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FIBROMYALGIA (FM) HISTORY Fibromyalgia History

Fibromyalgia (FM) is not a "new" disease, as some skeptics have claimed. It is a disease as old as mankind. Reports of FM can be found as far back as the Old Testament Biblical times. In the book of Job, Job gives a vivid description of his physical anguish:

"I, too, have been assigned months of futility, long and weary nights of misery. When I go to bed, I think, `When will it be morning?' But the night drags on, and I toss till dawn. And now my heart is broken. Depression haunts my days. My weary nights are filled with pain as though something were relentlessly gnawing at my bones." Job 7:3-4; 30:16-17 - NLT

Another well known person who reported FM-like symptoms was Florence Nightingale, an English army nurse during the Crimean War (1854-1856) who was a pioneer in the International Red Cross Movement. Nightingale became ill while working on the front lines and never really recovered. She was virtually bedridden much of the rest of her life with pain and fatigue resembling FM until her death in 1910.


The 1800's

Fibromyalgia has been studied since the 1800's. In 1913 in the British Medical Journal, a physician by the name of Luff talked about the factors of fibrositis. He noted that the symptoms grew worse when the barometric pressure lowered and rain was approaching. People with FM today are familiar with this phenomena. Luff's article also talked about temperature variations, fevers, infections and motor vehicle accidents. He also drew the connection between "growing pains" in children and fibrositis (Williamson, 1996, p. 16). We now know that fibrositis is the wrong name, because there is no inflamation in people with fibromyalgia.

William Balfour, a surgeon from the University of Edinburgh, described FM in 1815. Over the years, the syndrome has been called by many names, including "fibrositis", "neurasthenia", "nonarticular rheumatism", "hysterical paroxysm", "muscular rheumatism" and even "tender lady syndrome."


The 1900's

In 1904, Sir William Gowers again described the syndrome and named it "fibrositis." Smythe laid the foundation of modern FM in 1972 by describing widespread pain and tender points. In 1975, Dr. Harvey Moldofsky discovered that patients deprived of stage-4 sleep developed tender points in symmetrical locations in the body. The first sleep electroencephalogram study was performed in 1975. The first controlled clinical study with validation of known symptoms and tender points was published in 1981. This same study also proposed the first data-based criteria. The important concept that FM and other similar conditions are interconnected was proposed in 1984.

In 1976, Dr. Philip Hench coined the term "fibromyalgia," a descriptive term built on the Latin word for connective tissue (fibra), and the Greek words for muscle (myo-) and pain (algos). In 1977, Dr. Hugh Smythe classified the 18 tender points.

In 1987, it was first recognized by the American Medical Association (AMA) as a "true" illness and the cause of disability. In an article that same year, in the Journal of the American Medical Association (JAMA), Dr. Don Goldenberg called the syndrome fibromyalgia. Even though Goldenberg's paper was published in a highly respected medical journal, doctors are still slow to accept FM as a real diagnosis, although things are getting better. Doctors' reluctance is largely due to the lack of "clinical" evidence. In other words, there isn't an X-ray or blood test to prove FM.

The first American College of Rheumatology (ACR) criteria were published in 1990 and neurohormonal mechanisms with central sensitization were developed in the 1990s. Serotonergic/norepinephric drugs were first shown to be effective in 1986.

Over the years there have been a multitude of theories as to what FM is and what causes it. As the term fibromyalgia implies, it was logically thought to be a muscle disease, since muscle pain seemed to be the primary symptom. However, research studies could fine nothing wrong with the muscles. For a while, it was theorized that it might be an autoimmune disorder, but once again research revealed no disturbance of the immune system.


Today

Sadly, as often happens when medical science cannot identify an illness using standard technology of the day, for most of the past 200 years FM was thought to be a psychiatric or psychosomatic disorder. Even today, there are a few medical professionals who insist on hanging on to this theory. FM has also been called a "wastebasket" diagnosis and a fad disease. It is neither. Many doctors do not know how to diagnose FM, and even fewer receive training in the proper way to diagnose it. A better understanding of FM is slow in coming, but things are getting better. More and more medical schools are educating new doctors about this syndrome, so hopefully, it won't be long until better-educated healthcare providers are available to a make quick and accurate diagnosis of fibromyalgia.

FM is not directly life-threatening. It does not damage joints or body tissues. And once it becomes established, the condition does not progress further. However, the severity of symptoms may vary from day to day with periods of increased symptoms (called flares), and periods of improvement. Symptoms may worsen at certain times of the day, with weather changes, and during periods of stress. Although the condition is not progressive or destructive, it can certainly be disabling.

Fortunately, the 21st century has brought new laboratory tests and brain-imaging technology that has not only proven FM to be a real physical disorder, but has also shown that it is caused by a malfunction of the central nervous system. As a result of these discoveries, new, more effective treatments are on the horizon. Hopefully, one day the history of FM will be just that - past history!


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Sources:

  • Williamson, Miryam E. (1996). Fibromyalgia: A comprehensive approach. Walker and Company, NY.

  • Your Personal Guide to Living Well with Fibromyalgia. (1997) The Arthritis Foundation. Atlanta, GA.

  • Inanici F, Yunus MB, History of fibromyalgia: past to present, Curr Pain Headache Rep. 2004 Oct;8(5):369-78.

  • What is Fibromyalgia?, March 13th, 2009 by David Vallance, Physicians for Patients.

  • Florence Nightingale - A Biography, R.E.S.C.I.N.D., 1997-2000.

  • Fibromyalgia, Wikipedia, 2006.

  • History of Fibromyalgia, Fibrocenter.com.
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