Why do many colleagues say that Fibromyalgia does not exist?
The human being always has a tendency to ignore what he does not understand. And it is easier to ignore than to take the trouble to understand. But also, as Karl Popper says “True ignorance is not the absence of knowledge, but the fact of refusing to acquire them”
Fibromyalgia is a disease that is more than 150 years old, with other names and since 1990 it was recognized by the American College of Rheumatology, which also established the first diagnostic criteria. How can you ignore this?
In 1992 the World Health Organization also recognized and classified it, as well as in 1994, the International Association for the Study of Pain (IASP). How can you ignore this? How can a doctor ignore a disease that the WHO recognized?
The disadvantage of fibromyalgia, for unbelieving colleagues, is that it does not have a visible lesion; therefore, they say that it does not exist and, in addition, all the studies are normal. The diagnosis is purely clinical.
If we use this “logic” of colleagues with mental blindness, then none of the psychiatric diseases such as depression, schizophrenia, etc. would exist. because so far they do not have a visible injury either.
Neither would the atom, the electricity, etc. exist. because we do not see them. Fibromyalgia has a world day, on May 12, established by WHO. Then neither should there be every world day of all the diseases that have it.
Why do not you understand?
Because to understand it we need new paradigms that are unknown, such as Chaos Theory, Theory of Complexity, Stress Theory, Psychoneuroimmunoendocrinology, etc. And none of this is taught in the Faculty of Medicine. We must start from the basis that the human being is a complex unit not only physical, but also psychological, social, cultural, ecological and spiritual. This is to have an integral, holistic view of the human being and it is not taught in the Faculty of Medicine either. On one side is the mind and on the other the body. This is to have a very limited, bounded, linear, simple concept of the human being. That is why Medicine fails to solve all chronic diseases, which are becoming more and more known, but there are more and more patients. Why?
This reductionism makes more and more specialties, which divide the physical human body, and each sees that organ or apparatus that is the sustenance of their specialty. What happens is that they see the human being through the hole in a lock, losing sight of the overall vision, integral, as it should be. And when, they see some physical patient, who is anxious or discouraged, etc. there they remember the mind and then the inevitable happens: “pass to Psychiatrist”.
I do not deny Psychiatry, which is an important specialty like all of them, but every physician should have an integrating vision between mind and body. But also many psychiatrists think or assert that Fibromyalgia is a depression. Only about 30% of patients with Fibromyalgia have psychiatric problems. Who is not going to get depressed having a suffering like that of Fibromyalgia, with chronic pain without diagnosis, permanent fatigue, inability to sleep properly, etc.? Any chronic disease can cause depression.
Above all, it is not understood because the Psychoneuroimmunoendocrinology, which is a new paradigm that integrates the mind and the body, adopts the theory of stress, chaos, complexity, etc. is unknown. And Fibromyalgia is a psychoneuroimmunoendocrinological disease. And this is ignored by the School of Public Medicine. The Faculty of Medicine CLAEH teaches PNIE, and Fibromyalgia is taught, of which I teach to fourth-year students. If my only tool is a hammer, I will treat all of them as if they were a nail.
Contribution: Dr Carlos Ambrosio Uboldi