Fibromyalgia, despite being a mental health disorder, is misunderstood due to historical medical error guessing it an autoimmune disease — which it is not. Unfortunately, when a medical diagnosis is ascribed to medicine specialty, in this case Rheumatology, that specialty is stuck with it. Fibromyalgia is a clinical diagnosis based solely on symptoms as all rheumatology tests in Fibromyalgia are normal. Slowly the historical designation is changing to “Centralized Pain Disorder,” while some advocate “Neuronal Dysregulation.”

Fibromyalgia is not a disease; Fibromyalgia is a medical condition where the patient’s brain interprets nerve signals incorrectly. Mild stimuli most brains call “pressure” are interpreted as “pain” in Fibromyalgia. Some take offense to calling Fibromyalgia “all in your head” but in fact, it is — as is depression, anxiety, alcoholism, sinus infections and even brain tumors so we should not ignore fibromyalgia any more than these.

Physicians dislike fibromyalgia because patients are dissatisfied with diagnoses where all testing is normal. Therefore, physicians continually add ineffective medications and injections to convince the patient we believe their symptoms and the patients continually add supplements and increasingly expensive diagnostics which frustrates both.

Proven treatments provide partial relief for some patients — and these are all antidepressant or anti-seizure type medications. The best proven treatment is lifelong exercise with a yoga basis, which no patient wants to hear. We can only “cure” patients that have psychological trauma, in which case talk therapy, can be curative as proven by the nation’s leading Fibromyalgia clinic, a U of M offshoot. But if it doesn’t come in a pill or scalpel, American patients don’t feel they’re taken seriously no matter the facts.

Fibromyalgia is not “made up” by patients, it is real, manageable but usually life-long. If it responds well to traditional pain medications, it is by definition not Fibromyalgia.

Allan P. Frank, MD, MS

Alpena

Assistant Clinical Professor

MSU College of Human Medicine