by Dr. Bill Rawls
Tests for fibromyalgia are fundamentally flawed, which leaves sufferers without a diagnosis — or cure. Dr. Bill Rawls reveals a better way to find answers and relief.
Question: Why is fibromyalgia so hard to diagnose?
I call fibromyalgia the “non-diagnosis,” because it’s really just a collection of symptoms that people have. They are no abnormal lab tests; there’s no abnormal physical exam. It’s considered a disorder, so medical science doesn’t really define it as having a treatable cause.
It’s really frustrating for patients and physicians alike.
Physicians really get frustrated when someone walks in a room with a list of 20 or 30 really odd symptoms all over their body. They like to treat one thing, like a broken leg or pneumonia — something simple they can address directly.
Fibromyalgia, and conditions like fibromyalgia, really frustrate doctors.
Technically the thing that separates fibromyalgia from chronic fatigue syndrome — and other disorders that come with nearly exactly the same symptoms — is pain at trigger points. According to the American Rheumatology Association, there are 18 points on the body that supposedly, if you press those points, the person will have pain in at least 11 out of 18 of those points.
But a recent study came out showing that 70% of people who were diagnosed with fibromyalgia don’t meet that diagnostic criteria. Even the technical criteria for fibromyalgia is very frustrating for physicians.
I think you have to move beyond just classifying the diagnosis, and look at the potential causes of those symptoms. That’s the only way that this condition is going to be addressed properly.
When you get right down to it, here’s what it means to have a fibromyalgia diagnosis for a medical provider: It gives them an opportunity to check that box, so the patient has a diagnosis and is satisfied, and the physician has met the [insurance] coding criteria and can get paid.
It really boils down to the fact that you, the patient, have something that we, the physicians, don’t completely understand. We don’t have a test that defines a process so that I can give you a drug to treat the problem itself. All I can do is just give you some prescriptions for symptoms.
When you go beyond all that and stop asking, “What’s the abnormal process?” and instead ask, “What are the causes of the symptoms?” — then you move in a whole different direction with a different perspective. That’s what I found through my struggle with fibromyalgia. Once you start understanding causes, then you can move in a direction of actually overcoming the illness and working toward a goal of wellness, instead of just trying to relieve symptoms.