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History of Fibromyalgia
Sunday 12 July 2009
The history of fibromyalgia has been more of an evolution rather than cut-and-dry like most diseases.
Dating as far back as the 1800 descriptions of the condition can be found in medical journals. In 1824, a doctor named William Balfour briefly described “tender points” in his writing. However, the first person to write about these tender points was French physician named François Valliex in “Traité de Neuralgies” (“Treatise on Neuralgia”), in 1841. Other 19th-century doctors simply referred to the aches and pains of fibromyalgia as “muscular rheumatism” or “neurasthenia.”
In 1904, Sir William Gowers wrote an article published in the British Medical Journal (1:117-121), entitled: “Lumbago: Its Lessons and Analogues". In the article, he recommended that the pain of “muscular rheumatism” be called “fibrositis.” This stemmed from the mistaken belief that the pain and discomfort was a condition resulting from inflammation.
Ralph Stockman, a contemporary pathologist in Edinburgh, Scotland, reported seeing evidence of inflammatory change or swelling in patient biopsies of the fibrous, intra-muscular septa, the thin membrane that connects soft masses of tissue. These findings appeared to support the inflammation theory that was until future muscle biopsies did not produce the same findings as Stockman’s. “Fibrositis” is now considered an erroneous term used to describe fibromyalgia.
Before the term was discredited, Dr. Luff in 1913 also wrote about “fibrositisin” in the British Medical Journal. His findings suggested that a patient’s symptoms would worsen when barometric pressure increased due to an approaching storm. The Doctor also mentioned the relationship of infections, fevers, temperature variations, and automobile accidents to the pain and discomfort of fibrositis. Llewellyn and Jones, in a 1915 book plainly called “Fibrositis,” broadened the term to include other maladies, such as gout.
In 1953, a rheumatologist by the name of Smythe and a psychiatrist by the name of Moldovsky discovered through electroencephalographic studies that patients who had disturbed sleep as well as muscle pain were experiencing deep (non-REM) sleep interrupted by light (REM, or rapid eye movement) sleep. These symptoms resulted in additional symptoms the following morning, which included generalized muscle pain, morning stiffness, fatigue, and cognitive destruction.
Because of their findings, Smythe and Moldovsky revived the old term “fibrositis.” Nonetheless, the reason for discontinuing the earlier use of the term still applied as these patients were not experiencing inflammation. In 1976 the term “fibrositis” was replaced by “fibromyalgia” in order to correct the decades-old misnomer originally coined by Dr. Gowers.
After the syndromes name was, corrected awareness of fibromyalgia became more prominent. In 1987, Dr. Don L. Goldenburg, in describing the symptoms and treatment of 118 of his patients, recorded their diagnoses as “fibromyalgia.” Finally, in 1990, the American College of Rheumatology established definitive criteria that allowed for the diagnosis of fibromyalgia.
In 1997, the National Fibromyalgia Association (NFA) was formed. The NFA was the first national organization whose sole purpose was to help people with fibromyalgia better understand their condition. Nearly 10 years later, in October of 2005, the American Pain Society published the first guidelines for treating fibromyalgia. The guidelines stating that, “Fibromyalgia syndrome (FMS) has no cure, is difficult to diagnose, and effective pain management strategies are a must to help patients cope with the disease.”
The article originally appeared here.
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