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Is fibromyalgia more psychological, physical, or both?

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Updated January 09, 2005

Question: Is fibromyalgia more psychological, physical, or both?
Answer: Fibromyalgia, a pain modulation disorder, can be a frustrating and sometimes debilitating condition. Among fibromyalgia researchers there is an ongoing debate as to the cause. There is still no consensus of opinion, and current theories seem to favor both a psychological and physical cause for the illness. There is common agreement that patients with fibromyalgia very often experience anxiety and depression. However it is now believed by some, that patients with fibromyalgia are no more anxious or depressed than patients with similar chronic painful debilitating diseases, and depression and anxiety when present are the result rather than the cause of fibromyalgia. Fibromyalgia-like symptoms have been reproduced by sleep deprivation in normal volunteers. Studies have also demonstrated low levels of somatostatin, a hormone important in maintaining muscle and soft tissue health. This hormone is produced when the body is in a deep sleep pattern. Other hormones and body chemicals that alter pain, sleep, and mood, have also been suggested as possible triggers for fibromyalgia. It appears, therefore, that although psychological factors are an important part of the fibromyalgia symptom complex, this may not be a primary psychological disorder, a psychosomatic disorder, or a form of malingering behavior. Neither has it been proven that it is an inflammatory rheumatic disease since no evidence of inflammation has ever been demonstrated in fibromyalgia patients. The great debate continues....(Answer provided by the late Dr. Raymond Federman, aka Dr. Bones, who passed away on September 2, 2003. The care of his patients even in retirement was always his joy.)

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