Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Understanding the pain of fibromyalgia

Kim Kristiansen, MD
Conditions
February 2, 2012
Share
Tweet
Share

Many healthcare professionals find fibromyalgia difficult to believe as “a real disease” and most of all difficult to handle, and to be honest it is not so difficult to see why. Doctors and other healthcare professionals have learned how to search for diseases based on the specific symptoms the patients present, but fibromyalgia – and several other chronic pain syndromes – do not fit into that model.

The patients are presenting a broad spectrum of subjective symptoms and feelings that can not be objectified. A patient presenting a pain problem must in general be examined for the reason for the pain based on the localisation of the pain, but in conditions like fibromyalgia the pain is so widespread, that it is difficult to detect where it started and thereby to look for evidence for disease. The pain is “all over,” which actually is a part of the diagnostic criteria’s. What more is, the examination of the patient will often not show any specific signs of disease, and when diagnostic procedures like MRI and X-rays are used we find no signs of pathology or just hints of an explanation. Pharmaceuticals normally used for pain problems like NSAID and opioids are often prescribed, but they have only little or often no effect. And what more is, the condition is complicated with sleep problems, an extreme tiredness, mood disorders and more.

No wonder it is a challenge both for the health professional and for the patient whose proxies often also will find it difficult to understand and accept a situation with “pain all over,” with no signs of an explanation, not responding to what seems to be relevant pharmaceuticals and complicated with some psychological problems.

Presented with patients with these symptoms and sensations health professionals will often find their authority and self-image challenged, since the symptoms and complaints presented by the patients do not fit into to the normal biomedical frame for understanding and treating medical conditions, and into the traditional understanding of scientific and evidence based disease management, that are an deep and integrated part of our pride for what we do and how we work.

In the same manner the patient’s relatives might find the condition difficult to accept and understand, which might lead to even further stigmatization and have huge social consequences.

From neuropsychological research we now know that our brain is constantly busy trying to find meaningful patterns, both when the data make sense and when they don’t. This is beyond our control, and it helps us constantly interacting with the world around us and helps us live a normal life, but it can also lead us the wrong way. Healthcare professionals presented with the symptoms of fibromyalgia might unconsciously, due to the lack of meaningful data, draw the wrong conclusion that it is a “clear psychological case,” and relatives might be led to disbelief. The person suffering from the condition might on the other hand be led to the belief that it must be possible to find an objective explanation for the pain and its consequences, that some kind of pathology must be found, based on the their learned experience that injury leads to pain and pain is due to an injury.

No, it is indeed not so difficult to understand why persons with fibromyalgia are met with disbelief and doubt by healthcare professionals, relatives and perhaps often by them selves.

But it is a fact, that fibromyalgia is a well-defined condition, composed of symptoms with widespread pain combined with cognitive and psychological symptoms. It is also a fact, that scientific research has provided us with a evidence and understanding of neurological changes and transformations leading to the complex neurological and psychological alterations composing syndromes like fibromyalgia, and also other chronic pain syndromes like nonspecific low back pain and whiplash syndrome.

Whether we trust this evidence or not is it should be quite obvious, that these persons are living with a low quality of life. We need to accept this, so we (both healthcare professionals and patients) can act to improve the condition even though the improvements often are minor, have long responding time and changes forward and backward over time. The conditions can not be cured but it can be treated. We need to educate patients, healthcare professionals, relatives and indeed politicians and other decision makers to have and to share an understanding of these conditions, and that we need to accept this to help those affected by the condition. We must learn those involved and responsible that it is not enough to look at the symptom “pain” but rather we must focus of the whole complex by trying to improve the quality of life based on knowledge.

Kim Kristiansen is a family physician in Denmark who blogs at Picture of Pain.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

How a doctor uses Google to market and recruit patients

February 2, 2012 Kevin 16
…
Next

Why patients with implantable defibrillators deserve their data

February 2, 2012 Kevin 0
…

Tagged as: Rheumatology

Post navigation

< Previous Post
How a doctor uses Google to market and recruit patients
Next Post >
Why patients with implantable defibrillators deserve their data

ADVERTISEMENT

More by Kim Kristiansen, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Chronic pain has a price

    Kim Kristiansen, MD

More in Conditions

  • What Elon Musk and Diddy reveal about the price of power

    Osmund Agbo, MD
  • Understanding depression beyond biology: the power of therapy and meaning

    Maire Daugharty, MD
  • Why medicine must stop worshipping burnout and start valuing humanity

    Sarah White, APRN
  • Why perinatal mental health is the top cause of maternal death in the U.S.

    Sheila Noon
  • A world without vaccines: What history teaches us about public health

    Drew Remignanti, MD, MPH
  • Unraveling the mystery behind one of the most dangerous pregnancy complications: preeclampsia

    Thomas McElrath, MD, PhD and Kara Rood, MD
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • A world without vaccines: What history teaches us about public health

      Drew Remignanti, MD, MPH | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Recent Posts

    • From Founding Fathers to modern battles: physician activism in a politicized era [PODCAST]

      The Podcast by KevinMD | Podcast
    • From stigma to science: Rethinking the U.S. drug scheduling system

      Artin Asadipooya | Meds
    • The gift we keep giving: How medicine demands everything—even our holidays

      Tomi Mitchell, MD | Physician
    • The promise and perils of AI in health care: Why we need better testing standards

      Max Rollwage, PhD | Tech
    • From burnout to balance: a neurosurgeon’s bold career redesign

      Jessie Mahoney, MD | Physician
    • Healing the doctor-patient relationship by attacking administrative inefficiencies

      Allen Fredrickson | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 10 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • A world without vaccines: What history teaches us about public health

      Drew Remignanti, MD, MPH | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Recent Posts

    • From Founding Fathers to modern battles: physician activism in a politicized era [PODCAST]

      The Podcast by KevinMD | Podcast
    • From stigma to science: Rethinking the U.S. drug scheduling system

      Artin Asadipooya | Meds
    • The gift we keep giving: How medicine demands everything—even our holidays

      Tomi Mitchell, MD | Physician
    • The promise and perils of AI in health care: Why we need better testing standards

      Max Rollwage, PhD | Tech
    • From burnout to balance: a neurosurgeon’s bold career redesign

      Jessie Mahoney, MD | Physician
    • Healing the doctor-patient relationship by attacking administrative inefficiencies

      Allen Fredrickson | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Understanding the pain of fibromyalgia
10 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...