Fibromyalgia affects 1% to 5% of Americans, mainly women, but until recently, scientists had no idea what might be causing its severe and mysterious pains. For decades, doctors told patients their agony was imaginary, the result of emotional hysteria, not a physical ailment.
Sadly, nothing seems to have been learned from this cruel error. Some doctors are still making shameful use of these labels for people suffering from as yet undiagnosed illnesses. The diagnosis of “psychogenic pain” probably says more about the doctor’s ignorance than the patient’s pain.
But this year, researchers finally began to get a handle on the condition.
half or more of the cases of fibromyalgia are really a little-known condition affecting the nerves. People with this small-fiber neuropathy get faulty signals from tiny nerves all over the body, including internal organs, causing an odd constellation of symptoms from pain to sleep and digestive problems that overlap with symptoms of fibromyalgia.
there are excessive nerve fibers lining the blood vessels of the skin of fibromyalgia patients — removing any doubt that the condition is physically real.
These fibers in the skin can sense blood flow and control the dilation and constriction of vessels to regulate body temperature, Rice says, as well as direct nutrients to muscles during exercise. Women have more of these fibers than men, he says, perhaps explaining why they are much more likely to get fibromyalgia.
there is some preliminary evidence that the nerve damage is caused by the immune system
Fibromyalgia’s constellation of symptoms is very similar to those of chronic fatigue syndrome and Gulf War syndrome, which Oaklander’s group also studies. “If someone has more of one symptom than another they might call it one thing, like chronic fatigue, but it’s not clear that these are different,” Oaklander says.
“I think a lot of people, they get a blanket diagnosis as fibromyalgia because doctors don’t know what’s wrong with them,” says DiSilva, 47, who has suffered from unexplained pains for about 14 years. The non-stop agony and the pins and needles that plagued her for hours at a time forced her to give up her work
Understanding what’s causing her pain has helped her, she says, because doctors and others take her problems seriously, instead of dismissing her as they used to do.