What do you think of fibromyalgia?

[Emergent, RN]

What do my colleagues here think of fibromyalgia? It's sufferers seem to mainly women. I'm very skeptical about it. Is it a psychological disorder? I don't mean to dis anyone here, please forgive me, but every patient I've ever taken care of with this disorder strikes me as neurotic. Since there is no actual lab test the definitively confirms the diagnosis, I remain suspicious regarding this disorder.

What do you know about this condition?

[TheCommuter, BSN, RN]

My opinion might upset some people, but I think fibromyalgia is a 'catch-all' diagnosis some physicians use when they do not know what is really going on with the patient.

Doctors never say to patients, "I don't know why you're experiencing these signs and symptoms," or "I don't know what's happening to you." In fact, you will seldom hear a physician utter the words, "I don't know," so fibromyalgia is one of those broad paint-brush disorders that keeps the doc from saying "I don't know."

Also, some patients enjoy the sick role. Having 'fibromyalgia' allows a person to clutch onto that treasured sick role even though one might not be truly sick.

[Jory, MSN, APRN, CNM]

I find it interesting that most of the sufferers that I see are also on a laundry list of other meds such as prozac, lyrica, valium, etc.

I'm not saying that it doesn't exist, but only once I took a patient's blood pressure and she was very humble, very put together, seemed intelligent. She acted like the action absolutely killed her. She wasn't there for pain at all, it was for other issues she was having.

So far, only one I have seen that I thought may actually have it.

[THELIVINGWORST, ASN, RN]

My mother is one. She doesn't take pain meds but she has an autoimmune disease that leaves immune complexes in her blood vessels. This causes pain. Pain is subjective, that means it can't be proven.

You know, for years men thought menstrual cramps weren't real because they thought they were all in a woman's head.

[LTCNS, LPN]

I have fibromyalgia and it is extremely painful. I can assure you it is most definitely not in my head, and I am not an attention seeker looking to use fibromyalgia as an excuse to take sick time or get pity. In fact, I rarely miss work due to fibromyalgia pain, and most of my co-workers have no idea I have it.

I have been through countless tests for conditions such as Lupus, MS and RA (since fibromyalgia tends to mimic those conditions) and have been confirmed to have every single trigger point used to diagnose fibromyalgia. There are days I am in so much pain I can barely get out of bed, but I push on and work full time. I do not take anything for the pain except Tramadol and Ibuprofen. I am not a drug seeker. In fact, most of the drugs I have tried made me feel worse. I would rather be in pain than be non-functional.

Sorry if I come across as defensive, but until a person experiences the very real, sometimes almost unbearable pain of fibromyalgia, that person will not understand what it feels like. Just because someone with fibromyalgia doesn't "look" sick, doesn't mean they are not miserable.

[roser13, ASN, RN]

An acquaintance of mine, very accomplished, successful woman, was diagnosed with fibromyalgia at the Mayo Clinic. After that validation of the disease, I have tried very hard to remedy my previous disdain for the diagnosis.

[HikingEDRN, BSN, RN]

I have come across several patients with this diagnosis (often in the medical history - not necessarily why they are there). It does seem as though they also have other auto-immune type diagnoses to go along with it. While I believe that the condition is a real medical condition, I also agree with Commuter in that it can sometimes be a handy catch-all diagnosis which I believe is a disservice to those who have actually gone through the trigger point testing with a specialist and have been definitively diagnosed. I also think that some individuals have self-diagnosed it (web MD medical school) and report it as part of their medical history.

[blondy2061h, MSN, RN]

I think depression and anxiety are real illnesses that can cause very real physical symptoms, such as pain, fatigue, heart palpitations, stomach aches, etc. No one wants to acknowledge that it's mental illness causing these symptoms because there's still a lot of stigma there. It's easier for physicians too, to give it a diagnosis like fibromyalgia, chronic fatigue, or IBS and throw drugs at it that won't fix the true issue.

I also see this diagnosis used when the symptoms haven't truly been worked up. Especially in women. I had a patient diagnosed with fibromyalgia when multiple myeloma was causing her bone pain.

[LTCNS, LPN]

I think depression and anxiety are real illnesses that can cause very real physical symptoms, such as pain, fatigue, heart palpitations, stomach aches, etc. No one wants to acknowledge that it's mental illness causing these symptoms because there's still a lot of stigma there. It's easier for physicians too, to give it a diagnosis like fibromyalgia, chronic fatigue, or IBS and throw drugs at it that won't fix the true issue.

I also see this diagnosis used when the symptoms haven't truly been worked up. Especially in women. I had a patient diagnosed with fibromyalgia when multiple myeloma was causing her bone pain.

That is so sad, especially since fibromyalgia is mostly muscle pain. Poor woman

[Nurse SMS, MSN, RN]

I think it is a poorly defined, poorly explored and thus poorly understood diagnosis. I won't say it doesn't exist. I will say that those I have cared for with it also carry a heavy component of anxiety, manipulative and attention seeking behaviors and can be challenging to care for. With the lack of research and understanding I often wonder which came first, the pain or the psych symptoms. Either way, these individuals are suffering.

[Emergent, RN]

I notice the Lyrica is often prescribed for these patients. I also notice that it is heavily advertised.

Call me cynical, but I see a commercial exploitation component here. What do you all know about Lyrica?

[sissiesmama, ASN, RN]

LTCNS - I have it too, and can really relate to your symptoms. I was diagnosed with it about 3 years ago. The only med I take for it is Lyrica BID. I've been on the lowest possible dose for almost the whole 3 years - my doc just increased my dose a few weeks ago.

It seems like no matter what I do, even a dentist appt takes it's toll on me. If I'm in the dentist chair for 11/2 to 2 hours, for days after I have an intense ache - legs, arms, ect.

I had to retire a few years ago after having a stroke - there's little chance I could be able to work in my old ER. I'm hoping I can keep controlling my symptoms with just the Lyrica.

Anne