Smythe not only included poor sleep in the description but described what sleep was like for patients and also provided unpublished electroencephalogram (sleep study)findings that showed dysfunction in stage-3 and stage-4 sleep. Further, he stated that non-restorative sleep, trauma and emotional distress all could lead to heightened symptoms.
Subsequent research confirmed sleep abnormalities as well as showing that sleep deprivation can lead to fibromyalgia-like symptoms in healthy people.
Smythe then was involved in a study that better defined tender points and suggested their use in diagnosis. It also listed chronic pain, disturbed sleep, morning stiffness and fatigue as symptoms that could help diagnose the condition.
While researchers had made some good progress, they still hadn’t uncovered evidence of inflammation – the “itis” in fibrositis. The name was then changed to fibromyalgia: “fibro” meaning connective tissues, “my” meaning muscle, and “algia” meaning pain.
Still, a lot of questions remained. The primary symptoms were vague and common in the population. Doctors still didn’t have a handle on what fibromyalgia was.
Then, a seminal study lead by Muhammed Yunus came out in 1981. It confirmed that pain, fatigue and poor sleep were significantly more common in people with fibromyalgia than in healthy control subjects; that the number of tender points was significantly greater; and that multiple other symptoms were significantly more common as well. These additional symptoms included:
- Subjective swelling,
- Paresthesia (abnormal nerve sensations),
- Overlapping conditions such as irritable bowel syndrome (IBS), tension headaches and migraines.
This paper established enough of a consistent symptom cluster to officially denote fibromyalgia a syndrome as well as the first criteria proven to differentiate those with fibromyalgia from others.
A wealth of research has since confirmed that these symptoms and overlapping conditions are in fact associated with fibromyalgia.
Yunus then led research cementing the idea of several overlapping conditions, including primary dysmenorrhea (painful period) along with IBS, tension headache and migraine.
He then believed the unifying feature was muscle spasms, but that suggesting would later give way to the theory of central sensitization.
Since this point, we’ve had a tremendous amount of research published and progress made. We still don’t have all the answers, but we’ve gained a much better understanding of what may be going on in our bodies.
Important advances include:
1984 – First study published linking higher fibromyalgia prevalence in those with rheumatoid arthritis;
1985 – First controlled study of juvenile fibromyalgia was published;
1986 – Drugs influencing serotonin and norepinephrine were first shown to be effective;
1990 – American College of Rheumatology establishes official diagnostic criteriaof widespread pain and tenderness in at least 11 of 18 specific tender points, thus standardizing research inclusion criteria around the world;
1991 – Fibromyalgia Impact Questionnaire developed for doctors to evaluate function;
1992 – Discovery of low growth-hormone levels;