Is Fibromyalgia Real, or Is It All in Your Head?

Rear view photo of person with long black hair waking up with hands on back in painThe National Institutes of Health (NIH; 2011) reports that approximately 5 million American adults—or about 2% to 3% of the general population—are affected by fibromyalgia. Of those individuals, 80% to 90% are women. People experiencing fibromyalgia commonly report widespread chronic pain, anxiety, a lack of energy, and erratic sleep patterns. But as some doctors are focused on developing drugs and treatments for the condition, other medical professionals doubt its very existence.

Fibromyalgia is a hotly debated topic in the medical community. The primary issue is that although doctors do recognize the chronic pain experienced by people with the condition and acknowledge that therapeutic programs are needed to help affected persons find relief, some doctors do not recognize fibromyalgia as a categorical illness. It has even been suggested that the condition might all be psychosomatic, existing only as an illness in the affected individual’s head.

Is Fibromyalgia All in Your Head?

Some health care professionals claim fibromyalgia is psychosomatic because there are no X-ray images, blood tests, or biopsies that will definitively indicate the presence of fibromyalgia. The condition is not quantifiable. The debate is further heightened by the fact that Dr. Frederick Wolfe—a researcher who spearheaded a 1990 paper that presented the world with a diagnostic protocol for fibromyalgia—has since stated that “fibromyalgia exists as a continuum rather than a dichotomous diagnosis.” In other words, fibromyalgia exists on a spectrum and not as a black-and-white illness according to Wolfe.

Wolfe’s assertion and other research has led to several medical professionals calling for a reclassification of fibromyalgia from a categorical illness to a spectrum health condition. However, any such decision could have significant repercussions. Andrea M. Risi, LPC, a Denver-based counselor and Topic Expert in health, illness, and medical issues, said, “The problem with a spectrum diagnosis is that it can be unacknowledged in the medical community. Some doctors refuse to diagnose a condition that’s not quantifiable (such as the result of an X-ray or blood test). Therefore, it can be difficult for the patient to find and obtain the most effective treatment with a spectrum diagnosis.”

What Is Fibromyalgia?

Fibromyalgia is a chronic pain syndrome characterized by fatigue, sleep disturbances, and tenderness. Localized pain is felt when light pressure is applied to tender points throughout the body, and the pain can spread to other areas when light pressure is applied to fibromyalgia trigger points.

The Centers for Disease Prevention and Control (CDC) reports that individuals with fibromyalgia demonstrate abnormal pain perception processing. As a result, affected persons might react strongly to stimuli that others do not find painful, such as the sharp ridges on a paper bag or the feel of one’s clothes on the skin. Individuals with fibromyalgia are also 3.4 times more likely to experience major depression than persons who do not have the condition.

According to the CDC, other common fibromyalgia symptoms include:

  • Frequent headaches
  • Tingling sensations or numbness in the hands or feet
  • Morning stiffness
  • Irritable bowel syndrome (IBS)
  • Problems with memory and thinking (also referred to as fibro fog)
  • Painful menstrual periods

While risk factors such as stressful or traumatic events, repetitive injuries, viral infections, obesity, genetic predisposition, and certain diseases (such as chronic fatigue syndrome) have been linked with fibromyalgia, the CDC says there are no known fibromyalgia causes. Fibromyalgia might also occur on its own according to NIH. Additionally, the United States Food and Drug Administration (FDA) says people with lupus, rheumatoid arthritis, and spinal arthritis are at greater risk for developing the condition. Despite the debate that exists on whether fibromyalgia is a psychological or physical illness, researchers are making strides toward developing strategies for effective fibromyalgia treatment.

Approaches to Treating Fibromyalgia

“A diagnosis of fibromyalgia is based entirely on the self-report of a patient and the use of a sliding pain scale. Pain tolerance varies from person to person, so self-reports of different patients are difficult to compare,” Risi said. As such, doctors often have to approach fibromyalgia cases on both per person and per symptom bases.

Pharmacotherapy, or treatment with the administration of drugs, is a popular method by which fibromyalgia symptoms are treated. People experiencing fibromyalgia symptoms are typically given pain medication, muscle relaxants, sleep medication, and antidepressants to address specific symptoms.

There are beneficial approaches other than FDA-approved drugs used to treat fibromyalgia pain too. Risi explains, “A healthy lifestyle is particularly important for people living with fibromyalgia. Low-impact exercise, massage, nutrition, yoga, acupuncture, physical therapy, and chiropractic treatments can all help manage the symptoms. All of these options keep joints moving and muscles loose, which can help ease pain. Many people find supplements like omega-3 fatty acids, turmeric, ginger, magnesium, and calcium help ease the pain as well.”

Risi also suggests that affected individuals can benefit from speaking with a qualified therapist.

The Benefits of Psychotherapy in Fibromyalgia Treatment

There is a split between health care professionals as to whether fibromyalgia is best treated as a physical or mental condition. What is clear, however, is that in addition to medication and relaxation techniques, emotional support is crucial to finding relief. Such support is especially effective when it is regularly received from family members, friends, and an experienced therapist.

According to Risi, “If a person is depressed or anxious about the illness, there can be a greater frequency and intensity in pain and flare-ups. A therapist can help identify negative thoughts, feelings, and behaviors that are adding to the pain cycle and when the person uses coping skills, those flare-ups can diminish.”

