Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: Fibromyalgia..Is it a valid disease?
Forum: The Neurology and Neurosurgery Forum
Topic Area: Fibromyalgia
Posted by CCF neuro MD MM on November 01, 1998 at 14:57:32:
In Reply to: Fibromyalgia..Is it a valid disease? posted by Suzanne on October 31, 1998 at 23:18:55:




My question concerns your thoughts on Fibromyalgia. My sister has been ill for about 6 months..fatigue, continuous body aches, headaches, migraines, leg cramps, muscle aches and twitches, anxiety, occassional depression,etc.

She was tested for every other disease possible..MS, Lyme, Lupus, etc

Brain and Lumbar MRI were negative, Cat Scan negative, and nothing in blood or urine.

After all of the tests and numerous medical appointments and opinions, her Doctor told her he was almost sure that she has Fibromyalgia.

I dont know much about Fibromyalgia, but my sister feels that she was given this diagnosis because they couldnt find anything else to diagnose her with. She is under the impression that many medical professionals think that this is a disease that people bring on by themselves, (all in their head)and that there is really no sure test that determines whether someone has it or not.

I would be interested in your personal opinion (or that of the clinics) on whether Fibromyalgia is a "real" disease, what causes it, and treatments available. Do some Doctors believe that this is all in a person's head?

Thanks in advance for your help.



The question you ask is the subject of considerable, sometimes heated, debate
in the medical world.
Some physicians believe that this is a separate physical entity
while others believe that it is a physical manifectsation of psychological
distress ( this of coures does not mean that it is not :real " or that the
patient is not suffering severely).
This debate has been geberated because it is not possible to find any
consistentt objective abnormality on physical examination, laboratory testing,
or imaging and this tends to make some physicaians uncomfortable with
the diagnosis. )
Trigger point testing is not objective in the sense that it depends
completely on repoting of senastion rather than an objective measurment technique.
To add to the confusion the disease tends to respond to antidepresant
drugs, but these drugs are well known to have an independent pain
control effect so that doesn't really help.
So as you can see the medical jury is still out to some extent with
considerable division as to the true nature of the problem.
My own theory ( for what is is worth ) is that if a patient is distressed
the symptom should be taken seriously and what ever resources are
avaliable in terms of pharmacological therapy, physical therapy, training in
relaxation techniques etc should be brought into play.
People cannot be left to suffer while the medical world is waiting for
a definitive test.

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