Dr. Allan Horowitz, published newspaper article, Richmond Hill Liberal, Copyright November 29, 1989
Dear Readers:
The next two columns will be dedicated to a discussion of a disease commonly referred to as “Fibrositis”. I call this the rheumatic disease of the eighties.
It is a widely diagnosed disease, and one I really don’t like calling a disease at all. The reason is that most people who exhibit the symptoms of this condition will react in a non-productive manner if you tell them they have a disease. If you just say: “This and this and this” is wrong with you and we are going to do “this and this and this” to fix it, I find they react in a much more positive manner. Lets discuss this condition.
Fibrositis refers to a condition characterized by widespread aching, stiffness and pain in the muscles and joints. There is usually the complaint from the patient that she doesn’t sleep well at night.
This condition usually affects middle-aged females (I can hear them groaning now: “why does everything affect us?”) and may follow a stressful incident in life (car accident, divorce, etc.)
The one main feature of fibrositis is that there are multiple “trigger points” found in the muscles. These trigger points are localized areas of deep tenderness in muscles and feel like knots in muscles. Most people who have these trigger points feel like a real good, deep massage would help. (It usually does offer temporary relief).
The term “fibrositis” was initially coined by a fellow named Growers way back in 1904 and the criteria for diagnosis has changed somewhat since then. To be classed a true fibrositis, the patient must have muscle aching, especially in the neck and back. Multiple trigger points are also necessary for the diagnosis.
There is also something called a “fibrositis personality” where the patient tends to be a perfectionist, compulsive, high achiever, above normal intelligence and they often have a history of migraine headaches as well. Sleep disturbances are also commonly a feature of this condition. Laboratory tests are routinely normal and this serves to distinguish fibrositis from some other conditions with similar symptoms.
I emphasize again that I really don’t like calling this a “disease” as this word tells some patients that they are incurable. This is not true. Next week’s column will discuss various treatments used for fibrositis.
There are many theories regarding the etiology of fibrositis but no proof exists one way or the other. I want to be able to tell you exactly what a “trigger point” is and where they come from, but when doing my research, this is the best explanation I could find. What do you make of it? “Histopathologic changes described in uncontrolled studies of trigger points include a metachromatic substance in interfibrillar spaces, masses of mucoid amorphous substances between muscle fascicles, platelet clots or clusters, and mast cells discharging granules into intercellular spaces. In one report, the lactic dehydrogenase isoenzymes, LD 3-5 fractions were found to be increased in tissue and blood.”
There, now is it more clear. Now you know why I describe these trigger points to patients as “knots” in the muscles.
To sum up, remember that the condition known as “fibrositis” is a soft tissue “disease” where the patient has pain, stiffness, knots in the muscles, doesn’t sleep well, and is “uptight” as a result. It can happen to anyone at any age, but is most prevalent in that wonderful group who suffers the most, middle aged females.
When asked why middle aged females, most doctors will throw up their arms, shrug their shoulders and reply: “hormones, I guess!” You see, I’ll let you in on a secret. When doctors don’t know what causes something in females they usually blame it on hormonal changes. When they don’t know what causes something in men they usually blame stress. Now you know.