Talk:Fibromyalgia

Talk Page Re-Structuring - PLEASE HELP by moving your own discussion points to appropriate categories.

• Assertion: As the associated talk page has become cluttered and random, a revision is due.
• Goal: the associated talk page should aid in directing useful discussion whose intent is the improvement of the encyclopedic contect of the associated main page.
• Proposal:
  • the associated talk page structure should, wherever applicable, follow the structure of the Main page.
  • changes to the structure of the main page, shall be discussed on the talk page under a heading of that title
  • a specific section dedicated to Critics &/or Skepticism should be part of the main page, but should not be the primary focus of the article
  • all discussion, testimony, personal statements, etc. not specifically related to improving the encyclopedic content of the the main page do not belong in Wikipedia and should be taken to Usenet or discussion boards.

Iggynelix 20:18, 13 March 2007 (UTC)

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Diagnosis

Recent changes

• a reference is needed for either statement.

There were some recent changes by 212.83.178.60 that I don't agree with. He changed "and is probably genetic" to "and is unlikely genetic". Why the change? I don't want to get in an edit war, but "probably" is correct.

He removed the line "but there is no strong correlation between any specific type of trigger and the subsequent initiation of fibromyalgia." Why? There isn't a strong correlation.

He also added "particularly if this involves injury to the neck" regarding triggering fibro. I don't know of any evidence of this. Is this just speculation?

Quadell 13:29, May 3, 2004 (UTC)

While I disagree with the rest of his changes, the last (regarding neck injury) is entirely possible. Most researchers currently agree that fibromyalgia is a neurological disorder, effectively heightening sensitivity to pain (as seen by increased levels of Substance P in the spinal cord, lowered levels of serotonin, and other abnormalities), which may or may not sometimes be triggered by neck injury. (Reference: [1]) 69.232.119.171 20:06, 1 May 2005 (UTC)

This was me. :) -- Niveousnet 05:14, 2 May 2005 (UTC)

Changes on 5/3/04

Although genes for fibromyalgia have not been located, statistically it has been shown to be genetic.

Much research has been conducted regarding the onset of fibromyalgia and a particular trigger, and no trigger is statistically favored. The phrase "particularly if this involves injury to the neck" is incorrect.

Guaifenesin is one of the safest drugs on the market. It has very few side effects, is approved for long term use, and is not harmful. Although the treatment is not widely prescribed at this time, it shows promise and should be included. Stating that it is harmful is incorrect as well.

I hadn't noticed that line. Googling "Guaifenesin harmful" didn't turn up anything related. Certainly it's controversial, but I don't think there's any evidence that it's harmful. Quadell 14:44, May 3, 2004 (UTC)

I will wait a couple days for discussion on this before changing it.

--Beth ohara 14:37, May 3, 2004 (UTC)

... I'm pretty sure that Dryland (2005) says it's not genetic, though that does conflict with earlier literature. It'd be nice to see a review of the genetic or not theories over the past decade.--Aunt Amanda 06:31, 24 October 2006 (UTC)

Sex Ratio

The current ratio is listed as 3-5:1 Female-to-Male, but according to the eMedicine article on FM: http://www.emedicine.com/med/topic790.htm the ratio is 9:1 Female-to-Male. I'm not sure if I should edit this since I don't know where the current listing came from.

The numbers will vary depending on the criteria (worldwide, just US) the age group (all, adults, older adults), and the diagnostic method (diagnosed with criteria x, diagnosed with criteria y, estimated with corrections for reporting bias, etc).

It would probably be best to list two or three figures, given the authorites for each (eg, "the ratio is calculated to be 9:1 by the US xxx Assn, but the International XYZ Assn estimates 3.8:1").

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Treatment

References are needed for a couple of paragraphs in the treatment section, they have been commented out in the meantime. redcountess 20:10, August 22, 2005 (UTC)

Spiritual Assertions

I've removed the following from the article:

Some people with Fibromyalgia use spirituality as a form of treatment. Praying, meditating, or connecting with a higher being diverts the attention of the patient. They are no longer thinking about their pain but relying on the supernatural powers of the one whom they believe in.

While meditation is an important healing tool, I don't think it should be put forward as a form of treatment, especially the reliance of supernatural powers of higher beings. redcountess 20:32, Mar 22, 2005 (UTC)

In what sense are faith-based approaches to healing different from unproven and unproveable alternative medicine? I think it should be put back. JFW | T@lk 22:59, 22 Mar 2005 (UTC)

The information is, as written, NPOV and factual. NPOV requires we list all veiws: even those we disagree with. (Thanks for bringing this issue to talk, by the way, instead of just removing it without comment.) – Quadell ^{(talk) (sleuth)} 23:33, Mar 22, 2005 (UTC)

The only problem I have with that passage is that it could equally be written about any disease or ailment (or adverse circumstance of any kind, actually, including "being dumped by your girlfriend," "going broke," and "learning that your cousin has died"). As such, it says nothing whatsoever about Fibromyalgia, per se. --Ray Radlein 22:30, Mar 23, 2005 (UTC)

Hm. Interesting point. I guess the reason it's particularly relevant here is that there is no known, scientifically-proven treatment, and it's a painful condition. (My wife has it.) So people expect there to be a cure, or at least a treatment program, and so this is what some people do. Yeah, they pray and focus on spiritual things to deal with Strep Throat too, but that's not a significant part of treatment. Now having laid out that argument, I'm not totally sure I've convinced myself, and I'm open to other thoughts. – Quadell ^{(talk) (sleuth)} 23:49, Mar 23, 2005 (UTC)

I've commented it out (not deleted it) until we have a good reference showing why it's relevant to fibro in particular, not just to any ailment that mainstream medicine has trouble solving as yet. As is, the para reads to me like an ad - David Gerard 16:32, 25 Mar 2005 (UTC)

I talked with my wife about this (yes, our pillowtalk is laced with references to Wikipedia), and she said the paragraph might be relevant in articles on pain, chronic illness, or spirituality, but that it's not appropriate in this article. Maybe I'm biased, but I think she's right. – Quadell ^{(talk) (sleuth)} 17:28, Mar 25, 2005 (UTC)

Heh, yours too? :-) - David Gerard 12:06, 28 Mar 2005 (UTC)

I agree that this is not appropriate for inclusion here. Maybe it would be on an article on spirituality but not here. MollyBloom 19:07, 3 June 2006 (UTC)

"Marijuana, the Wonder Drug"

Finally ethical professionals are standing up: http://www.iht.com/articles/2007/03/01/opinion/edgrinspoon.php

Nice quotes:

"Neuropathic pain is notoriously resistant to treatment with conventional pain drugs. Even powerful and addictive narcotics like morphine and OxyContin often provide little relief. This study leaves no doubt that marijuana can safely ease this type of pain."

"If marijuana were a new discovery rather than a well-known substance

carrying cultural and political baggage, it would be hailed as a wonder

drug."

Lester Grinspoon, an emeritus professor of psychiatry at Harvard Medical School, is the coauthor of "Marijuana, the Forbidden Medicine."

It's time this option were legal -- because some of us have no alternatives left. Step up and send this article to your congressional reps. [/end soapbox, pep_rally, PSA] Can someone work this stuff into the article? There's a lot more research on this treatment that can be added as well -- though most of it is research by pharmaceuticals trying to cash in. --Renice 06:25, 3 March 2007 (UTC)

Living with...

Living with the syndrome seems most closely related to treatment, but a consensus is needed (see consensus)

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Theories

All theories should all have verifiable references, preferably medically sound and researched All Wikipedia information should be written from a "Neutral Point-of-View" (see NPoV)

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Skepticism

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Removed skepticism as it is conspicuously missing from other articles with a similar nature to fibro myalgia, if it is to be included, it should be placed under all such articles.Correctwiki 07:30, 12 May 2007 (UTC)

References

Is anyone else concerned that there is no bibliography for this article?

copyright

This information is a c'n'p from http://www.fibromyalgia-associationuk.org/whatisfm.htm. The information is © 2002 Fibromyalgia Association UK, but for this page the site says "you are welcome to print [it] out for your use". Is this enough permission for Wikipedia? ²¹² 13:28 10 Jun 2003 (UTC)

I wouldn't say so. Can the page not be rewritten? Theresa knott 14:56 10 Jun 2003 (UTC)

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External Links

Chlamydia pneumoniae help & treatment (formerly "finally getting well")

I've had fibromyalgia for decades. I am finally getting well treating it as a stealth infection. http://www.cpnhelp.org/ is started and run by patients. It is noncommercial. I would like it included in the links. I am grateful I found the site, and want others to find it, too.

