Fibromyalgia syndrome (FMS) is a condition of chronic pain in certain locations known as tender points. FMS is further formally defined by the American College of Rheumatology (ACR) by the number of areas involved and the length of time they have been present.
FMS patients are frequently improperly diagnosed for long periods of time. This delay can lead to anxiety, insomnia, depression, or other emotional disturbances This delay can also lead to the notion that these patients are malingerers. Unfortunately, these concepts are perpetuated by the traditional referral to IME's (independent medical evaluators) of inappropriate specialties, such as neurology, orthopedics, or neurosurgery. These opinions are then supported by claims adjusters or case managers whose primary responsibility is to a third party carrier. The medical literature shows that emotional disturbances are no more frequent in pre-morbid FMS patients than in the general population.
While many cases of FMS are idiopathic (no known cause), a significant portion of cases are caused by isolated injuries or repetitive trauma. FMS can develop when an otherwise common ailment is not treated in a timely or aggressive fashion.
Since the condition is chronic, FMS patients usually need ongoing care. Treatments include anti-inflammatory agents, anti-depressants, analgesics, physical therapy, and selected injections of anesthetics, steroids, or other compounds. The keys to establishing causality lie in proving the diagnosis through education, demonstrating the symptoms and signs in the patient, and documenting the chain of events through use of appropriate references in the medical literature.