Why Your Doctor Keeps Getting Fibromyalgia Wrong — Transcript

What if the debilitating pain and crushing fatigue you're feeling isn't just in your head? And what if the key to finally feeling better is something your doctor might not have time to tell you about fibromyalgia? I'm Dr. Michael Lens, a pediatrician, internist, lipidologist, and lifestyle medicine physician with over 29 years of clinical experience. As the author of the Conquering Your Fibromyalgia book and host of the podcast and this channel, I've dedicated my work to helping people navigate this complex condition as well as related conditions. Before we dive in, please remember that this video is for educational purposes only. All signs, symptoms, and treatments should be discussed with your personal physician. For the millions living with this invisible illness, the path to a diagnosis is often long and frustrating. You're told you look fine. Your blood tests come back normal. Yet, you feel like you're living inside a body that's constantly fighting itself. Today, we're getting real about what's going on. We're not just talking about the textbook symptoms. We're going deep into the neurologic reality of fibromyalgia, clearing up the myths that even some doctors still believe, and sharing truths that will empower you to finally take back control. This is the conversation you've been waiting for. When people hear fibromyalgia, they're usually thinking of pain. And yes, pain is a huge part of it. The discomfort can be a persistent, dull ache that feels settled deep into your muscles and bones. But for others, it can be a sharp burning or stabbing sensation. The official diagnostic criteria talk about pain on both sides of your body above and below your waist that lasts for at least 3 months. But saying fibromyalgia is just pain is like saying a hurricane is just a bit of wind. It's a massive misunderstanding of the daily battle people face. What often gets overlooked in a quick doctor's visit is the relentless soul-crushing fatigue. This isn't about being tired after a long day. It's a bone-deep exhaustion that doesn't go away even after a full night's sleep. Many people with fibromyalgia wake up feeling as if they've run a marathon overnight. Their bodies are just as drained and sore as when they went to bed. That's because the condition itself disrupts the deep restorative stages of sleep. Then there's the infamous fibro fog. This isn't just being a little forgetful. It's a frustrating cognitive issue that can make you feel like you're walking through a dense haze. It's struggling to find the right word, having a hard time concentrating on a simple task, or forgetting a conversation you just had. It affects your work, your relationships, and your confidence, making you feel like your own mind is letting you down, and the list keeps going. Many also deal with chronic headaches, irritable bowel syndrome, known as IBS, and an overactive bladder. Fibromyalgia often overlaps with other nociplastic pain syndromes, including chronic fatigue syndrome, known as ME/CFS, Stanford, and hypermobility syndromes, and chronic migraines. A heightened sensitivity to noise, light, and even temperature is also common. Anxiety and depression also occur frequently, not as the cause of pain, but it's a completely understandable response to living with a chronic misunderstood illness. This isn't just a random collection of problems. It's a complex syndrome, a cascade of symptoms, all originating from a central nervous system issue that science is learning more and more about. So, you go to your doctor with all of these debilitating symptoms. They run blood tests and imaging studies and then you hear the words that hit so many people like a punch to the gut. Everything looks normal. This is where the frustration and feelings of being dismissed often start. And this is the first big thing doctors don't always explain. Pro myth number one, the tests are normal, so you must be fine. The truth is standard tests aren't designed to find fibromyalgia. Blood tests look for inflammation markers like in rheumatoid arthritis. Imaging studies look for structural damage. Fibromyalgia is neither of those. It is not an autoimmune disease and it doesn't cause the kind of inflammation or damage that these tests can see. So when tests are normal, it doesn't mean your pain isn't real. It just means you don't have those other conditions, which is an important diagnostic step called ruling out alternatives. It's also important to recognize that these may co-occur and sometimes do. Myth number two, it's all in your head. This is probably the most damaging myth. For years, because there was no definitive test, the condition was often brushed off as psychological. But here's the scientific truth every person with fibromyalgia deserves to hear. It's not in your head, but it is in your brain and central nervous system. Brain imaging studies showed that fibromyalgia is a real neurological condition. The modern term for this is nociplastic pain. This replaces an older term central sensitization and it describes pain that arises from a change in the way the nervous system itself processes pain signals rather than from a specific injury to your body tissues. In lay language, think of it this way. Your central nervous system, your brain and spinal cord and brain stem has a volume knob for pain. In people with pain, that volume knob is cranked way up and has become stuck. Your brain and nerves become hypersensitive. Overreacting to both painful and even non-painful signals. A gentle touch might feel painful. A minor bump can feel like a major injury. It's as if your brain's pain receptors develop a memory of pain, replaying it over and over. This is a real physical change in how your central nervous system functions. It's a disorder of pain processing, not a disorder of your imagination. Myth number three, it's just a diagnosis a doctor gives when he or she can't find anything else wrong. Many doctors were taught that fibromyalgia is what you diagnose when all the other tests are negative. This makes it sound like a wastebasket diagnosis, but that's outdated thinking. The American College of Rheumatology has clear evolving diagnostic criteria. The old model, which required finding 11 out of 18 specific tender points, is no longer the standard because it was too narrow and missed patients, especially male. Today's criteria focuses on your actual experience. A history of widespread pain for at least 3 months combined with the severity of your other key symptoms like fatigue, waking up tired, and cognitive issues. It's a clinical diagnosis based on a specific cluster of symptoms, not just the lack of another disease. It's also corroborated by a careful physical exam and history. The unspoken truth. What causes fibromyalgia? You may be asking, "So why me? What caused this?" This is a question doctors often struggle to answer. Partly because the medical field is used to looking at problems from a simple biomedical approach. For an infection, you get an antibiotic. For a broken bone, you get a cast. This model looks for a single clear cause and a direct fix. But nociplastic pain syndromes like fibromyalgia don't fit that neat box. They are better understood from a biopsychosocial, spiritual, environmental approach. This model sees your health as an interconnected web of biological, psychological, social, spiritual, and environmental. Let's start with the bio part. There's a strong genetic component, but it's more like you inherit a certain neurotype, specific wiring of the nervous system that makes you more susceptible to developing widespread pain, fatigue, brain fog, and insomnia. Then come the triggers. For a person with this neurotype, experiencing a significant triggering event or a series of smaller ones over time can flip a switch. It can take someone from having a regional pain syndrome like migraines to a five-alarm fire where the whole body feels like it's on fire. These triggering events are part of the ps

