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Fibromyalgia (FM) & the rheumatisms. Common sense & sensibility

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Chronic musculoskeletal pain syndromes are common problems, but the

etiology, pathogenesis, and pathology of many of them are very

poorly understood. Because the currently used nomenclature

suggests an understanding that we do not have, I propose that

names like “myofascial pain,” “tension myalgia,” and “FM” be

abandoned in favor of the more indefinite (but more honest)

terms like “regional” and “generalized rheumatism.” No matter

what we rheumatologists call it, however, the condition of

chronic generalized musculoskeletal pain probably is only one

part of an even more generalized condition that includes IBS,

chronic headaches, regional migratory numbness, TMJ syndrome,

and a whole host of other somatic pain syndromes. The same

patients end up seeing many specialists who themselves feel

frustrated with the labels at their disposal, and these

specialists end up resembling the blind men confronting the

elephant. In this regard, the new ACR criteria for the

diagnosis of fibrositis, by emphasizing tenderness and

ignoring the presence of these other syndromes, are too

circumscribed and represent a step backward in our attempts to

understand. Although the chronic rheumatisms are problems

difficult to manage and frustrating for both the patient and

the physician, when patience can be applied and confidence

achieved, a positive relationship can result and the patient

can be helped. [References: 35]

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