COMMENTARY

What Is Fibromyalgia? Medscape Readers Weigh In

Bret Stetka, MD

Disclosures

February 28, 2011

In This Article

What Is Fibromyalgia? Introduction

"Fibromyalgia is a name in search of a meaning."
-Anonymous Canadian rheumatologist

What is fibromyalgia, aside from being a major frustration to patients and clinicians? And what causes it?

Medscape recently published a debate posing these questions to Dr. Charles Argoff, a neurologist specializing in pain, and Dr. Jonathan Kay, a rheumatologist. Tempers flared throughout (respectfully of course), with Dr. Argoff taking the position that fibromyalgia is itself a distinct condition associated with widespread reduction in a patient's pain threshold, and thus a heightened sensitivity to pain. Dr. Kay held a different view, arguing that fibromyalgia is merely a symptom complex with a number of possible causes.

Etiology aside, progress has been made: There are currently 3 US Food and Drug Administration (FDA)-approved treatments for fibromyalgia. These are duloxetine, milnacipran, and pregabalin: all of which appear to be at least partially effective. Still, managing the condition remains a major challenge to clinicians, and disagreement continues as to what exactly fibromyalgia is and how one should approach diagnosis and management.

In response to our debate, readers -- including physicians, nurses, and patients -- flooded Medscape's open discussion forum with their own thoughts, theories, and management tips (plus a few tirades). On the following pages, we've highlighted some of the more interesting, thoughtful, and strong reader opinions.

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