Fibromyalgia (FM) syndrome & myofascial pain syndrome. Do they exist?
May 10, 1995
"It is in the healing business that the temptations of junk science
are the strongest and the controls against it the weakest."
Despite their subjective nature, these syndromes (particularly
MPS) have little reliability and validity, and advocates paint
them as "objective." Despite a legacy of poor-quality science,
enthusiasts continue to cite small, methodologically flawed
studies purporting to show biologic variables for these
syndromes. Despite a wealth of traditional pain research,
disciples continue to ignore the placebo effect, demonstrating
a therapeutic hubris despite studies showing a dismal natural
history for FS.
In reviewing the literature on MPS and FS,
F.M.R. Walshe's sage words come to mind that the advocates of
these syndromes are "better armed with technique than with
judgment." A sympathic observer might claim that labeling
patients with monikers of nondiseases such as FS and MPS may
not be such a bad thing. After all, there is still a stigma
for psychiatric disease in our society, and even telling a
sufferer that this plays only a partial role may put that
patient on the defensive. Labeling may have iatrogenic
consequences, however, particularly in the setting of the work
Furthermore, review of a typical support group
newsletter gives ipso facto proof of this noxious potential.
The author of a flyer stuffed inside the newsletter complains
that getting social security and disability benefits for "the
invisible disability" can be "an uphill battle. But don't
loose (sic) hope." Apparently the "seriousness of the
condition" is not appreciated by the medical community at
large, and "clinician bias may well be the largest threat,"
according to Boston epidemiologist Dr. John Mason. Sufferers
are urged to trek to their local medical library and pull four
particular articles claiming FS patients have more "stress,"
"daily hassles," and difficulty working compared with
arthritis patients. If articles can't be located, patients are
told to ask their lawyers for help.
Although "Chronic Fatigue
Syndrome" and FS are not considered by everyone to be the same
malady, the "National Institute of Health (sic) has lumped
these two conditions together. This could work in your favor."
(A U.S. political advocacy packet is available for $8, but a
list of U.S. senators with Washington, DC addresses is freely
provided.) These persons see themselves as victims worthy of a
star appearance on the Oprah Winfrey show. A sense of
bitterness emerges; one literally bed-bound Texas homemaker
writes in Parents magazine that "Some doctors may give up and
tell you that you are a hypochondriac."(ABSTRACT TRUNCATED AT
400 WORDS) [References: 97]
MCM: A sceptical view!Prefers to drop use of FM and MPS and
substitute "aches and pains", chronic pain syndrome,
generalized rheumatism, pain amplification S, somatic
dysthymia, hypervigilance S, and affective spectrum disorder--
terms which are more "neutral".
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