I don't like the word fibromyalgia, and I try very hard not to use it as a diagnosis. Here's why:

Experts may differ on the specific features, but in general people with fibromyalgia have chronic, diffuse pain that lasts for at least three months and involves multiple parts of the body, including muscles or joints. They also have trigger points (also called tender points), which are areas that are painful to the touch. Most have poor sleep and fatigue. 

Other common — but not universally shared — symptoms include headaches, bowel problems (irritable bowel syndrome), bladder problems (like a urinary tract infection, but without a real infection), and difficulty thinking clearly (sometimes called "fibro-fog").

To make things more confusing, these symptoms overlap with another poorly understood and poorly defined condition, chronic fatigue syndrome.

To me, fibromyalgia is really just a collection of symptoms that don't represent a single diagnosis or condition. The challenge is figuring out why someone has these symptoms — that's going to be the real underlying diagnosis. And finding out why a person has a particular combination of these symptoms can sometimes help guide treatment or identify other body systems that may need attention.

Just think about headaches — entire books have been written about all the various types and causes of headaches and different ways to treat them.

My biggest reason for not liking fibromyalgia as a diagnosis is that the term immediately creates images in many people's minds that may not accurately describe any one particular patient. Not everyone with fibromyalgia, for example, is depressed or anxious, although those are common complications. Many other such assumptions are frequently wrong.

There are, however, two uses of the word "fibromyalgia" that can be helpful and that are worth acknowledging. First, when defined narrowly and when assumptions are avoided, the term "fibromyalgia" indicates clearly and succinctly that this is a patient with chronic pain, tender points, and poor sleep.

Second and more important, giving these symptoms a name can guide people to a support group where they can share their feelings, experiences, and knowledge with new friends who understand what they're going through, and where they can help each other cope with this difficult challenge in the best ways possible.

In future entries, we'll talk about what is known about the possible causes of fibromyalgia and chronic pain, as well as strategies to manage it.