Some people say fibromyalgia is a real disease, and some people say it doesn't exist. Is fibromyalgia a real disease?
This is a common question, but it actually covers two very different issues:
- Is fibromyalgia a disease?
- Is fibromyalgia real?
Disease vs. Syndrome
Technically, fibromyalgia is a syndrome, not a disease. Some people seem to think that somehow makes it less valid or less serious. However, the difference is really one of understanding, not validity or severity.
The definition of syndrome is:
A collection of signs and symptoms known to frequently appear together but without a known cause.
Defining disease is a little more complicated. Many medical dictionaries define it as:
A disorder in a system or organ that affects the body's function.
Some dictionaries, however, add that a disease is characterized by at least two of the following criteria:
- A recognized etiologic agent (cause)
- An identifiable group of signs and symptoms
- Consistent anatomic alterations
In fibromyalgia, we don't yet have a recognized cause, and anatomic alterations -– while present –- have not been consistent enough from one case to another.
You can see that "syndrome" and "disease" are classifications based on what doctors understand, and not on the legitimacy of the illness.
With research and better understanding, syndromes can be re-classified as diseases.
"Realness" of Pain
It's hard to look at someone and see pain. Even if it's obvious something is wrong, you can't judge the severity. Making it harder, people who live with chronic pain generally become skilled at masking it.
That invisibility has been a real obstacle to overcoming skepticism about fibromyalgia. When X-rays and other scans fail to show anything wrong at the site of pain, and when pain roams around the body and comes and goes, it's hard to understand.
Technology is now helping us, though. Several types of sophisticated brain scans have demonstrated abnormalities in brain activity when it comes to pain processing. Analysis of cerebrospinal fluid shows high levels of something called substance P, which is known to be involved in how we perceive pain.
For more information on these findings and what they mean, see Fibromyalgia Pain: Physiological Evidence.
Guedj E, et. al. Journal of nuclear medicine. 2008 Nov;49(11):1798-803. Clinical correlate of brain SPECT perfusion abnormalities in fibromyalgia.
"Pathogenesis of fibromyalgia." UpToDate. Accessed: March 2009.