The History of Fibromyalgia

The understanding of what fibromyalgia is has been more of an evolution than a cut-and-dried history.

Descriptions of the syndrome can be found in medical journals dating back to the 1800s. In 1824, a doctor named William Balfour briefly described “tender points” in his writing. The first person to write at length about tender points, however, was French physician François Valliex in “Traité de Neuralgies” (“Treatise on Neuralgia”), published in 1841. Other 19th-century doctors simply referred to the aches and pains of fibromyalgia as “muscular rheumatism” or “neurasthenia.”

Sir William Gowers, in his 1904 article, “Lumbago: It’s Lessons and Analogues” in the British Medical Journal (1:117-121), recommended that the pain of “muscular rheumatism” be called “fibrositis.” This stemmed from the erroneous belief that the pain and discomfort of the condition was the result of inflammation.

A contemporary of Gowers, a pathologist by the name of Ralph Stockman in Edinburgh, Scotland, reported seeing evidence in patient biopsies of inflammatory changes (swelling) in the fibrous, intra-muscular septa, the thin membrane that connects soft masses of tissue. This appeared to reinforce the inflammation theory, until it was found that future muscle biopsies did not produce the same results as Stockman’s. “Fibrositis” is now considered an incorrect term when used in reference to fibromyalgia.

In 1913, a Dr. Luff also wrote about “fibrositis”—before the term was discredited—in the British Medical Journal. He noted how a patient’s symptoms would tend to worsen when barometric pressure rose with an approaching storm. Dr. Luff 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.

A rheumatologist named Smythe and a psychiatrist named Moldovsky found through electroencephalographic studies in 1965 that patients who had disturbed sleep accompanied by muscle pain were experiencing deep (non-REM) sleep interrupted by light (REM, or rapid eye movement) sleep. This resulted in symptoms such as morning stiffness, generalized muscle pain, fatigue, and cognitive impairment.

In reference to their findings, Smythe and Moldovsky resurrected the old term “fibrositis.” But the medical community’s reasons for dropping the term earlier in the century still applied: the patients were not experiencing inflammation. The term “fibrositis” was replaced by “fibromyalgia” in 1976 in order to correct the decades-old misnomer originally coined by Dr. Gowers.

Now that the syndrome had a more accurate name, the awareness of fibromyalgia began to speed along. In 1987, Dr. Don L. Goldenburg, in describing the symptoms and treatment of 118 of his patients, recorded their diagnoses as “fibromyalgia.” And in 1990, at long last, the American College of Rheumatology established the definitive criteria for diagnosing fibromyalgia.

The National Fibromyalgia Association (NFA) was formed in 1997. It was the first national organization dedicated to helping people with fibromyalgia better understand their condition. Almost 10 years later, on October 10, 2005, the American Pain Society published the first guidelines for treating fibromyalgia, 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.” (http://www.ampainsoc.org/press/2005/101005.htm)

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