Tuesday, 14 July 2009


(not written by me) Thanks to Cynthia Martin for finding and posting this in a fibro support group.

Although the term "fibromyalgia" was not coined until 1976, throughout
history people have reported illnesses with strikingly similar symptoms.
These reports can be found as far back as Old Testament Biblical times.

Early Evidence:

Depictions of chronic widespread pain have appeared in literature since the
dawn of literary embellished recorded time. For example, such references to
the protagonist' s symptoms and appearance appeared in the Babylonian epic
of Gilgamesh from 2800 B.C.

In 500 B.C. Hippocrates wrote about "those lighter pains which have no
evident association with podagra and do not cause swelling." He observed
that the pains had imprecise localization and character, tended to be
weather sensitive and were assocaited wtih stiffness, tenderness and

The Bible also includes references to chronic neuro-muscular pain.

Following is Job's vivid description of his physical anguish: "I, too, have
been assigned months of futility, long and weary nights of misery. When I go
to bed, I think, `When will it be morning?' But the night drags on, and I
toss till dawn.And now my heart is broken. Depression haunts my days. My
weary nights are filled with pain as though something were relentlessly
gnawing at my bones." (Job 7:3-4; 30:16-17 - NLT)
or also from Job 30:17 "...my bones are pierced in me in the night season
and my sinews take no rest."
Also the passage, "It is nothing to you, all that pass by? Behold ye and see
if there be any pain like unto my pain, which is done unto me, wherewith the
Lord hath afllicted me in the day of his fierce anger. From above hath he
sent fire into my bones...and I am weary and faint all day." (Jeremiah in
Lamentations 1:12-13)

Alfred Nobel, who invented dynamite and originated the Nobel Prize, may have
endured fibromyalgia. Many letters to his mistress describe multiple muscle
aches and pains, migraine headaches, gastrointestinal disturbances, cold
intolerance and problems when the weather changed.

Another well-known person who reported fibromyalgia- like symptoms was
Florence Nightingale, an English army nurse during the Crimean War
(1854-1856) who was a pioneer in the International Red Cross Movement.
Nightingale became ill while working on the front lines and never really
recovered. She was virtually bedridden much of the rest of her life with
pain and fatigue resembling fibromyalgia until her death in 1910.

Descriptions of musculoskeletal aches and pains can be found in the European
literature dating back to the late 16th century. The French physician
Guillaume de Baillou first introduced the term rheumatism to describe
clinical manifestations of muscular pain and acute rheumatic fever in 1592.
In the 1600's Fibromyalgia- like symptoms were first given a name: muscular
rheumatism. By the 18th century, physicians started to distinguish articular
rheumatism with deforming features from painful but nondeforming soft tissue
musculoskeletal disorders, which generally were called muscular rheumatism.

Changes in weather and their association with symptoms were recorded by
Shakespeare in A Midsummer Night's Dream. "Therefore the moon, the governess of flood. Pale in her anger; washes all the air. That rheumatic diseases do abound. (Act 2, scene 34, I, 105).

Robert Burton's treatise on "The Anatomy of Melancholy" published in 1621,
noted that "the Minde most effectually works on the Body, producing by his
passions and perturbations, miraculous alterations as Melancholy, Despaire,
cruelle disease.." Some people with melancholic depression were noted to
have pain and fatigue as well.

In 1750, Sir Richard Manningham described "febricula" or little fever, among
mostly upper class women who were afflicted with "listlessness, with great
lassitude and weariness all over the body...little flying pains...the patient is a little...forgetful. "

The term "rheumatism" was also used to be a diagnostic of nonarticular
musculoskeletal disorders by F.B. de Sauvages de la Croix in 1763 in the
first modern classification of rheumatic diseases.


