Have you ever wondered about the history of fibromyalgia (FM)? Did you know that it’s been around for centuries? Even though the official term, fibromyalgia, wasn’t coined until 1976, physicians have been writing about conditions resembling FM since the early 1800s. Reports of illnesses with strikingly similar symptoms can even be found as far back as around 1500 BC.
Probably the earliest description of a fibromyalgia-like condition is found in the Biblical account of Job’s 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 and 30:16-17 – NLT)
Hammer heroine … Florence Nightingale as we don’t know her. Photograph: Wellcome Library
In the 19th century, the English army nurse and Red Cross pioneer Florence Nightingale was taken ill with fibromyalgia-like symptoms. She became ill while working on the front lines during the Crimean War (1854 – 1856) and never really recovered. Until her death in 1910, Nightingale was virtually bedridden much of the time, suffering with unrelenting pain and fatigue.
A Short History
• 1600s – Fibromyalgia-like symptoms were first given a name: muscular rheumatism.
• 1816 – Dr. William Balfour, surgeon at the University of Edinburgh, gave the first full description of fibromyalgia.
• 1824 – Dr. Balfour described tender points.
• 1904 – Sir William Gowers coined the term fibrositis (literally meaning inflammation of fibers) to denote the tender points found in patients with muscular rheumatism.
• 1972 – Dr. Hugh Smythe laid the foundation for the modern definition of fibromyalgia by describing widespread pain and tender points.
• 1975 – The first sleep electroencephalogram study identifying the sleep disturbances that accompany fibromyalgia was performed.
• 1976 – Because no evidence of inflammation could be found, physicians changed the name from fibrositis to fibromyalgia (meaning pain in muscles and tissues).
• 1981 – The first controlled clinical study with validation of known symptoms and tender points was published.
• 1987 – The American Medical Association recognized fibromyalgia as a real physical condition.
• 1990 – The American College of Rheumatology developed diagnostic criteria for fibromyalgia to be used for research purposes. The criteria soon began to be used by clinicians as a tool to help them diagnose patients.
• 1990s – The concept of neurohormonal mechanisms with central sensitization was developed.
• 2007 – The U.S. Food and Drug Administration approved the drug Lyrica for the treatment of fibromyalgia. This was the first drug ever to receive FDA approval for fibromyalgia. (Since then, two additional medications – Cymbalta and Savella – have also received FDA approval for the treatment of FM.)
A number of different theories about what fibromyalgia is and what causes it have come and gone over the years. Unfortunately, for several hundred years fibromyalgia was considered by most doctors to be a psychological disorder. Its victims, mostly women, were accused of being hypochondriacs, malingering or simply trying to get attention. Even today, some insist on hanging on to this theory.
During the 20th century, fibromyalgia began to be recognized by some medical professionals as a real physical condition. At first it was thought to be a disease of the muscles and fibrous tissues, which was a logical assumption since muscle pain seemed to be the main symptom. However, tests done on the muscles and tissues of FM patients failed to show any actual damage. Next, researchers theorized that it might be an autoimmune disorder, but research could not uncover any disturbance of the immune system.
Finally, as the 21st century approached and technology brought new laboratory testing methods and brain-imaging techniques, researchers were able to identify a sensitization of the central nervous system in fibromyalgia patients. Today ongoing research continues to uncover exciting new information about the causes and treatment of FM. Hopefully one day soon fibromyalgia will be relegated to the pages of past history.