Ep. 137 What was the misunderstood condition in the 1800s known as Railway Spine and the similarity to Chronic Pain conditions like Fibromyalgia?

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The podcast discusses the historical medical phenomena of 'Railway Spine', a post-accident "traumatic neurosis" condition noted in the 19th century, and its relevance to understanding modern chronic pain conditions like fibromyalgia. This condition often arose after railroad accidents, showing symptoms similar to fibromyalgia such as pain, fatigue, and cognitive difficulties. The podcast discusses how physicians struggled to diagnose this condition due to the lack of clear physical abnormalities and the role of psychological factors, exploring the theories of notable physicians like Dr. Erickson and Dr. Page. It also mentions how the exploration of railway spine led to modern understanding of conditions like fibromyalgia, known as software problems in contrast to the hardware problems of classic organic conditions. Dr. Lenz emphasizes the importance of historical perspectives to understand and manage fibromyalgia better in the present.

00:00 Introduction to Railway Spine
00:39 Understanding the Symptoms of Railway Spine
00:54 Medical Dilemma and Physician's Response
02:00 Historical Perspective and Modern Relevance
03:08 Symptoms and Overlapping Conditions
12:16 Theories of Pathophysiology
14:55 Psychological Impact and Trauma
22:00 Evolution of Medical Understanding
25:37 Reflections and Conclusions

Click here for the Fibromyalgia 101 link.

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When I started this podcast—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. You’re not alone. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 28+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace personal medical advice.*