Lens, a pediatrician, internist, lipidologist, and lifestyle medicine physician with over 29 years of clinical experience. As the author of the Conquering Your Fibromyalgia book and host of the podcast and this channel, I've dedicated my work to helping people

navigate this complex condition as well as related conditions. Before we dive in, please remember that this video is for educational purposes only. All signs, symptoms, and treatments should be discussed with your personal physician. For the millions living with

this invisible illness, the path to a diagnosis is often long and frustrating. You're told you look fine. Your blood tests come back normal. Yet, you feel like you're living inside a body that's constantly fighting itself. Today, we're getting real about what's going on.

We're not just talking about the textbook symptoms. We're going deep into the neurologic reality of fibromyalgia, clearing up the myths that even some doctors still believe, and sharing truths that will empower you to finally take back control. This is the

conversation you've been waiting for. When people hear fibromyalgia, they're usually thinking of pain. And yes, pain is a huge part of it. The discomfort can be a persistent, dull ache that feels settled deep into your muscles and bones. But for others, it can be a sharp

burning or stabbing sensation. The official diagnostic criteria talk about pain on both sides of your body above and below your waist that lasts for at least 3 months. But saying fibromyalgia is just pain is like saying a hurricane

is just a bit of wind. It's a massive misunderstanding of the daily battle people face. What often gets overlooked in a quick doctor's visit is the relentless soulc crushing fatigue. This isn't about being tired after a long day. It's a bone deep exhaustion that

doesn't go away even after a full night's sleep. Many people with fibromyalgia wake up feeling as if they've run a marathon overnight. their bodies are just as drained and sore as when they went to bed. That's because the condition itself disrupts the deep

restorative stages of sleep. Then there's the infamous fibro fog. This isn't just being a little forgetful.

It's a frustrating cognitive issue that can make you feel like you're walking through a dense haze. It's struggling to find the right word, having a hard time concentrating on a simple task, or forgetting a conversation you just had.

It affects your work, your relationships, and your confidence, making you feel like your own mind is letting you down, and the list keeps going. Many also deal with chronic headaches, irritable bowel syndrome, known as IBS, and an overactive bladder.

Fibromyalgia often overlaps with other nosooplastic pain syndromes, including chronic fatigue syndrome, known as ME/CFS, Stanlo, and hypermobility syndromes, and chronic migraines. A heightened sensitivity to noise, light, and even temperature is also common.

