The Great Gift of Legitimacy

A Sneaky Condition

Fibromyalgia is a sneaky condition since all that pain doesn't ever manifest in any concrete damage to the organs. The work of one doctor, Muhammad B. Yunus, MD, and his colleagues in documenting the clinical signs of fibromyalgia some 25 years ago, did, however, bring about the first formal recognition of the disease by the greater medical community. But Dr. Yunus didn't stop there; in 2007 he once again made a significant donation to the study of chronic pain and fatigue by creating the concept known as central sensitivity syndromes, or CSS.

Classic Examples

Some 2% of Americans have fibromyalgia, a classic example of the group of illnesses known as CSS. Such maladies have their roots in abnormalities in the neurochemical systems of the body and include such conditions as restless leg syndrome, migraines, and irritable bowel syndrome.

Dr. Yunus and his team reviewed more than 225 publications and found that the data described 13 different conditions that are connected to central sensitization (CS). In CS, the spinal cord and brain or central nervous system, becomes hypersensitive at specific body points so that a light touch may cause significant pain. Associated conditions would include sleep disturbances and chronic fatigue.

"CSS are the most common diseases that are based on real neurochemical pathology and cause real pain and suffering. In some patients stress and depression may contribute to the symptoms but they are all based on objective changes in the central nervous system," says the indefatigable Dr. Yunus.

Commenting on the findings of Dr. Yunus, Dr. Norman L. Gottlieb, Editor of Seminars in Arthritis and Rheumatism, says he believes the published report, "advances our understanding of fibromyalgia, unifies and advances concepts, and suggests that this and several other common disorders have much in common in terms of their biopsychosocial development. This, hopefully, will expand both clinical and research interest in this group of diseases and lead to advances in therapy for many of them."

An editorial that accompanied the Yunus report by John B. Winfield, MD, states, "Science and medicine now have a rational scaffolding for understanding and treating chronic pain syndromes previously considered to be 'functional' or 'unexplained.' ...Neuroscience research will continue to reveal the mechanisms of CS, but only if informed through a biopsychosocial perspective and with the interdisciplinary collaboration of basic scientists, psychologists, sociologists, epidemiologists, and clinicians."

Dr. Yunus believes that the CSS concept must now be tested to see how it directs research and patient care protocols. Says Dr. Yunus, "Each patient, irrespective of diagnosis should be treated as an individual, considering both the biological and psychosocial contributions to his or her symptoms and suffering."