Fibromyalgia: Uncovering Silent Suffering

Running Up That Hill

Run. For 10 miles. Up a hill. You’re not allowed to stop until you hit that 10-mile mark. No warmup or preparation. How would your muscles feel the next day? Depending on your fitness, they might be aching, and moving around could feel like wading through honey. For someone living with Fibromyalgia, this is just an idea of what it’s like to live in their body.

Now read the dullest, most boring book you can find in the library. Stay up all night, no sleep, reading that book. Now go about your day and deliver the same high-performance work that’s expected from you. Fibromyalgia sufferers can sleep for hours, only to wake up feeling unrefreshed – like they were awake long into the night.

And to top it off; call in sick to work, every month, for six months. If you’re lucky, your manager might ask if everything is okay. However, if you’re not so lucky, do you think you’d still have a job at the end of the year? When you’re undiagnosed with Fibromyalgia, this can make life very unpredictable. The pain and fatigue can be so severe that you could be housebound at any given moment.

What is Fibromyalgia?

Fibromyalgia Syndrome (FMS) is often described as widespread pain across the entire body, combined with intense fatigue. You have heard of it more in the past few years, as awareness around the condition is growing steadily. Years of FMS being understudied, alongside some medical gaslighting, have left sufferers in the dark about their health. Over the course of three articles, we aim to debunk some rumours, shed some light and deepen our understanding of what this complicated condition is all about.

We’ll start with some context about what FMS is – what it is and what it is not. The second article, is a look at what’s happening in the brain of someone with FMS and its interaction with depression. And finally, how FMS could be treated effectively with Transcranial Magnetic Stimulation.

A Painful History

The journey of building up our understanding of FMS has gone through many minds, dating all the way back to 1592. The word Rheumatism was first uttered by French physician, Guilliame de Baillou, to describe musculoskeletal pain when pain could not be described through physical trauma.

As our understanding of medicine increased, the way we diagnosed unexplained pain grew with it. It was not until 1852 when a Librarian from the Royal College of Physicians in Edinburgh, George William Balfour identified the “tender points”. This would later be essential for some time in identifying and diagnosing fibromyalgia. Throughout the years other terms and symptoms were thrown about and added to the melting pot. It was not until 1904 where Neurologist, Sir William Gowers, developed the term Fibrositis. Leaping ahead to 1976, P.K. Hench developed the name Fibromyalgia, split into three meanings. “Fibro” – connective tissue; “my” – meaning muscle; “algia” – a suffix added meaning pain.

It’s NOT All in Your Head

Diagnosing FMS is, for want of a better term, a pain. To date, there are little to no physical markers that make Fibromyalgia easy to identify. This isn’t the first diagnosis medical professionals while go to when a patient appears complaining of global pain and chronic fatigue. Cases of FMS have typically been diagnosed through a process of elimination. Physicians will look to rule other illnesses, auto-immune disorders, or rheumatoid arthritis. While this can be helpful to get closer to a diagnosis, it doesn’t exactly instil confident for the patients on the receiving end: “Well, it’s not this, or this. And we’ve tried “this”, this and this – it must be Fibromyalgia!”

The truth is this; diagnosing FMS takes times to gather a full history of your health and investigation, likely needing way more than a couple of appointments with your GP. FMS effects everyone differently chronic pain and intrusive fatigue are the main indicators. But many other alerting factors may can crop up over time that raise alarm bells. Sometimes they can happen all at once, or spread-out overtime, coming and going. This can make it tricky spot something is wrong.

Eat, Sleep, Yawn: Repeat.

Most sufferers of FMS will struggle with poor quality of sleep. Despite the chronic fatigue, a full night’s sleep will often leave patients feeling unrefreshed and no better off. Cognitive function is often prominent too; this ranges from poor concentration, memory – coining the term “fibro fog”, where they feel like they’re in a constant haze. Fluctuating symptoms can make it much harder for medical professionals to find you are suffering with FMS. Often when symptoms worsen for a period then diminish altogether – this is called a “flare up”.

Patients with FMS are often hypersensitive. No, they’re not being hysterical. They’re hypersensitive to their environment! Changes in the temperature, too much walking around, sometimes even types of food can all contribute towards a flare up. Symptoms coming and going, “random” flare ups, medical professionals telling you there’s nothing wrong with you and you’re fine, leads to feeling mentally overwhelmed. A study published on the National Library of Medicine investigating the psychological impact of FMS, determined that 20% – 80% of patients will display high rates of anxiety and 13% – 63.8% depressive symptoms.

So, what do we know?

From genetic predisposition to a response to psychological trauma, there are few from explanations as to how and why FMS even occurs to begin with. It’s been theorised, however, that it’s caused by the brain’s inability process our pain correctly. While we may still have answered questions, there are defiantly things we can say FMS is not:

It is NOT caused by muscle inflation on tenders – there are no physical markers!
It is NOT a reflection on someone’s inability to cope with pain.
It is NOT a person’s overreaction to trauma or stress.
It is NOT caused by poor physical fitness.
It is NOT “all in their head”.

Fibromyalgia is real, and even though there is much we do not know, there is still hope for affective treatment. It is unclear how many people in the UK are currently living, as diagnosis can be elusive. By increasing our awareness, people with Fibromyalgia can start to be seen. Perhaps after reading this, you may know or notice someone living with Fibromyalgia, and let them know – they are not alone.

Author, Paul,

Smart TMS Edibnburgh Practitioner