The phrase I hear out of the mouth of so many people after they say the word 'fibromyalgia' is, "if you believe in that sort of thing." Not without justification, fibromyalgia has transcended simple diagnostic criteria and entered the realm of myth. People will walk into the office and tell me that their fibromyalgia is acting up, or that they know someone else who has fibromyalgia and that they benefited from
I really want to find the doctor who first started telling people they have fibromyalgia and beat him. While I agree, there are chronic pain syndromes, but to simply write it all off as fibromyalgia and call it a day, that's practically criminal. And even worse, to give out narcotics and call that treatment, that should be a capital offense.
If you ask me which camp I'm in, I ascribe to the 'there is no such thing as fibromyalgia' philosophy. There is a root cause always, whether it's osteoarthritis, hepatitis C, or any number of diseases that fuck one up. Half the time, I am willing to say that rather than having fibromyalgia, the patient has narcotic withdrawl symptoms. The best successes I've had with chronic pain patients are to introduce changes in living. I have yet to meet someone who is happy and well-adjusted and in chronic pain.
Part and parcel with my disbelief of fibromyalgia, I don't believe in OxyContin either. It has no therapeutic value. There is never a situation, except terminal cancer patients, where I would say go ahead, here's some oxycontin. I've written scripts for oxycontin 5 times.
Maybe I'm just not sympathetic, but from this side of the examining table, it's hard to figure out if someone has pain from some random disease or pain from being alive. Even worse, how can I tell if their pain is from too little pain medication or from being on too much pain medication? And only seldomly do I have a patient that has the insight to realize that they've traded one demon for another.