Thursday, December 20, 2012

Men with Fibromyalgia go undiagnosed

Note: Although depression and anxiety are listed as symptoms of
fibromyalgia technically they are separate disorders which can co-occur
with any disease. They may be a normal response to chronic pain. As
always, a common caveat with medical populations is that symptoms that
commonly occur with disease, including fatigue or loss of energy, changes
in sleep patterns and changes in appetite, may be misinterpreted by
healthcare providers, researchers or patients as mood-related particularly
when specificity and severity are lacking

Men with fibromyalgia often go undiagnosed, Mayo Clinic study suggests
December 19, 2012 in Arthritis & Rheumatism

Fibromyalgia is a complex illness to diagnose and to treat. There is not
yet a diagnostic test to establish that someone has it, there is no cure
and many fibromyalgia symptoms—pain, fatigue, problems sleeping and memory
and mood issues—can overlap with or get mistaken for other conditions.

A new Mayo Clinic study suggests that many people who have fibromyalgia,
especially men, are going undiagnosed. The findings appear in the online
edition of the journal Arthritis Care & Research. More research is needed,
particularly on why men who reported fibromyalgia symptoms were less likely
than women to receive a fibromyalgia diagnosis, says lead author Ann
Vincent, M.D., medical director of Mayo Clinic's Fibromyalgia and Chronic
Fatigue Clinic.

"Health care providers may not think of this diagnosis when face to face
with a male patient with musculoskeletal pain and fatigue," Dr. Vincent
says. "These findings need to be explored further."

Researchers focused on Olmsted County, Minn., home to a comprehensive
medical records pool known as the Rochester Epidemiology Project, and used
multiple methods to try to get at the number of people over age 21 with
fibromyalgia. They used the epidemiology project to identify just over
3,000 patients who looked like they might have fibromyalgia:

Roughly a third had a documented fibromyalgia diagnosis. That amounted to
1.1 percent of the county's population 21 and older. In the second method,
researchers randomly surveyed Olmsted County adults using the American
College of Rheumatology's fibromyalgia research survey criteria. The
criteria include the hallmarks of fibromyalgia: widespread pain and
tenderness, fatigue, feeling unrested after waking, problems with memory or
thinking clearly and depression or anxiety, among other symptoms.

Of the 830 who responded to the survey, 44, or 5.3 percent, met those
criteria, but only a dozen had been diagnosed with fibromyalgia. Based on
the study's findings, the researchers estimate that 6.4 percent of people
21 and older in Olmsted County have fibromyalgia—far more than have been
officially diagnosed
with it. Fibromyalgia is more common in women, but men
can get it too.

The discrepancy between the number of people reporting fibromyalgia
symptoms and the number actually diagnosed with the condition was greatest
among men, the study found. Twenty times more men appeared to have
fibromyalgia based on their survey response than had been diagnosed, while
three times more women reported fibromyalgia symptoms than were diagnosed.

"It is important to diagnose fibromyalgia because we have effective
treatments for the disorder," says co-author Daniel Clauw, M.D., director
of the University of Michigan Health System Chronic Pain & Fatigue Research
Center. Studies also show that properly diagnosing people with fibromyalgia
reduces health care costs, because they often need far less diagnostic
testing and fewer referrals looking for the cause of their pain, Dr. Clauw

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