I think it is good to have links to various support information, but is this a commercial site? Not sure by looking at it...MollyBloom 19:06, 3 June 2006 (UTC)

The site is non-commercial, and says that clearly on the home page. It is privately owned and run (I am the founder of it), but there is no advertising or selling of products allowed, only discussion and information about treatment of Chlamydia pneumoniae in a variety of diseases including Fibromyalgia, Chronic fatigue, Multiple Sclerosis and others via a protocol researched at Vanderbilt University.

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Other

Removal of some comments

If anybody want to work something out of what I just removed, it's here in the history. --Menchi 05:43, 21 Sep 2003 (UTC)

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Former Talk Topics

Please take the time to place your comments in appropriate categories as directed by the main page.

5/5/04 Changes

I kept the recent grammar changes, but removed the incorrect information that was discussed above. I welcome discussion on these points.

--Beth ohara 20:55, May 5, 2004 (UTC)

Stated evidence

There is stated evidence that chronic fatigue syndrome is the same disorder as fibromyalgia in individuals with high pain tolerance.

That's interesting, but what is the evidence, where is it stated, and by whom? --[[User:Eequor|ηυωρ]] 08:31, 18 Sep 2004 (UTC)

I am in the middle of a move and have all my references boxed up. As soon as I unpack them, I'll be glad to provide references for this.

Beth ohara 17:52, Sep 19, 2004 (UTC)

My docs explained it to me as a spectrum, with CFS on one end and FM on the other. Dryland (2005) theorizes that the two are very different and not related if I understand correctly (I read his book this morning, borrowed from a friend and don't have it in front of me) which is different from what I'd understood previously.--Aunt Amanda 06:33, 24 October 2006 (UTC)

Look in the book "What Your Doctor May Not Tell You About Fibromyalgia" by R. Paul St. Amand, Warner Wellness 2006. It states that Chronic Fatigue Syndrome is the same disease as Fibromyalgia, but the difference in manifestation is due to the difference in pain tolerance (as noted by the first comment above). I'm new at commenting so sorry if I'm not following protocol. I made an edit and took the word "unrelated" out of the paragraph that lists comorbid diseases. The reasoning is the same as chronic fatigue, and the reference is also the same. I added vulvodynia and interstitial cystitis to comorbid conditions and listed Dr. St.Amand's view that these are all subsets of FM. I'd like to add www.vulvarpainfoundation.org to the online links because they do a good job setting out the connections between FM, vulvar pain, interstitial cystitis, irritable bowel and other connective tissue diseases. Also FYI Dr. St. Amand told me personally that FM is not an autoimmune disease and that this has been disproven. Hsiaokuo62 02:48, 1 November 2006 (UTC) Hsiaokuo62 lwittke@npgcable.com

Recent edits

Major reworking, have provided reference for genetic predisposition and other contentious sections. Have merged tender points and commented out para on people faking the test for benefit and insurance fraud. Still a work in process.

IANAD but was diagnosed with fibromyalgia this year, although I've had symptoms all my life. I had been previously diagnosed with chronic fatigue fyndrome in 1997 but began to suspect I had fibromyalgia in 2002 when I started getting pain. A lot of sites I've linked to are sites I've found useful. I hope that people who read the article when I've finished editing it will come away with a better understanding of fibromyalgia, and that people living with the syndrome will find information they previously may have missed. Am keeping NPOV policy in mind :-) redcountess 00:36, Dec 27, 2004 (UTC)

Current and forthcoming edits, concerns

I am relatively new to Wikipedia, so I apologize for stepping on anyone's toes if I have done so -- it is certainly not my intent.

I just tentatively reorganized/expanded the treatment section of this page, and I am considering expanding it further so as to be slightly more comprehensive -- i.e. perhaps a list of treatments? Would putting an external link or two regarding each treatment next to that treatment's mention be more appropriate than sticking it down at the bottom? (I'll check and see if there's any "footnote" formatting on Wiki.)

The theories/causes section... most researchers do now lean toward a neurological/central nervous system explanation for FMS, to my knowledge, yet it only gets passing mention in the causes section, not even an explanation. I have done a lot of research into this over the past few years -- if only I had collected my resources! Now I have to go find them all again. Regardless, I expect to be expanding on this somewhat in the next few days. (I have FMS myself, and I only have energy for so much ;))

Anyway, if I have done anything wrong, please inform. Thank you! -- Niveousnet 05:14, 2 May 2005 (UTC)

You are free to make these edits - if someone doesn't like them they will simply be reverted. Only on very controversional pages woult it be wise to request "permission" before introducing material or making changes.

Footnote formatting is not yet standardised, but you can use {{ref|1}} etc. (see here for an explanation). Generally, I find this better than inlined links, but this is entirely personal.

Are you sure researchers have abandoned the CNS/neurological explanation? This is not quite my impression... JFW | T@lk 21:16, 2 May 2005 (UTC)

Links at end

The number of links at the end is overwhelming, which makes it hard to keep out sites with commercial interests. There's a long section called "references", but since they don't tie to any specific assertions in the text, they should just be "external links", like the rest of them. For now, I'm just merging them into a single section, but I think they should be categorized and reduced in number. Does anybody have any opinions on which ones should stay and which should go? --Arcadian 23:18, 1 December 2005 (UTC)

The ones from important organisations and authoratitive health information outlets can stay. Personal webpages, blogs and other transient phenomena make poor links. JFW | T@lk 01:14, 2 December 2005 (UTC)

I've winnowed down the External Links list some, and got rid of the ones that seemed most commercial and the ones that were the most tangential. The six left aren't necessarily the best on the web, but I think they're the best of the ones that had been submitted. I also put in the "BEFORE inserting new links here you should first post it to the talk page otherwise your edit is likely to be reverted" comment at the top of the section. You guys might want to take a look to see how you feel about the current list. --Arcadian 03:40, 2 December 2005 (UTC)

A breakthrough not mentioned

I have had chronic fatigue (sorry, not FM) for years now. I am certainly no medical expert or microbiologist, and I'm new to wikipedia, so I don't feel it's my place yet to edit anything. I've done a LOT of reading online over the years, and I recently found a very interesting article (more so than the typical article on CFS/FM) that links chronic fatigue syndrome/fibromyalgia to sinusitis that is specifically caused by staphylococci.

http://www.masmith.inspired.net.au/aus_info/bioscreen/toxic.htm

Having lived with chronic fatigue for many years now myself, I would love to see this information mentioned (at least briefly) under "staphyloccus" and especially under "chronic fatigue syndrome" and "fibromyalgia".

68.35.13.128 05:10, 4 December 2005 (UTC) SH

It's not proven. JFW | T@lk 05:15, 4 December 2005 (UTC)

Unproven theories should still be listed, if they're noteworthy. – Quadell ^{(talk) (bounties)} 07:05, 12 December 2005 (UTC)

Absolutely, but this theory is not noteworthy compared to the myriad other theories about fibromyalgia. JFW | T@lk 10:32, 12 December 2005 (UTC)

None of the theories on FMS have been "proven". --Biochemza 23:10, 20 April 2006 (SAST)

Side note and little rant - This makes them all "hypotheses", rather than "theories", but there is no solid proof of anything. Which is taken as proof by skeptics for their "theories"

Additions from a fibro-skeptic

In regards to this addition, I think it's important that a skeptical view be represented. However, there are numerous dubious claims made that are not sourced. I'm rewording parts, moving them, and removing a few parts. If there are sources for statements such as "Most practitioners that actually treat patients who have been given the diagnosis of fibromyaligia feel that it is not an actual disease" and "Most patients report no relief with medicines other than narcotic analgesics", then let's discuss them here. – Quadell ^{(talk) (bounties)} 15:39, 14 January 2006 (UTC)

