Fibro What? Who has Fibromyalgia?
What is Fibromyalgia Syndrome? How Doctors Define and Diagnose FMS
Feb 10, 2009
Fibromyalgia Syndrome (FMS) is complex. Fibromyalgia can be described most simply as a condition characterized by tender points and pain in the soft tissues (muscles, ligaments, etc). It also usually involves a variety of other symptoms, but the pain and tender points are the core symptoms, and are used for diagnosis.
Is it Fibromyalgia, or is Something Else Causing My Pain?
Fibromyalgia pain is
- widespread (above and below the waist)
- bilateral (on both sides of the body)
- chronic (existing for more than three months)
The pain can vary in
- location
- number of sites
- severity
Fibromyalgia pain is not due to a specific injury or trauma (such as a hard workout or pulling a muscle), and so far as researchers know, FMS is not due to
- an inherited disease (example: sickle cell anemia)
- a chromosomal abnormality (example: Down's Syndrome)
- any known pathogen or disease-causing agent (example: a virus)
Tender Points are a Touchy Subject With Fibromyalgia Patients
In fibromyalgia, tender points accompany the muscle pain and are found in bilateral pairs (one on each side of the body), such as on both forearms just below the elbow joints, at the base of the skull and neck on each side, and at the back of the knees.
Tender points are areas on the body that are tender and painful when palpated (“Palpate” means to use one’s hands to assist in diagnosis, pressing and feeling the area). Palpation is usually fairly gentle, but not in the case of FMS diagnosis. Perhaps a better word would be “poked” or “jabbed.” To test for these tender points, doctors press their thumbs into the tender points with approximately 10 pounds of pressure.
The reaction of a fibromyalgia patient to being poked in a tender place is usually immediate and pronounced, and has been known to involve profanity. A patient at the Kansas City Free Clinic in Kansas City, Missouri, swore loudly during her examination. Following her exam, she said, “Sometimes, any amount of pressure (even the weight of clothing) can cause pain in tender points; stabbing a thumb into one is tantamount to torture. They shouldn't be allowed to do that, and I think that doctor enjoyed it. Did he really have to poke me in all eighteen places to know I have fibromyalgia?”
Fibromyalgia Does Not Exist and Other Fibromyalgia Myths are Common
Myths and confusion about fibromyalgia are common, even among doctors, but more are learning. The cause of fibromyalgia is still uncertain, even though evidence of its existence is clear. Tests on cerebrospinal fluid reveal that fibromyalgia sufferers have higher levels of Substance P, a chemical that transmits the pain signal to the brain. Something is physically different about fibromyalgia patients.
Research continues, in the hope of finding both a cause and a cure. In the meantime, fibromyalgia sufferers seek treatment, try different therapies, and do whatever they can to cope with their symptoms.