Fibromyalgia was once thought to be a mental disorder. This mysterious
illness has been studied since the 1800's and has been identified by a
variety of names, including hysterical paroxysm, muscular rheumatism and
fibrositis. The symptoms were stiffness, aches, pains, tiredness, and
difficulty sleeping.Literature on muscular rheumatism was published by
German, Scandinavian, and British physicians from the beginning of 1800s. In
1816, Dr. William Balfour,a surgeon at the University of Edinburgh, gave the
first full description of fibromyalgia. He described nodules and suggested
that inflammation in muscle connective tissue is the cause for nodules and

In 1821 the British physician R.P. Player observed that patients reported
pain when certain vertebrae were pressed and "in many instances patients are
surprised at the discovery of tenderness in a part, of whose implication of
disease they had not the least suspicion." The tender points that are common
with fibromyalgia were first described by Dr. Balfour in Scotland in the
early 1824.He argued that chronic rheumatism included disorders of the
"cellular membrane which abounds in the human body and connects every part."
In 1827, another British physician, Scudamore, identified rheumatism as
"pain of a peculiar kind, usually attended with inflammatory action,
affecting the white fibrous textures belonging to muscles and joints, such
as tendons, aponeuroses, and ligaments; the synovial membranes of the bursae and tendons; and nerves.." He endorsed the idea of inflammation in fibrous tissue asserted by Balfour. The term "spinal irritation" entered the terminology in 1928 largely due to the efforts of Thomas Brown of Glasgow, who noted that young women had painful tender spots in their spine on pinching. This pain was "in the majority of cases more severe than in those of real vertebral diseases." And in 1832, I. Parrish noted that irritation of the spinal marrow accounts for a "peculiar neurologic affection of females."

In the 1841, F. Valleix set forth in his treatise on neuralgia, "Traite de
Neuralgies", the referred painful trigger point concept (points douloureaux) .
He described painful points in various parts of the body, which caused
referred pain to other regions on palpation. He noted that these painful
points were closely related to the route of different nerves. He proposed
muscular rheumatism as a form of neuralgia.

In 1858, Inman remarked that the radiation of pain was independent of the
course of nerves. He proposed a functional change in muscles and explained
nodules as hypertonus or spasm of the muscle. In 1903, Cornelius opposed
Valleix's idea of referred pain via nerves. He suggested that local points
of tenderness were related to hyperactive nerve endings, which he called
nerve points. He attributed nerve point hyperactivity to external
influences, such as climatic, emotional, or physical exertion. However, he
insisted that the radiation pathway was different from nerve routes. He
explained referred pain on reflex mechanisms.

Robert Froriep, a German physician noted in 1843 a type of rhuemetism in
which he would palpate what he called "muskelschwiele" or muscle callouses
or welts. He described a rheumatic state in which tender areas in the
muscles were accompanied by pain, stiffness and occasionally, fever. In 19th
century Germany this condition was called Weichteilrheumatism us or soft
tissue rheumatism. The Swedish massagist Unna Helleday described neurologic
pain spreading from nodules in rheumatic muscles in 1876.

A psychiatrist in the United States wrote in 1880 about a collection of
symptoms consisting of fatigue, widespread pain, and psychological
disturbances. He called it neurasthenia and attributed it to the stress of
modern life. The first description of this condition with the term
neurasthenia can be found in a text published in 1892 by a physician
referred to as the father of modern medicine, Sir William Osler. In his text
The Principles and Practice of Medicine: Diseases of the Nervous System he
describes a condition termed "Neurasthenia" as one that is associated with
"sleeplessness, unhealthy reaction to stimuli, weariness on the least
exertion, and the constant complaint is that of aching pain in the back of
the neck."

In 1904, the term "fibrositis" ("fibro-" means to fiber; "-itis" means
inflammation) was first used by Sir William Gowers in an article in the
British Medical Journal entitled "Lumbago: It's Lessons and Analogues" to
describe the chronic and crippling pain of fibromyalgia. The ending "itis"
was used as a part of its name because swelling was thought to be a cause of
the pain. Gowers began his study from his own lumbago and his interest in
back pain that did not have a mechanical nature. Dr. Gowers observed that
his patients were exhausted, unable to sleep, and that their illenss was "so
painful it would make a strong man cry out." He tried everything he could
think of in an attempt to relieve this pain and found that nothing worked
well. He chronicled a list of failed therapies, including salicylates (the
newly discovered aspirin) and noted a few things that seemed to help, such
as gentle manipulation and cocaine injections.

