On Monday it was announced that Lady Gaga has cancelled her European tour, due to begin next week, because of “severe physical pain that has impacted her ability to perform”. She has fibromyalgia, and has made a Netflix documentary, Gaga: Five Foot Two, to raise awareness about this long-term condition. A statement says: “She plans to spend the next seven weeks proactively working with her doctors to heal from this and past traumas that still affect her daily life and result in severe physical pain in her body. She wants to give her fans the best version of the show she built for them when the tour resumes.”
People with FMS often notice that a fairly innocuous injury, such as stubbing a toe, hurts more intensely and for longer than it should. And even a light touch that shouldn’t hurt at all can be experienced as an unpleasantly painful sensation. The fatigue means you need to sleep a lot but wake up feeling groggy, stiff and achy. Even mental processes feel sluggish, so it becomes a huge effort to concentrate or learn anything new, and your speech may sound slow and a bit muddled. Patients call this “fibro-fog”, and it is not clear whether Lady Gaga experiences it or not.
Diagnosis rests on a history of widespread pain and pressure points. An examiner prods you in 18 places (with enough pressure to blanche the examiner’s fingernail). If 11 out of the 18 points are unusually tender, it supports the diagnosis.
No one knows what causes FMS. There is probably some disorder in the way pain is processed in the brain in people with the condition. And there is a cycle in which pain makes you depressed and anxious and this makes the experience of pain worse. Sceptics may say “it’s all in the mind” but all pain is processed in the brain, so that sort of disparaging and dismissive remark makes no sense. There is some suggestion that FMS is more common among people who have suffered from physical, emotional and sexual abuse in childhood; the evidence is weak, but this is an area that needs more study. Lady Gaga has been very open about being raped at the age of 19 and her anti-rape song, Swine, hints at the trauma she experienced.
As there is no specific cure, living with FMS means being aware of triggers (stress, bereavement, other illnesses or surgery, weather changes, travel and sleep deprivation, for instance) that can cause a flare-up, and finding a way of living, working, exercising and eating that works for you. Exercise, physiotherapy, adjustments in the workplace, counselling and stress management techniques can help. Drug treatment with anti-inflammatories, antidepressants and drugs used in the treatment of epilepsy have all been tried, but there is no single easy fix.
But Lady Gaga – and her millions of fans – may take heart from the fact that, however bad the symptoms are, FMS does not cause long-term joint damage and many people do get better over time. However, you cannot predict how long recovery may take, or whether symptoms will recur, so it is hard to know when she might feel ready to commit to touring again.