Whenthe standarddepictionof fibromyalgia was first introduced, we lackedevenbasiccomprehension of the condition, and had onlya guide for researchers who wereattemptingto deepen this knowledge.Due to increasing research, our understandinghas grown from countingtenderpointsand focusingon painf;ul;musclesto an evolvingconcept of a heterogeneous set of subgroups who havecentralnervoussystemsensitivityand a countless variety of potentialdysfunctional biochemicaland metabolic interactions. With this new FM concept comes the need for a depictionthatacknowledges the complexityof fibromyalgia.
We are delighted;to present an innovative workof art,designed by artistAnne Félicité, wife of the famed French researcher Dr. JeanB. Eisinger.The figuredepicts fibromyalgia in a new way,reflecting thatthose of us withfibromyalgia are not victims of fate (or of threeFates), are morethan the sum of our tenderpoints,and are complex individuals who are each unique in metabolic makeup and needs.
FM is not a catchall, “wastebasket” diagnosis.FM is a state of centralsensitization. Thismeansthatyourcentralnervoussystemmay be unusually sensitiveto pain(hyperalgesia) and you alsomay findcertain sounds, vibrations, light, and other sensations (evensmells) to be translated by yourbodyintodiscomfort or pain. Certain typesof sound,suchas staccatomusic or talk, or certain pitches, may be unendurableand promoteincreasedsensitivityto other stimuli. The same may be trueof the pattern of shadow and lightby trees passing alongin a car, or evenbeing stuckin an elevator or car witha woman withheavy perfume. Diffuse,body-wide painis partof FM, but not all of it by any means.
Fibromyalgia is not yet considereda disease. Diseaseshaveknown causes and well-understood mechanisms for producingsymptoms.FM is a syndrome, whichmeansit is a specificset of signsand symptomsthatoccur together. Syndromes are no less serious or potentially;disablingthan diseases. Rheumatoidarthritis and lupus are alsoclassifiedas syndromes.Lab testsfor FM do not exist rightnow. Lab testsare valid onlyto checkfor co-existing conditions. You can haveother conditions and alsohaveFM.You haveprobably heard about the official FM definition requiring11 of 18 tenderpointsto be present.Thiswas partof the criteria originallyto be usedto define patients to be admitted intoclinicalstudies of FM, and the tenderpointshad to be present in all four quadrants— thatis, the upper rightand leftand lowerrightand leftparts;of yourbody. You must havehad widespread,more-or-less continuous painfor at least threemonths. Thiswas not originallyintendedto be diagnostic. Since most clinicalstudies fail to separate symptomsof FM from co-existing CMP,the conclusionsof manystudies may be faulty. Tenderpointsoccur in pairs on variousparts;of the body. In traumatic FM, tenderpointsmay be clusteredaroundan injuryinsteadof, or in additionto, the 18 “official” points. These clusters can alsooccur arounda repetitivestrain or a degenerative and/or inflammatoryproblem, suchas arthritis.Localized painusually indicates a co-existing condition, suchas chronicmyofascial pain(CMP), but evenwithCMP this can be misleading, as you willreadlater.
About the Author
Dawn Stevens is a Fibromyalgia Expert and noted author