Facts and Fiction regarding Fibromyalgia Syndrome

I have patients who come into my office complaining of generalized foot pain. It is frustrating to me as the practitioner and the patient when the patient can only say, "my feet hurt!", with no definitive reason. During the history phase of the visit, I find out that the patient has been diagnosed with fibromyalgia. There are still some social stigmas regarding this syndrome and here are a few facts regarding this debilitating disease.
1: FMS is caused only by stressors, such as infections or injuries. False: There may be multiple causes, though recently it was proven that FMS is primarily a disorder of pain signaling in the central nervous system. This is probably a genetic component. This precise nature of the cause is still unclear.
2: The presence of tender points provides a definitive diagnosis of FMS. False: The American College of Rheumatology (ACR) classification criteria involve indentification of 11 tender points, but pain and tenderness are often more widespread without the presence of true tender points. There is no simple approach to diagnosis, and that can be a barrier to effective treatment.
3: The prognosis for patients with FMS is hopeless. False: There is no cure, but early appropriate treatment can prevent deconditioning and dysfunction. A variety of pharmaceutical and nonpharmaceutical therapies are available, and a multidisciplinary approach that combines therapies is recommended. Drug use focuses mainly on pain reduction, and physical therapy is geared to disease consequences, such as pain, fatigue, and sleep disturbances. Several alternative therapies have been shown to be effective.
4: FMS is a "phantom" illness that's "all in the patients head." False: Many in the medical profession have held the view that FMS does not exist or is a manifestation of depression or anxiety disorders. FMS often is associated with depression - depression can cause FMS, and the symptoms of FMS may lead to depression - but FMS is a real illness in its own right. Again, better understanding can lead to earlier and more effective management.
5: Because FMS is such a complex disorder, treatment provided by a rheumatologist or other specialist is required. False: No specialized care is necessary, and the condition usually is managed by generalist physicians. Some rheumatologic practices are no longer accepting FMS patients - they find FMS patients difficult and they also know they might not provide any better treatment than the generalists.
FMS is a complicated disease that is still misunderstood and very little understood regarding the cause. With knowledge on your part and finding an understanding generalist, your disease can become manageable.

"The journey of life is taken one step at a time... none of them should be painful." G.M. Barclay, DPM, AACFAS