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Fibromyalgia Disability
Most FM patients cite pain as a major cause for disability. Chronic widespread pain is a common finding. The valid assessment of disability in chronic pain states is notoriously difficult. The problems that are encountered in assessing the chronic pain patient are largely related to four issues: 1) pain is a purely subjective sensation which is usually interpreted in an emotional context, 2) chronic pain cannot be fully understood in terms of the classical model of disease that equates pathogenesis with tissue damage or dysfunction, 3) many "non-sick" people have persistent pain but are not disabled, and 4) disability due to pain results from a complex interplay between past experiences, education, income level, work related self-esteem, motivation, psychological distress, fatigue, personal value systems, ethno-cultural background and the availability of financial compensation. Rheumatologists are usually more confident of reliably assessing disability in patients with rheumatoid arthritis and osteoarthritis; yet important determinants of dysfunction in both of these diseases are psychosocial issues such as coping style, symptom focus, anxiety and depression. It is increasingly evident that dysfunction in chronic pain states is poorly correlated with the severity of pain. Disabled pain patients usually link impaired functioning to having persistent pain and cannot conceive of living a normal life as long as they are in pain. Thus they pursue a fruitless search for a cure which is never realized -- thus rationalizing their continued disability. In the process they not only remain dysfunctional, but also over-utilize medical care and develop increasing personal distress. Interestingly it is the belief that pain is the major cause of disability, that seems to determine the actual degree of dysfunction, rather than the absolute level of pain. These psychosocial and behavioral issues are clearly relevant to some FM patients seeking disability, but should not be generalized. Each patient has to be thoughtfully evaluated according to their unique set of circumstances.
Fibromyalgia Resources:	Fibromyalgia Disability by nfra.net   Fibromyalgia Diet by fibromyalgia-syndrome.com   Cure Fibromyalgia by fibromyalgia-treatment.org

Resourse Sites:
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www.nfra.net | www.fibromyalgia-syndrome.com | www.fibromyalgia-treatment.org

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National Fibromyalgia Research Association
PO Box 500, Salem, OR 97308

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