When Fibromyalgia Is More than Pain

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By Celeste Cooper

The body-wide pain of fibromyalgia is usually the symptom that leads us to seek medical advice. Other complaints such as non-restorative sleep, fatigue, and thought processing difficulties have also become predominant diagnostic criteria.

However, other symptoms do cluster with what Dr. Frederick Wolfe calls “fibromyalgianess” (1), a label that is often interpreted as “these symptoms are all in your head.” This poly-symptomatology is mentioned in the American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia. (2) Interestingly, the ACR assured me in writing that they did not — and will not —  approve any diagnostic criteria, preliminary or otherwise. I am equally appalled when lead investigator Dr. Frederick Wolfe says, “There is a lot invested in what I would call a psycho-cultural illness.” (3)

Following is the list of what Dr. Wolfe calls poly-somatic complaints. I have categorized them by disorders that have been recognized to occur with FM by various health organizations such as the American College of Rheumatology, the Centers for Disease Control, and The National Institutes of Health. It ONLY includes symptoms included or alluded to in the Wolfe criteria. It is not complete and not meant to be a self-diagnostic tool.

Irritable bowel syndrome

  • Constipation/Diarrhea
  • Depression/Nervousness
  • Diarrhea
  • Loss of appetite
  • Nausea/Vomiting
  • Pain/cramps in abdomen
  • Pain in upper abdomen

Temporomandibular Dysfunction (TMD/TMJ)

  • Dizziness
  • Dry mouth/Oral ulcers (from sleeping with mouth ajar)
  • Headache
  • Insomnia/ Sleep problems
  • Muscle Pain
  • Muscle Weakness
  • Numbness/tingling
  • Ringing in ears

Thyroid problems

  • Bruising, easy
  • Constipation
  • Cold sensitivity
  • Dizziness
  • Depression/Nervousness
  • Dry eyes
  • Dry mouth/Oral ulcers
  • Fatigue/Tiredness
  • Hair loss
  • Impaired memory
  • Loss of appetite
  • Muscle Weakness
  • Insomnia
  • Nervousness
  • Sleep problems

Myofascial Pain Syndrome

  • Blurred vision
  • Chest pain
  • Depression/Nervousness
  • Dizziness
  • Hearing difficulties
  • Insomnia
  • Muscle Pain
  • Muscle Weakness
  • Numbness/tingling
  • Ringing in ears
  • (Multiple other symptoms – Known as the great imitator)

Painful Bladder Syndrome (Interstitial Cystitis)

  • Bladder spasms
  • Depression/Nervousness
  • Frequent urination
  • Painful urination
  • Pain/cramps in abdomen (lower)

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

  • Chest pain
  • Depression/Nervousness
  • Dizziness
  • Fatigue/Tiredness
  • Fever
  • Headache
  • Impaired memory
  • Muscle Weakness
  • Nausea
  • Sleep problems

Headache, severe

  • Blurred vision
  • Dizziness
  • Depression/Nervousness
  • Diarrhea
  • Headache
  • Hearing difficulties
  • Loss/Change in taste
  • Nausea/Vomiting
  • Ringing in ears
  • Seizures
  • Sleep problems

Raynaud’s

  • Cold sensitivity
  • Numbness/Tingling

Rheumatic disorders

  • Blurred vision
  • Bruising, easy
  • Cold sensitivity
  • Chest pain
  • Dry eyes
  • Dry mouth/ Oral ulcers
  • Fever
  • Heartburn
  • Hearing difficulties
  • Hives/welts/rash
  • Itching
  • Loss/change in taste
  • Loss of appetite
  • Ringing in ears
  • Shortness of breath
  • Seizures
  • Sleep problems
  • Sun sensitivity
  • Vomiting
  • Wheezing

If your symptoms are bothersome or ignored because your physician aligns with the opinions of Dr. Wolfe, they need to be investigated. A secondary condition that is properly diagnosed and treated will improve your overall outcome.

I am a proponent of the research and alternate criteria (4) led by Dr. Robert Bennett, who has been kind enough to answer questions here on ProHealth.

References:

  1. Frederick Wolfe. Fibromyalgianess. Arthritis Rheum. 2009 Jun 15;61(6):715-6.
  2. Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care Res (Hoboken). 2010 May;62(5):600-10
  3. News Medical Life Sciences & Medicine. March 22, 2013. Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine. http://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx
  4. Bennett R, Friend R, Marcus D, et al. Criteria for the diagnosis of fibromyalgia: Validation of the modified 2010 preliminary ACR criteria and the development of alternative criteria. Arthritis Care Res (Hoboken). 2014 Sep;66(9):1364-73.

Celeste Cooper, RN, is an advocate, writer and published author, and she is a person living with chronic pain. She is lead author of Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain and Broken Body, Wounded Spirit, Balancing the See Saw of Chronic Pain (a four book series). She spends her time enjoying her family and the rewards she receives from interacting with nature through her writing and photography. You can learn more about Celeste’s writing, advocacy work, helpful tips, and social network connections at http://CelesteCooper.com.

 

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2 thoughts on “When Fibromyalgia Is More than Pain”

  1. HypoGal says:

    I began taking 4.5 mg of Low Dose Naltrexne about eight months ago. I have autoimmune diseass ; Sheehan’s Syndrome and Relapsing Polychonritis , and I believe my fibro is secondary. LDN has made a noticeable change in my life. More so than any vitamins or alternative mess I have tried. #HypoGal #LowDoseNaltrexone

  2. KimmeeKMiller says:

    It is incredibly difficult to understand how there are medical professionals today who still think Fibromyalgia is not real. Central Sensitivity, Chronic Fatigue Syndrome, and the numerous comorbidities that accompany FMS, are all figments of the collective imaginations of a huge number of people.

    Wake me up when these medical professionals wake up. Living in constant pain, waiting for the next comorbidity to strike, has left me too exhausted to deal with this much ridiculousness. But wait, I can’t sleep. My imaginary Interstitial Cystitis won’t let me!

    Kim Miller

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