Should Rheumatologists Be Treating Fibromyalgia? And If Not, Then Who?

Regarding the article reporting on a physician survey published May 2 in Clinical Rheumatology – see “55% of rheumatologists in Ontario think fibromyalgia is psychosomatic; 71% don’t think rheumies should manage it” – ProHealth readers commented that:

Something is Going on That is REAL

I was diagnosed with fibromyalgia in 2007 after years of struggling. In 2008, I had a sleep study and did not have (significant) apneas. But last year, I reluctantly agreed to a retest… thought I had been down that road. I got a sleep apnea diagnosis. I have been CPAP compliant since July 2011 and my roving nerve pain is gone, some daytime fatigue remains. Mom has a fibromyalgia diagnosis and has osteoarthritis all through her. She had an emergency laminectomy (a month after MRI). She has sleep apnea (recently diagnosed).

Point being: Something is going on that is REAL. When Moldofsky took healthy folks and deprived them of sleep (1970s), they developed fibromyalgia-like symptoms. I feel some sleep problem is central in this… be it apnea, other chronic pain issue disrupting sleep… something. I don't believe it is a coincidence that folks with fibromyalgia tend to have multiple health issues.

Just because it is not well-understood does not mean it is not real. These folks are losing their quality of life. [Doctors] are you there to help or be aloof? Please consider what I have to say. – G

Why Aren't Neurologists the Obvious Choice?

FM is about pain nerve endings and brain signals gone awry. That is most certainly more a neurological problem than a rheumatoid one. – B

My "Guess" is Rheumatologists Got Stuck with Us Because They Deal with Pain.

And not much else 'bout FMS was known. Assuming they remember their regular med training (I know, big assumption), they should I'd imagine be as capable as the average GP.

That said, in my opinion it's more about being willing to actually give decent care – personally I wouldn't care if the doc was a podiatrist if s/he provided that care. I don't expect my doc to do the research – just be aware of it & willing to consider the treatments, etc. – M

The Family Physician? Seriously?

If fibromyalgia were "indeed" a psychosomatic illness, do they think a primary care doctor would be competent and/or have the time to deal with it? I find this very discouraging and angering, actually.

I have also found it to be true with my experience with the 2 rheumatologists I have had. They are excellent at treating my juvenile arthritis, but do not believe in fibromyalgia. They say I am "just depressed." What absurdity! I am thankful I have found help from that VERY different kind of pain from other professionals.

I agree that neurologists should be involved, and possibly endocrinologists, if they could ever stop believing that all they have to treat is diabetes. But I guess that's where the money is. – J

Whomever is Willing to Give Care Should be Allowed

I've had terrible, terrible experiences with specialists in different fields of medicine – they've truly been equal opportunity offenders – but the few that have actually tried to help weren't in the more expected disciplines.

Years ago a Pulmonary specialist, who'd been called in on a consult during a bout of pneumonia, turned out to be really great & was the doc directly responsible for the diagnosis of CFS/ME – FMS. He went out of his way to learn, contacting the CDC etc.

The Neurologist that called him in for the original consult, on the other hand, could fill the starring role in a horror movie. [My] coughing brought on what appeared to be seizures and the ER assigned me to the neurologist. During an EEG I went into very severe seizure-type behavior (causing lots of bruising etc.). He said according to the EEG it wasn't a seizure so not his problem & walked out. Of course I was still bouncing around, injuring myself… later that day I lost my front teeth to the bed rail.

And I had to fight with the insurance company for 6 months afterward since this neurologist told them it was completely psychosomatic & they shouldn't pay a dime. – M

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1 Star2 Stars3 Stars4 Stars5 Stars (23 votes, average: 4.39 out of 5)

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