BOSTON, Dec. 1, Reuter: Patients who complain of chronic back or muscle pain, fatigue and depression are often labeled hypochondriacs by their families, friends and sometimes even their physicians.

But doctors at the Arthritis Centre at Boston University School of Medicine believe that large number of these sufferers may actually have a little-understood form of Arthritis known as Fibrositis, which can be very difficult to diagnose and even harder to cure.

The disease is 10 times more likely to strike women than men. It is the leading cause of Rheumatism in women between the ages of 25 and 50.

Victims typically suffer from a combination of complaints, including chronic pain, tiredness, bowel disorders, disrupted sleep patterns, depression and chronic headaches.

Cold and damp weather and too much or too little activity can ‘exacerbate the condition and some patients cannot continue to work ‘or function normally because of the pain.

“This is a disease that results in the patient’s whole way of life being changed”, said Dr. Don Goldenberg, Clinical Director at the Arthritis Centre and one of only a handful of medical researchers in the country studying Fibrositis. “It is a chronic, painful condition”

Fibrositis was first identified at the tum of the century but its causes could not be pinpointed and many physicians over the ‘years have regarded its symptoms ‘as psychosomatic.

“Fibrosis is so ill-defined that 20 years ago the food and drug administration ordered it taken off of drug package inserts because they believed the disease did not exist”, said Dr, Alan Cohen, and Director of the Arthritis Centre.

Despite the Myriad of systems, routine physical examinations and laboratory tests usually fail to produce any evidence of illness, and victims are frequently misdiagnosed, Goldenberg said.

There is no clear-cut inflammation of the joints and most attempts to find something wrong with the tissue around the joints have failed, he said.

He recommends that physicians look for a specific set of tender areas in the patient’s body, but noted that these points “can be all ‘over the place”.

Goldenberh, a Rheumatologist, first began studying the disease several years ago when his wife displayed some of its symptoms and could find no remedy, despite being examined by several doctors. He made the diagnosis himself after reading an article on Fibrositis in a medical journal, and in researching the condition discovered there was very little scientific information available.

Doctors at the Arthritis Centre have since conducted several clinical studies of the disease in an effort to identify links between Fibrositis and other physical or psychological disorders.

“We do a lot of psychiatric evaluation”, said Goldenberg, although he believes most patients fit a certain physical profile and have no major ongoing psychological disorders.

However, the researchers have found that in a significant number Of cases, a severe depression preceded the muscular pain by a year or more and these patients often had family histories of depression.

In many patients who suffer from depression, doctors believe that the condition is caused by alterations in body chemicals found in the brain. Goldenberg said Fibrositis may result from a similar imbalance, although no conclusive link has been found to date. He said there is also a theory that Firbrositis sufferers may lack enough “stage four sleep”, a very deep sleep that allows the muscles to relax.

Doctors are currently testing the effects of Elavil, an anti-depression drug that also aids in restoring regular sleeping patterns on Fibrositis patients and have met with some success, he said.

Goldenberg team, which includes specialists from a variety of fields, also discovered a greater incidence of Raynaud’s phenomenon in Fibrositis patients than the population at large.

Raynaud’s phenomenon is a condition found primarily in young women that causes them to develop blueness or whiteness of their fingers or toes in response to cold or other stimuli. Doctors have yet to find a cure for Fibrositis and until they do ‘most patients diagnosed with the condition will probably have to live with it for the rest of their lives.

However, Goldenberg said that if the disease is properly diagnosed, symptoms can often be alleviated with a program of medication, exercise and avoidance of stressful situations.

Article extracted from this publication >> December 5, 1986