The DSS Umbrella

A Pioneer

Muhammad Yunus, MD, a rheumatologist and professor of medicine at the University Of Illinois College Of Medicine, Peoria, was a pioneer in the study of fibromyalgia. As long as a decade ago, Yunus sought to describe a link between fibromyalgia (FM) and several diseases that share some the same characteristics, for instance chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), tension headaches, migraine, and restless leg syndrome. These diseases were grouped by Yunus under an umbrella he called “Dysregulation Spectrum Syndrome,” which he defined as a, “a common biophysical syndrome characterized by endocrine dysregulation and dysfunction.”

Defining the Paradigm  

Yunus uses the following ideas to define the DSS paradigm:

*Clusters are seen of those with similar symptoms within a given patient group where symptoms occur more often than in the general population.

*Patients share similar clinical characteristics.

*In these patients exists a state of heightened sensitivity to pain.

*There is an absence of a classic disease model: illness cannot be detected on clinical examination, lab tests cannot confirm the presence of disease, and there is no cure or relief that can be achieved by conventional treatment.

*There is an absence of any typical psychiatric model.

*A common neuroendocrine mechanism exists.

*There is a common genetic link.

*There is a shared response to neuromodulating drugs and treatments.

Statistics prove the wisdom of Yunus’ contentions. For instance, the medical community has proven that the symptoms of IBS, headache, and menstrual difficulties occur more often in those with FM than in that of the general population. There is such a great disparity between those in the general population who experience these symptoms and those with FM that it is impossible to attribute the difference to chance. An example of such disparity can be seen with restless leg syndrome, which affects 31% of those with FM as opposed to 15% of those with rheumatoid arthritis, and only 2% of the general population.

IBS is more common in those suffering from FM and the converse is also true: more people with IBS suffer from FM. However, the same cannot be said of the inflammatory bowel diseases, for instance, Crohn’s disease and ulcerative colitis. One third of those with rheumatoid arthritis suffer from FM.

There are 10 conditions in the DSS umbrella: FM, CFS, IBS, tension headaches, migraine headaches, primary dysmenorrhea (painful period cramps), periodic limb movement disorder, restless leg syndrome, temporomandibular pain syndrome (TMDJ), and myofascial pain syndrome. Dr. Yunus argues against the classification of FM as a depressive illness.