The Damaging Effects of Physicians

Many people with fibromyalgia spend a great deal of time, energy, and money in order to find a doctor who knows how to diagnosis fibromyalgia. Just having the symptoms of pain and fatigue does not necessarily mean that a person actually has fibromyalgia. When a physician knows how to do the Tender Point Index Test, which is the definitive test set up by the American College of Rheumatology in 1990, and says that a person definitely has fibromyalgia, then it means that it is not a psychological illness.

The American College of Rheumatology's 1990 criteria for the classification of fibromyalgia is:

1. History of widespread pain.
   Definition. Pain is considered widespread when all of the following are present: pain in the left side of the body, pain in the right side of the body, pain above the waist, and pain below the waist. In addition, axial skeletal pain (cervical spine or anterior chest or thoracic spine or low back) must be present. In this definition, shoulder and buttock pain is considered as pain for each involved side. "Low back" pain is considered lower segment pain.

2. Pain in 11 of 18 tender point sites on digital palpation.
   Definition. Pain, on digital palpation, must be present in at least 11 of the following 18 sites:
   • Occiput: Bilateral, at the suboccipital muscle insertions.
   • Low cervical: bilateral, at the anterior aspects of the intertransverse spaces at C5-C7.
   • Trapezius: bilateral, at the midpoint of the upper border.
   • Supraspinatus: bilateral, at origins, above the scapula spine near the medial border.
   • Second rib: bilateral, at he second costochondral junctions, just lateral to the junctions on upper surfaces.
   • Lateral epicondyle: bilateral, 2 cm distal to the epicondyles.
   • Gluteal: bilateral, in upper outer quadrants of buttocks in anterior fold of muscle.
   • Greater trochanter: bilateral, posterior to the trochanteric prominence.
   • Knee: bilateral, at the medial fat pad proximal to the joint line.

Digital palpation should be performed with an approximate force of 4 kg. For a tender point to be considered "positive" the subject must state that the palpation was painful. "Tender" is not to be considered "painful."

* For classification purposes, patients will be said to have fibromyalgia if both criteria are satisfied. Widespread pain must have been present for at least 3 months. The presence of a second clinical disorder does not exclude the diagnosis of fibromyalgia.

Dr. Richard E. Easton, who is the president of F.I.D.&A. (Forensic Intelligence Display and Analysis, Inc.), has written these words on his web site. "Somatoform Pain Disorder(s): {Myofascial pain syndrome, fibromyositis} The essential feature of (these) disorders is preoccupation with pain in the absence of adequate physical findings to account for the pain or its intensity. The pain symptom is either inconsistent with the anatomical distribution of the nervous system or, if it mimics a known disease entity (as in angina pectoris or sciatica), cannot, after extensive diagnostic evaluation, be adequately accounted for by organic pathology. Similarly, no pathophysiologic mechanism accounts for the pain, as in tension headaches caused by muscle spasm.

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