Recall what fibromyalgia is… Otherwise referred sometimes referred simply as central sensitization. It is a very real condition, still thought to be fictitious by many practitioners out there.

A condition of the central nervous system

An analogy that I did not have the genius to create- “the volume dials in the brain for pain perception are turned way up, resulting in widespread pain.” This is likely on the basis of inflammation.

Minimal amounts of stimuli result in disproportionate amounts of pain. In the most extreme cases basic every day activities can put these patients in a world of hurt. Patients often tell me every fiber of their being hurts. It hurts to receive a hug.

Often a secondary manifestation of a deeper problem…

While it can be a primary problem, Fibromyalgia is often a manifestation of a deeper problem, the tip of the iceberg.

In other words a symptom… That may be hard to conceptualize, associating the word symptom with Something much less complex like a runny nose, headache or a rash.

We called this secondary fibromyalgia, often on the basis of inflammation.

It has been the observation of many that fibromyalgia is often comborbid with various inflammatory disease:

It’s been the observation of many that fibromyalgia is often comorbid with:

Lupus
Sjogren’s
Rheumatoid arthritis
Autoimmune thyroiditis
Anti-phospholipid syndrome
Ankylosing spondylitis
Polymyalgia rheumatica
Multiple sclerosis
And more!

An unfortunate outcome…

I have had several cases that have come to me only having a diagnosis of fibromyalgia despite an elevated CRP or sed rate or they have a history of persistently elevated antibodies.

In some cases these women had longstanding inflammatory disease that went untreated. We want to identify an inflammatory process and start some intervention as soon as possible due to the fact that as autoimmune disease advances, it is more difficult to treat and control.

These are clues that the fibromyalgia is a symptom and further investigation should be done.

A suboptimal approach

Many of these patients are not treated appropriately… Worst case sent to pain management and given narcotics which is the very last thing we want for the fibromyalgia patient.

What should happen is that they are treated for inflammation, their auto immune diseases treated.

Have you been diagnosed with fibromyalgia? Was it determined to be primary or secondary fibromyalgia?