The 3-10% figure mentioned in the intro seemed remarkably high to me; on the first of the ext. links it says: "According to a paper published by the American College of Rheumatology (ACR), fibromyalgia affects 3 to 6 million - or as many as one in 50 - Americans." Well, 1 in 50 is 2%, and it seems like they are saying this is a relatively high estimate ("as many as"). The second ext. link mentions a 3-6% figure. Everyking 09:19, 6 February 2006 (UTC)

Well, INTERESTINGLY, someone REMOVED the latest functional resonance imaging studies that support evidence of augmented pain response that I posted.

www.nidcr.nih.gov/NR/rdonlyres/ 2F6D6B72-7144-4FD7-9BBF-CC467826585D/4948/ArticleNo50.pdf

Delisted GA

Hi. I have removed this article from the Wikipedia:Good article listing due to the following:

• No references. One of the GA criteria is that a reference section must be provided. Inline citations are preferred but not required. When this issue has been addressed, please feel free to re-nominate. Thanks! Air.dance 04:06, 25 March 2006 (UTC)

Addition of resources/links

What are the criteria required of this article to add links? I must say, this is the most moderated Wikipedia page I've ever seen (but I don't edit that much, gasp shock, horror). Having FMS myself, I'v found it very useful to have other people to talk to, and there is a very useful podcast (the only one on the internet, at this time, I believe) dedicated to Fibromyalgia (and chronic fatigue). Knowledge is power, and the more people can learn, and the more people are exposed to differing views on the subject, the better choices they can make about their own treatment. This podcast ([2]) has a linked Yahoo group ([3]) which discusses the podcasts, and shares medical literature (peer-reviewed articles from respected medical journals). Unlike other discussion groups, they also discuss the aspects that no FMS sufferer really wants to acknowledge - the theories of illnesss behaviour based on labelling, theories about how FMS is all just a bunch of hoohaa, etc. I think a group like that would be a useful link to add to this page.

Question

I see that differentials include lupus. I have been diagnosed with lupus and MS, and my rheumatologist suggested that fibromyaliga that I developed was secondary to those diseases. Is this possible? From what I have read, this is a theory. Shouldn't it be included?

By the way, I think this is a good article, and kudos to those who worked on it! MollyBloom 19:04, 3 June 2006 (UTC)

I believe it's pointed out here and on the lupus article that both conditions can be comorbid with other conditions. I'd be wary of repeating that by adding specific examples of what can develop alongside what. Snowflake Sans Crainte 23:39, 3 June 2006 (UTC)

Fibromyalgia as severe TMS

I placed a NPOV-section in this section because the wording makes it appear as if TMS is a generally accepted syndrome, which, from what I can tell, it is not. I tried to think of some different wordings or additional information to add, but didn't come up with anything satisfactory, thus the NPOV marking. Davedrh 04:12, 14 June 2006 (UTC)

The diagnosis of TMS (tension myositis syndrome) has been used since 1984 by Dr. Sarno of the Howard A. Rusk Institute of Rehabilitation Medicine and his followers to designate a mindbody disorder that causes chronic back, neck, or limb pain that is frequently mistaken for structurally caused pain. Dr. Sarno says on p.62-63 of Healing Back Pain: The Mind-Body Connection (1991)[4] "Typical of these reports is one published in the Scandinavian Journal of Rheumatology in 1986 (Vol 15, p.165) by N.Lund, A. Bengtsson and P. Thorborg titled 'Muscle Tissue Oxygen Pressure in Primary Fibromyalgia.' Using an elegant new laboratory tool, they were able to measure muscle oxygen content with great accuracy and found that it was low in the painful muscles of patients with fibromyalgia."

"What this means for the etiology (cause) of TMS, as I have long maintained, is that fibromyalgia, also known as fibrosis and myofibrositis (and to some as myofasciitis and myofacial pain), is synonomous with TMS. I have treated a large number of patients who came with the diagnosis of fibromyalgia; their medical histories and physical examinations were consistent with severe TMS. As proof that the diagnosis was correct, they recovered completely."

In his later book, The Mindbody Prescription: Healing the Body, Healing the Pain (1998)[5] in which he expanded the TMS diagnosis to other TMS equivalents based on his long experience at the Rusk Institute, he says on pp 76-77, "I have maintained for years that fibromyalgia was a severe form of TMS. The similarity of my findings to the diagnostic criteria of the American College of Rheumatology reinforces that diagnostic conclusion."

"People with fibromyalgia commonly have psychological symptoms as well. They are often anxious and depressed, have sleep problems and suffer from lack of energy."

"Since fibromyalgia ia part of TMS, I have seen and sucessfully treated many patients who had been given that diagnosis before they came to me."

In Dr. Sarno's latest book, The Divided Mind: The Epidemic of Mindbody Disorders (2006)[6], he says on pp.21-22, "Fibromyalgia is a medical term that has been around for a long time. For some reason it was adopted by the rheumatology community in the early 1980s and applied to patients suffering pain in many locations in the trunk, arms, and legs. In fact, it is a severe form of TMS. Significantly, fibromyalgia patients commonly suffer from other mindbody disorders as well, like headache and irritable bowel syndrome, as well as emotional symptoms including anxiety, depression, and sleep disorders. When rheumatologists first became interested in people with these symptoms, they were not able to explain what caused the disorder, but they created diagnostic criteria to define it. That became a kind of medical kiss of death. The American College of Rheumatology decreed that the diagnosis could be made if the person under examination exhibited pain in eleven of a potential eighteen locations. Since that time, hundreds, if not thousands, of papers have been published describing studies that try, still unsuccessfully, to explain the disorder. Two of these published studies of people with fibromyalgia found that the oxygen levels in their muscles was reduced, confirming the hypothesis that fibromyalgia is a manifestation of TMS, which we've seen is caused by mild oxygen deprivation. But the rheumatology community community did not accept the idea of mild oxygen deprivation as the cause of fibromyalgia, and the epidemic continued. By the year 2000 the enormous increase in the number of people with this diagnosis prompted an article in The New Yorker magazine by Jerome Groopman, a professor of medicine at Harvard, in which he noted that there were six million Americans (mostly women) with this disorder of unknown cause and that it appeared to be analogous to the nineteenth-century epidemic of neurasthenia."

"The fibromyalgia story is another tragic example of the epidemic proclivity of psychosomatic disorders when they are misdiagnosed and, therefore, inevitably mismanaged."

I have removed the NPOV designation based on this discussion. The fact that Dr. Sarno and his associates have successfully cured supposedly incurable fibromyalgia by treating it as severe TMS should cause other doctors to give more attention to his diagnosis, and should give the millions of sufferers given the diagnosis of fibromyalgia real hope for a real cure.Ralphyde 00:09, 23 June 2006 (UTC)

Ralphyde, first off, where did you find this "discussion"? It certainly does not appear to be of journalistic quality. It also incredibly biased (with such wording as "for some reason, fibromyalgia is accepted as a disorder"). It also has a lot of basic facts wrong. I don't understand how in one article, this person states that FM is not real, and follows it up by claiming that fibro is part of TMS -- which one is it?

Additionally, keep in mind that one doctor (and his "team) has found these conclusions. They are not generally accepted in the medical community -- at least not yet. Furthermore, Dr. Sarno is not claiming he has found a cure -- he has found a connection between two diseases (which he erroneously refers to as psychosomatic disorders). He is claming he has found treatment. Many patients have already found treatment -- at times this treatment can cause a temporary remission. However, there is no cure for fibromyalgia.--Meg 15:23, 27 June 2006 (UTC)

Meg, First off, I told you exactly where I got this "discussion," the books and page numbers are given above. Secondly, that quote you made, "for some reason..." does not seem to exist. The closest thing I can find is the quote above from Dr. Sarno's recent book, The Divided Mind: The Epidemic of Mindbody Disorders (2006)[7], "For some reason it (the term, Fibromyalgia) was adopted by the rheumatology community in the early 1980s and applied to patients suffering pain in many locations in the trunk, arms, and legs. In fact, it is a severe form of TMS." Thirdly, what basic facts do you think Dr. Sarno has wrong? And he doesn't say that FMS doesn't exist, but does say that the cases that have come to him with a diagnosis of FMS from other doctors have evidently been misdiagnosed, as they are actually severe TMS, tension myositis syndrome, a mindbody disorder for which he does have a "cure."

