The fate of patients with persistent widespread pain labeled as FM stands in reproach to whatever theory underpins this sophistical treatment act. In the community, the majority of people with persistent widespread pain improve with time12. That is not the fate of those who become patients and are labeled FM. Based on the science that pertains to the regional musculoskeletal disorders, I would suggest that this unhappy fate is not solely a reflection of the intensity of their symptoms or the pervasiveness of the psychosocial factors that confounded their coping so that they chose to be patients in the first place. I would suggest that the treatment acts, dripping with empty promises of elucidation and unproved promises of palliation, are iatrogenic. I would further suggest that these circular treatment acts will exacerbate whatever mood or thought disorder is complicating the plight of these patients13.
NORTIN M. HADLER says "I suspect that few suffering with persistent chronic pain are suffering in silence."... Well, I am buddy. Other than my blog rants, I don't talk about FMS with anyone, because I do not see the point and I do see the negative. I do not seek treatment for it because I do not see the point and I have given up trying. Mostly because of doctors like him. Go figger. Yeah, when your in a bucket load of pain you do want to find someone to help you, to end it, to prevent you from screaming... but in the real world, going to the doctor about chronic pain that is not going to kill you or cripple you, then you might get 'labeled' so it is sometimes seems better if you minimilize it, or suffer in silence, which many of us do. It is like going to the ER with a persistent migraine... expect inferior information and treatment.
There is no more valid a diagnostic label for patients complaining of persistent widespread pain than "overwhelming persistent widespread pain." FM and its sister labels2,14 means no more than that. "Functional somatic syndromes"15 and "medically unexplained symptoms"16 denote the same subset of the woebegone. The former is difficult to define, even by its proponents, and the latter implies that one would be better off if symptoms are medically explicable.
While it is true when you are diagnosed the wide spread pain thing is the focus, along with intense sleeping issues and memory issues. But just because that is the criteria for diagnosis, once other things have been eliminated and if you have other symptoms, does not mean there is not something specific going on. Studies have shown the brain of someone with FMS does some funky things, that the patient feels pain at a higher intensity and for a longer duration, that the body is hyper sensitive to it and other stimulus. I don't care what you call FMS, but it is there. We all are not chronic complainers whining about our pain, and so making it persist simply by will power. And there are treatments that work. Lyrica, for an example. I would not say it works 100%, but I know from my trip to Scotland trekking up hills and walking the royal mile, that it is a drug that makes a big difference. A significant and noticeable difference... as in the pain normally felt right away takes more to be activated, and the pain felt after is significantly diminished. It works better at dampening that overactive pain response in FMS than it does as a migraine preventative, which is why I am technically on it... so much that I would not want to be taken off it and switched to a different migraine preventative because of the positive effects on the FMS. But hey, what do I know... maybe I have some other obscure chronic pain condition that coincidentally was improved by a anti-seizure med.
I am a little sick of all this debate on whether FMS is real or not. It severely affects the mind set of a patient to doubt themselves so, causes more frustration and depression, and less communication. It limits awareness and the quest for effective treatments. And it totally ticks me off. Back in the day, shortly after my diagnosis, I ended up with the chest pain from repetitive movements at work. I went to the ER with it when it got to be severe, because I was young and did not yet know the difference between lung pain, heart pain and chest wall pain. I told the doc I had FMS and thought maybe it was something like that, because rationally, if it was a heart attack it would have killed me weeks prior when it started. He said he did not believe in FMS. To which I replied, 'How about I list the different diagnosis I have had prior to FMS and you take all of those into consideration instead'... but not in so many words. But the point is, I don't care what you call it, as long as you treat it. And that idiot ER doctor did nothing, when it turns out it was something, and something common (comorbid) in people with FMS and a chest x-ray would have done the trick.
If I do not have FMS, I sure as hell would like to know what I do have, because while FMS is a bitch it will not kill me, whereas if you take all the symptoms and look at the other conditions it can be and add in my abnormal blood work, there are some other conditions that could kill me... and that is rather something I would like to know. And if it is all in my head then I need a serious bitch slap to knock me out of whatever crazy ass thing causing me to want chronic pain, chronic insomnia, IBS, fibro fog... Seriously, how crazy would you have to be to will that sort of hell on yourself? That is some self deluded crazy imagination. And a lot of brain power to trick yourself like that. I mean, I get that depression causes muscle pain (because moods affect our neuro chemistry), but if your not depressed or getting off on the negative attention of being ill (which I actually think you could do without actually manifesting an illness), then why and how could you use your sizable mental abilities to trick yourself into feeling like crap on a daily basis, then learning to cope with feeling like crap on a daily basis and then developing a facade so people don't know you feel like crap. If I have that much control over how I feel physically... then I am totally going to wish away my pain, my migraines, wish myself to sleep every night, wish myself to lose twenty pounds and wish to win the lottery, because if it works one way it should work the other way. And obviously if FMS is not real and I am causing myself to feel this way, then clearly my mind body connection is supper strong, like super hero strong, and thus I can, by pure willing, affect my body in amazing ways. So the next time I have a migraine I ought to be able to tell myself that I am not in pain or maybe that I like pain or that what I think is pain is actually just a mild tingly sensation. And when I get a migraine aura, instead of thinking 'ooh, I'm getting a migraine' I will think 'Ooh, I see dead people' or 'Ooh, I see air particles' or 'Ooh, I have the psychic ability to see auras but it hurts my mind'.
Whatever. Pain can be doubted because pain is not a shared experience. Lots of things are subjective. Like because I cannot see this doctors brain, I can really doubt it exists. Any idiot can play devil's advocate. You say you are in pain and I say prove it. You say people with FMS once they get that label make themselves more ill, and I say getting a diagnosis at all is a profound relief. You say god exists and I say he is a societal construct based on cultural ideals. You say the world is composed of tiny atoms and I say show me one?You say the world is real and I say it is all the perceptions of the observer. Doubt everything. The only thing that cannot be doubted is the 'I'. I think therefore I am. And you know what? I am in pain, is pretty hard to doubt as well. By doing so you just shove all the need to prove onto the other person. I say prove FMS does not exist. Prove that pain we feel is not explainable or demonstrable. Maybe by expending a little effort to prove it does not exist, you will find the truth behind the condition, rather than pushing all that responsibility onto your poor patients to prove to you they are actually suffering.