Fibromyalgia, The Myth of the Mystery of

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This is the false belief that the cause of fibromyalgia is a complete mystery, and therefore, it is totally unclear how to treat it. It is held by many patients and healthcare workers. Historically, fibromyalgia has been a muddle. There are probably 30 separate names for it, or related syndromes. The myth is both a product and a symptom of the muddle.

Here are some possible reasons for the belief that fibromyalgia is a mystery:

  • Failure to keep pace with the scientific literature of central sensitization and other key concepts.
  • Getting confused by the multitude of theories of fibromyalgia.
  • Getting lost is the genuine complexity of the scientific literature which has now documented thousands of scientific findings, numerous symptoms and bodily changes.
  • Expecting that all medical conditions should follow known basic anatomy.
  • Inadequate study of new discoveries in the neuroscience of pain, sleep, and the defensive systems of the brain.
  • Under-reliance on detailed history taking and failing to delve into the details of the emotional life of the patient while the first symptoms of fibromyalgia were taking hold. (In other words, an inadequate search for connections between emotional and psychological upheavals and the onset of the main physical symptoms of fibromyalgia, especially the earliest onset of chronic widespread muscular pain and fatigue.)
  • General over-reliance on lab tests in medical diagnosis. (This would be more acceptable if there was a solid affordable lab test, but as of 2016 there isn’t.)
  • Over-reliance on outdated and formulaic neurological examination procedures without observing in detail for the patient’s reactions to pressure applied to tender points. Depending on the severity of the case, these may include: withdrawal reflexes, facial grimacing, local radiation, distant radiation, tone of protest in the voice, pain vocalizations, etc. [For an entry on methods of examination of tender points and how to record patient reactions, see Tender Points Exam Form.]
  • An anti-psychological attitude that causes disregard of reasonable psychological explanations for the patient’s symptom and the general course of their symptom progression. Examples include when there is a clear and obvious onset of the symptoms of fibromyalgia at the same time as a major new psychological conflict or the mental turmoil of a clear and obvious traumatic event.

In some cases, the anti-psychological attitude involves mechanistic thinking, but the person parades themselves just being a rigorous person with a healthy scientific skepticism.

In other cases, the anti-psychological attitude occurs as a defence to prevent the psychological problems. (For further perspective, see the entry Anti-psychological Attitude.)

  • Secondary gain by the patient. They may even be quite disabled by fibromyalgia. They may privately believe that they have to prove that their symptoms and disability are totally due to an accident in order to receive funding through an insurance claim. This could result in a failure by the patient to bring forward important details about themselves and their case. This could serve to contribute to the confusion and mystery, at least in their own particular case.
  • Repression: This is a psychoanalytic term whereby unconscious processes block conscious awareness of some psychological conflict.
  • The anti-psychological attitude, in the opinion of the author, contributes to a research bias and also a treatment bias in some people. It works like this: Instead of courageously approaching one’s psychological deficiencies and accepting that they may have contributed to the sleep disorders and pains of fibromyalgia, one circumvents this by becoming attracted to various “toxin” theories of the disease such as the theory that it is all caused by yeast, or some virus. These theories are sometimes gravitated to unconsciously because they negate any personal responsibility for one’s condition of having fibromyalgia. If it accepted they lift the heavy burden on health care professionals to delve into many fine details of a psychological nature. Such work requires a patient thoughtful and creative approach, and not the formulaic “one-size-fits-all” quick pill approach, that actually works quite well in many other areas of medicine.
  • The problem of promotors of pet theories. There has never been a shortage of people who want to believe that they have defied the odds by discovering the holy grail i.e. the cause of fibromyalgia (or many other diseases). The hallmark of a pet theory is that the inventor is in love with it, and not merely using it as a tool for improved understanding. They tend to be narcissistic in nature and the inventor casts themselves as the great genius who has found “the answer”.

Pet theories are sometimes half-baked. They may have an almost magical element. In the worst case they are quackery. Some are partially true. Some pet theories are more plausible and while wrong, are not quackery.

The landscape of fibromyalgia (and also neurasthenia before it) has always been polluted by pet theories such as toxin theories. Some pet theories can be emotionally appealing because they deflect any personal responsibility for one’s own health. Patients and health case workers can be taken in by these theories. Until they are refuted, it is easy to become confused. The confusion contributes to the mystery.

PubMed as of 2020 listed over 11,000 scholarly papers that mention fibromyalgia or one of its synonyms in their title. Numerous studies prove that there are a variety of brain changes or abnormalities in fibromyalgia. The time has arrived for putting an end to claims that it does not exist.