So there are millions of "fibromyalgia" patients out there in the most severe chronic pain that have been told by their doctors that there is "no cure," for them, when in fact, Dr. Sarno, and other doctors, have indeed been curing such patients by correctly diagnosing them as severe cases of TMS. This is indeed tragic for those suffering millions who were told there is no cure.

I would like to point out that Dr. Sarno is 83 years old and still seeing and curing patients at the Howard A. Rusk Institute of Rehabilitation Medicine at NYU Medical Center, and is a Professor of Clinical Rehabilitation Medicine at the NYU School of Medicine. He has been curing patients with severe chronic pain for three decades. His beliefs are based on more than thirty years of frontline clinical experience, and he has written four books about his successful breakthroughs. I suggest that you read Dr. Sarno's latest book, The Divided Mind: The Epidemic of Mindbody Disorders (2006)[8], before you are so quick to say that his work is "erroneous."

In this book are chapters by six other doctors who accept his theories and approach, including a chapter by Andrea Leonard-Segal MD, a board-certified internist and rheumatologist, and assistant professor of Medicine at George Washington University Medical School and a physician at the Center for Integrative Medicine at GWU Medical Center. She says on p. 265, "As with other TMS patients, those with fibromyalgia can be helped if they are open to considering and then accepting that there is a psychological cause for their pain. If they are unable to be open in this way, I have not been able to help them." TMS requires acceptance of the diagnosis for the treatment to bring about a cure, but when there is acceptance and understanding, and the requisite changes in attitude, then significant improvement and even complete cure can rapidly follow.

Dr. Leonard-Segal concludes on p. 269-270 that, "The beauty of the TMS diagnosis is that it is a hopeful one that can result in a true cure. The treatment leads to resumption of full physical activity, the emergence of a more emotionally healthy life, and an education in self-awareness. The patient who has recovered from TMS grows into a happier, more comfortable, more peaceful person who sees new paths toward greater personal fulfillment."

I would also suggest that you read Freedom from Fibromyalgia: The 5-Week Program Proven to Conquer Pain (2001)[9] by Dr. Nancy Selfridge and Franklynn Peterson, both of whom cured their own fibromyalgia by using Dr. Sarno's treatment plan for TMS. People suffering with "fibromyalgia" need to know that there is hope for them, and that some doctors have found a cure for them that works!Ralphyde 19:29, 27 June 2006 (UTC)

Sorry Ralphyde, your citing a book that expresses an opinion. An opinion does not matter in wikipedia. It may be your opinion too, that does not matter either. It also does not matter how many patients he claims to have cured, nor does it matter how old he is, nor does it matter how many other people helped write the book.

Why does it not matter? Because if it did, I could write a sentence behind your sentence: "Other doctors think that's a prime example of bullshit and psychobabble" and then cite a suitable book, there are engough of them, by all means.

Or I could use my academic titles, write a book about stating that fibromyalgia can be cured by Snake oil, put it in and cite it. Or writing a book together with some colleagues stating that you are Eva Braun and then cite it. (I am just kidding, I don't mean to offend you, ok, I am just trying to illustrate my point)

The reason why I am not doing it, is that it would be below Wikipedia Standards for a medical aritcle.

I am sorry, from what you write I would guess that you would actually want to help people, but if you want to prove your point in a medical article, you have to come up with studies or reviews. A book about X by Dr. Y ist not enough.

You set yourself up as a Wikipedia expert, upholding "Wikipedia standards," yet you don't have the courtesy to use your name or even sign your posts, and then you remove cited and relevant text claiming it is just "opinion." You sound like a POV-warrior who used to be active, who was subsequently banned for marking everything he didn't believe in as "not scientific."

In this case you are accusing respected physicians with decades of successful clinical experience of being "just opinion." For example, Dr. Sarno is a Professor of Clinical Rehabilitation Medicine at the New York University Medical School and attending physician at the Rusk Institute of Rehabilitation Medicine at the New York University Medical Center where he has been seeing and curing thousands of real patients in serious chronic pain day in and day out for over thirty years. He has found through experience what works, with a 90% success rate, and has written four books on his theories and methods, and has a worldwide reputation for healing chronic pain.

Dr. Andrea Leonard-Segal, whose reference you also arbitrarily removed, is a board-certified Internist and Rheumatologist, and a Professor of Medicine at George Washington University Medical School and a physician at the Center for Intergrative Medicine at GWU Medical Center. See the quotations from her chapter in, The Divided Mind: The Epidemic of Mindbody Disorders (2006)[10]above. Her article is entitled "A Rheumatologist's Experience with Psychosomatic Disorders," and is based on her solid clinical experience. For you to delete such references with a know nothing skeptical attitude is not only arrogant, but also deprives suffering millions of finding a proven path out of their very real suffering to a pain free life.

Unfortunately, since Descartes, mainstream medicine has cut itself off from mindbody medicine and only physical causes are sought for physical symptoms, and if the true cause is emotional or psychological, it is overlooked and treatment is not successful. Fortunately, this is changing. Our bodies aren't just machines.

As Dr. Marc D. Sopher, puts it in his book, To Be or Not to Be... Pain-Free(2003)[11], on pages 6-7, "TMS is a strategy of the brain's to keep unpleasant thoughts and emotions from rising from the unconscious into the conscious mind. The brain, through established physiologic pathways, creates pain as a distraction. By focusing our attention on physical symptoms, we keep these painful thoughts and emotions repressed. This is a very effective strategy as there is an absolute epidemic of mindbody disorders in our society.

"Eliminating the pain is startlingly simple. We can banish the pain and thwart the brain's strategy by simply understanding and accepting that the pain has a psychological causation, that it is not physically based.

"While much of the pain we experience has a psychological basis, it is essential to first be evaluated by your physician to determine that there is not a significant disease process. Unfortunately, if your physician does not consider TMS in the process of generating a differential diagnosis of your symptoms, it is possible that he or she will give an incorrect diagnosis. This occurs all too frequently as a physical cause is mistakenly offered. This results in a treatment plan that it often unsuccessful. As an example, many people with back pain are told that their symptoms are due to a herniated disc or disc degeneration, when in fact these findings are often incidental and normal. This helps to explain why physical therapy, medications, and surgery are often unsuccessful." pp 5-7

Dr. Leonard-Segal also discusses the difficulty of creating studies with mindbody disorders such as TMS: She says, "It is difficult because psychological treatments do not easily lend themselves to the ideal clinical trial methodology. How can we conduct studies to see if psychological approaches can cure this condition? Patients with TMS must be psychologically open to the diagnosis to improve. They must be ready to renounce the idea that their cure is to be found in structural or chemical means. Thus, it would be exceedingly difficult, if not impossible, to conduct a study in which patients with the same condition are randomly assigned to different treatments, one of which is the TMS treatment. Because getting better depends on accepting the TMS diagnosis, most patients assigned to TMS treatment would not improve because they would not be able to accept the diagnosis." p.259

And not accepting the diagnosis would be the equivalent of not taking one's prescribed medicine.

If you are a Fibromyalgia patient and wish to get rid of your pain, I strongly suggest you look into the above mentioned books, and let go of the conventional and toxic idea that there is "no cure."

Another book that builds on the mindbody approach, by a doctor who cured herself from fibromyalgia using Dr. Sarno's approach, is: Freedom from Fibromyalgia: The 5-Week Program Proven to Conquer Pain (2001)[12] by Dr. Nancy Selfridge and Franklynn Peterson. There is real hope out there for you. If you don't believe it, just read some of the customer reviews of these books on Amazon.com. Mindbody medicine is real, and more and more doctors and patients are finding through their own experience that it works. Ralphyde 23:02, 26 February 2007 (UTC)

For your information, I am not a FM Patient. I am sorry Ralphyde, I guess you really are trying to help people out. And you have an opinion about how that can be achieved. But that is not relevant for Wikipedia - it's just your opininon and our POV. And you can't keep it in the article unless you have scientific evidence living up to Wikipedia's Standards to back it up with. Again a book written by whomever will not do. And no matter how much excerpts you post and how often you reassure that this is definitely right - it won't do the trick. Come up with evidence (admitted, that IS difficult) or stay down.

