Fibromyalgia: Misunderstood and Poorly Treated Condition

January 31, 2023

Summary: Fibromyalgia is quite a common condition, yet many of those living with fibromyalgia remain undiagnosed and untreated. Fibromyalgia remains a diagnosis of exclusion, which means that a person is diagnosed based on symptoms, and by excluding other well-known physical ailments, as most lab tests in fibromyalgia are close to normal. Nonetheless, some early studies confirm neuroinflammation in those living with fibromyalgia, thus raising the hopes that fibromyalgia will be more readily diagnosed and treated in the future.

Chronic pain, fatigue, and lack of concentration are widespread complaints. However, in many instances, doctors fail to identify the cause of such complaints. Quite often, doctors would carry out many tests, but the results of most tests would be close to normal.

Many such individuals with constant body aches and fatigue are living with fibromyalgia, and the diagnosis is still a bit controversial. It is controversial as the diagnosis is mainly based on the clinical findings and not on the lab tests. It is a diagnosis of exclusion – a condition diagnosed when doctors fail to find other reasons for symptoms like chronic pain, fatigue, and brain fog.

Since the symptoms are so vague, and lab tests do not show many changes, doctors are often hesitant to diagnose someone with fibromyalgia. As a result, patients often continue to suffer from chronic pain, body aches, fatigue, sleep issues, and poor memory for years. The condition was not even recognized as a disease just a few decades ago. Nonetheless, now it is accepted to be a health disorder.

Fibromyalgia long remained an unrecognized disease. Most extensive research into the subject started happening in the 1970s. However, it became well recognized as a separate disease entity only in 1990, when the American College of Rheumatology first came up with diagnostic criteria. Since then, it has updated its criteria multiple times. Thus, researchers are still trying to understand the condition fully1.

To date, there is no lab test that can confirm its diagnosis. In fact, the exclusion of other diseases is one of the main criteria for diagnosing the condition. Another important criterion is the widespread pain symptoms lasting more than three months. Here it is vital to understand that though the most used criteria for diagnosing the condition have been set forth by the American College of Rheumatology, it is not a rheumatic condition. It is also not an autoimmune or severe inflammatory condition.

Most experts agree that fibromyalgia occurs due to certain changes in the brain causing central sensitization. This causes their spinal tract and brain to become more sensitive to pain. This explains why people living with the condition experience pains throughout the body. This hypersensitivity of central origin also causes other issues like discomfort caused by strong chemicals, bright lights, and various sounds. Therefore, people who are living with fibromyalgia avoid going to loud and crowded places.

Despite so much distress and chronic pain caused by fibromyalgia, many doctors still do not recognize it as a real disease condition. This is the reason why so many people living with fibromyalgia do not get adequate care.

However, new studies have now started showing that there are some changes in the body of those living with fibromyalgia. Studies using brain scans show that the brains of those living with fibromyalgia differ from healthy adults. These scans also show inflammation in specific brain regions. These findings are a significant step forward2. Doctors do not take people with fibromyalgia seriously despite chronic pain, widespread body aches, fatigue, memory, and sleep issues. Thus, they often fail to receive adequate treatment and chronic pain treatment.

Treating fibromyalgia also remains challenging. Most existing drugs do not provide sufficient pain relief. What worked for one fibromyalgia patient may not work for others—painkillers like acetaminophen help, but inadequately. Similarly, drugs to treat nerve pains, like pregabalin, often fail to help in fibromyalgia.

Interestingly, many complementary treatments may work well in medication for fibromyalgia and fibromyalgia. Thus, many may benefit from health supplements, CBD, and some may even benefit from vitamins like vitamin D. Others may report a benefit from magnesium.

Physical and physiotherapy can help reduce chronic pain and body aches in most fibromyalgia patients. Thus, massage therapy, yoga, regular exercise, and participating in specific sports may help. Additionally, it is a good idea to join online support groups. People who are living with fibromyalgia benefit from psychological support, too.

By Gurpreet Singh Padda, MD, MBA, MHP