The struggle to define a fibromyalgia diagnosis has been a long one. It is an example of a reversal of scientific disbelief in the face of consistent reports of unexplained symptoms. Fibromyalgia doesn’t show up on tests. For many years, the mostly women were dismissed as hypochondriacs, or hysterical. Although it was called “muscular rheumatism” in the mid-1800’s to distinguish it from “joint rheumatism,” or arthritis, it wasn’t identified as a distinct syndrome until the last 30 years.
Who gets it?
Women have fibromyalgia eight to nine times as often as men. Women from 30-50 years old show an increasing incidence, especially if they had complaints from years of unrefreshing sleep, although it can also appear in children. 50% associate the onset with unusual stress, an infection, injury or trauma. The other 50% include some who have a genetic predisposition. It occurs in about 20% of people after a serious neck injury, and is strongly associated with inadequate stage 4 sleep. In fact, depriving healthy research subjects of stage 4 (deep, non-dreaming) sleep provoked the widespread pain and tender point symptoms of fibromyalgia within a few days. However, it isn’t certain if there is a causal link. For many people, there is still no known initiating event.
How is it diagnosed?
Between 1975 and 1980, clinical researchers documented many people’s complaints of chronic, widespread pain in muscles and tendons. They had stiffness around their joints, headache, sleep disturbance and fatigue to the point of exhaustion. In 1987, the AMA recognized the syndrome. A paper was published that same year by the Journal of the American Medical Association about the fibromyalgia diagnosis–written by a rheumatologist whose wife had gone through 3 years of agony and testing before she was finally diagnosed. In 1990, the first standards were adopted by the American College of Rheumatology Classification Criteria. The criteria for a fibromyalgia diagnosis in adults include 11 of 18 specific localized tender points.
Having diagnostic criteria has been instrumental in its acceptance by the medical community. It brought relief to sufferers for whom their condition finally had a name, and they could be freed from the accusation of malingering by their doctors, spouses and employers. It is quite debilitating, with 25% of people in the U.S. going on disability after a lengthy and exhausting battle. However, a fibromyalgia diagnosis does not end the mystery.
to be continued in next post–Fibromyalgia: Cause is Still a Mystery
References, or for more information:1. http://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis
4. If you suspect you have fibromyalgia, a rheumatologist is the best doctor to make a correct diagnosis. Support groups can be very helpful for everyday tips and coping skills.