Who are you? and why don't you sign your posts? And where do you get off arbitrarily deleting cited text in an area you don't seem to know much about? I would call that vandalism, not discussion. You don't think decades of successful clinical experience constitute scientific evidence, and so you delete it. Ralphyde 17:05, 28 February 2007 (UTC)

I have removed the mention of this information from the introdiction to the fibromyalgia article, as it does not belong there, it is fine to mention it under alternate theories, or whatever, but listing it in the very opening paragraph is irresponcible, and misleading, as there have been numerous claims made that a cure has been found and as someone who has to live with this condition, I find it deplorable to find the newest "cure" mentioned in the opening paragraph. I have no problem looking at the information, but unless the guy gets some more PROOF other than his own opinion, I will delete it every time it shows up in the opening paragraph. Again I stress I have no problem with a link and mention of his theories elsewhere in the article. But if someone whose life has been destroyed by this disease comes looking at the article and finds a mention of a cure, that has little more credibility than snake oil, well its irresponcible and cruel.Correctwiki 07:23, 12 May 2007 (UTC)

You really should sign your posts. And if you truly want a cure for your condition, you should read the above mentioned books, but first click on the above links and go to the Amazon.com customer reviews of those books. There you'll find the testimonies of many people who have cured themselves of fibromyalgia by using the mindbody techniques therein, especially, the book by Dr. Nancy Selfridge (click this link) [13], who cured herself of fibromyalgia using Dr. Sarno's methods. You'll find a few skeptics, but many more who cured themselves. And Dr. Andrea Leonard-Segal, a board certified Rheumatologist, and a Professor of Medicine, adopted Dr. Sarno's mindbody techniques after he cured her of her own severe chronic back pain. And Dr. Sarno, now 84 and still curing people with fibromyalgia, has been doing it at the [Rusk Institute] for over 30 years. You should really give yourself that chance, rather than believing the toxic statement that "there is no cure." Don't you want to get well? Ralphyde 06:25, 12 May 2007 (UTC)

Have you personally been cured by this book, or are you the doctor who wrote it? You are hyping the book as a cure then list it as the cure, or is it that it is a cure? for some? like i stated earlier i have no problems with it being mentioned as a possible cause and cure, but if you list it as a cure you have to list ALL other claimants to have provided "cures" as well otherwise it is dishonest, or you apparently have an agenda for pushing it, be it financial or otherwise. It belongs in alternate theories not in the opening paragraph as an advertisement. Correctwiki 07:23, 12 May 2007 (UTC)

I have moved ALL of the references from the main article, and placed them under this sub heading, I deleted NOTHING, Just re arranged it to give this theory its proper place, as a theory, along with the other theories about this disorder. Again I stress I have no problem with including this information, as it may help SOME, but it is not nessesarily a cure all, and should not be disingenuously portrayed as so. I have investigated this route in the past, and it has not personally helped me in the slightest, however, I realize it may help others, but it belongs here, as an alternate, not given preferential treatment because you in particular prescribe to it. I have noticed that several others have attempted to make this point with you in the past, yet you continue to treat the issue with some apparent agenda. I have only moved the references , to one subheading, which is clearly listed in the table of contents, Hopefully this will resolve the issue, as I have no desire to continually edit the page. But I will not allow you to monopolize the page, and give it some sort of slant, no matter what your reasons are, be they financial gain, personal favoritism toward the proponent of this theory, your own original research, or even misplaced altruism. Correctwiki 01:50, 13 May 2007 (UTC)

In answer to your questions, I have nothing to do with any of the books listed above other than having read them. I have been a serious student of chronic back pain and tension myositis syndrome since 2003 when a close family member had become nearly disabled by serious chronic back pain, which the conventional medical establishment was unable to relieve over a period of three years before discovering Dr. Sarno's methods. I have read over a dozen books on back pain and TMS since then, as well as many articles, as well as communicating with various sufferers of chronic pain and fibromyalgia. Dr. Sarno, and the growing number of doctors adopting his methods, have shown the greatest ability to abolish such pain, and anyone suffering such pain owes it to themselves to investigate his approach, if they truly want to get better.

Another good friend, who had been diagnosed with fibromyalgia and had tried many different treatment methods to no avail, finally cured herself only after dealing psychologically with her severe repressed childhood parental abuse, she said, which fits in well with Dr. Sarno's theory that repressed anger and other unpleasant emotions that one doesn't wish to face are the true cause of the very real chronic pain, created as a distraction through the autonomic nervous system to aid the repression of such unpleasant emotions. The biggest problem with his method is that it won't work unless the patient is able to accept the idea that her pain might have a psychological rather than a physical root. Accepting this, however, and changing one's attitude toward the pain, defeats the syndrome, and the pain recedes, as it no longer distracts one from dealing with the underlying emotional issues.

In the meantime, two other good friends of mine have cured their own longtime chronic back pain (17 years in one case), just by reading one of Dr. Sarno's books. Chronic back pain, along with fibromyalgia and some other ailments have reached epidemic proportions, increasing at fourteen times the rate of population growth. Here's a new interview (April 10, 2007) with Dr. Sarno (He's 84 now and still seeing and curing patients, due to his worldwide reputation for success) that you might wish to listen to.[14] Ralphyde 19:58, 13 May 2007 (UTC)

Thats fine , and I have already explored these avenues myself, and been unsuccessful, and yet again I will continue to revert the page if you continue to do so, I even went to far as to keep all your previous information in my last revision, only just consolidating it under the TMS subheading, If you wish to continue this I can and will do so as well. But yes I am offended, you a person who has never even had the disease continue to attempt to monopolize the page and proport TMS as the "only" and prefered treatment. I repeat again all I have done is rearranged the info, and placed it inder its own subheading where it belongs.Correctwiki 04:11, 14 May 2007 (UTC) Why not read the page instead of reverting it without looking at it.

Dear Correctwiki, I am sorry you have suffered with this syndrome for so long. Have you read Dr. Nancy Selfridge's book, Freedom from Fibromyalgia: The 5-Week Program Proven to Conquer Pain? Did you listen to the interview with Dr. Sarno? I have not attempted "to monopolize the page and proport TMS as the 'only' and preferred treatment," as you accuse me of. It's just that the cited sentence you keep removing is totally true. It says simply, "Because the nature of fibromyalgia is not well understood, some physicians believe that it may be psychosomatic or psychogenic. Although there is no universally accepted cure, some doctors have claimed to have successfully treated fibromyalgia when a psychological cause is accepted." That's absolutely true on its face, and is cited. It replaced the previous toxic statement "The nature of fibromyalgia is not well understood; some physicians believe that it may be psychosomatic or malingering. There are few, if any, treatments available. Although there is no cure, the disease itself is neither life-threatening nor progressive, though the degree of symptoms may vary greatly from day to day with periods of flares (severe worsening of symptoms) or remission." I don't make any claim that this is the "only and preferred treatment." It's just that it's only the only cure that I know of, and it isn't even mentioned in the introduction, but only in the section on TMS, which I didn't write. But your last edit totally messed up that section. Ralphyde 06:55, 14 May 2007 (UTC)

Correctwiki, if you want to purge ralphydes psychobabble from the article you can nail him with wikipedia's standards about medical article. A book doesn't live up to them. No matter how loud Ralphyde screams that Dr. Sarno is the best doctor and the friend of every patient. Go to pubmed, get some reviews about fibromyalgia research and shut him up. It's less dificult than it looks, because ralphyde is not following wikipedia's rules, so you can easily turn that against him. If he doesn't want to back down, because Dr. Sarno is a doctor and gave an interview, get an administrator to help you. Removing or diminishing the POV from a book in a medical article is rather easy. —The preceding unsigned comment was added by 192.68.211.173 (talk) 10:40, 14 May 2007 (UTC).

For instance, here is a link to a study from pubmed describing subgroups of fibromyalgia: :::http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17393187&query_hl=3&itool=pubmed_DocSum

One quote from the abstract: "Bland inflammatory processes must be considered as the cause in the first group, while depression is the underlying reason for the development of pain in the second group." So there you go. Ralphyde is unduely generalising - show him his place with this study and others. They all weigh more in wikipedia than the books he bought.

Major discrepancies with this article!!

Whoever has contributed to this article first off must not have fibro, and second of all, has not consulted a truly knowledgeable source.

