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Rheumatology 2004; 43: 535
Rheumatology Vol. 43 No. 4 (c) British Society for Rheumatology 2004; all rights reserved

Letter to the Editor

Symptoms without pathology

G. E. Ehrlich

University of Pennsylvania, Philadelphia, PA, USA

Correspondence to: G. E. Ehrlich, 241 South Sixth Street, 1101, Philadelphia PA 19106, USA. E-mail: g2e{at}mindspring.com

SIR, Peter Croft's wise words [1] are slightly marred by his reference to the American College of Rheumatology criteria for fibromyalgia as diagnostic criteria rather than as classification criteria for reporting purposes [2]. There are no diagnostic criteria, as even the ‘tender points’ are circular reasoning and self-reported (and in many instances, learned). The sooner we abandon fibromyalgia as a diagnosis and treat the very real physical and psychological symptoms that characterize chronic pain, the better off we and the patients will be [3–6].

The author has declared no conflicts of interest.

References

  1. Croft P. Symptoms without pathology: should we try a little tenderness? [Editorial]. Rheumatology 2003;42:815–7.[Free Full Text]
  2. Wolfe F, Smythe HA, Yunus MB et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis Rheum 1990;33:159–72.
  3. Schochat T, Raspe H. Elements of fibromyalgia in an open population. Rheumatology 2003;42:829–35.[Abstract/Free Full Text]
  4. Ehrlich GE. Fibromyalgia, a virtual disease. Clin Rheumatol 2003;22:8–11.[CrossRef][Medline]
  5. Ehrlich GE. Pain is real; fibromyalgia isn’t. J Rheumatol 2003;30:1666–7.[Free Full Text]
  6. Ehrlich GE. Low back pain. Bull WHO 2003;81:671–6.[Web of Science][Medline]
Accepted 30 September 2003


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