Every few months someone in the media decides to write an article questioning the validity of fibromyalgia. I don't know why – perhaps it's a slow health news day; perhaps they want to increase readership by stirring up a little controversy; or maybe they just have a personal prejudice about it. Whatever their reason, they are hurting an already suffering group of people. Yesterday another spate of such articles appeared in a variety of media outlets.
This time the Associated Press presented their arguments under the guise of attacking the pharmaceutical companies for promoting drugs for an illness that may not be real just to make money and the FDA for cooperating with them by approving the drugs. The media always says “some doctors” question whether the condition is real. In fact, they always trot out the same two doctors – Frederick Wolfe and Nortin Hadler – who seem to have made it their life's work to disprove FM. I can only speculate as to why.
There seem to be two versions of the article, a short version and a long version. Both boil down to four basic issues that they feel makes fibromyalgia questionable. I'd like to address those issues.
1. They still don't know what causes it. – Scientists don't know what causes many diseases but that doesn't make them any less real. Even a disease as well-researched as cancer doesn't have an easily defined cause. There are risk factors and things that may contribute to the development of cancer, but no definitive cause. Yet I don't know of a single doctor who would question the reality of cancer.
2. There is no test for fibromyalgia. – Fibromyalgia is not alone in not having a lab test that provides an easy way to diagnose it. There is no test for multiple sclerosis either, but again doctors are not questioning its validity (although they did for many years). Researchers have used tests like fMRIs, which reveal brain abnormalities in people with FM, but they are still working to find an affordable test that can reliable diagnose most if not all cases of FM.
3. A quarter of patients diagnosed with FM also fit the criteria of other disorders. – If my math is correct, that means three quarters of those diagnosed with FM do not fit the criteria of other disorders – so what do they have if it's not fibromyalgia? As for the quarter who fit the criteria of other disorders, there's a chance they may have been misdiagnosed. Unfortunately, some doctors use FM as a wastebasket diagnosis. If they can't figure out what is wrong with a patient who is in pain, they say it's fibromyalgia. Rather than disproving FM, I think this is a good argument for training doctors how to properly diagnose fibromyalgia.
4. FM patients are more likely to have a history of mental illness, be overweight and economically disadvantaged. – All untrue. Let's take these one at a time. 1) Mental illness – There is no indication that most FM patients had or have a mental illness. While depression does sometimes accompany FM, studies have shown that the incidence of FM patients with depression is no greater than for any other chronic illness. 2) Overweight – Although a lot of FM patients may be overweight, it is usually due to the fact that they are unable to exercise and be as active as they once were due to the pain. Also, some of the medications prescribed for FM carry the side effect of weight gain. In my experience, most FM patients were not overweight before they developed fibromyalgia. 3) Economicaly disadvantaged – Studies have shown that FM is equally distributed among all nations, races, faiths and ecomonic statuses.
One final comment
These anti-fibromyalgia doctors claim that giving a patient the diagnosis of fibromyalgia dooms them to a life of suffering, that they give up trying to get better because they have a disease with no cure. What I have found is actually the opposite. In my own personal experience, I got progressively worse for seven years until I finally got an accurate diagnosis. Once I knew what was wrong, I was able to learn more about it and focus my efforts on finding ways to help myself. That has made a tremendous difference and I am doing much better now than I was in my pre-diagnosis days. Not giving a patient a diagnosis leaves them living in fear and frustration, wondering what is wrong with them and how serious it might be.
Frankly, I don't know how any physician who has really studied the research on fibromyalgia over the past few years can still honestly believe it's a psychological problem that patients can “unlearn” as Hadler suggests. There's just too much evidence that it is a very real physical disorder. We can only hope the media will either research the subject more thoroughly or find something else to write about.
Published On: February 10, 2009