A new study from the Mayo Clinic found that Fibromyalgia (http://www.arthritistoday.org/conditions/fibromyalgia/index.php) may be more common than previously believed, especially among men.
Until recently, Fibromyalgia has been understood as a difficult to diagnose and treat rheumatic disease, primarily affecting women. Researchers found that men have been underdiagnosed with the disease- and they might actually account for as many as one-third of undetected Fibromyalgia cases. Experts believe the reason for this misrepresentation in men can be attributed to outdated diagnosis methods.
The American College of Rheumatology (ACR) http://www.rheumatology.org/ developed a checklist that has faithfully been used to diagnose Fibromyalgia since 1990. This checklist has been criticized for overlooking significant symptoms – such as fatigue, depression, sleep difficulties and cognitive problems – and requiring a difficult-to-perform “tender point” exam – a physical check for 18 predetermined painful areas on the body. In 2010 and again in 2011, the ACR published an updated checklist including symptoms important to those who suffer from Fibromyalgia. Both of these newer checklists leave out the tender point exam.
In this study, researchers used both the 1990 and 2010 versions to look for Fibromyalgia in the population of Olmsted County, Minn. When using the 2010 checklist, the rate of Fibromyalgia in women was three times higher than officially diagnosed; in men it was 20 times higher. Ann Vincent, MD, medical director of the Fibromyalgia and Chronic Fatigue Clinic at Mayo Clinic in Rochester, Minn. says that “Men are innately less tender than women and they’re less likely to pay attention to pain or seek medical attention for it,” she says. “What this study shows is that men who meet the 2010 criteria for Fibromyalgia are unlikely to have been diagnosed [using earlier standards].”
The older tender point checklist restricts men- who are less likely to report pain or seek medical attention for it- from a more accurate assessment. Broadening the definition of Fibromyalgia to include other important symptoms opens up opportunity for proper diagnosis and treatment for both men and women.
Dr. Vincent explained the significance of broadening the definition of Fibromyalgia to include other symptoms besides pain. This will not only facilitate a more accurate diagnosis, but will improve the quality of treatment too. “Fibromyalgia is multidimensional,” she says. “Patients have pain receptors firing all the time. This generates a lot of pain, to which the body gradually becomes sensitized. And in fighting that pain, people become fatigued, have unrefreshing sleep and cognitive problems. It’s important for primary providers to recognize that chronic pain kicks the symptom burden much higher and that symptom management [is important].”
Researchers emphasize that the 2010 guidelines are expected to compliment, not replace, the 1990 criteria. Dr. Vincent says, “The most important finding of our study is that the new criteria provide a more comprehensive way for clinicians to recognize Fibromyalgia.” The findings of this study offer new insight into the prevalence, diagnosis, and treatment of a very complex disease. See http://www.arthritistoday.org/news/fibromyalgia-in-men-239.php