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Fibromyalgia: another view

By on June 28, 2010

Photo © Elena Derevtsova

 

As a general practitioner, hardly a day goes by when I don’t see at least one patient with a painful condition affecting the moving parts of the body.  Such patients come to see me complaining of pain in the back, neck, or shoulder, or it may be felt anywhere in an arm or leg.  There may be an obvious cause for this – an injury from a fall or sustained while playing sports – though not uncommonly the pain arises for no obvious reason.  In the practice of medicine there is an important rule: no treatment without diagnosis.

 

In my experience, in the large majority of such patients, by carrying out a systematic physical examination, it is possible to reach a diagnosis.  Then, logical treatment can be applied to the part at fault and symptoms relieved.  In most cases, blood tests, X-rays, and scans are unnecessary.  Of course, if it is suspected that a serious disorder may be present (cancer or tuberculosis, for example) then full investigation is essential.  

 

The conditions I regularly treat include low-back pain, sciatica, tennis elbow, frozen shoulder (go-juu kata), cricked neck, and muscles strains.  The methods used include steroid (cortisone) and local anaesthetic injections, spinal manipulation, and ‘deep friction massage’ and may involve working in collaboration with a physiotherapist (physical therapist).  I find such treatments are usually successful in relieving patients’ symptoms.  In over forty years of medical practice, I have never come across a patient with ‘Fibromyalgia’, and in my view this is a non-disease.    

 

The diagnosis of so-called Fibromyalgia seems to rest on persistent pain felt anywhere in the muscles, in combination with tenderness to pressure in specific areas around the neck, upper chest, lower back, elbow, or knee.  Such a patient may become demoralised by the apparent inability of doctors to help them and depression may set in.  Obviously, if you press anyone anywhere hard enough it will hurt!  The ‘tender spots’ which are cited as a diagnostic criterion are either spuriously produced or are due to the phenomenon of referred tenderness and pain.  For example, a slipped disc in the neck may cause pain and tenderness felt in the muscles at back of the upper chest, though there is nothing inherently wrong with these muscles.  I do not believe muscular aches and pains have anything to do with dietary deficiencies or that dietary alterations have any part in treating these conditions.

 

Dr Gabriel Symonds is a British general practitioner who has been serving the foreign population of Tokyo since 1984.  He has a special interest in orthopaedic medicine – the diagnosis and treatment of disorders of the moving parts of the body by non-surgical means. Tel: (03) 5458-6099   www.tokyobritishclinic.com

About Dr. Gabriel Symonds

Dr. Gabriel Symonds was the director of the Tokyo British Clinic. The clinic closed down in May 2014 after serving the expatriate community for 20+ years. Dr. Symonds has retired and the Tokyo British Clinic is now closed. Dr Symonds will continue to live in Tokyo and may be contacted by e-mail over any questions concerning medical records or related matters: symonds@tokyobritishclinic.com He will be available from another address for: smoking cessation psychotherapy/counselling circumcision information Tel: (03) 5458-6099 www.tokyobritishclinic.com