In a recent entry, I reviewed some of the diagnoses that are usually thought about in a patient with fibromyalgia. Here are several more conditions that can cause pain, fibromyalgia, chronic fatigue, and similar symptoms.
About 1 in 100 people of northern European ancestry have celiac disease, but the diagnosis is often missed, especially in milder cases. When people with celiac disease eat gluten (found in wheat and many other grains), they have an autoimmune inflammatory reaction in the intestines, similar to an allergic response.
This results in abdominal pain and poor absorption of many nutrients and vitamins. Either the malnutrition, or possibly just the autoimmune reaction itself, can cause many of the general symptoms of fibromyalgia and chronic fatigue. Other inflammatory conditions or causes of malnutrition might also result in chronic pain.
Poor sleep can't help but make you feel tired, and being tired generally makes pain feel worse. Insomnia, sleep apnea, and mood disorders such as depression or anxiety can also result in at least some of the symptoms of fibromyalgia and chronic fatigue syndrome.
Just being under constant stress, or having been exposed to an intense traumatic episode in the past — physical or emotional — can trigger surprisingly real and severe symptoms throughout the body.
There are many different types of arthritis, which is a common cause of pain. When nerves get pinched or injured by the effects of arthritis, pain can occur in areas beyond where the arthritis is most noticeable.
There are many genetic conditions that result in pain or fatigue or both. Some cause the connective tissue to be a little weaker than normal, resulting in very flexible joints. People with these disorders often have chronic pain and fatigue, which may be related in some way to the loose joints.
Two of the more common examples of joint laxity disorders are Ehlers Danlos syndrome and Marfan syndrome. Some genetic disorders directly cause painful arthritis, joint stiffness, or problems with the bones.
There are also many types of muscular dystrophy and other genetic problems that affect muscles. Pain and fatigue may be common in these disorders. Weakness can be an important symptom to help make the correct diagnosis.
And yet, this is only a partial list of diagnoses that should be considered in the medical evaluation of chronic pain. It takes patience and perseverance by both doctor and patient to work through all of the possibilities — but it is well worth the effort.
It is very frustrating, of course, when we doctors can't identify any specific cause and just have to call it "fibromyalgia," but getting a thorough evaluation still helps eliminate a lot of other diagnoses. If you are among this group, please don't give up. There are still plenty of treatment options for you.
