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    Fibromyalgia 10 Years Later: Medical Community Still Puzzled


    "There is too much emphasis on looking at these syndromes as being distinct entities [diseases], and that's where I think some physicians and patients fall into the trap of saying that something like chronic fatigue syndrome or irritable bowel syndrome are specific conditions. I think it's more important to look at all of these disorders as 'mind-body' functional illnesses that have much more common threads," Goldenberg tells WebMD.

    In the decade since fibromyalgia was identified, numerous treatment options have been studied. In clinical trials, several types of treatment -- including central nervous system medications, cardiovascular fitness training, regional sympathetic (nerve) block, biofeedback, hypnotherapy, and acupuncture -- have been effective. Some patients have benefited from taking antidepressants, but these drugs? beneficial effects appear to decrease over time, Goldenberg notes. Behavior modification and stress reduction programs also have been shown to be helpful.

    Despite the continuing controversy, fibromyalgia may receive more attention in the future, because the costs of caring for people who have it can be substantial. Studies have shown that patients average 10 outpatient visits per year and sometimes use several drugs in an attempt to reduce symptoms. One 1996 study found that the mean yearly per-patient cost was $2,274.

    Even with good medical care, fibromyalgia studies have shown that most patients experience little improvement in their overall condition or symptoms. Nonetheless, Goldberg says, patients with the syndrome find it reassuring to obtain "a diagnostic label," and just making the diagnosis leads to decreased use of costly testing and health care services.

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