Fibromyalgia, a widely misunderstood disease, confuses and frustrates both patients and physicians. I know because I saw it on both sides – both as a doctor and a woman with the disease myself.
This common chronic disease is characterized by widespread muscle pain, fatigue and brain fog. An estimated 5 million Americans currently suffer from the disorder and nearly 90 percent of those diagnosed are women.
Yet there is still a lot of confusion about the disease and how it is treated. Here are five truths about fibromyalgia that are not known even by most doctors:
1. Fibromyalgia is real and can be treated, but it requires a holistic approach.
The research on fibromyalgia has lagged behind other diseases, tainted by controversy and a century of arguments about whether it is a “real” disease.
This changed in 2002, when a groundbreaking study showed abnormalities in the way the brain treats pain in fibromyalgia. These brain imaging studies gave objective data to prove that fibromyalgia was “real” and triggered a decade of intensive research, which resulted in three FDA-approved drugs that painful pain signals.
But these medications do not treat the often more debilitating symptoms of fatigue and fuzzy thinking called “fibrofog”. To do this, physicians and patients need to be well informed about different treatment options, especially holistic approaches such as dietary modification to reduce inflammation or adding supplements to stimulate cellular energy production.
2. It is no longer a complete mystery.
I often hear that the myth has repeated that “we do not know what causes fibromyalgia”. Recent surveys of doctors reveal that most doctors still do not know how to help their patients with fibromyalgia, despite the existence of very effective treatments. Fibromyalgia is often described in medical journals as “perplexed,” “mysterious,” and “confused.”
TV ads that say fibromyalgia is a condition of overactive pain Nerves do not tell the whole story. In fact, pain management problems are just the tip of the iceberg. A much larger factor is a response to stress (or danger) that has been extinguished and is constantly “red alert”, resulting in a chain reaction that causes fatigue, brain fog and muscle aches.
The only way to permanently improve all these symptoms is to systematically address the negative effects on the body of a chronic hyperactive stress response. A chronically activated stress response wreaks havoc by preventing deep sleep and keeping muscles tense, causing pain and tenderness; hindering digestion and energy production; and eliminate the hormones. It also results that the nerves sensitive to pain increase the volume of their signals.
3. Fibromyalgia is primarily a sleep disorder.
Unfortunately, many doctors, even sleep specialists, do not know the sleep problems that accompany fibromyalgia. But fibromyalgia is in many ways a sleep disorder, a state of chronic and profound sleep deprivation. Studies have repeatedly shown that patients suffer from inadequate deep sleep that is frequently interrupted by “awake” brain waves. This deep sleep famine contributes to the tiredness, muscular pain and hazy thinking characteristic of the disease.
Treating sleep is the key to treating fibromyalgia, and this is where I see the most ways to reduce pain, fatigue and brain fog. While sleep should always be improved before other treatments work, it is essential to address this issue with your health care provider to treat hidden sleep problems such as obstructive sleep apnea, then add medication. and supplements to restore normal deep sleep.
4. Most doctors do not know much about fibromyalgia, and it’s not their fault.
Fibromyalgia is an orphan disease that is not claimed by any specialty and instead overlaps clumsily in the areas of rheumatology, neurology, sleep, and pain medicine. The majority of care concerns submerged primary care physicians who do not have time to go for new treatment ideas in the sea of medical publications. Major medical journals neglect fibromyalgia. In fact, since 1987, only one study on fibromyalgia has been published in the New England Journal of Medicine, the most widely published medical publication in the world.
Given that the busy primary care provider does not have the time to actively seek new treatments for fibromyalgia, the research must be brought to their attention in another way, namely by their patients. So, in my new book, The FibroManual, I included a health care provider’s guide with research-supported medical advice for patients to grab their doctor’s attention.