Fibromyalgia. Is it real? Maybe. The symptoms are real, but many “fibromyalgia” clinics do patients a disservice by handing out anti-inflammatory drugs and antidepressants without first attempting to determine the real cause of the symptoms.
I have been a neurologist for over three decades. Nearly every patient I have seen who comes to see me with the diagnosis of “fibromyalgia” really has a neurologic explanation for their symptoms. These symptoms include headache, neck pain, fatigue, numbness, pain in the limbs, and mild depression.
Finally we have an explanation for the links between these symptoms, and that is the hypermobility syndrome, described here. The parallel between the symptoms associated with hypermobility syndrome and fibromyalgia are striking, and may finally provide a path toward improved quality of life for patients who have been diagnosed with fibromylagia.
Fatigue is a major symptom in patients with “fibromyalgia,” but it is also a major symptom in many sleep disorders. For instance, many patients with mild sleep apnea are thin, and don’t have snoring or witnessed apneas. Yet they are tired all the time no matter how much sleep they get, because the sleep they think they are getting is not good sleep, and is interrupted constantly by episodes of increased airway resistance.
Another common symptom of “fibromyalgia” is neck, shoulder, or arm pain. But as a neurologist I know that many times these symptoms are caused by pinched nerves in the back, neck, or arm. Joint pain itself is common in various types of arthritis.
Joint pain and neck and back pain are also present in hypermobility syndrome, or those people who are extraordinarily flexible. These patients are oftentimes referred to as “double jointed,” and can touch their thumbs and fingers to their forearms, hyperextend their elbows, wrists, and knees early in life. They also sometimes have problems with their “automatic” nervous system that causes sweating and gastrointestinal problems, and postural dizziness. They can be slender or overweight, and oftentimes have problems with their breathing in sleep.
Headache can have many causes, and we at the RNI have a comprehensive headache center that gets to the root causes of headaches and does not just try a different drug, or lump it into a grab bag called fibromyalgia.
All these separate neurologic symptoms must be treated individually
. Using drugs as a band aid for them will not help them in the long run. As with all we as doctors do, an accurate diagnosis is critical to their successful treatment.
For sleep disorders, the RNI has its own accredited sleep disorders center, and two physicians board certified in sleep medicine. For pinched nerves in neck, back, arms and legs, we have our own imaging and EMG.
So before you accept a canned diagnosis of “fibromyalgia,” and begin taking anti-inflammatory drugs and antidepressants for the rest of your life, you may want to check into the real causes of your symptoms