Fibromyalgia Wars | The Journal of Rheumatology

Fibromyalgia (FM) is easy to recognize. Patients diagnosed with it have medically unexplained symptoms (MUS)1 that are often severe and generally include widespread pain, fatigue, sleep disturbance, depressive symptoms, cognitive problems, irritable bowel syndrome, multiple somatic symptoms, and a single partially objective sign — tenderness on palpation2. Representing perhaps 2% to 4% of the adult population3, patients with FM incur substantial direct and indirect medical costs, including high rates of disablement. FM is a bitterly controversial condition. It pits patients, pharmaceutical companies, some specialty physicians, professional organizations, and governmental agencies — groups with substantial political and economic power who benefit from the acceptance of FM — against the large majority of physicians, sociologists, and medical historians in what we call the “fibromyalgia wars.” The wars are fought over a series of questions that concern the legitimacy of the diagnosis. In

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• Karen Ge