When I was diagnosed, I instantly snatched up one of the best fibro books around: Fibromyalgia: Up Close and Personal, by Mark J. Pellegrino, MD [[15]]. The author is a physiologist who not only treats FM patients, he also has the disease (yes, disease) himself. He is widely considered one of the leading researchers of FM in the country, and his work has so far changed many physicians' opinion on the matter.

In this book, Dr. Mark asserts that fibromyalgia is not a syndrome (which typically defines something more psychological in nature), it is a disease of the nervous system -- not an exact quote from the book, but I can provide one if you like. It is a disease that screws with your pain receptors, which tenses you up, which leads to the many other symptoms of the disease.

It is definitely NOT a psychosomatic disorder as is listed in one of the first few sections! You do not see a psychiatrist for treatment. You see a rheumatologist or physiologist -- medical "pain" doctors.

That is the first thing that must be changed.

The second thing is this. It is true that some medical professionals do not acknowledge FM as a true medical disease. However, this sentiment is not expressed fairly in this article. Instead of stating "some doctors accuse their patients of fabricating their illness", why not say "because of its internal nature, and because no diagnostic tests have yet been developed (other than testing pressure points), some doctors do not yet accept FM as a medical condition"?

The majority consensus in the medical world is that FM is a real disease, but it is not yet understood. Therefore, many doctors are intimidated by it, and refuse to give treatment for it. Others fear their patient may become disabled, and then they'll have to assist the patient with the disability claims.

It is important to mention to you all that Alzheimer's was also initally not wholly accepted by the medical community, but became so after some time. As is the case for depression, dementia, Chronic Fatigue Syndrome...

For these two reasons, and for other reasons I don't have time to write about, it appears to me that this article was written with a strong anti-FM bias. It is also not factual in all places. Major rework needed. Consult and site medical (not internet) sources if you must post a "skeptical", generally rejected, opinion..

A syndrome is any collection of symptoms that occur together. It does not mean that they are psychosomatic - no one would suggest that acute coronary syndromes (ie heart attacks and unstable angina) are psychosomatic for example. Maria

--Meg 14:55, 27 June 2006 (UTC)

One problem is that there is no evidence(at least objective) that fibromyalgia is any more than a "syndrome"? that occurs primarily in older women who are relatively physically inactive and do notstretch their muscles.Any physiologist or anyone who exercises knows that stretching is important to avoid injuries caused by shortened muscles. If one does not know that, then fibromyalgia may occur--shortened muscles that are tender, but unassociated with any laboratory, Xray or other findings. While physical therapy will alleviate the chronic problem--if the subject will exercise AND stretch, rather that feeling sorry for their misery(which is real)and gathering sympathy from caregivers. It may induce some depression, and the disability people do recognize it as a form of disability. However it is "self induced", lifestyle malady and can be alleviated by changes in lifestyle. Any one with a relative or friend with fibromyalgia should be able to recognize this--but instituting a change is difficult for the subject, so some in the medical field don't encourage the subject, but either write an Rx or don't deal with them. The only field of medicine that deals with these people effectively is the Mind-Body field, championed by a Dr. Benson? in Boston. Find him or his "students" by Googleing "Mind-Body". No Agenda, other than to educate. Fred MD

I was an athletic 25 year old man when I had my first symptoms (now 26). I was working at a physically strenuous job, and so the notions about lazy old women do not apply to me. I also do not suffer from depression, despite my relatively pronounced disability: I can no longer work or take care of myself, and when I can walk, I must use a cane. Even with my disability, I have excellent genes - I'm still very lean and muscular, and I look like I must workout in the gym every day. Clearly there is no problem with my physical activity level, and I'm otherwise extremely healthy and strong. However, most of the people with fibromyalgia may fit the "lazy old woman" stereotype, but that may be an upside down evaluation. What if "laziness" is caused by the condition? What if the condition becomes more pronounced with age? What if the disease mostly affects women? All of those things are true, and as such it's incorrect to make a causal judgement based on the fact that most sufferers are lazy old women. Rather, that's more likely a symptom of the disease, not the cause. I've become profoundly "lazy" since I've been struck by this. I have frequently been bedridden and literally unable to feed myself. Before this, I was a competitive athlete. There's no gray area from my point of view, this disease is real and horribly debilitating! I also must point out to you, Fred MD, that you are behind in your study of the current research on this topic. There are plenty of physiological indicators for this disease, with more being uncovered as research progresses - it's not just a nebulous catch-all diagnosis with no proven scientifically testable symptoms. Qwasty 00:13, 18 July 2006 (UTC)

After reading some of these 'medical opinions' it makes me wonder about MDs whether they do their job for the cushie hours and excellent pay or because they give a stuff about people. I my experience (as a Fibro sufferer) and of people I know who suffer from Fibro, it has struck young, active women and dibilitated them, and turned their life upside down. I am a very positive person, and am very proactive. I have never dwelled on this disease/ syndrome (I don't really care what you pigeon-hole it as) but have actively sought ways to get well. I do pilates twice a week to help stretch out spasming muscles (my pilates instructor also has Fibro by the way - I'd like you to tell her that she's lazy!), I always did eat healthily anyway, and take time out to relax when possible. My particular problems lie in sleeping. I have suffered from insomnia and lack of 'quality' sleep for also 15 years since my teens, I find that Amitryline has helped significantly, although I have to undertake certain destressing activities before bedtime also. I have never sought out a sympathy vote, but have certainly questioned my sanity following people attitudes to me (including seeing what one doctor wrote in my notes before I was diagnosed- appalling). You try not sleeping properly for 15 years and see how much ooomph you have in the morning! I can only describe it as the tiredness you feel when you have a new born baby waking you up all through the night, but everynight. And waking up feeling like you've slept on a hard floor. It is disheartening that MDs feel it appropriate to challenge a person as to their feelings and perceptions with this condition. All I would say is pray you never have to suffer from such a condition which touches everything in your life, and makes you struggle at the age of 28 to pick up your toddler when he's fallen over. And all this despite leading a healthy and active lifestyle, trying to do all the right things. It is these poor attitudes and negativity which helps it all the harder to cope with the condition.

Why was the section about disability removed?

I remember seeing a section about this a couple months ago on this page -- who removed it and why? A number of FM patients are disabled as a result of the disease. The Social Security Administration (U.S.) acknowledges fibro as a disability, however, only pays support for those with severe cases (i.e. bedridden for months at a time).

It really seems to me like someone came to this page with an agenda...

--Meg 15:14, 27 June 2006 (UTC)

Meg, Let me guess, you yourself have FM and now ASSUME someone else has an "agenda" against you? Geesh. You just confirm why so many MD's doubt that FM is physical, but instead may be a psychological disorder that should be seeking psychiatric help for better resolution of symptoms.

Some MD's doubt FM isn't a physical disorder because they are basing their opinions on outdated research (mostly a lack thereof). Many disorders go through a phase during which people wonder if they are real or not. While there is a ton of good, solid research that now shows that fibromyalgia is real, it takes time for people to become aware of that research. Doctors are human and they already have a lot to do. Most don't have time to do much research of their own, particularily if it is about a disorder not directly a part of their field. Therefore, it is not surprising that many doctors have not for some reason made themselves more knowledgeable about one of many disorders. They are, however, less common than they used to be. The question that you should be asking is why so many psychologists and psychiatrists do believe that fibromyalgia is a physical problem! I have seen a few personally to ensure that there was not such an underlying issue and they all agree that I am mentally sound and that there is nothing they can do for me, so I hope you will their and my word for it. Another question for you - how come people with fibromyalgia are not cured (or treated to the point of normal or near normal function) by psychiatric help or drugs if it is a psychiatric disorder? AliaGemma 04:12, 25 January 2007 (UTC)

Guaifenesin Protocol

I'm really uncomfortable with the line "One of the more promising approaches..." Umm, who says this is "promising?" And who are the "several doctors" who are now using this protocol. Don't get me wrong, I'm not saying it's untrue, but I won't be comfortable with it until it's sourced. Actually, a lot of this article is unsourced. "Studies have found gentle exercise, such as warm-water pool therapy, improves fitness and sleep..." What studies??? It's very worrisome to have so many "treatments" with no sources. DejahThoris 09:16, 1 July 2006 (UTC)

I have to agree with DejahThoris here. Unless these "treatments" and statements are sourced they should be removed. We're supposed to be creating a entry in an encyclopaedia, not a resource of "handy hints" or a soapbox for any old tom, dick or harry to claim they can treat/cure this illness. Snowflake Sans Crainte 22:26, 3 July 2006 (UTC)

"No evidence" statements

Phrases claiming that there is no scientific or laboratory evidence for the factual existence of fibomyalgia are outdated and need to be stricken from this article. This article in its current form contradicts itself by mentioning sleep disorders, substance-p disorders, and other evidence while also saying there is no evidence. Qwasty 08:11, 3 July 2006 (UTC)

Merge?

