Is Your Fibromyalgia Primary or Secondary? Does it Matter?
A fact I think tends to be frequently overlooked or glossed over is that fibromyalgia (FMS) can be either primary, meaning without a known trigger, or secondary, which means we know (or at least have a pretty good idea) why it developed.
While we still don't know exactly what's going on in the body that leads to fibromyalgia, we do know that chronic pain can cause changes in the brain and central nervous system that lead to central sensitization - essentially making the body overreact to pain and other stimuli (noise, smell, bright lights, etc.). That's why it's believed people with rheumatoid arthritis (RA), lupus, multiple sclerosis (MS) and other chronic pain conditions frequently develop FMS.
Why do I bring this up? Because I think it's important to make the distinction when we talk about treatments. For example, I've written here about my success with acupuncture. It could be that I've had amazing success because acupuncture is one of the best treatments for my original condition, which is myofascial pain syndrome (MPS, or CMP for chronic myofascial pain). In fact, that's why I started the treatments. I can't say for sure whether acupuncture relieved my fibromyalgia symptoms directly (some studies show it can), or whether relieving the MPS symptoms had a secondary effect of calming my fibro symptoms.
I probably wouldn't qualify for fibromyalgia drug trials because I have another pain condition that makes it hard to gauge what effect a fibromyalgia treatment is having. The same goes for someone with RA, MS, etc. It makes me wonder if that's part of why medications effect different people so differently. Maybe MPS-related FMS responds differently than primary FMS or RA-related FMS. (Maybe not, but wouldn't it be interesting to know for sure?)
Another reason I think the distinction is important is that some conditions that can lead to fibromyalgia may go undiagnosed, their symptoms lumped blindly in with FMS. My rheumatologist realized I had MPS well after diagnosing my FMS. I've had mild-to-moderate chronic pain, with bouts of severe pain, since I was 10 years old, but no one had ever figured out why. If she'd missed the MPS (like everyone else had), I'd probably be far less functional today.
Do you know if your FMS is primary or secondary? Has treating your other condition helped your FMS? Share your stories here or in About.com's Fibromyalgia & Chronic Fatigue Syndrome forum.
- Conditions that Overlap with Fibromyalgia & Chronic Fatigue Syndrome
- Fibromyalgia vs. Myofascial Pain Syndrome
- Fibromyalgia Symptoms - The Monster List!
Comments
Hummm…good question Adrienne. I don’t know that it really matters what triggers it…if you actually know what did. If it’s MS or another illness like RA, then treating that condition is the best way to go.
In my case, I have had quite serious blows to my head, a chipped tailbone, surgeries and a long period of time with “high chronic stressors.” I also had a large area on my leg that I thought was poison ivy…the docs. didn’t know what it was, but treated it and it went away. Now i’m wondering (after having been in a wooded area a week before) if it isn’t Lymes. Lymes is difficult to diagnosis if it’s not caught early.
My doctor once said that no matter what may be going on, it won’t change the medical issues that I have or the way I feel. He’s right…but it sure would be nice to know if one has Lymes, MS or something of that nature as opposed to being tossed into the ‘melting pot’ of fibro. symptoms.
I definitely have secondary FM. In june of 95 I was injured in a car accident and that caused disk problems in neck, upper and lower spine, PTSD, and depression. All of this went undertreated due to becomming unemployed, divorcing and living way below the poverty line I was unable to afford or access the care that would have made any of these illnesses less traumatic. As a result I am convienced that the FM (diagnosed early this year) has developed. My reading on the effects of repeated trauma and knowing what it is like to live in constant fight or flight with adrenalin coursing through my system means I was no wonder FM developed. Having now diagnosised the FM and getting treatment for it – all of my other health issues are more under control.
Regards from Australia
Auto accident onset. I think it is important too. I had not even thought about your reasons concerning treatment. For me it is important because auto insuers are getting away with shirking their responsibilities. They get away with it because those who could validate us don’t have the guts to do it. As a result the battle to receive proper health care paid for by the insurers just adds tenfold to our suffering. We need to have this “cause” validated so that we can get coverage for the care we need without a constant fight with the insurers!