A diagnosis of fibromyalgia is often given when doctors are unable to find another cause for chronic widespread body pain. But many fibromyalgia suffers are often told the pain is all in their heads. Now, discoveries about the potential cause of fibromyalgia, along with a new test to diagnose fibromyalgia, could offer relief to millions — the vast majority of whom are women. If you have fibromyalgia, you've likely experienced frustration when trying to find a treatment that works to alleviate body pain, fatigue, brain fog, and more. And, you might experience the additional blow of family, friends, and even doctors telling you that your symptoms are psychosomatic.
"Fibromyalgia patients tend to be stressed, tense, anxious, ambitious, and sometimes depressed. Some fibromyalgia sufferers describe themselves as perfectionists," Stanford Medicine reported. "They may also suffer from symptoms of irritable bowel syndrome or migraine or tension headaches. Physicians who dismiss their patient’s complaints as being 'all in the head' can also make symptoms worse."
More and more evidence has emerged about how the body and brain work together, and how a communication breakdown between these two systems can contribute to chronic pain conditions. Researchers at Massachusetts General Hospital have identified an underlying condition that could play a role in illnesses like chronic fatigue, fibromyalgia, and irritable bowel syndrome, according to a study published in the journal Current Pain and Headache Reports. Additionally, another study published in the Journal of Evaluation in Clinical Practice reported that a new test could more effectively differentiate fibromyalgia from other chronic pain conditions.
New Screening Can Effectively Diagnose Fibromyalgia
The study from the Journal of Evaluation in Clinical Practice was conducted to help primary-care physicians become more skilled at correctly identifying fibromyalgia. According to the study, half of all primary-care providers from the U.S., Asia, and Europe did not know how to diagnose fibromyalgia. The screening method, which involves using achilles tendon pressuring in tandem with inquiry about widespread body pain, can help doctors determine if a chronic pain patient might have fibromyalgia in less than one minute.
Being able to get a fast and accurate diagnosis can save chronic pain suffers years of tests and uncertainty. "Because of the many different symptoms it may present, fibromyalgia can be challenging to diagnose," Fibromyalgia News Today reported. "The process often takes two to three years and three to four evaluations by different medical teams to reach a correct diagnosis."
If you've seen Gaga: Five Foot Two, then you know that Lady Gaga did not receive her fibromyalgia diagnosis for five years. This new screening method is meant to speed up that process. According to Fibromyalgia News Today the study used three clinical measures — blood pressure (BP) cuff‐evoked pain, digital palpation evoked pain, and a single question about “persistent deep aching” — to indicate fibromyalgia.
"The study found that patients with fibromyalgia showed significantly greater sensitivity to digital pressure and BP-evoked pressure pain compared to patients with chronic pain but no fibromyalgia," Fibromyalgia News Today noted. "When questioned about deep ache, more fibromyalgia patients responded positively than the other groups of participants. Additional analysis showed that patients who had right Achilles tenderness and who endorsed the deep-aching question had an 11 times greater chance of having fibromyalgia."
The study concluded that patients who receive a positive diagnosis need a follow-up exam to confirm whether or not they have fibromyalgia.
Half Diagnosed With Fibro Might Have SFPN
The Massachusetts General study found that something called small fiber polyneuropathy — the impairment of small nerve fibers — is present in a variety of different diseases and often results in symptoms of burning and shooting pain. Fox 25 in Boston spoke to Dr. Anne Louise Oaklander, who was involved in the study and said that those who suffer from diseases like fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome might actually have a disease called small fiber polyneuropathy, or SFPN, a disorder in which nerve cells found under the skin are attacked by the body's immune system. One of the reasons it's so hard to diagnose is that even though patients suffer from widespread pain, no one can see it — but that's now changing.
She discovered that drugs called immunomodulators — medications used to help regulate or normalize the immune system — can be effectively used to treat SFPN in some patients, which is offering relief to long-time sufferers. "It's pretty routine that I have patients who break down and cry when they get an answer for the first time to something that's been disabling them for years or decades," Oaklander said, adding that SFPN is diagnosable by biopsy.
The study described symptoms of SFPN, and they're pretty on point with what many people with fibromyalgia, IBS, chronic fatigue, and undiagnosed chronic pain report. "Many individuals report the gradual onset of distal symptoms that include vague disturbances of sensation in the feet. These symptoms may include the feeling of a wrinkle in a sock that cannot be removed or of small pebbles or sand in the shoe. Others may report a cold-like pain, tingling or a pins and needles sensation," the study detailed.
Other, more severe, symptoms include persistent burning pain and transient electric shock–like pain with symptoms worsening during periods of rest and at night. Additionally, "Patients with small fiber neuropathy frequently complain that the bedsheets are exquisitely painful, and therefore, wear socks or use 'foot tents' to keep the sheets from making physical contact with the feet."
Harvard's newspaper, the Harvard Gazette, reported that as many as half of all people diagnosed with fibromyalgia may actually have SFPN, which could be good news because unlike fibromyalgia, SFPN is treatable with immunomodulators. Because the two diseases are so similar, it can be difficult to tell them apart. And, while not everyone who has fibromyalgia has SFPN, those who do may find some relief with medication. What's more, because SFPN can be diagnosed with a biopsy, patients can finally find out one way or the other if they have it.
Over all, these two discoveries offer hope for chronic pain sufferers who often feel like they're fighting an invisible war. Having more options to diagnose and treat chronic pain is a positive step on the road to healing.