A Canadian judge preferred the evidence of a psychiatrist that Fibromyalgia was a form of Hysterical Conversion. She discounted the opinion of a rheumatologist because of his "personal and perhaps financial interest in perpetuating the existence of this condition."
Another rheumatologist and a specialist in physical medicine and rehabilitation have argued that Post-Traumatic Fibromyalgia is not a disease entity because it fails all eight rules of medical causation. They proposed rather that the symptoms are an expression of psychosocial distress.
The 1990 report of the American College of Rheumatology criteria for Fibromyalgia did not address the role of trauma. The first recommendation of much the same working group in their 1994 Consensus Report was that the terms "reactive" and "post-traumatic" be eliminated.
While the biochemical mechanisms producing the symptoms of Fibromyalgia are being clarified, a causal connection with trauma is becoming more tenuous.
A long-term study of 39 patients found that symptoms of Fibromyalgia Syndrome improved somewhat in the majority but persisted at least 15 years on average.
Meantime, laboratory researchers have been clarifying the disturbances of neurotransmitter hormones, and the development of antibodies which might attack the patient's own tissues. Are these side-effects, or are they part of the causal mechanism of symptoms, perhaps as a result of chronic stress?
Medical Litigation News
Fibromyalgia 1999 - 2000
The Arthritis Foundation
National Fibromyalgia Research Association
David A. Nye MD
Robert Bennett, M.D. Oregon Health Sciences University
National Chronic Fatigue Syndrome and Fibromyalgia Association
Colorado Health Net
Frederick Matsen III MD Chairman, Department of Orthopaedics, University of Washington
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