Tuesday, October 2, 2012

Fibromyalgia Poorly Served By Drug Happy Rheumatologists

The term “fibro” was used to designate soft (or fibrous) tissue involvement and “myalgia” is Latin for “pain”. 

Fibromyalgia was originally thought to be a rheumatologic condition because - like a disease such as rheumatoid arthritis - it is characterized by musculoskeletal pain. But research has since shown that there are no abnormalities in the musculoskeletal system in people with fibromyalgia. Instead, the problem appears to lie in the pain processing pathways of our central nervous system.

The term Fibromyalgia was created by rheumatologist Dr. Frederick Wolfe in 1984 to describe a condition affecting primarily women.

Of course if you’re subscribed to my free Health Matters newsletter, http://drmurphreesnewsletters.com, you read my article about how Dr. Wolfe now denies that fibromyalgia is a real disease-Sad but true.

Before 1990, no guidelines for evaluating and diagnosing fibromyalgia existed. To reduce misdiagnosis and confusion, the American College of Rheumatology (ACR) sponsored a multicenter study to develop these criteria; the results were published in 1990. In 1992, at the Second World Congress on Myofascial Pain and Fibromyalgia, the diagnostic criteria for fibromyalgia were expanded and refined.

Since rheumatologists were the first health specialty to promote and ratify the diagnostic criteria for fibromyalgia, they became the doctors of choice for seeing fibro patients. It didn’t matter that may at least early on had no idea what fibromyalgia was or how to treat it-unfortunately this is often the case today. Many rheumatologists won’t take any new fibro patients or are openly skeptical about the condition.

I believe rheumatologists are the worst possible doctors to manage a fibromyalgia patient’s case. 

Why? There are several reasons -

Because they deal in hard to treat autoimmune diseases, and see patients other doctors don’t want to see, Rheumatologists have a lengthy waiting list-may take 3 months to be seen.

A waiting list of patients can create a lack of empathy for the longwinded, hard to treat fibro patient who needs more than a five-minute office visit every 3 months. “Who cares if you come back I have plenty of other patients waiting in line to be seen.”

Rheumatologist are trained to use drugs, usually incredibly toxic drugs, Methotrexate, gold salts, Plaquenil, Enbrel, etc.

Here is the warning box info for Enbrel:


Patients treated with Enbrel are at increased risk for developing serious infections that may lead to hospitalization or death.

Most patients who developed these infections were taking concomitant immunosuppressant’s such as methotrexate or corticosteroids.
Enbrel should be discontinued if a patient develops a serious infection or sepsis.

Reported infections include:

Active tuberculosis, including reactivation of latent tuberculosis. Patients with tuberculosis have frequently presented with disseminated or extrapulmonary disease. Patients should be tested for latent tuberculosis before Enbrel use and during therapy. Treatment for latent infection should be initiated prior to Enbrel use.

Invasive fungal infections, including histoplasmosis, coccidioidomycosis, candidiasis, aspergillosis, blastomycosis, and pneumocystosis. Patients with histoplasmosis or other invasive fungal infections may present with disseminated, rather than localized, disease. Antigen and antibody testing for histoplasmosis may be negative in some patients with active infection. Empiric anti-fungal therapy should be considered in patients at risk for invasive fungal infections who develop severe systemic illness.

Bacterial, viral, and other infections due to opportunistic pathogens.
The risks and benefits of treatment with Enbrel should be carefully considered prior to initiating therapy in patients with chronic or recurrent infection.

Patients should be closely monitored for the development of signs and symptoms of infection during and after treatment with Enbrel, including the possible development of tuberculosis in patients who tested negative for latent tuberculosis infection prior to initiating therapy.

Lymphoma and other malignancies, some fatal, have been reported in children and adolescent patients treated with TNF blockers, including Enbrel.

Scary huh?
The black box warning for Plaquenil is just as scary.

Immunosuppressive medications used by rheumatologists for autoimmune diseases are fraught with danger. That is the reason these drugs are used only by rheumatologists and not by internists, family physicians, or other medical specialists. Rheumatology is a medical specialty developed to prescribe and monitor the side effects of these high-risk medications.

