The Frustration of Fibromyalgia : A Daunting Medical Challenge

The Fibromyalgia Solution: A Breakthrough Approach to Heal Your Body and Take Back Your Life
by David Dryland, M.D.

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Since fibromyalgia was officially recognized, it has been one of medicine's most confounding disorders. Symptoms are highly varied and can come and go intermittently, making it extremely frustrating to diagnose. Unfortunately, most doctors are trained to treat existing and known conditions, and very few have the time to take on the unexplainable in a twenty-minute office visit. As a result, fibromyalgia patients go from doctor to doctor, hoping for answers. Typical fibromyalgia patients visit one doctor per month and wind up in the hospital once every three years. They have a high incidence of surgeries and a disproportionately high occurrence of carpal tunnel syndrome and other pain-related problems. Surgeries are rarely successful and can sometimes make their suffering even worse. Many are misdiagnosed and may even undergo unnecessary surgery. The average fibromyalgia patient suffers for five years or more and sees between five and fifteen doctors before receiving an accurate diagnosis. Even when people are finally diagnosed, they have a label, which is more than they had before, but not nearly enough.

The ACR conservatively estimates that up to six million people in the United States have fibromyalgia. That's about one person in fifty. Other organizations and experts estimate that eight to ten million people suffer from fibromyalgia - one in thirty-four. Personally, I believe that about one out of ten people is suffering from fibromyalgia, having either the preliminary stages or the full-blown disorder. Consider the fact that at any given time, 10 to 12 percent of the population reports chronic, generalized pain unrelated to a structural or inflammatory cause. That percentage represents thirty million people in this country who may have fibromyalgia or are seriously at risk of developing this disabling condition. A lot of these people gradually get better, and that constant ache becomes a distant memory. However, just because they get better doesn't mean they didn't have a brush with fibromyalgia. These patients may have sought treatment, but their symptoms, being relatively less severe, allowed rest, pain alleviation, and self-nurturing to facilitate natural remission. It was not necessary for their condition to be exhaustively explored or for any official diagnosis to be made. These statistics paint an important picture of a common and devastating illness that has been shunned by modern medicine. More important is that behind each one of these statistics is a real person whose life has been torn apart by pain, confusion, and unending frustration.

Perhaps it is due to the long-standing dominance of men in medicine that fibromyalgia patients struggled so hard for recognition. Approximately 85 percent of fibromyalgia patients are female. Back in the 1970s and 1980s, when increasing numbers of women were complaining of fibromyalgia symptoms, more than 80 percent of physicians were men. Too many of those male physicians of past generations simply couldn't relate to women complaining of pain not immediately traceable to an obvious medical condition. Men have also suffered from the long-standing view of fibromyalgia as a "female illness." As a result, men are much less likely to be correctly diagnosed with fibromyalgia or to even have it considered as a possible problem.

Although attitudes about fibromyalgia have shifted radically in the past decade, there remains an undercurrent of mistrust and suspicion regarding this illness that runs through the medical community. As I have traveled, leading seminars on fibromyalgia, I have encountered entire cities where not a single rheumatologist will accept fibromyalgia patients. A national shortage of rheumatologists combined with an aging population means that patients suffering from even the most serious cases of arthritis may have to wait as long as seven months to see a rheumatologist. As a consequence, too many rheumatologists believe that they should reserve their time for those patients with diseases they can understand and help treat through a proven medical regimen. The implications of this situation are profound not only for patients and doctors but also for those responsible for setting healthcare policies. The growing number of untreated fibromyalgia cases causes more suffering, more disabilities, and more insurance claims than ever before. Consider that 26 percent of people with fibromyalgia report receiving some type of disability payment. Close to 30 percent of patients report difficulty maintaining a job. When calculated in terms of medical fees, lost wages, diminished work productivity, disability benefits, and other societal expenses, the costs of fibromyalgia likely exceed ten billion dollars per year.

The Slow Pace of Research

The amount of research being done on fibromyalgia has increased exponentially over the past decade. This surge of research was greatly aided by the establishment of diagnostic criteria in 1990. Once the diagnostic criteria was established and fibromyalgia gained traction as a legitimate illness, research began in earnest. However, with such a complicated illness, it can take a lot of small discoveries in seemingly unrelated areas of medicine to add up to any useful answers. Even though advances in science continually change the face of medicine, change can happen at a snail's pace. For someone waiting for an answer to pain, the pace of research moves on a geologic timescale. Scientists develop hypotheses, write grant proposals, get funding (if they're lucky), painstakingly set up their studies, patiently cultivate their petri dishes, and hopefully come up with something groundbreaking along the way. Then, the results of the research are discussed, written about, and submitted to medical journals for eventual publication. Other scientists read about the results, develop their own hypotheses, and slowly repeat the same process. Scientific discoveries rarely come in a sudden flash of luck, genius, or something in between - although that certainly does happen. Instead, they are pieced together, one small discovery at a time. When the public hears about the "latest medical development," chances are that particular development has been simmering in laboratories and medical journals for a decade or more.

In recent years, a steady stream of credible medical research shedding new light on fibromyalgia has begun to appear in the pages of medical journals, some of which even seeps into the mainstream media. But that information is helpful only when it is pieced together in a way that helps patients understand their condition and learn how to recover. Even as new discoveries help shed light on the problem, doctors often hesitate to apply this new information in their practices until the treatment becomes mainstream. Unfortunately for fibromyalgia patients, this reluctance to share new information leaves a lot of desperate people in the dark.

Copyright © 2004, 2007 by David Dryland, MD

About the Author

David Dryland, MD, is a Yale-trained clinical rheumatologist with a busy practice in Medford, OR. Having successfully won his own battle with fibromyalgia, Dr. Dryland has developed a ground-breaking treatment protocol that his own patients have followed with success. Through his educational seminars and writing, Dr. Dryland is changing many popular misconceptions about the origins of fibromyalgia and how to effectively reduce or eliminate fibromyalgia symptoms. A much sought-after speaker, Dr. Dryland leads seminars and workshops on how to recover from fibromyalgia and control the fight or flight response. He lives in Ashland, OR with his partner Laurel and his three children.