GregorB has suggested merging Fibromyalgia_Syndrome with this article. I agree. Actually, the "Fibromyalgia Syndrome" article looks like it was lifted from the National Fibromyalgia Association, which I think is a copyright violation. DejahThoris 02:57, 7 July 2006 (UTC)

I'd agree with merging but any information that's been lifted wholesale from elsewhere (in both articles, should that be the case) should be removed or, if it's not already covered in this article, rewritten entirely to avoid copyright. Snowflake Sans Crainte 08:50, 7 July 2006 (UTC)

it appears this has been done. —The preceding unsigned comment was added by Iggynelix

NPOV

This article does not conform at all to Wikipedia standards concerning NPOV. I cannot glean any information from this article regarding what, from my observations, is the generally accepted opinion of the medical community: that fibromyalgia is not a disease in and of itself, but is merely caused by depression and various lifestyle patterns (or so is my understanding). This article dismisses out of hand any skepticsm, or reduces it to a tiny collection of unsourced generalizations, which are not truly reflective of the debate over FM. Remember: it is not Wikipedia's job to be ahead of the curve. We report on what is the currently accepted concensus first, and leave secondary opinions for later. While some FM sufferers, and editors of this article, may not see physicians, JAMA, The Lancet...etc as reliable or unbiased sources, they are accepted as reliable and definitive by most others. This article treats FM as a fact that has yet to gain widespread expert endorsement or notice, instead of a theory that has yet to be proven or accepted by the majority of the medical community. Even if FM were 110% true in my eyes, I would still have qualms with stating it as fact until a few reliable, emperical, and widespread studies were published in reputable journals. No such thing is sourced here. We need editors from both sides of the debate here, as of now there seems to only be 'believers' (save perhaps Meg) posting here and editing, and that won't lead to an NPOV article.

Also, for those of you who are about to pull out the "evolution is a theory not a fact, yet you still accept it lol!" argument on me: evolution is not concretely proveable, but has been observed for over a century, and is accepted by almost every respectable scientist in the community- this is not the case with FM.

I appoligize in advance for ticking people off, but it's time this article was brought up to Wikipedia standards. --Ringmaster j 19:05, 31 July 2006 (UTC)

All recent serious medical documentation (See Harrison, UpToDate) have an accurate description of the "sindrome". If you read carefully you would notice that it is not caused by depression, rather it may cause depression. I'm suffering from it for 10 years. I can assure you it is supra-realistic real, I do not have abnormal "lifestyle patterns", nor was I depressed before or after the onset of the ilness. If you do not know about it you better refrain yourself from comments. Also, the ilness do has a history, long time it has been believed to be degenerative reumathic disease and you find it under name "fibrositis". -- M.

There is a section on Skepticism as required by the NPOV policy. – Quadell ^{(talk) (bounties)} 15:08, 24 August 2006 (UTC)

Wrong

Fibromyalgia is made up and wrong. It is purely a form of depression but people dont like to be told they are depressed. Any effects of "treatment" are purely a result of the placebo effect

Got any evidence for that? Any at all? No? Thought not. Back under your bridge with ye. Snowflake Sans Crainte 08:29, 24 August 2006 (UTC)

So untrue!!! The idea that people with fibromyalgia are just depressed (or even that we all have depression) is a stereotype that does not hold water. We have no more depression than others with similar chronic illnesses. In my own case, I have fibromyalgia but have had several psychologists tell me and my doctors that I am definitely NOT depressed. However, my pain and other symptoms are unfortunately very real. AliaGemma 00:14, 6 September 2006 (UTC)

In my experience and in numerous reports from friends and colleagues, GPs use the old 'you've got depression', as they are too bone-idle and lazy to look into symptoms and relations between existing ailments.  It's a way to get you out of the door, you're depressed so take some of these and you'll be right as rain in 2 weeks.  It is scandalous.  I actually suffered from depression when I was in my teens (triggered by an event), I worked very hard with therapists and helathy mind healthy body etc. and recovered.  Several years later I began developing physical symptoms which led to an eventual diagnosis of Fibro.  I accept that this may have been triggered by the depression in a cause effect relationship, so I also understand that it is sometimes umbrella'd with depression for this reason.  But I challenge anyone which says it is a psychological 'syndrome' and doesn't really exist.  Work a day in a suffers shoes!  

It's the old 'when a tree falls in the forest' argument.

• a freind of mine recently died of what her physician indicated were complications originating from years of battling FS. Wikipedia is a place for open exchange of ideas; so if you choose to express your skepticism, please do so. However, it is reprehesible to summarily dismiss, without evidence, research or factual basis to support your assertions, the significant numbers of sufferers who reach out to the global medical community for answers . (see also Wikipedia:Civility)Iggynelix 20:50, 13 March 2007 (UTC)

Fibromyalgia and Long Distance Bike Touring

I've removed the paragraph about Paula Werme's web page on | Fibromyalgia and Long Distance Bike Touring because while it's interesting, I don't believe it should have a paragraph to itself in the Skepticism section of the article. I believe this would be more appropriate as an External Link. Snowflake Sans Crainte 11:45, 28 August 2006 (UTC)

"Consumption of Alcohol"

I've marked the recent addition of "consuption of alcohol" temporarily increasing symptoms of fibromyalgia because I've noticed that it does the exact opposite in people I've spoken to (my theory being it doesn't change anything except the brain's awareness of the symptoms but that's another point entirely). Is there any actual evidence either way regarding the effects of alcohol on sufferers? --Snowflake Sans Crainte 16:38, 7 September 2006 (UTC)

Good question. The National Fibromyalgia Research Association simply states "A common thread in many cases of fibromyalgia seems to be a tendency to feel better when refined sugar, caffeine, alcohol, fried foods, red meat, and highly processed foods, are kept to a sound personal minimum in the diet," but it doesn't offer any evidence. The Bastyr Center for Natural Health claims that "the use of alcohol can cause 'leaky gut' syndrome which has been demonstrated by clinical studies to be a major factor in conditions such as fibromyalgia", but I'm not sure what they're calling 'leaky gut' syndrome, or how strong the connection is. And a somewhat scholarly article here says "Caffeine, alcohol, and sugar should be eliminated", but although the article has 18 footnotes, that part isn't footnoted. Several other prominant sites recommend cutting out alcohol, without saying why.

There are a couple of reasons I can think of, though. First, sleep disturbance exacerbates fibro symptoms (some theories say it causes fibromyalgia), and alcohol interferes with deep sleep. Anything that helps you get healthy sleep has to be good. Second, alcohol is involved in a huge percentage of all accidents, and physical trauma is often a trigger for fibro getting markedly worse. Third, many fibro patients are on pain medication, and alcohol can be very harmful when combined with pain medication. And lastly, alcohol is of course addictive, and anytime you use alcohol to treat chronic pain you risk withdrawal, tolerance, addiction, and many other nasty side effects. – Quadell ^{(talk) (bounties)} 18:29, 7 September 2006 (UTC)

Fibromyalgia and dopamine agonists

This article contains no mention of the recent theories by Dr. Andrew Holman in Seattle and Dr. David Dryland concerning the positive impacts of dopamine agonists such as Mirapex and Requip on fibromyalgia. Dr. Holman's medical journal articles are from 2000 I think, Dr. Dryland's book from 2005.

Just seems like a gap in article quality.

Additionally, current trials such as Dr. Bennet's at OHSU on low IGF and low cortisol levels in fibromyalgia aren't mentioned....

