Living with fibromyalgia is not easy! Any chronic health condition has its challenges of course, but fibromyalgia can be more challenging than most. To explain why, let’s learn a bit about the condition and its history. 

Fibromyalgia is a chronic widespread pain condition that takes your independence, liberty and much more. It also impacts your sleep so that you are less able to deal with the pain. Add to this fibrofog where you feel like you could forget your own name and you have a starting point of this condition. Lack of treatments, working treatments being taken away, disbelief from friends’ family and health professionals means that this condition is challenging. We would not wish it on anyone.  

The condition is thought to affect between 2% and 5% of the population but without recording diagnosis accurately these figures are up for dispute. However, we are now in a period of greater awareness than even 5 or 10 years ago. 

Brief History of Fibromyalgia

Fibromyalgia is usually thought of as a fairly new illness or a fad diagnosis. However, it may have actually existed for centuries. Although the term “fibromyalgia” was first coined in 1976, physicians have written about conditions resembling fibromyalgia since the early 1800’s. Reports of illnesses with strikingly similar symptoms can even be found as far back as around 1500 BC.

Notable Historical Accounts

Probably the earliest description of a fibromyalgia-like condition is found in the Biblical account of Job’s physical anguish. “I, too, have been assigned months of futility, long and weary nights of misery. When I go to bed, I think, `When will it be morning?’ But the night drags on, and I toss till dawn…And now my heart is broken. Depression haunts my days. My weary nights are filled with pain as though something were relentlessly gnawing at my bones.” (Job 7:3-4 and 30:16-17 – NLT)

In the 19th century, the English army nurse and Red Cross pioneer Florence Nightingale was taken ill with fibromyalgia-like symptoms. She became ill while working on the front lines during the Crimean War (1854 – 1856) and never really recovered. Until her death in 1910, Nightingale was virtually bedridden much of the time, suffering with unrelenting pain and fatigue.

rheumatism that included conditions like fibromyalgia that did not cause deformity there has been a push to define it better.

500 BC	Biblical times with the life of Job reference Job 7:3-4, which states, “so I have been allotted months of futility, and nights of misery have been assigned to me. When I lie down I think, ‘How long before I get up?’ The night drags on, and I toss till dawn.” They also reference Job 30:16-17, which states, “And now my life ebbs away; days of suffering grip me. Night pierces my bones; my gnawing pains never rest.”
410 BC	Hippocrates (430-380 BC) described the “Rheuma Theory” as a mechanism of pain where the brain sends excessive liquid to the lower limb resulting in increasing pain. Rheuma means fluid in Greek.
1600‘s	Fibromyalgia-like symptoms were first given a name: muscular rheumatism.
1816	Dr. William Balfour, surgeon at the University of Edinburgh, gave the first full description of fibromyalgia.
1824	Dr. Balfour in Edinburgh described tender points.
1829	Fat and Blood: Treatment of Different Forms of Neurasthenia and Hysteria Silas Weir Mitchell, M.D., an American physician who discussed the combining physiological and psychological problems. Dr. Mitchell use the term “Neurasthenia” as a term that was first used at least as early as 1829 to label a mechanical weakness of the actual nerves.
1850‘s	Florence Nightingale, social reformer, statistician and founder of nursing, served as an English army nurse during the Crimean War. She became ill during the war with Fibromyalgia-like symptoms never recovering. Bedridden the rest of her life with pain and fatigue, she died in 1910.
1869	As a psychopathological term, Neurasthenia was used later by Beard in 1869 to denote a condition with symptoms of fatigue, anxiety, headache, neuralgia and depressed mood.
1870	William James, an American philosopher and psychologist also trained as a physician suffered from a Neurasthenia which was chronic. Americans were said to be particularly prone to Neurasthenia, resulting in the nickname “Americanitis” which as popularized by William James.
1880	A psychiatrist in the United States wrote about a group of symptoms including widespread pain, fatigue and psychological problems referencing Neurasthenia and believed it to be the result of stress.
1881	The clinical and diagnostic profile for nervous exhaustion (Neurasthenia) was first described in 1881 by George Miller Beard, M.D., an early neurologist and graduate of the College of Physicians and Surgeons of New York. Beard based his ideas on a theory of “nervous energy,” that is, the health and capability of the nervous system. With the energy was depleted or abused, the individual developed debilitating nervous exhaustion. Beard’s best known books were American Nervousness, With Its Causes and Consequences (1880) and Practical Treatise on Nervous Exhaustion (1884).
1904	Sir William Gowers coined the term Fibrositis (literally meaning inflammation of fibers) to denote the tender points found in patients with muscular rheumatism.
1972	Dr. Hugh Smythe laid the foundation for the modern definition of fibromyalgia by describing widespread pain and tender points.
1975	The first sleep electroencephalogram study identifying the sleep disturbances that accompany fibromyalgia was performed.
1976	Because no evidence of inflammation could be found, physicians changed the name from Fibrositis to fibromyalgia (meaning pain in muscles and tissues).
1981	The first controlled clinical study with validation of known symptoms and tender points was published.
1987	The American Medical Association recognized fibromyalgia as a real physical condition.
1990	The American College of Rheumatology developed diagnostic criteria for fibromyalgia to be used for research purposes. The criteria soon began to be used by clinicians as a tool to help them diagnose patients.
1990‘s	The concept of neurohormonal mechanisms with central sensitization was developed.
1994	Research showed an elevated cerebrospinal fluid levels of Substance P in patients with the Fibromyalgia syndrome (IJ Russell, MD Orr, B Littman, GA Vipraio)
1999	Introduction by Dr. Michael J. Rosner that there may be a overlap between Fibromyalgia and Chiari malformation/cervical stenosis. This was followed up in 2000 by Dr. Rosner and others including Robert Bennett, M.D.
2007	The U.S. Food and Drug Administration approved the drug Lyrica for the treatment of fibromyalgia. This was the first drug ever to receive FDA approval for fibromyalgia. Later, Cymbalta and Savella (not available in Canada) also received FDA approval for the treatment of fibromyalgia.
2011	Research was completed by Korean physicians showing that women with Fibromyalgia have lower levels of calcium, magnesium, iron and manganese in hair mineral analysis. (Ministry of Knowledge and Economy and Economy Frontier R&D Program in Korea), J Korean Med Sci. 2011 October; 26(10): 1253–1257

Theories

A number of different theories about what fibromyalgia is and what causes it have come and gone over the years. Unfortunately, for several hundred years fibromyalgia was considered by most doctors to be a psychological disorder. Its victims, mostly women, were accused of being hypochondriacs, malingering or simply trying to get attention. Even today, some insist on hanging on to this theory.

During the 20th century, fibromyalgia began to be recognized by some medical professionals as a real physical condition. At first it was thought to be a disease of the muscles and fibrous tissues, which was a logical assumption since muscle pain seemed to be the main symptom. However, tests done on the muscles and tissues of fibromyalgia patients failed to show any actual damage. Next, researchers theorized that it might be an autoimmune disorder, but research could not uncover any disturbance of the immune system.

Finally, as the 21st century approached and technology brought new laboratory testing methods and brain-imaging techniques, researchers were able to identify a sensitization of the central nervous system in fibromyalgia patients. Today ongoing research continues to uncover exciting new information about the causes and treatment of fibromyalgia. Hopefully one day soon fibromyalgia will be relegated to the pages of past history.

Ref: Prepared by Rory Fleming Richardson, Ph.D., ABMP | HealthCentral |