Odyssey to Relief
by Marie Karnes

As scientists start to unravel the complex underpinnings of fibromyalgia, effective management strategies and treatments are revealed. But diagnosis still is tricky.

Imagine a young life brimming with vitality -- taking college theatre classes by day, playing soccer after school, dancing at night -- when suddenly, without warning, intense, widespread pain appears and is disabling. It hurts to lift a toothbrush, and it's too much trouble to go to class, leading to stress and worry about graduating and what the future has to hold. 

That was theatre major Gregory Shane's experience when fibromyalgia upstaged his active lifestyle. But for Shane, then a senior at Tulane University in New Orleans -- and for the estimated 0.5 percent of men and five percent of women in the United States who have fibromyalgia -- the development of symptoms was not an ending. It marked the beginning of his personal odyssey to find effective treatments and get his life back. Doctor appointment after doctor appointment failed to yield a diagnosis, let alone relief or a cure. The pain didn't yield, but neither did Shane. His persistence -- along with the persistence of many researchers in recent years -- has been paying off. 

Now thought to involve abnormal pain-processing pathways within the central nervous system, fibromyalgia gained some long-overdue legitimacy in 1990, when the American College of Rheumatology (ACR) set criteria for classifying the syndrome. With this classification structure in place, researchers could assemble and study people with similar clinical profiles, and that made it easier to do consistent studies to determine which treatments were effective. 

Fibromyalgia research has since skyrocketed. In fact, according to a search of the National Library of Medicine database (www.pubmed.com) more than 2,700 studies and research papers referenced the word "fibromyalgia" in the title or abstract from the publication of the ACR criteria in February 1990 through October 2004, compared to just 437 studies and research papers from 1976 -- the year the term "fibromyalgia" became standard -- to 1990, when the ACR criteria were published. 

Although these studies haven't resulted in a specific cause or magic-bullet cure, they have, in leaps and bounds, enhanced the knowledge of the complex mechanisms involved in fibromyalgia and enabled medical professionals to spotlight more effective, individualized management strategies and treatments that relieve symptoms for people with fibromyalgia.

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