The Ongoing Conflict About Fibromyalgia Pain
Article by Erik Dalton
by Erik Dalton, Ph.D.as published in Massage & Bodywork Magazine
Fibromyalgia syndrome (FMS) is a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. Ongoing investigations continue as medical and manual therapy offices are flooded with increasing numbers of reported fibromyalgia cases; but like the oft-quoted analogy of the blind man and the elephant, we currently know more about the components of FMS than we know about the “beast” as a whole. Now that rheumatologists have granted legitimacy by labeling and classifying this vague and controversial syndrome current, beliefs regarding possible origins must be discussed.
Fibromyalgia chiefly manifests as pain in muscles, ligaments and tendons — the fibrous tissues in the body. FMS was originally termed fibrositis, implying the presence of muscle inflammation, but modern research proved that inflammation did not exist. Some in the complementary medical community believe that fibromyalgia should be a primary consideration in any client/patient presenting with musculoskeletal pain that is unrelated to a clearly defined anatomic lesion. Conversely, many researchers question the very existence of the condition since fibromyalgia sufferers typically test normal on laboratory and radiologic exams.
For more than a century, medical science has continued to go forward in its ability to recognize, categorize, and name painful patient disorders. Technological advances have made it much more basic for medical doctors to rule out specific maladies from a variety of symptoms presented in the clinical setting. Additionally, modern testing methods have allowed researchers to become more secure in their ability to determine what is and what is not a disorder or disease.
Psychosomatic or Physiologic
Fibromyalgia has come under fire in many circles including medical, psychological, and manual therapy. There are two camps firmly at odds on their beliefs as to the cause and treatment of the disorder while a third group of researchers and medical practitioners reject the existence of fibromyalgia altogether. Simply put, one camp believes that FMS is a mental health issue without a biological origin whereas the other camp is firmly convinced that it is a physiological disorder – even though researchers have yet to identify definitive diagnostic criteria. While each side argues over the fibromyalgia conundrum, thousands of Americans suffer diverse and sometimes disabling symptoms each year with little help coming from the medical and insurance industry.
Meanwhile the debate as to the true reality of the disorder carries on as scientific evidence continues to accumulate in favor of the physiological aspect of fibromyalgia. Currently, traditional and complementary medicine success rates in treating the disorder indicate the fact that it is primarily a physiological condition with biological origins.
In the face of the dispute as to the origin of disorder, the American College of Rheumatology comprised a list of criteria for the purpose of classifying fibromyalgia. The list includes basic symptoms such as having a history of widespread pain for more than three previous months. The college went on to describe a series of 18 checkpoints (tender points) for the pain sites.
A client is required to have pain in eleven or more of the eighteen sites to be considered a confirmed case of fibromyalgia. Since the symptoms are relatively basic to recognize, why the continued debate? Part of the trouble lies in the fact that the symptoms are sometimes unclear and reminiscent of other musculoskeletal complaints.
From the massage therapy office to the traditional medical facility, clients and patients alike are appearing in increasing numbers with a variety of unexplained symptoms. But there are definitely some shared symptom commonalities, such as predictable tender points, extreme fatigue, poor sleeping patterns, and whole-body pain upon awakening. Regrettably, musculoskeletal pain research generally lags behind well-funded scientific projects that promise more profitable outcomes. It often takes years to definitively confirm and classify conditions with vague, widespread symptoms like fibromyalgia. As a result, this confusing disorder continues to be poorly understood, and clients often suffer for several years before a medical diagnosis is made.
Fibromyalgic symptoms have been described as steady, radiating, burning, and spreading over spread-out areas of the body. The pain commonly involves the neck, shoulders, back, and pelvic girdle. Clients say that pain seems to emanate specifically from muscles, tendons, ligaments, bursa, and joints. Most identify pain as their central symptom. Fibromyalgia pain seems to worsen with cold temperatures, increased humidity, weather changes, overexertion, and stress. Almost all clients report symptomatic pain reduction with
Erik Dalton, Ph.D., Certified Advanced Rolfer founded the Freedom From Pain Institute and created Myoskeletal Alignment Techniques to share his passion for massage, Rolfing, and manipulative osteopathy. Visit http://www.erikdalton.com for workshop, book, massage home study courses and bodywork training videos.
Read More ~