If someone you love is affected by fibromyalgia, be a source of comfort by showing patience, affection, and understanding. Increase your understanding of the condition and, if appropriate, encourage your loved one to seek the help of a therapist. A qualified mental health professional can help alleviate symptoms and some conditions that may accompany fibromyalgia.

Fibromyalgia can severely affect a person’s quality of life. Even when an affected individual looks healthy, they might not feel healthy. Ongoing research is revealing more and more about fibromyalgia and the best way to treat it, and with dedicated doctors continuously testing new treatments and understanding the nature of the condition, the future is looking brighter for people experiencing fibromyalgia symptoms.

References:

  1. Atzeni, F., Cassisi, G., Ceccherelli, F. & Sarzi-Puttini, P. (2013). Complementary and alternative medicine in fibromyalgia: A practical clinical debate of agreements and contrasts [Abstract].Clinical and Experimental Rheumatology, 31, Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24373372
  2. Cashin-Garbutt, A. (2013, March 22). Fibromyalgia: An interview with dr. frederick wolfe, university of kansas school of medicine. News Medical. Retrieved from http://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx
  3. Centers for Disease Control and Prevention. (2012). Fibromyalgia. Retrieved from http://www.cdc.gov/arthritis/basics/fibromyalgia.htm
  4. United States Food and Drug Administration. (2014). Living with fibromyalgia, drugs approved to manage pain. Retrieved from http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107802.htm
  5. National Institutes of Health. (2011). What is fibromyalgia? Fast facts: An easy-to-read series of publications for the public. Retrieved from http://www.niams.nih.gov/Health_Info/Fibromyalgia/fibromyalgia_ff.asp

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  • Layne

    Layne

    November 7th, 2014 at 10:39 AM

    Calling something that causes so much pain in patients like this disease does psychosomatic is just demeaning and very demoralizing to these patients. Sure, there are no absolutes when it comes to this disease, but that is totally different when you take to the patients about what they are feeling. Ask them, and they can tell you exactly what hurts, what their triggers are and the things that they have found that can relieve the pain. I don’t think that I have ever met anyone who would want to hurt in this way and still have so few answers for what is causing it.

  • Mem

    Mem

    May 14th, 2017 at 1:16 AM

    Psychosomatic literally means brain body ,this doesn’t mean that the pain and suffering isn’t as real as say abrocken bone which can be seen on an X-ray .we are ALL affected by our mental state our suffering goes up if we are feeling miserable .it shouldn’t mean that we are less deserving if empathy but it dies mean that the treatment shouldn’t ficus inky on the physical

  • sally

    sally

    November 8th, 2014 at 2:29 AM

    whether it is psychosomatic or “real” is irrelevent as if you physically feel the pain it is very real. I had fibromyalgia and my psch nurse kept telling me the pain was in my mind which added to my anxiety and made the pain worse, the pain is a result of your nervous system being so anxious and stressed that it is sending pain signals all over your body and producing very real pain ( i felt like my whole body was on fire it was a burning sensation all over and it was so unbearable i wanted to die. Thus mind and body are totally interlinked and produce symptons in eachother, in the end i had ect treatment and after one treatment the pain went, thus the pain was abviously a reult of the chemical imbalance in my brain affecting my nervous system. psychosematic pain is very real and very painful.

  • diana t

    diana t

    November 9th, 2014 at 10:25 AM

    the symptoms can seem so vague and yet so difficult to manage for those who feel them.
    I would have to think that finding the right provider to treat this would have to be essential to finding quality of life when living with this, although I bet that there are a lot of obstacles to finding this right person due to the vagueness and the difficulty that there can be in articulating just what the issues are.
    I feel bad for someone living with this who not only has to defend themselves from all of the naysayers that they must encounter as well as the challenges that they face with receiving adequate treatment.

  • Shell

    Shell

    November 10th, 2014 at 3:48 AM

    I have to admit to you that if I struggled with something that was this real to me and painful, but I knew that there were those around me being dismissive and writing me off then I would probably be very apt to just keep it all to myself.

    No one wants to feel this kind of pain that those with fibromyalgia have to deal with, and certainly no one wants to have to deal with it if they don’t feel that anyone really believes them. It is a very tough situation to be in, because you need treatment but then you could be so hesitant to ask for it because of the disbelief that is so often present.

  • Catherine Boyer, MA, LCSW

    Catherine Boyer, MA, LCSW

    November 11th, 2014 at 5:42 AM

    I have seen finding a good MD who validates the disease to be an important part of treatment with fibromyalgia, not just because of the MD’s expertise but because of the positive effects of having a professional to collaborate with who listens. I have also seen neurofeedback be helpful, possibly because the brain learns to re-normalize its processing of pain.

  • Meri Levy, MFT

    Meri Levy, MFT

    November 12th, 2014 at 12:03 PM

    I objected to the word “Just” in the title of the article. Psychosomatic pain is very real. Even if the cause is in the brain, the person suffering cannot just choose to not to feel it. It’s time to eliminate false distinctions between the mind and the body. Illnesses (even those commonly accepted by Medical Doctors) are often caused or exacerbated by stress, trauma, or depression. Conversely, being ill or in pain can be traumatic and can cause or worsen anxiety and depression. Taking an approach that recognizes both physical and psychological contributing factors and treats the whole person is what every individual deserves.

  • Bobbi

    Bobbi

    August 22nd, 2015 at 7:05 PM

    It’s real…trust me it’s real. I live it everyday:(

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