How has fibromyalgia affected one of the best-selling musical artists of the 21st century?
In “Gaga: Five Foot Two,” a documentary released on Netflix this month, Lady Gaga describes the pain that’s characterized her life with fibromyalgia for the past half-decade.
“I have chased this pain for five years,” Gaga said. “I can still be me, and when I feel the adrenaline, and my music, and my fans, I can f****** go. But it doesn’t mean that I’m not in pain.”
Between clips of rehearsals, performances, and candid commentary about her work and personal life, Gaga allows the audience to see glimpses of her pain.
In one scene, she lies on a couch crying, describing the muscle spasms that wrack her body.
In another, she prepares for a round of injections in her doctor’s office, while her makeup team helps her get ready for an interview later that day.
“Who gets their makeup done while they’re getting a major body treatment?” she asks.
For Gaga and others, that kind of multitasking may be critical to their ability to pursue their ambitions while coping with the pain that fibromyalgia causes.
Chronic widespread pain
Fibromyalgia affects an estimated two percent of people in the United States.
It’s characterized by chronic widespread pain and tender spots throughout the body.
“For some individuals, the pain feels debilitating,” Dr. Kevin Hackshaw, an associate professor in the Division of Rheumatology and Immunology at The Ohio State University, told Healthline.
It can also cause a variety of other symptoms, such as chronic fatigue, sleep disturbances, mental confusion, and headaches.
While fibromyalgia isn’t progressive, its symptoms fluctuate over time, getting worse during periods of exacerbation known as “flares.”
Physical and psychological stressors are common triggers of flares.
“If I get depressed, my body can spasm,” Gaga says in the opening scenes of the film.
By showcasing her experiences, the singer hopes to help raise awareness of fibromyalgia and connect people who are facing similar challenges.
While fibromyalgia can occur at any age, it’s more common among older adults.
It’s also more prevalent among women than men.
The exact cause of the condition is unknown.
Historically, many medical professionals have treated it as a psychosomatic condition with no physical cause.
While modern research findings have challenged that framework, some people remain skeptical of fibromyalgia diagnoses and claims of chronic pain.
According to Janet Armentor, PhD, an associate professor of sociology at California State University Bakersfield, disbelief from medical professionals, coworkers, friends, and others, contributes to the stigma that many people with fibromyalgia face.
“One of the bigger challenges is that this illness is contested among the medical establishment and among the general population,” Armentor told Healthline.
“There’s a lot of disbelief and lack of understanding,” she added. “And in the interviews that I conducted with women who [were] diagnosed with fibromyalgia, some spoke of that challenge: ‘This is real. This is not in my mind. I’m actually feeling real symptoms and real pain.’”
Over the past decade, researchers have identified biochemical changes that occur in people with fibromyalgia.
“Studies have shown that there are documented biochemical changes in these patients. For example, spinal fluid can be obtained from patients with fibromyalgia, and you can see elevations in certain neurochemicals,” Hackshaw said.
“So it’s not a made up diagnosis,” he added. “It’s a true nerve disorder manifested as diffuse musculoskeletal pain.”
Treatment is available
For now, no simple laboratory tests are available to diagnose fibromyalgia.
Instead, doctors rely on patient reports of symptoms, following criteria adopted by the American College of Rheumatology in 2010.
While there’s currently no known cure for fibromyalgia, a variety of treatment strategies are available.
To start with, doctors typically recommend lifestyle changes and other non-pharmaceutical treatments.
“We know that regular exercise is essential in order to try to minimize some of the symptoms,” Hackshaw said.
“There’s also a good body of research that suggests that meditation and other types of mindfulness exercises may be beneficial in terms of alleviating some of the pain,” he added.
If those strategies aren’t enough, doctors often prescribe a low dose tricyclic antidepressant (TCA) or serotonin and norepinephrine reuptake inhibitor (SNRI).
“These meds are typically used not for their antidepressant characteristics, but because they increase levels of certain neurochemicals at nerve endings, and those increases lead to a decrease in pain signals going to pain processing centers in the brain,” Hackshaw explained.
Calcium channel blockers can also help block pain signals to the brain.
In addition to biomedical interventions, recognition and social support are also important for people with fibromyalgia and other chronic conditions.
“One of the more significant findings of my research is that because of the disbelief and lack of understanding they face, they tend to isolate themselves, which can lead to a whole range of social problems and well-being issues,” Armentor said.
She suggested that Lady Gaga and other high-profile advocates can help raise awareness of fibromyalgia and help others with the condition feel less alone.
“Often fibromyalgia is so invisible from the outside that people don’t recognize that this is happening to people all around us. So I think that to have someone with a high profile say, ‘I’m experiencing this and understand what you’re going through.’ That’s really important,” she said.
“Lady Gaga doesn’t want to let fibromyalgia define her,” she added. “There are still things that she wants to accomplish. But she knows the price and that she has to manage what’s important to her, and what she needs to do to cope with this illness. And I think that’s a very useful message.”