David M. Brady, ND, DC, CCN, DACBN, IFMCP, FACN
Millions of individuals silently suffer from widespread pain and fatigue, but seem unable to receive either a clear diagnosis or an effective treatment plan. The reality is that the overlapping symptoms of fibromyalgia and other global pain and fatigue syndromes has led to widespread misdiagnosis and mismanagement of fibromyalgia. According to a 2011 National Institutes of Health finding, nearly 15 million people in the United States are suffering from fibromyalgia, but when the only diagnostic criteria available is based on subjective questions on patient’s pain perception, the diagnosis is equally subjective. Many individuals may be suffering from fibromyalgia, but not properly diagnosed while up to two thirds of individuals diagnosed with fibromyalgia, may be suffering from a chameleon condition instead. Fibromyalgia is the correct diagnosis only when all other medical and functional conditions have been ruled out – a task most physicians do not tackle. Therefore, many individuals needlessly suffer from an improper diagnosis and improper treatment.
Chameleon pain and fatigue conditions
Widespread pain and fatigue can be rooted in a variety of causes and therefore, opens the door for a plethora of medical conditions. Conducting a systematic evaluation that will navigate the maze of possibilities before landing on the diagnosis of fibromyalgia is extremely important, but often neglected because the task is not for the faint-hearted. There are 3 broad categories of conditions that often cause widespread pain and fatigue, yet are not a diagnosis of fibromyalgia. The standard treatment approach for classic fibromyalgia will not help patients whose pain and fatigue is rooted in any of these 3 categories, including:
(1) Medical problems associated with another medical condition or disease such as thyroid disease, diabetes, Lyme disease, cancer, and others.
(2) Musculoskeletal problems of a specific muscle or joint such as occurs with myofascial pain syndrome, trigger points or “muscle knots”, and spinal joint problems such disc degeneration and pinched nerves.
(3) Metabolic/Functional problems rooted in dysfunction of internal organs and individual metabolism, rather than a true disease. Examples include subtle functional hypothyroidism, mitochondrial dysfunction that blocks optimal energy production in cells, nutritional deficiencies, chemical and food sensitivities, reactions to medications, and other problems with body metabolism and biochemistry.
The True Condition of Classic Fibromyalgia
A hyper-responsive central nervous system is the key element that sets fibromyalgia apart from its camouflaging conditions. Pain that is rooted in a dysfunctional nervous system is experienced in response to normal stimuli, unlike the pain associated with musculoskeletal problems, medical conditions, or metabolic/functional problems. The development of fibromyalgia often (but not always) begins in early childhood while the central nervous system is maturing. Studies show strong correlations between physical and/or emotional trauma during these early years and the development of fibromyalgia. Other cases of fibromyalgia can develop after a severe car accident, work related injury, serious surgical procedures, physical or emotional abuse, or after witnessing a horrific event. Traumatic events derail the central nervous system and once this happens, it may lead to a heightened and prolonged pain response to normal stimuli such as bright lights, sounds, changes in temperature, moderate pressure on the skin or muscles, household chemicals, etc. Additionally, extreme stress and intensely emotional events in the past can contribute to the development and exacerbation of fibromyalgia. The stress and emotional trauma disrupts the brain’s ability to process pain appropriately. Therefore, widespread pain and fatigue in the presence of stress and trauma, but in the absence of a metabolic, functional, or musculoskeletal problem, often points to classic fibromyalgia.
A Real Possibility of Classic Fibromyalgia
Fibromyalgia is a real problem but there is also a real solution, when it is diagnosed correctly and not confused with the pain and fatigue associated with chameleon conditions stemming from medical, musculoskeletal, and metabolic/functional problems. It is imperative that these conditions be ruled out before making a final diagnosis of fibromyalgia. An extensive health history and systematic evaluation of each body system is crucial for discovering the root cause of widespread pain and fatigue. Take this short quiz and find out whether its likely that you may be experiencing fibromyalgia. If you score over 13 after adding your scores from sections 1, 2, and 3, and you answer “yes” to section 4, and “no” to section 5, you may have classic fibromyalgia.
Dr. Brady’s new book, The Fibro Fix, will give you a wealth of information on how to negotiate your way toward getting the proper diagnosis and the proper treatment for your symptoms of widespread pain and fatigue. The book can be ordered on Amazon, Barnes & Noble, Books-A-Million and other fine book vendors, or at FibroFix.com. Also, learn more about The Fibro Fix Summit where Dr. Brady interviews 30+ experts on FM at FibroFixSummit.com. Also, please visit Dr. Brady’s main website at DrDavidBrady.com and follow him on Facebook at DrDavidBrady.
David M. Brady, ND, DC, CCN, DACBN, IFMCP, FACN, has 28 years of experience as an integrative practitioner and over 24 years in health sciences academia. He is a licensed naturopathic medical physician in Connecticut and Vermont, is board certified in functional medicine and clinical nutrition, a fellow of the American College of Nutrition, and completed his initial clinical training as a doctor of chiropractic. Dr. Brady has been the chief medical officer of Designs for Health, Inc. and also currently serves as the chief medical officer for Diagnostic Solutions Labs. He is the long-time director of the Human Nutrition Institute, and associate professor of clinical sciences at the University of Bridgeport in Connecticut. He has appeared on the plenary speaking panel of some of the largest and most prestigious conferences in the field including; IFM, ACAM, A4M, ACN, IHS, AANP, AIHM and many more. He is in clinical practice at Whole Body Medicine in Fairfield, CT, specializing in functional, nutritional and metabolic medicine.
