I admit to sometimes being defensive about fibromyalgia. Days like today when I’ve essentially stayed in bed the whole day make me feel like a lazy butt slacker, and natural paranoia makes me figure everyone else views me that way too. I recently read an article (see Busse et al in library) which evaluated attitudes of patients have about how they think other people view them and how other people actually do view them. The two don’t match. People with fibro figure “regular” people have a negative attitude toward them, but “regular” people actually regard people with fibromyalgia with empathy rather than being judgmental. It was interesting to see that people with fibro not only kind of worry about other people’s impression of them, but that the perception of negative impression is possibly a projection of the fibro patient’s own self-perception. In short, I’ve really resisted the idea of fibromyalgia being a stress reaction, a psychological reaction, because that puts it in the “it’s all in your head” realm, which then compounds the way attitudes are perceived.
There’s a different way to look at it all, however. I just read an article titled, “Psychological Stress in Early Life as a Predisposing Factor for the Development of Chronic Pain: Clinical and Preclinical Evidence and Neurobiological Mechanisms” by Burke et al (see library). I’ll have to add another page to the main website to be able to summarize this review article properly, but essentially, it explains how stress – either psychological or physical – in early childhood does predict the development of chronic pain disorders, such as fibromyalgia. Physical and/or psychological stress during formative years stimulates or inhibits the proper development of the pain processing system.
It makes sense. There are cultures that have bound feet, causing deformation of the soft bones that have not fully developed, or have created elongated necks (which is actually deforming the shoulders by pushing them downward), or even bound unformed skulls to create an elongated head. The human body is pliable at birth, and according to this article, chronic pain disorders (including arthritis, which has never been considered a psychological disorder) can be considered a kind of developmental malformation of the pain processing system caused by something akin to binding pliable bones.
Thinking about it that way is a little bit of a conundrum, difficult to twist the head around, but at the same time, it answers the chicken and the egg question pretty definitively. I think the next step for me to fully understand this theory (which has been pretty extensively tested with pretty tragic animal testing) is to compare the hormones and chemicals that are released by stress to the hormones and chemicals that are required for the proper development of the pain processing system. If they correlate, then it seems like there’s a possibility for prevention. Nope, medical school is out of the question….