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10 Articles in Volume 17, Issue #8
A Fresh Look at Opioid Antagonists in Chronic Pain Management
Addressing Chronic Pain in the United States Armed Forces
Are biosimilars as effective as their biologic counterparts?
Integrative Pain Care: When and How to Prescribe?
Lady Gaga, Fame, and Fibromyalgia
Letters to the Editor: An opportunity to learn what is on the minds of your colleagues and patients.
Must-Have Devices for Your Pain Practice
Obsessive-Compulsive Disorder & Chronic Pain
Theory of Motivated Information Management and Coping With Death
United Nations Says Untreated Pain Is “Inhumane and Cruel”

Lady Gaga, Fame, and Fibromyalgia

Pain management expert, Don L. Goldenberg, MD, provides a professional assessment of this pop icon's battle with mood disturbances, sleep difficulties, and chronic widespread pain from fibromyalgia, a condition affecting some six million Americans.
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I was taken aback when one of the journalists who works with Practical Pain Management called me last month to ask if I knew that Lady Gaga had just postponed her European tour because of an exacerbation of her fibromyalgia. I never had a clue that one of the most famous artists in the world had been diagnosed with fibromyalgia.

A statement released via Twitter on Sept. 14, 2017, proclaimed that she was “suffering from severe physical pain that has impacted her ability to perform.” Shortly thereafter, Gaga tweeted that she was suffering from fibromyalgia, an illness that I have been studying for 40 years. Around the same time, Netflix released the documentary film Gaga: Five Foot Two and reviews of the film mentioned that Gaga opens up about her “overwhelming pain”.

Lady Gaga shares her struggle with Fibromyalgia in a Netflix film.

For me, this was a perfect storm for many of my life-long interests. Rock and pop music is a passion for me. I also consider myself a film buff, so I was anxious to see if the documentary on Lady Gaga might fall into the same class as classics like Scorsese’s “The Last Waltz” or Demme’s “Stop Making Sense”. But most importantly, as an international authority on fibromyalgia and related disorders,1 I was professionally and personally invested in what Lady Gaga might say about her illness and any subsequent good or bad fall-out.

What follows is my analysis of the documentary in terms of how it fits with mainstream fibromyalgia information and how I see Lady Gaga fitting into the spectrum of the thousands of patients I have treated who suffer from this condition. It is important to disclose that I have never spoken to or interacted with Lady Gaga; I have not treated her and have no first-hand knowledge of her health situation or care. My comments are solely gleaned from watching the documentary, Gaga: Five Foot Two, a few times. My goal is to use my long-standing clinical expertise, including more than 100 peer-reviewed publications and three books on fibromyalgia, to help provide some objective perspective on this subjective endeavor.

Gaga’s Medical Background, Genes, and Aunt Joanne

The background story of Lady Gaga’s deceased aunt, Joanne, as described in the documentary, was fascinating. Joanne died 41 years ago, at age 19, from systemic lupus erythematosus (lupus). From the brief discussion in the film, Joanne’s lupus had not been appropriately treated, and Joanne was told that both of her hands would require amputation, just before she died. Despite never knowing Joanne, Gaga has identified closely with her, especially recently. Lady Gaga dedicated her most recent album, as well as her current world tour, to her Aunt Joanne, and in the film, tells a New York Times reporter, “I am Joanne.” Indeed, Gaga’s full name is Stefani Joanne Angelina Germanotta.

There is a very moving scene in the film when Gaga plays her song titled, “Joanne,” to her grandmother.  Lady Gaga seems to have been touched by Joanne’s illness, as well as that of a woman named Sonja, who is identified in the film as Gaga’s friend, undergoing treatment for cancer. It is possible that Gaga may have wondered whether her own symptoms could be related to lupus or another autoimmune disease. Lupus and fibromyalgia both have significant genetic underpinnings. There is an 8.5 odds ratio of having fibromyalgia in family members compared to the general population.2

There is nothing in the film that suggests to me that Lady Gaga has lupus. Fibromyalgia is not considered to be an autoimmune disease in the classic sense. Nevertheless, fibromyalgia is present in 40% of women with lupus compared to 3% of the general population.3

Lady Gaga performs despite having fibromyalgia, a chronic pain condition. i

The Pain of Fibromyalgia

The film opens with Lady Gaga at her mansion in California, in a happy mood, in her kitchen with her loving dogs. I was immediately struck by the close relationship she displays with her dogs and her staff. From years of working with fibromyalgia patients, I have observed that they function best when surrounded by loving family and friends. Her personal chef is carefully preparing Gaga’s food. It has been well documented that poor eating habits and obesity can aggravate fibromyalgia and chronic pain. In one study, nearly 50% of women with fibromyalgia were obese.4

While Lady Gaga does not struggle with obesity, she does describe in the film her chronic pain and its relationship with her mood. She states in the documentary, “If I get depressed, my body goes into spasm”, describing the spreading pain from her lower extremities to her trunk and up to her face. This spreading pain is characteristic of fibromyalgia.1 Lady Gaga often reports the pain as “spasms” or “pulling and tightness”. She also uses the term “inflammation”.

There are many different descriptions of the quality of fibromyalgia pain in the literature, from “dull and throbbing” to more of an “acute pain with muscle spasms”, Gaga identifies a specific thigh muscle as being particularly troublesome. I have found over the years that patients, like Lady Gaga, who is very athletic or involved in dance or the performing arts tend to describe their pain more anatomically, as one would with an injury.

This characterization also fits with Lady Gaga’s statement in the film that her pain followed her “broken hip”. This could be interpreted in a number of different ways. It is certainly possible that the hip injury she references in the film as occurring three years ago precipitated fibromyalgia. Many patients with fibromyalgia report that physical trauma was the inciting event of their chronic pain.5 The initial, localized pain seems to spread and become chronic and widespread in such situations. However, later in the film, Lady Gaga describes enduring more than five years of physical and mental anguish. It is, therefore, possible that she may have been suffering from long-standing fibromyalgia well before the hip injury.

Last updated on: October 16, 2017
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A Fresh Look at Opioid Antagonists in Chronic Pain Management

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