Challenges of FMS Care
How is FMS care complicated?
There are no conventional medical tests that can rule in or rule out FMS. The symptoms, like pain, come and goes and can move around the body in a seemingly random way. A vast number of symptoms may appear to be so unrelated that you don’t realize they have the same cause. Who would think their nasal congestion and skin problems were related to severe abdominal pain?
On top of all that, not all healthcare providers are up to speed with the latest developments on FMS. Doctors specialize for a reason, and that’s because the human body is too complex for anyone to be an expert on everything that can go wrong with it.
Also, it’s important to note that—while this is becoming less common—some doctors still have the opinion that FMS is “all in your head” and not a real illness at all. That’s why it’s important for you to find a specialist.
Finding a Rheumatologist
Because symptoms of FMS are similar to those of several rheumatic illnesses, such as lupus and rheumatoid arthritis, rheumatologists have become familiar with the condition. You have a lot of resources at your disposal for finding a rheumatologist.
If you have a family doctor or primary care provider, you can ask who they would recommend. You can check with area clinics and hospitals to see if they have a list of rheumatologists In your area. If you see a physical therapist, massage therapist, or chiropractor, you can ask for a recommendation. You can also talk to talk to friends and family.
Depending on your insurance plan, you may need a referral. And you can also check your insurance company’s list of providers.
Additionally, you can search online for a doctor in your area at the following sites:
National Fibromyalgia Research Association The American College of Rheumatology website
Once you have the names of rheumatologists practicing in your area, you may want to do a little more investigating. Here’s a list of questions you may want to ask:
How much experience does the doctor have with FMS?How long will you have to wait to get an appointment?If you call with a problem or question, will you get to talk to the doctor?Does the doctor use a multidisciplinary approach to treatment?
You’ll also want to find out whether the doctor is accepting new patients, if the office will accept your insurance (and vice versa), and whether payment or co-pays are due at the time of your appointment.
Meet With the Doctor
Once you’ve come up with a short list of rheumatologists, you might want to consider a “get acquainted” appointment where you can meet the doctor face to face, ask more questions and get a feel for whether this is someone you’d like to work with.
Managing FMS requires teamwork between the doctor and patient, so it’s important for you to have a positive relationship. If it’s not possible to meet this way, treat your first appointment in the same way so you can decide whether this rheumatologist is a good fit for you.
Ongoing Management
The American College of Rheumatology has established diagnostic criteria for FMS. While rheumatologists often diagnose this condition, long-term management does not need to come from a rheumatologist, and typically comes via a primary care doctor, pain management specialist, physiatrist, and/or psychiatrist.
Over the past several years, research has shown that FMS is linked to hypersensitivity of the central nervous system (generally called “central sensitization”) and can be considered a neurological condition. Some neurologists have begun treating it, but not all of them do.
Some general practitioners have seen enough people with FMS to be familiar with diagnosing and treating it, so could ask yours if they are comfortable treating it. Physiatrists, who specialize in rehabilitation and restoring physical function, also often manage FSM.
