Fibromyalgia

Fibromyalgia is a complex and controversial condition that can have devastating effects on your work and personal life.  Fibromyalgia causes widespread muscular pain and weakness, but can also be associated with a host of other debilitating symptoms such as fatigue, muscle spasm, headache, digestive problems, sleep disturbance and depression.  One of the most distressing symptoms for many people is what is commonly referred to as “fibro fog”.  Fibro fog is a mental cloudiness and inability to focus that makes just getting through a simple day almost impossible.  People who suffer from fibromyalgia usually have both physical and mental limitations that prevent them from working.

Fibromyalgia is a diagnosis of exclusion in that other potential causes of these symptoms must be eliminated before a diagnosis of fibromyalgia is reached.  Too often primary care physicians will use this diagnosis as a kind of “trash can” diagnosis, i.e., “I can’t figure this, out but she keeps complaining, so I’m going to call it fibromyalgia.”  However, fibromyalgia is considered a rheumatologic disorder with some very specific rheumatologic diagnostic criteria.  Because other causes must be ruled out, a proper diagnosis of fibromyalgia can take a very long time to get.  Typically, fibromyalgia sufferer goes from doctor to doctor to investigate all potential causes of the chronic pain and fatigue associated with this condition.  It is not unusual for a fibromyalgia sufferer to have seen a neurologist, an orthopedist, a psychiatrist and a pain specialist in addition to a primary care physician and a rheumatologist, before we ever speak to them about disability.  If you can see all those doctors, you should.

Unfortunately, fibromyalgia is by its nature a highly subjective problem.  In other words, no one can get inside your skin and feel how much pain you are experiencing or how tired you are.  We cannot take a picture of it, and there is no machine that is going to give us a number that reflects the degree of severity of your pain.  So how do we prove a fibromyalgia case?  The key is that you consistently present as having difficulty moving around and you appear visibly fatigued and out of it to many different medical professionals over the course of years.  Showing up at your primary care physician’s office and getting a one off diagnosis of fibromyalgia is not going to cut it.  What it takes is a big stack of medical records, from multiple doctors, over the course of a long time.  And those doctors need to be able to say, “Yes, I believe her, and here’s why.”  For that reason, compliance with recommended treatment is critical.  You need to maintain credibility with your doctors, and the best way to lose your credibility is to fail to do what they ask.  If they want you to lose weight, make sure they know about your weight loss efforts.  If they want you to quit smoking, quit smoking.  If they want you to walk 30 minutes a day, do it.  If your doctors are willing to say that you would not be able to attend work regularly, would not be able to complete a whole 8 hour work day, and would not be able to maintain concentration and focus on even simple tasks, then you have a shot at being considered disabled.  However, be aware that a case based on fibromyalgia alone is always an uphill battle.