One in four doctors think so. If the physician doesn’t think FM exists, he or she will think the pain is all in your head or you are faking it for ulterior motives, such as acquiring pain pills. The controversy among doctors is whether or not FM is an actual disease, curable illness or just a set of symptoms to manage. It has polarized the medical community.
Is it really “real”?
There are at least two schools of thought about FM care. Sufferers are either masquerading with an illness they know they don’t have, or sufferers are being abused by a society that doesn’t give them the support them deserve. The problem is that the medical community doesn’t really know how to classify an illness in which the patient hurts all over with a multitude of other symptoms accompanying this complaint of pain. Some doctors believe that if a test cannot determine a disease, then it may not be a disease at all -- or it may just be depression.
There are others who say that designating FM as a disease will help pharmaceutical companies’ bottom line. If a disease can be identified, it must have a cure or medication that will alleviate the condition. This is where some people see the greed of drug companies looming. If you watch closely, TV commercials for FM drugs state that it is not known how the drug works, just that it relieves some symptoms.
Fibromyalgia Symptoms
Fibromyalgia is a soft tissue and muscle affliction. Symptoms include chronic muscle pain, incapacitating fatigue, sleep problems, and painful spots on the body, or “trigger points.” It also includes depression; inability to concentrate or focus; social anxiety; deep, stabbing pains in the muscles; temporomandibular joint disorder; muscle twitching and burning; and shoulder, back, and hip pains. Many patients also experience abdominal pains; dryness of nose, mouth and eyes; chronic headaches; rheumatoid arthritis; lupus; hypersensitivity to hot or cold; inability to concentrate; incontinence; irritable bowel syndrome; numbness or tingling in hands and feet; and muscle stiffness.
Now with all those diverse symptoms, is it any wonder there are skeptics out there?
It is estimated that worldwide, there are 100 million sufferers, with about 12 million in the U.S., mostly women. FM strikes women at 10 times the rate of men. There is no cure for FM and no treatment except to alleviate symptoms of the disease or syndrome.
Known Risk Factors
Risk factors for FM seem to include gender – women bear the brunt of this illness -- genetic disposition, menopause and the loss of estrogen, poor physical conditioning, trauma to the brain or spinal cord, surgery, injuries from accidents, certain illnesses, and emotional stress.
Fibromyalgia -- Myriad Theories of Existence
Theories of why FM occurs are as diverse as the range of symptoms and risk factors. Genetics, hormonal disturbances and stress are three items put forth as the cause of FM. Most researchers think FM results from a combination of physical and emotional stressors. Theories abound. They include:
- Low levels of the neurotransmitter serotonin are responsible for symptoms. Serotonin has anxiety-reducing qualities.
- Some studies show that women have seven times less serotonin circulating in their brains than men. This may explain why FM affects more women than men.
- One theory holds that a traumatic brain or spinal cord injury may precipitate FM.
- Some sufferers have been found to have low levels of human growth hormone, contributing to muscle pain.
- Estrogen cessation causes hormonal changes in women, which then may change the way the body responds to pain.
- Stress or poor physical conditioning could be the genesis of pain.
- Some put forth that sleep disorders are at the root of FM. The theory goes that the lack of restorative sleep lowers serotonin levels, which have been known to increase pain sensitivity.Some scientists believe that a person’s genetic makeup has everything to do with the way that person reacts to stimuli. It has been found that people with FM react much more intensely to stimuli that most people wouldn’t find painful or disturbing. It is thought that a person with this particular gene reacts to traumatic events or stressors with a change in the body’s physical response to those disturbing stimuli.
- FM amplifies painful sensations because of the manner in which the brain processes these pain signals.
Whew! That’s a lot to know about FM theories. Now one research study has shown that when the sufferer feels pain or other discomfort, the sensation is real, not an imagined malady. With advances in the medical sciences and scanning techniques, the raging debate as to whether or not FM is really a disease may one day be settled.
SPECT scans and functional MRI tests show which part of the brain is activated by stimuli. SPECT scans are a type of nuclear imaging test that creates 3-D images and shows how the organs work, rather than just providing a static image. Functional MRIs measure brain activity and blood oxygenation and flow. Because more brain activity means more oxygen and blood to that affected area, scientists are able to see which organs are related to what sensation.
The midbrain acts as kind of a relay station for auditory and visual information. It also has control over some body movements and contains dopamine-producing neurons. With the use of these scanning techniques, researchers noted that the FM sufferer’s midbrain lit up when pain was encountered. It also reacted to other stimuli like hot and cold, light touch and even certain sounds. This, said researchers, makes it appear that the FM sufferer's brain is hypersensitive to sensations that occur in everyday life.
But that is just one study, and it is predicted that the debate over FM will continue. If you find yourself with signs of FM, see a doctor. Have a list of all your symptoms, the time of day when they occur and the circumstances of those moments. And if you have a physician who you feel isn’t taking you and your symptoms seriously, it may be time to look for a more sympathetic medical ear.