To the Editor:
Harth and Nielson are colleagues whose work has enlightened the issues of fibromyalgia (FM) and its identification and management. Our views differ in several ways1. They believe FM is a “separate entity”; we do not2. They believe FM is a useful concept; we see it on balance as harmful. They appear to believe that the “physiological” or “pathological processes” that have been observed are causally and uniquely related to FM symptoms. We do not believe that: all pain occurs through physiological processes — processes that are not unique to FM.
FM is an easily recognized syndrome that is defined and characterized by high levels of polysymptomatic distress. The pain and suffering of people with FM is real and substantial. Some of us who helped characterize the FM syndrome, and who have treated people with the syndrome, now believe that the FM concept has evolved into something harmful, and such was the subject of our previous essay1. We described our concerns in the context of social construction and medicalization, and mainly with respect to societal harm.
Harth and Nielson make light of our concerns about academic and societal integrity. In 2008 I was invited to speak at an FM symposium directed by a major New York academic center. It was a big symposium designed to attract primary care physicians in …
Address correspondence to Dr. Wolfe. E-mail: fwolfe{at}arthritis-research.org