I have fibromyalgia and am just trying to get a handle on the literature as well as the leaders in the field. I know that there are many competing theories out there, but this article didn't cover them all. I'm happy to help write up the most recent info. someday, though it would require significant research to be able to cite sources properly etc. --Aunt Amanda 06:24, 24 October 2006 (UTC)

Provigil as a treatment for brain fog and fatigue

It'd take some time on pubmed etc. to find the studies, but on the fibro blogs provigil (modafinal) is showing up as a treatment for fibro fog and fatigue. Just a research lead in case anyone wants to follow it up. --Aunt Amanda 06:43, 24 October 2006 (UTC)

Treatment section strikes me as not particularly objective

There are a number of treatments which are presented as either commonplace, accepted, or promising that are, in my experience as a physician, without substantial, reliable supporting data. These include: The guaifenesin protocol, dietary supplements, "managing blood sugar", biofeedback, etc... In addition, in reference to the last lines of the article, I can assure everyone that there are no "blood tests" for this condition.Royalewithcheese2 01:14, 5 December 2006 (UTC)

Misleading and biased article

This article is skewed towards skepticism about fibromyalgia, despite that fact that it (and CFS/ME, related conditions) are recognised by the WHO as neurological conditions.

As a sufferer, I am appalled by the negative way in which this illness is represented here, with much more focus on 'skeptical' views (which are in a minority in the medical community) than on the enormous body of research and medical experience which shows it to be, in all likelihood, a severe and debilitating condition with neurological causes.

Furthermore, the dopamine theory has much more research behind it than this article suggests.

I suggest that Wikipedia needs a specialist in the condition to re-write this article entirely. The vast majority of rheumatologists not only believe in this condition but also know a great deal more about it than is represented here. —The preceding unsigned comment was added by 62.31.54.36 (talk) 16:56, 28 January 2007 (UTC).

I can't see what you're talking about. I've read the article and, if anything, it's not sceptic enough. Only in the introduction the word 'psychosomatic' is mentioned and it doesn't return until the 'skepticism'-section, which is only 7 lines in length! On the whole, the article treats FM as an organic disease. Scepticists being in the minority (which I doubt) isn't a reason to make this article SPOV.

Furthermore, recognition by the WHO doesn't mean the disease can't be psychosomatic! Not so long ago, the DSM included homosexuality as a disease. Does that mean it was, at the time, really a disease? Of course not.

- Troy 12:06, 31 January 2007 (UTC)

I have found a very interesting page where people with Fibromyalgia can learn about Fibromyalgia Self Care and appropriate exercises, I am posting that on the external links since I didn't find any related link for that. I hope people find it very useful and would appreciate the other users opinion

Thanks

Chirostudent

Contradiction here?

Hello, I'm rather new to the world of Wiki, so please be patient with me if I trip over the occasional shibboleth.

I noticed in this article that in the second paragraph we have the phrase "The disease itself is neither life-threatening nor progressive....", and yet in the third paragraph we find "For example, in some cases it is progressive..."

Might it be worth finding a form of words that avoids a fairly clumsy (apparent) contradiction?

Bytebro 15:09, 7 February 2007 (UTC)

I've never heard that fibromyalgia can be progressive. I'm going to put a on that claim and if no one can provide a reference, remove it in a few days. Rosemary Amey 18:47, 7 February 2007 (UTC)

I believe that it should be removed (and have removed it for now), as well as the part about it being impossible to generalize about fibromyalgia - at least until it can be rewritten. The author appears to be talking about secondary fibromyalgia (as opposed to primary fibromyalgia), which is fine, but it should be somehow noted there to distinguish it from primary fibromyalgia since normally when people talk about "fibromyalgia" they mean primary fibromyalgia and not simply the symptoms of other known diseases. AliaGemma 03:13, 8 February 2007 (UTC)

Counter Arguments

I have just removed the counter-arguments section, as the "references" given at the bottom had nothing to do with the "counter-arguments". The counter-arguments talked about how treating depression didn't cure fibromyalgia. However the references talked about genetic predisposition and brain abnormalities in fibromyalgia patients and had nothing to do with depression.

I also noticed that there is no mention of PTSD in this article, even though multiple studies over the past 3 years have linked fibromyalgia with PTSD. I'll write up a section about this in the next few days.

This article still needs a helluva lot of work. There is still an awful lot of crud here and not much science.

--Sciencewatcher 05:22, 8 February 2007 (UTC)

For the record, the references are for the entire page, not the "counter-arguments" section, which is under the larger skepticism section. It was meant to address skeptics who believe that fibromyalgia is just depression. While it does need citations, I believe that it might have been cut too soon, seeing how most of it does not seem to be very contentious. However, seeing how the skepticism section no longer says how some people believe fibromyalgia is depression, that specific counter-arguments section has more or less become irrelevant anyways. I do think a new counter-arguments section, focusing on the skepticism given, would be appropriate and even needed. AliaGemma 07:39, 13 February 2007 (UTC)

I don't think anyone believes that FM is depression. Depression is just a symptom - people with FM might or might not have depression. FM is a syndrome with a number of symptoms. The skepticism is related to whether FM is an organic or psychiatric illness. Most of the evidence points to FM being a psychiatric/psychosomatic illness caused by stress or trauma. That is to say, it is a real illness with real physical symptoms (primarily pain), but caused by stress. --Sciencewatcher 23:08, 13 February 2007 (UTC)

Fibromyalgia and sleep disturbances

Often it's witten that fibromyalgia can be due tue a sleep disturbance, in particular alpha-wave itrusion into deep sleep (stage 4). I found a very interesting article on PubMed written more than 10 years ago which found that ". The alpha NREM sleep anomaly is present in only a small proportion of patients with fibromyalgia. It does not correlate with disease severity nor is it affected by treatment with amitriptyline." Full article here:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=7575714&query_hl=30&itool=pubmed_DocSum

Any ideas about this?

81.208.118.74 11:28, 8 February 2007 (UTC)

My sleep dysfunction was what helped led to my diagnosis. I have had good results from (low) does of Amitryp, in sleep function and related ease of symptoms.

Dopamine

Just a note to explain why I have removed the sentence about dopamine in the introduction. First, dopamine is covered later in the article. Second, the reason for that sentence was to counter the argument that FM could be psychosomatic, but the sentence does not do that. Dopamine is a factor in depression and the placebo effect, so the fact that there are dopamine abnormalities in FM does not really have any bearing on whether FM is psychosomatic or not. A recent study showed that Parkinson's patients receiving a placebo had significant improvement in symptoms and in their dopamine levels. If you want references, let me know. --24.64.32.57 22:57, 13 February 2007 (UTC)

Contradict tag

The statement: "The cause of fibromyalgia is currently unknown." contradicts this from Bianca Trump: "However, in late 2001, her silicone breast implants ruptured, causing fibromyalgia and they were removed." Mdbrownmsw 14:07, 14 February 2007 (UTC)

I don't see how there is a contradiction. Ruptured breast implants appeared to cause fibromyalgia in one woman. However other women who have had ruptured breast implants did not get fibromyalgia. Therefore there is no reason to think that rupturing breast implants cause fibromyalgia. Maybe it was the stress which triggered the fibromyalgia. I think the contradict tag should be removed - it is inappropriate here. --Sciencewatcher 16:38, 15 February 2007 (UTC)

As the neccessary edits (a mention with references in "other theories") have been done, and there is no no contradiction at all, the tag has been removed. LinaMishima 01:02, 16 February 2007 (UTC)

Sciencewatcher is close. The contradiction was that the fibromyalgia article said the cause was unknown while the Bianca Trump article said that her fibromyalgia WAS CAUSED by ruptured implants. Even with the addition to this article of the now disproven claim, there was a conflict, as this article says only that some CLAIM there is a causal link. I have made one additional edit to the Bianca Trump article, making it clear that some have SPECULATED that the ruptured implants caused the fibromyalgia. Previously, it said the rupture DID cause fibromyalgia, which is unproven. Mdbrownmsw 21:47, 19 February 2007 (UTC)

Add a new external link Hello I would like to add a link to the Fibromyalgia Support Group for Surrey and Sussex at www.fibromyalgia-south.com. This website is not only about the support group but also gives valuable information about fibromyalgia and has a fantastic links section. The group runs many activities to help members and keep them up-to-date with the latest developments. They will also help anyone thinking of starting a support group or collaborating with an existing group. Thanks Ralees 11:15, 29 March 2007 (UTC)