Anxiety and depression also occur frequently, not as the cause of pain, but it's a completely understandable response to living with a chronic misunderstood illness. This isn't just a random collections of problems. It's a complex syndrome, a cascade of symptoms,

all originating from a central nervous system issue that science is learning more and more about. So, you go to your doctor with all of these debilitating symptoms. They run blood tests and imaging studies and then you hear the

words that hit so many people like a punch to the gut. Everything looks normal. This is where the frustration and feelings of being dismissed often start. And this is the first big thing doctors don't always explain. Pro myth

number one, the tests are normal, so you must be fine. The truth is standard tests aren't designed to find fibromyalgia. Blood tests look for inflammation markers like in rheumatoid arthritis. Imaging studies look for structural damage. Fibromyalgia is neither of those. It is not an

autoimmune disease and it doesn't cause the kind of inflammation or damage that these tests can see. So when tests are normal, it doesn't mean your pain isn't real. It just means you don't have those other conditions, which is an important

diagnostic step called ruling out alternatives. It's also important to recognize that these may co-occur and sometimes do. Myth number two, it's all in your head. This is probably the most damaging myth. For years, because there was no definitive test, the condition

was often brushed off as psychological. But here's the scientific truth every person with fibromyalgia deserves to hear. It's not in your head, but it is in your brain and central nervous system. Brain imaging studies showed that fibromyalgia is a real neurological

condition. The modern term for this is no plastic pain. This replaces an older term central sensitization and it describes pain that arises from a change in the way the nervous system itself processes pain signals rather than from a specific injury to your body tissues.

In lay language, think of it this way. Your central nervous system, your brain and spinal cord and brain stem has a volume knob for pain. In people with pain, that volume knob is cranked way up and has become stuck. Your brain and

nerves become hyper sensitive. Overreacting to both painful and even non-p painful signals. A gentle touch might feel painful. Minor bump can feel like a major injury. It's as if your brain's pain receptors develop a memory of pain, replaying it over and over.

This is a real physical change in how your central nervous system functions. It's a disorder of pain processing, not a disorder of your imagination. Myth number three, it's just a diagnosis a doctor gives when he or she can't find

anything else wrong. Many doctors were taught that fibromyalgia is what you diagnose when all the other tests are negative. This makes it sound like a waste basket diagnosis, but that's outdated thinking. The American College of Rheumatology has clear evolving

diagnostic criteria. The old model, which required finding 11 out of 18 specific tender points, is no longer the standard because it was too narrow and missy patients, especially male. Today's criteria focuses on your actual experience. A history of widespread pain

for at least 3 months combined with the severity of your other key symptoms like fatigue, waking up tired, and cognitive issues. It's a clinical diagnosis based on a specific cluster of symptoms, not just the lack of another disease. It's

also corroborated by a careful physical exam and history. The unspoken truth. What causes fibromyalgia? You may be asking, "So why me? What caused this?" This is a question doctors often struggle to answer. Partly because the medical field is used to looking at

problems from a simple biomedical approach. For an infection, you get an antibiotic. For a broken bone, you get a cast. This model looks for a single clear cause and a direct fix. But no plastic pain syndromes like fibromyalgia

don't fit that neat box. They are better understood from a biocschosocial, spiritual, environmental approach. This model sees your health as an interconnected web of biological, psychological social spiritual and environment. Let's start with the bio part. There's a strong genetic

component, but it's more like you inherit a certain neuroype, specific wiring of the nervous system that makes you more susceptible to developing widespread pain, fatigue, brain fog, and insomnia. Then come the triggers. For a person with this neuroype, experiencing

a significant triggering event or a series of smaller ones over time can flip a switch. It can take someone from having a regional pain syndrome like migraines to a five alarm fire where the whole body feels like it's on fire.

These triggering events are part of the psycho social environmental side of the model. It could be a physical trauma like a car accident or major surgery. It could be a serious infection or illness or recovery from it. Or it could be a

period of intense prolonged emotional stress. It's believed that in a genetically predisposed person, these events can be the final push that disrupts the central nervous system and turns up that pain, fatigue, and brain fog volume control knob for good.

Finally, certain risk factors make you more vulnerable. Women are diagnosed with fibromyalgia more often than men.

It's most often found in middle age, and having other conditions like lupus or rheumatoid arthritis also increases your risk. Additionally, science is now recognizing a strong connection to neurode divergence, finding that being autistic or having untreated ADHD also

increases your risk. Understanding these connections helped you see fibromyalgia not as some random curse, but a complex biological response. If this is all starting to sound painfully familiar and you're finding this information validating, please take a moment to like

this video and subscribe. It really helps us reach more people who are looking for these exact same answers.

Now for the most important part, what can you do about it? When you finally get a diagnosis, the first step for many doctors is to write a prescription. And to be clear, medications can be a really important part of this puzzle. Drugs

like Delloxitine, measylin have been approved by the FDA for treating fibromyalgia and can help some people manage their pain, sleep, and mood. But here's the biggest secret. The one doctors often don't have the time or training to really emphasize.

