Dealing with chronic pain: The Diagnosis
by Susan Fishell
Diagnosing fibromyalgia isn’t as straightforward as you may think.
While it may seem a “no-brainer” that the path towards healing from chronic pain lies in obtaining a diagnosis the reality of receiving one can be anything but easy. Pain which appears to be emanating from fractured vertebrae may actually be caused by a pinched nerve. Lower back pain may originate in knotted muscles mid-back. For the fibromyalgia sufferer, the difficulty is compounded by the fact that no test currently exists for a definitive diagnosis. The diagnosis is a clinical one which is made when a physician applies pressure to 18 specific points over the body. If at least 11 of these are tender to the touch and the patient has a history of diffuse musculoskeletal pain, a positive diagnosis is made. Often this diagnosis only comes after thousands of dollars in tests and numerous visits to a wide range of specialists. It is once test results read normal and a host of other maladies have been eliminated that a diagnosis often finally occurs.
My own journey with fibromyalgia began with a sore shoulder. My primary care physician referred me to an orthopedist specializing in shoulders. He in turn prescribed physical therapy after consulting x-rays. Three physical therapists, two orthopedists specializing in shoulders and one in spines, two rheumatologists’ visits and thousands of dollars in tests and treatments later, I finally received my diagnosis of fibromyalgia. I count myself fortunate as my journey only lasted 10 months. For many it can take years.
What have I learned from this journey? First and foremost, don’t give up. Some days it will take every ounce of strength and courage you possess just to roll out (and I mean that literally on those days where every movement causes pain) of bed in the morning. Do it anyway.
Second, don’t be afraid to question doctor prescribed treatments or procedures. I had never visited a physical therapist prior to fibromyalgia. I blindly accepted that the treatment would make me better even as my pain and lack of mobility increased. Physical therapy was in reality one of the worst treatments I could do as it often focuses on repetitive motions and strength conditioning which can quickly cause flare-ups for fibro sufferers.
Third, don’t be afraid to seek additional medical opinions or change medical professionals if one isn’t working for you. It took three physicals therapists before I found one who really listened to me and who became a key player in obtaining my diagnosis. One of the three made me feel that I was a hysterical female whose symptoms were all in her head. Get rid of anyone who makes you feel that way!
Four, seek out medical professionals and therapists who really listen to you. It was only after I found a physical therapist and orthopedist who listened to me and to each other that I was referred to my rheumatologist who was able to make my diagnosis. My massage therapist at Nimbus is a skilled listener. Because of that, in conjunction with an expertise in myofascial release massage, we have been able to tailor make a therapy plan that works best for me.
Five, keep a journal or log of your daily activities and symptoms.
At my lowest point, daily activities such as eating breakfast, washing and drying my hair and putting on my coat could only be accomplished with great difficulty and pain or with assistance. I now have full range of motions in my arms, shoulders and legs. I often walk a mile per day and lead a fairly normal life as long as I “listen” to my body. You can get there too. It all begins with a decision to either literally roll out of bed or to throw the covers over your head, stay in bed and cry. Choose to roll out (although an occasional covers over the head and good cry can be therapeutic as long as the next day you roll!)
Thanks to Nina at Nimbus Massage who acted as my arms and typed this blog for me when my arms were too fatigued to do so. It is only because of Nimbus’ skillful and compassionate care that I continue to move with ease most days and can write this blog.