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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

Fibromyalgia, It is not just in your head

Allan N. Schwartz, LCSW, Ph.D. Updated: Nov 5th 2007

It was not so long ago that many doctors rejected Fibromyalgia as nothing more than an example of hypochondria. Now we know this was incorrect. Fibromyalgia is a very real and chronic disorder that is now fully recognized by the medical community.

Approximately six million Americans are affected by Fibromyalgia and this closely approximates world wide statistics. This is according to the National Institute of Health. Most of those affected by this illness are women ranging in age from 25 to 55 years of age. What has been so frustrating about this illness and why it has taken the medical establishment so long to accept it is the fact that there are no laboratory tests that can be used to make the diagnosis. Instead, the diagnosis must be made through careful examination. This examination includes the MD tapping pressure points throughout the body that respond with soreness and pain. The Medical Doctors best trained in recognizing and diagnosing this illness are Rheumatologists.

The symptoms of Fibromyalgia are:


Muscle pains in the shoulders, buttocks, neck and lower back.

Difficulty sleeping with the inability to dream: REM sleep is limited.

Numbness or tingling sensations in the legs



Irritable Bowel Syndrome

Sensitivity to loud noises and to temperature changes



It seems to have been the depression and anxiety that contributed to some of the initial confusion about this illness. Many medical professionals tended to dismiss Fibromyalgia as a mask or screen for a deeper underlying depression. In point of fact, depression is usual the result of this illness rather than the other way around.

Chronic feelings of pain and frequent fatigue, making it impossible to work, are what cause both depression and anxiety in Fibromyalgia. At the very same time, one of the underlying factors in this disorder is a low level of serotonin levels, one of the major contributors to depression.

While this illness does not get worse or lead to either Lupus or arthritis those who already have Lupus or Arthritis can develop Fibromyalgia.

While there is no cure for this disorder treatment by a team of healthcare providers is usually the best approach in relieving its symptoms. For example, there are a variety of pain medications that can be prescribed by the doctor to relieve those symptoms. Presently, there is a new drug called Lyrica that some doctors are using for its treatment. Because sleep is so very important in reducing stress and allowing for relief from both fatigue and pain, the Rheumatologist may prescribe a sleep medication.

Along with medical treatment, there are other, non medical treatments and life style changes that are encouraged for those afflicted with this disorder. Among these are:

Massage therapy


Chiropractic treatment

Yoga classes

Meditation classes

Self care treatments include:

Avoiding caffeine

Do not drink alcohol

Eat a balanced diet

Do not smoke

Regular aerobic exercise: Even though jogging may feel painful at first, the symptoms will gradually be relieved.

Eat a balanced diet

Reduce stress

If you suspect that you may have Fibromyalgia seek the advice of your medical practitioner immediately. Do not engage in any treatments unless and until you have been examined by an MD and until you have been given a positive diagnosis. Never make any assumptions of what is wrong with you if you experience pains. Pain can be symptomatic of many illnesses.

However, if your medical tests continue to be negative and you experience depression and anxiety along with pain then seek the advice of one of the specialists in Rheumatology.

The symptoms of depression and anxiety associated with Fibromyalgia are extremely serious and not to be dismissed as minor. Even if your physician has treated you with anti depressant medications for three months and there is no relief from the pain that you experience it is time to get more expert opinion. It is true that pain can be a symptom of depression. However, if psychotherapy and medication have failed to work after a minimum of three months it is an indication that something more serious is going on.

Your comments are welcome and encouraged.

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

Fibro - Allan N. Schwartz, PhD - Apr 27th 2009

It is possible that, under the circumstances, you qualify for Medicaid and that would entitle to medical care.Dr. Schwartz

fibro and pain management - Neva Crump - Apr 27th 2009

I have fibro, I don't have any insurance and cannot afford the pain meds nor the Dr. visit to get the prescriptions.  How can I get help.  I am unemployed and cannot find work that I can handle.  I have a great deal of trouble dealing with the pain.  I can't do just any job. thanks,Neva

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