For many years Fibromyalgia has been considered something of a mystery, confounding the doctors who are trying to treat it and the patients who have to live with it. Only recently has new technology begun to unravel the truths about this mysterious disorder. As a result of the previous lack of scientific evidence, several myths about Fibromyalgia have developed that, unfortunately, are still being repeated today. It’s time to dispel the myths and clarify the facts.
Myth 1: Fibromyalgia is a form of arthritis.
Fact: Fibromyalgia is a neurologic disease.
Although it was once thought that Fibromyalgia might be a form of arthritis, research over the past 10+ years has proven that to be false. Arthritis is defined as an inflammation of the joints, but there is no inflammation with FM, nor is there any damage to the joints. A Fibromyalgia patient may have a type of arthritis (like osteoarthritis or rheumatoid arthritis) in addition to FM, but it is a completely separate disorder. On the FM research front, new brain-imaging techniques and scientific studies are revealing that Fibromyalgia is better defined as a central nervous system disorder that results in abnormal pain processing.
Myth 2: Fibromyalgia affects the muscles, joints and connective tissue.
Fact: There is no damage to the muscles, joints or connective tissue of people with Fibromyalgia.
For many years Fibromyalgia was described as a musculoskeletal disorder because much of the pain people experience with FM feels like it is coming from the muscles, joints and connective tissues. However, years of testing failed to reveal any actual damage to the musculoskeletal system. What research has discovered is that a malfunction in the central nervous system of FM patients causes disordered sensory processing which leads to pain amplification. In other words, a stimulus that would not even be noticed by most people can be extremely painful to someone with Fibromyalgia.
Myth 3: Fibromyalgia is an autoimmune disease.
Fact: Fibromyalgia is NOT an autoimmune disease.
Autoimmune disease is the result of a body’s overactive immune response. In a sense, the body’s immune system begins to attack its own cells and tissues. There is no evidence that Fibromyalgia is an autoimmune disease. In fact, years of research have not turned up any virus, bacteria or immune disorder.
It’s not unusual, however, for someone with FM to also have one or more autoimmune diseases, such as: celiac disease, Crohn’s disease, lupus, multiple sclerosis, rheumatoid arthritis, Sjögren's syndrome, or some types of thyroid disease. Other illnesses that are suspected to have an autoimmune link and may occur with FM include: Chronic Fatigue Syndrome, endometriosis, interstitial cystitis, and Lyme disease.
Myth 4: Fibromyalgia is a middle-aged woman’s disease.
Fact: Fibromyalgia affects men, women and children.
To date, a larger percentage of adult women have been diagnosed with Fibromyalgia than men or children. However, it does affect all ages and both sexes. In fact, it may turn out that more men and children have FM than previously thought. Doctors are finding that men may have fewer than the traditional 11 tender points, yet still meet all the other criteria for FM. Thus, there may be considerably more men with FM than previously thought. And what was once thought to be “growing pains” in children may actually turn out to be a form of Fibromyalgia. But because most pediatricians are not very familiar with FM, they are unlikely to diagnosis it. Although FM will likely continue to be diagnosed more often in women, we may eventually discover it affects significantly more men and children than once thought.
Myth 5: Fibromyalgia is a psychological problem.
Fact: Fibromyalgia is a physical disorder with real, measurable biological abnormalities.
This myth probably causes the most frustration to Fibromyalgia patients. After years of being told “It’s all in your head,” patients finally have proof that Fibromyalgia is a very real, physical illness. Research studies have revealed a number of biological abnormalities, including:
- Decreased blood flow to specific areas of the brain, particularly the thalamus region, which may help explain the pain sensitivity and cognitive functioning problems experienced by Fibromyalgia patients.
- High levels of “substance P,” a central nervous system neurotransmitter involved in pain processing.
- Low levels of nerve growth factor.
- Low levels of somatomedin C, a hormone that promotes bone and muscle growth.
- Low levels of several neurochemicals: serotonin, norepinephrine, dopamine and cortisol.
- Low levels of phosphocreatine and adenosine, muscle-cell chemicals.
Despite the scientific evidence, some medical professionals continue to dismiss Fibromyalgia as a psychological problem, insisting that the symptoms are caused by depression. The fact is that the percentage of FM patients who suffer with depression is no higher than for any other chronic illness. Unfortunately, since it takes an average of 17 years for new research to become part of mainstream medicine, we’re probably going to be fighting this myth for several more years.
Karen Lee Richards is the Expert Patient, specializing in Fibromyalgia and Chronic Fatigue Syndrome, for HealthCentral's ChronicPainConnection (http://www.chronicpainconnection.com). She is a co-founder of the National Fibromyalgia Association and was its vice-president for eight years. From 2002 thrugh 2005 she was Executive Editor of Fibromyalgia AWARE, the first magazine devoted to Fibromyalgia and other invisible illnesses.