Is Fibromyalgia Seen as a Psychosocial Disease?

The Psychosocial Disease? – Has Fibromyalgia Been Captured by a Mind/Body Paradigm? by Cort Johnson | Sep 30, 2016

The very nature of fibromyalgia, like chronic fatigue syndrome (ME/CFS), has left it prone to psychological interpretations.  No injury or lesion has ever been found. No accepted blood test points to a biological problem.

The disease produces lots of symptoms – a sure sign to some of a psychological problem – and it mainly effects women – who historically have had problems being believed by the medical profession. Plus, mood disorders such as depression and anxiety appear to be fairly common.  

Many brain imaging studies have documented central nervous system problems and autonomic nervous system problems. 

Three drugs have been approved by the FDA to reduce pain. (One drug is an anti-depressant which can relieve pain in FM patients who do not have depression.)  

Small nerve fiber neuropathy occurs in a significant subset of patients.  

An immune blood test may have been found.

Plus, because the pain-producing centers of the brain that are involved in FM also regulate emotions it stands to reason that people with FM might get emotionally tweaked by the disease.

A large number of mind/body/psychological FM studies have been noticeable for quite some time, but lately their sheer number leapt out at me

That prompted the question of whether a psychological approach to FM has or is in the process of taking over.

As a preliminary assessment of that, a short survey, done about a week ago, of the last four months of FM research citations, was done

The Survey

This quick survey covered 46 studies, and it did indeed uncover a bias toward studies using psychological or mind/body approaches to FM.  

Twenty-two of the 46 citations or almost 50 percent of the studies or clinical trials focused on psychological interpretations of FM or on behavioral approaches to treating it (including exercise).

That trend was especially evident in treatment trials where 60 percent of treatment trials focused on CBT-like programs or exercise.

After this, Cort gives a list of the types of trials that were done, with a description and  links to each one.

Conclusion

The answer to the question whether FM has been captured by a mind/body/behavioral paradigm is, thankfully no.

Some really interesting biological studies are going on. It’s clear, though, that much more time and money is being spent on behavioral aspects of FM than on trying to understand it biologically.

There’s nothing inherently wrong with a mind/body approach to FM. The central nervous system link between pain and emotions, and the autonomic nervous system studies indicating that an overactive fight/flight response is present in fibromyalgia suggests that these approaches might be helpful.

NIH funding for fibromyalgia has declined 30% recently

Something disturbing is going on, though, when such a high percentage of FM studies are devoted to behavioral studies and clinical trials. If a behavioral approach was curative that would be one thing, but as in chronic fatigue syndrome the effects of these approaches tend to be quite modest.

The behavioral approach is not a pathway to a cure for the vast majority of people with FM.

I have the seen the same problem with the latest pain studies: very few are biological studies. They focus on various previously debunked “alternative” therapies and cognitive behavioral therapies.

I also see numerous pain medication studies, but they are ALL about addiction NOT legitimate use.

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