In 1913 in the British Medical Journal, a physician by the name of Luff
talked about the factors of fibrositis. He noted that the symptoms grew
worse when the barometric pressure lowered and rain was approaching. Luff's article also talked about temperature variations, fevers, infections and motor vehicle accidents. He also drew the connection between "growing pains" in children and fibrositis. In 1937, Arthur Steindler followed up on an earlier work relating to painful and tender areas and is credited with popularizing the term "trigger points" and injecting them with procaine. The 1930's and 1940's also saw the publication of studies from Michael Good in Great Britain, who exhaustively mapped out "myalgia spots" and Michael Kelly of Australia who connected "visceral" pain syndrome with fibrositis.

In 1960, Canadian Dr. Hugh Smythe wrote an article about fibrosis that
appeared in a textbook. He is thus credited wtih being the man who brought
the illness of fibromyalgia into the modern spotlight. Dr. Hugh Smythe laid
the foundation of modern FMS in 1972 by describing widespread pain and
tender points. The first sleep electroencephalogram study was performed in
1975.The term fibromyalgia was first coined in 1976 in an effort to describe
its primary symptom. It was changed because swelling in the body was no
longer thought to be the cause of pain. The term fibromyalgia is taken from
three Latin and Greek words: fibra, which means fibrous tissue and has to do
with painful tendons and ligaments; myos, which means muscles; and algos,
which means pain.

In 1981, the first clinical study was published by Dr. Muhammad B. Yunus,
considered the father of the modern view of fibromyalgia. The study
confirmed that symptoms and tender points could actually be found in the
body.This same study also proposed the first data-based criteria.The
important concept that FMS and other similar conditions are interconnected
was proposed in 1984, again by Dr. Yunus.Serotonergic/ norepinephric drugs
were first shown to be effective in 1986.

In 1987, it was first recognized by the American Medical Association (AMA)
as a "true" illness and the cause of disability. This acceptance was largly
due to a study published in an article that same year, in the Journal of the
American Medical Association (JAMA), by a physician named Dr. Don
Goldenberg. He described the symptoms, lab findings and treatment results of
188 patients with fibromyalgia. Goldberg used the term fibrostis and
fibromyalgia interchangably at the beginning of the paper the he switched
exclusively to fibromyalgia throughout the rest of the paper.

It wasn't until 1990, when Dr. Hugh Smythe, along with Drs. Yunus, Wolfe,
Bennett, Goldberg and Bombardier carefully detailed the location of eighteen
tender points symmetrically located around teh human body for the American
College of Rheumatology' s Criteria for the Classification of Fibromyalgia.
This became the developed diagnostic criteria for doing fibromyalgia
research, and the term fibromyalgia gained wide usage.

On January 1, 1993 the Copenhagen Declaration established fibromyalgia as an
official disease recognized by the World Health organization. The document
described the condition as painful, non-articular (not in the joints) and
predominately involving the muscles. The World Health Organization added
several other symptoms to the list, including "the presence of unexplained
widespread pain or aching, persistant fatigue, generalized morning
stiffness, and non-refreshing sleep." The Copenhagen Declaration also
recognized depression and anxiety as possible manisfestations of the
syndrome. In 1997, the first national organization for fibromyalgia, the
National Fibromyalgia Association (NFA), was formed. It helps educate people
with fibromyalgia about their condition. It also helps them manage their
condition. By speaking out about fibromyalgia, NFA helped to create a
greater awareness of the condition.

In 2005 the first guidelines for treating fibromyalgia pain were published
by the American Pain Society

Information gleaned from:














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