so many people in the medical profession even question whether or not it exists. The only way it is diagnosed is based on the symptoms reported by the patient. Typically, a patient with fibromyalgia has had chronic pain for over 3 months duration and it covers all 4 quadrants of the body. There are also 18 trigger points or sensitive points on the body that are typically painful for a fibromyalgia patient. In order to be diagnosed with fibromyalgia, 11 of those 18 points should be sensitive to light pressure. However, in my practice I have found that fibromyalgia patients have good days and bad days. On a good day only 8 of those points may be sensitive, but with that same patient on a bad day all 18 of them are sensitive. So I personally do not get so hung up on counting the points.
Medically speaking, the cause of fibromyalgia is still unknown. However, in recent years, research has found some reasons why the patients experience the symptoms that they do. Research has shown that fibromyalgia patients experience an amplification of pain in the sensory nervous system above normal. What do I mean by this? Pain is something that’s perceived by your brain. Messages from certain receptors in your nervous system transfer a signal up to your brain that then perceives that you are experiencing pain. However, with fibromyalgia patients, their brain perceives that the pain is stronger than what it really is. A good way to understand this is say you accidentally cut off the tip of your finger and you go to the ER. They give you morphine to help with the pain. The morphine affects how your brain perceives the pain. Does the finger still hurt? Sure it does, but your brain no longer perceives that pain. The exact opposite happens with Fibromyalgia patients. Research done by the University of Michigan has shown that they have an excess of a protein called glutamate in their brains. This protein excites or turns up the messages coming from nerves to the brain and is probably why fibromyalgia patients perceive abnormally high amounts of pain.
Research has also found that Fibromyalgia patients have other protein imbalances in their brains that could possibly be causing some of their symptoms. Research has shown that Fibromyalgia patients have below normal levels of serotonin in their brains. One of the roles of serotonin is it is responsible for the feeling of happiness in the brain. You have low levels of serotonin, either due to problems with its production or its uptake, you will have depression; one of the symptoms of fibromyalgia. Research has also found that Fibromyalgia patients do not have adequate levels of tryptophan. Tryptophan is a protein that is partially responsible for deep, restorative, restful sleep. You do not have enough tryptophan in your system, and you end up having awake-like brain activity during your sleep. Just like Fibromyalgia patients experience.
So you can see, research has shown there are reasons for some of the symptoms of Fibromyalgia that may lead to better understanding of this condition. I also believe as time goes on they will discover tests to confirm its diagnosis and eliminate some of the confusion around its diagnosis as well. If you would like further information on Fibromyalgia, you are welcome to contact our office which is a member of the Fibromyalgia Centers of America at 919-363-0041 More
Millions of Americans are living with a condition that is often misunderstood and misdiagnosed, known as Fibromyalgia. The American College of Rheumatology estimates that 6 million (or 1 in 50) Americans suffer from this debilitating condition, with women being affected 9 times as often as men. However, the National Foundation for Fibromyalgia believes that as many as 12 million Americans suffer from Fibromyalgia but go undiagnosed due to its elusive nature. This means that many people walk around in constant pain and not understanding why.
Fibromyalgia Syndrome is very debilitating, and it often gets progressively worse. Because of its debilitating nature, Fibromyalgia affects not only the patient, but the people around that patient. Family members, co-workers, and children are very much affected by Fibromyalgia. This affect comes in many levels and in varying degrees, but the most affected are the spouses as they watch their loved one in pain.
More often than not, Fibromyalgia sufferers have difficulty performing their normal daily activities. Sure, they are able to clean the house a bit, but they pay for it for afterwards. They have trouble attending church functions or kids sporting events because it may hurt them to stand just as bad as it does to sit on the bench or church pew. It affects every aspect of their life.
So what exactly is fibromyalgia? If you were to look up its definition in a medical dictionary, it would be defined as “an increasingly recognizable chronic illness condition that is characterized by widespread pain, tenderness, fatigue, stiffness and sleep disturbances to name just a few symptomatologies.” But let’s break that definition down into understandable terms. Pain is the primary symptom of fibromyalgia. The pain of fibromyalgia is profound and it migrates throughout the body without any boundaries. For example, a fibromyalgia patient could have pain in their shoulder one day and then it migrates down to the hip and then it goes up to the back. In fact, one of the diagnostic criteria for fibromyalgia is the pain must cover all 4 quadrants of the body at some point in time. One of the oddities of fibromyalgia is the pain is not perceived the same from patient to patient. In fact, one patient may describe the pain as dull and achy, and another may describe it as sharp and stabbing. It ranges from person to person.
The fatigue associated with fibromyalgia is also profound. The fatigue of fibromyalgia is not just “I’m tired today”. The fatigue is “I do dishes, and I have to go sit down because I’m wiped out” or “I do laundry, but after one load I can’t do anymore”. It is not normal to be wiped out after doing the dishes or a single load of laundry! Along with the fatigue, most fibromyalgia patients describe having sleep disturbances. They either have a hard time going to sleep or staying asleep or a combination of the two. Research has found that this is because fibromyalgia patients have awake-like brain activity while they are sleeping. Their brains never turn off or go into that deep, restorative sleep.
Other symptoms that are frequently reported by Fibromyalgia patients include irritable bowel and/or bladder syndromes, headaches, restless leg syndrome, and depression and/or anxiety.
So let me encourage any of you who may have the symptoms I have been describing to consult a health care professional about your condition. Many people are walking around with this condition without knowing it, and they are not able to get the help and the relief they need. More