Chapter 1

Introduction

Fibromyalgia and Chronic Fatigue Syndrome

I consider fibromyalgia and chronic fatigue syndrome to be similar conditions. I have seen hundreds of patients with these 2 diagnoses and I have noticed that their symptoms overlap along a continuum. Most patients with the diagnosis of fibromyalgia also have fatigue and most patients with the diagnosis of chronic fatigue also have some muscle aches. Only rarely do I encounter patients at either end of the continuum with only muscle aches or only fatigue. Regardless of the diagnosis healing and recovery is the same for both groups. Nailing down the precise label for your condition is not necessary for recovery. However, if you are dealing with any legal, insurance or disability forms a medical professional needs to confirm your diagnosis as the legal and insurance system is strictly black and white.

Fibromyalgia is defined as muscle pain present for at least 3 months in all quadrants of the body (upper and lower, left and right side) with at least 11 out of 18 standard tender points established by the American College of Rheumatology in 1991. It is a diagnosis of exclusion as other medical conditions such as rheumatoid arthritis must be ruled out by a thorough examination by a medical doctor and appropriate blood tests. Rheumatologists are usually the medical specialists that confirm the diagnosis. Many patients have symptoms for years before the diagnosis is made. If you examine the definition of the diagnosis you will see that it is quite dependent on the individual examiner and how you are doing on the consultation day. Tender points can vary from day to day. If you are having a good day you may have only 10 positive tender points and not meet the criteria for a definite diagnosis. If this situation applies to you this manual is still appropriate for you. Note that the subtitle states that the manual is a guide to healing and recovery for people with symptoms of fibromyalgia and/or chronic fatigue and not just for people with a definite diagnosis. You can make excellent progress in your recovery. If you have a borderline diagnosis do not wait until you are severe enough to have a definite diagnosis. Start working on your recovery now.

Chronic fatigue syndrome is an unexplained severe, persistent or relapsing, debilitating fatigue that is not due to ongoing exertion and does not improve substantially with rest. It is diagnosed when fatigue symptoms exist for at least 6 months and there are at least 4 of the following symptoms also present: impairment in memory and concentration, sore throat, sore lymph nodes in the neck, muscle pain, joint pain, headache, unrefreshing sleep and post-exertional malaise. Like fibromyalgia it is also a diagnosis of exclusion as other medical conditions such as anemia, depression or thyroid deficiency must be ruled out. Both fibromyalgia and chronic fatigue syndrome do not have any standard medical tests that can confirm the diagnosis in today's current range of medical tests. Both diagnoses are based on patient reports and are considered subjective. This is why so many of you have problems with the legal system or insurance companies which rely on objective information. If medical technology in the future makes it possible to do a simple objective test then those of you struggling with the legal and insurance system would no longer have any problems.