Book Excerpt: The Fibro Fix
Author: David M. Brady
Publisher: Rodale Books (July 12, 2016)
For over two decades, the health-insurance industry defined fibromyalgia syndrome as generalized pain that isn’t associated with
In 1990, the American College of Rheumatology (ACR) developed the first diagnostic criteria for FM, using a scoring system based on a physical examination by a doctor. To qualify for a diagnosis of fibromyalgia, the patient had to have a minimum of 11 out of 18 anatomical areas that were tender to moderate pressure as well as pain above and below the waist on both sides of the body,
That sounds good unless you probe into the history and discover that these criteria were never really meant to be used by practicing doctors to diagnose patients. They were meant for use by researchers studying FM—an entirely different matter.
However, given doctors’ desperation for any diagnostic tool, these criteria fell into common use and resulted in significant overdiagnosis of FM. One problem was that this tool didn’t adequately discriminate between true, or classic, FM and other disorders that, as you will see, met the criteria’s standards.
The ACR revised the criteria in 2010 and again in 2011. The current criteria consist of a Widespread Pain Index, based on a patient’s own report of pain, and a symptom severity index, calculated from a patient’s responses to a questionnaire. Questions deal with the presence of symptoms such as fatigue, sleep disturbance, cognitive deficit, inability to concentrate, anxiety, and depression. The symptoms must be present for at least 3 months and must not be attributable to any other disorder.
Although the revised ACR criteria are somewhat improved, they now do not require the doctor to actually touch and examine the patient. Instead, the diagnosis relies solely on the patient’s report of pain in various parts of the body. Yet a hands-on exam is crucial to determining whether
Don’t miss the opportunity to hear David M. Brady speak at the Integrative Healthcare Symposium Annual Conference February 23-25, 2017 in New York City. Click here for more information.