The rheumatologists mentality has been conditioned over the years to continue prescribe more and stronger symptom suppressing drugs. This is a disastrous approach for fibromyalgia patients. Most fibro patients can’t tolerate drugs - they only make them worse. Drugs don’t make you healthy, they can be helpful but they don’t make you healthy. The only way to reverse fibromyalgia is to get healthy!

Using an atomic bomb like Enbrel or Plaquenil to treat fibromyalgia symptoms is not only stupid, it is incredibly dangerous!

Traditional medicine and drug therapy is a dead end for fibro patients. You can read my past blog Traditional Medicine Fails Fibro below or even better:

You can listen to my past First Tuesday of the Month Fibromyalgia Teleconference recordings here:

My fibro blog- Traditional Medicine Fails Fibromyalgia


  1. I have never tried Enbrenil, but my Rheumatologist put me on Plaquenil. That stuff IS scary. I started getting vision problems with a month of use. Scotomas, ocular migraines...not to mention weight gain and stomach pain. The Rheumatologist told me that it wasn't due to the medicine. Really? They do want to keep pushing drugs and I am so tired of it. More medicines mean more side effects! I just want my life back!

  2. I was dx'd with Fibromyalgia in 2008. Last week I was dx'd with Psoriasis and this week with Psoriatic Arthritis. When I asked this new rheumatologist if maybe I had been wrongly dx'd with Fibro she said "No, you clearly have both.".
    So now what should I do? She is running tests before starting me on Methotrexate. And although I know the risks of these drugs I've had very little life in the last 5 years. I want some quality of life back.
    I mean I am a 7+ year breast cancer survivor.....I deserve to have a life worth living.

  3. Just keep looking for the right doctor. I found mine ... she's a GP but is well versed in Fibro and keeps up with all the newest findings. She also sent me to a Pain Management Clinic .. just to see if they would do anything differently that she was .. Nope, they said they would be willing to take me on but since I had a good relationship with my Primary doctor that there would be no benifit to my changing doctors. She sees me every three months. I do use some narcotics but only as prescribed and haven't had a dosage increase in over 5 years. I manage my flares with other things like muscle relaxers or Lyrica ... but honestly.. I have had the best five years of my adult life. I am able to hold down an 18 hr a week job and while I still have some bad days ... I no longer lay in the bed and pray for death. The right doctor is out there .. just keep looking .. don't give up .. don't compromise ... and be your own best advocate. You know what works for you and what doesn't. You know the risks you are willing to take and what you aren't. Don't let a doctor bully you into something you are uncomforable with. Find a doctor you feel REALLY gets it.. find one that gets YOU... it took me nearly 8 years but I wouldn't change doctors now for anything. Good Luck out there... there IS help and hope.

  4. Help! I had a bout of Stevens-Johnson Syndrome in 1996, and the issues started. After 2 months they told me what it was, then 2 months later they told me they thought I would live through it, then the pain started. It went from one spot to another with no let up. I was left with a partially paralyzed voice box, and very bad skin that still sloughs off. After 5 years they said I had Fibromyalgia, Reynauds phenomenon and Osteo-arthritis. Last year my dermatologist told me I now have Psoriasis. They think the S-J was caused by Ibuprofen, which leaves me very little help. I try to keep going, but now for no reason my weight has started going up enough that I can really notice it, and I am very heavy already. I will not give up, but it is very hard to stay positive a lot of the time. I need something that will at least ease my constant discomfort.

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  6. Fibromyalgia is a bewildering and regularly incapacitating jumble, yet medicine can offer assistance. Lyrica, a prescription used to treat patients with Seizures, torment from shingles, and nerve torment from diabetes and spinal line wounds, is putting forth new plan to those living with the agony of Fibromyalgia. Here is the thing that you have to ponder the utilization of Lyrica to administer Fibromyalgia, from the medication's profits to its reactions.

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