Medications alone are never the whole answer. The real path to a better quality of life is a multi-part approach that puts you in control in partner with the physician who understands fibromyalgia. Here are some key treatment pillars for those living with

fibromyalgia or caring for those living with fibromyalgia to be aware of. Movement is medicine. When you're in pain, the last thing you feel like doing is exercising, but the research is clear. Gentle, regular movement can be one of the most effective treatments for

fibromyalgia. The key is to start low and go slow. We're not talking about intense training. We're talking about low impact activities like walking, swimming, or biking. These can help reduce pain, improve sleep, and fight fatigue. Mindbody exercises like Taichi

and yoga are also fantastic as it can help gently retrain the brain body connection. Pillar two, retrain your brain. Since fibromyalgia is a condition of the central nervous system, it makes sense that therapies aimed to the brain can be effective. Cognitive behavioral

therapy or CBT and under that acceptment and one branch of that is acceptance commitment therapy has been shown to be incredibly helpful. CBT teaches you real practical ways to cope with pain, stress, and the negative thought loops that can make your symptoms worse. Also,

psychoeducation is a big part of this. Likewise, stress management techniques like mindfulness, meditation, and deep breathing may help calm your overactive nervous system. Pillar three, prioritize sleep. Fatigue is a core symptom, and poor sleep is a huge trigger for

flare-ups. So, practicing good sleep hygiene isn't just nice advice. It's a critical part of your treatment. This means going to bed and waking up around the same time every day, even on weekends. It means creating a cool, dark, quiet bedroom. And it means

avoiding stimulants like caffeine and limiting screen time right before bed. It's about giving your body its best shot at getting the restorative sleep it desperately needs. Furthermore, it's vital to recognize that for many, poor sleep isn't just about habits and sleep

hygiene. Fibromyalgia has high rate of coorbidity with specific sleep disorders that prevent restorative sleep. No matter how good your sleep hygiene is, conditions like sleep apnea, where breathing repeatedly stops and starts, as well as restless leg syndrome and

periodic limb movement disorder, are common. Getting tested for and treating these underlying conditions can be a gamecher as it directly affects a major physiological barrier to getting the deep sleep your brain and body need.

Pillar four, know your triggers and pace yourself. Fibromyalgia often has a cycle of good days and bad days which are called flares. These flares can be brought on by stress, overexertion, poor sleep, or even changes in the weather.

One of the most powerful things you can do is become a detective of your own body. Consider keeping a simple log of your symptoms and daily activities to figure out your personal triggers. On good days, it's so tempting to do

everything at once, but this boom and bus cycle often leads straight to a flare up. Learning to pace yourself is a crucial skill for long-term management.

And last, but not least, pillar five. Finally, a crucial pillar is recognizing a connection that is only now getting the attention it deserves. As mentioned, being neurode divergent, such as being autistic or having ADHD, is a significant risk factor for

fibromyalgia. This isn't a coincidence. overlapping traits like sensory hypersensitivity, nervous system dysregulation, and challenges with interosception, sensing, internal body signals can create a perfect storm.

Recognizing this is vital for management. Getting the right support for your specific neuroype can dramatically reduce the overall stress on your system. This might look like treatment for ADHD that helps with the executive function needed for pacing and

symptom tracking as well as emotional dysregulation or could mean finding autistic affirming strategies to manage sensory overload which can worsen pain.

It's about treating the whole person, not just the fibromyalgia. When your neurode divergent brain gets the support it needs, you build a more stable foundation for managing all of your symptoms. Living with fibromyalgia can feel like a lonely fight, but it doesn't

have to be. This brings me to why I call this channel conquering your fibromyalgia. I use the word conquering instead of conquered because this is an ongoing battle. It's much like someone who has inherited a predisposition to type 2 diabetes. We know that type 2

diabetes can often be reversed into the normal range through the consistent implementation of a healthy lifestyle, including a low-fat, whole food plant-based diet and regular activity.

So, in the world of fibromyalgia, one is not necessarily cured, but symptoms can be reversed into the normal range. The most important thing to remember is this. Your pain is real. It's caused by a recognized neurologic condition. And

while there may not be a simple cure, there is a clear path forward. It's a path that goes beyond just pills and involves gentle movement, stress management, better sleep, and being your own advocate. It's about understanding that you have the power to influence

your symptoms and reclaim your quality of life. You are not broken and you are not alone. To get more nuanced and in-depth looks at fibromyalgia and related nosiplastic pain Syndromes, I encourage you to check out my book, Conquering Your Fibromyalgia, as well as

the other podcast episodes and videos here on this channel. And to prove you're not alone, I want you to be part of the solution for someone else. Share your story in the comments. What is the one thing you wish people understood

about fibromyalgia? Let's turn this comment section into a resource in a community of support for everyone on this journey. Thanks for watching.