Spinal stenosis and fibromyalgia do not seem to have any obvious connection, yet in many patients, the symptoms blamed on one disorder may actually originate from the other.
As in many cases where FMS exists, the diagnosis may implicate structural spinal issues as being causative, while the fibromyalgia remains undiscovered.
Likewise, in a great number of diagnosed FMS sufferers, every symptom is typically included under the fibromyalgia umbrella, when some expressions instead are sourced from other causative or contributory spinal factors, such as central or foraminal stenosis.
essay will provide some information about how stenosis and FMS can exist
in the same patient. We will focus on how a single diagnosis is often
utilized to explain all the symptoms, when 2 distinct conditions may be
the actual sources.
Spinal Stenosis and Fibromyalgia Diagnosis
Spinal stenosis leaves distinctive evidence of its occurrence which can be visualized using any of the wide range of advanced diagnostic imaging tests, such as MRI technology.
FMS leaves no such definitive evidence and is diagnosed subjectively, based on symptomatic patterns and a general lack of other possible causative conditions.
However, spinal stenosis can be diagnosed unjustly, when the canal narrowing is mild and not at all likely to be the source of any symptomatic expression whatsoever. This is common and explains why so many patients with minor stenotic changes can never find relief, while many patients with far more serious stenosis can.
In these scenarios, the diagnosis is obviously flawed, so all subsequent therapy fails to resolve the actual symptomatic source process.
FMS might never be considered as a diagnosis, or might also be pronounced in error. Since there is no actual definition of fibromyalgia, the types of symptoms associated with diagnosed cases range wildly.
Some patients have all the classic
signs, yet receive a diagnosis of spinal stenosis, while others really do not qualify to be classified as FMS sufferers, yet are diagnosed as such, regardless.
Spinal Stenosis and Fibromyalgia Concerns
Since stenosis and FMS are often misdiagnosed, patients who fit the profile of both conditions have an exponentially higher chance of not achieving an accurate diagnosis.
FMS is known to cause widespread pain, similar to stenosis, but will generally affect areas above the usual stenosis locations.
Furthermore, FMS usually entails other types of symptoms, including flu-like expressions, and psychoemotional sufferings, which do not fall under the stenosis diagnosis.
Meanwhile, stenosis, although a diverse symptomatic condition, usually has inherent neurological consequences not inherent to FMS. Luckily, these can usually be ascertained and verified by neurological testing.
Keep these important distinctions in
mind if you fall into the category of patients who are really not sure
how much of your pain may be related to stenotic changes and how much
might be attributed to a possible FMS condition.
Spinal Stenosis and Fibromyalgia Conclusion
I know that this is a complex topic, but it needs to be explored in order to help patients who have received contrasting diagnostic verdicts, as well as patients who have been diagnosed with one condition, but feel they might suffer from the other.
FMS is typically a revision diagnosis. This means that it is often substituted for other previously diagnosed conditions if treatments fail to bring relief. I have met thousands of patients over the years who were originally diagnosed with everything from spinal arthritis to herniated discs, and from spinal stenosis to scoliosis, since diagnostic evaluation showed clear structural changes in the anatomy.
Despite active treatment, including surgery in many instances, these patients never recovered. At some point in the continuing treatment process, FMS was suggested as a new diagnosis. In some patients, this diagnosis was embraced, while in others, the switch game was obvious and the patient went for a second opinion.
In most instances where FMS is a revised diagnostic theory, it is done simply so the doctor can begin anew and treat yet another possible source of symptoms. This serves 2 purposes.
First, it takes the heat off the physician for unsuccessfully treating the previous diagnosis for months, years or possibly decades.
Second, it allows the money to come pouring back in to cover treatment for the new theorized source: FMS.
I do not see much of the opposite case circumstances occurring, but it is always worth keeping in mind that many patients with fibromyalgia are also misdiagnosed and actually suffer from some purely physical structural problem.
High level spinal stenosis, such as that in the cervical region, might be worth investigating, since the expressions can be almost as diversified as FMS.
To learn more about spinal stenosis and fibromyalgia, talk to your physician.
Spinal Stenosis and Fibromyalgia to Spinal Stenosis
6/6/12 Revised 9/1/13
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