Photo by Bill Green Linda Bryant spends at least five days each week exercising at the Hagerstown YMCA to keep the pain caused by fibromyalgia in check. She swims about 27 laps in the pool and is accompanied by her husband Willie. Following her swim she spends time in the gym.

But Bryant isn't exercising to fit into a new dress or her favorite pair of jeans. Without following her schedule Bryant can go into a tailspin of pain caused by fibromyalgia.

Diagnosed 15 years ago, Bryant, of Middletown , is one of about 10 million Americans afflicted with the often debilitating illness. Fibromyalgia is a complex chronic pain illness that is so difficult to diagnose that it is often misinterpreted for other diseases. "Fibro" means fiber, "mya" means muscle and "aglia" means pain.

Wendy Crum was in her 20s when her muscle pain and fatigue forced her to stop her career as an occupational therapist and go on disability. Told she had multiple sclerosis, Crum spent time using a cane and wheelchair to get around.

It took finding the right doctor and self-advocacy to determine it was fibromyalgia and not MS that was giving her the pains. A strict regimen of work, rest and exercise helped Crum not only to work again, but also to have a son.

"It was a wake-up call for me what I went through. I had to evaluate what is important to me and where I should put my energies," the Smithsburg woman said.

Both women credit knowledgeable physicians for putting a name to their pain.

Dr. Nathan Wei, a Frederick rheumatologist knows what it's like to solve the mystery of fibromyalgia. He said he treats four to five patients a day who have the illness.

"The patient population I see has been steady. I do see more patients and physicians who are aware and now have a suspicion that this is what they are dealing with," he said.

Patients who show symptoms of fibromyalgia experience widespread body pain and at times overlapping conditions such as irritable bowel syndrome, migraines and depression. One diagnostic criterion is a history of pain in all four quadrants of the body for a minimum duration of three months and pain in at least 11 of 18 so-called trigger points in the body when pressure is applied to them.

That's how doctors determined Bryant suffered with fibromyalgia.

"I responded to every one of those trigger points. The doctor diagnosed fibromyalgia and my reaction was, 'well, what is that?'" she said. "When the doctor told me what I had, it was such a relief because you begin to think there is something mentally wrong with me before that. I thank heaven that it is something that now I can get on and deal with."

Wei said that is often times the reaction he gets, too.

"The symptoms are so confusing and don't seem to make anatomic sense," he said. "Traditionally, you were diagnosed with fibro when nothing else was available. It was a waste basket term."

Now doctors understand the condition has its roots in a malfunction of the central nervous system.

"This is a disorder in the brain due to the abnormal way the brain process pain," Wei said.

According to the National Fibromyalgia Association, while the cause is unknown, fibromyalgia often occurs following a physical trauma that acts as a trigger. It also appears to have a genetic component.

Treating the illness has doctors helping patients with a combination of medications and exercise. Wei said he has three cornerstones to his treatment plan including cognitive behavior training, non-impact aerobics and medications. The U.S. Food and Drug Administration approved Lyrica, Cymbalta and Savella as pharmacological treatments for fibromyalgia as well as narcotic pain relievers and low doses of antidepressants.

It is this combination of treatments that has gotten Crum out of the wheelchair and racing after her 6-year-old son Alan. She started by slowly pedaling a stationary bike next to her bed for two minutes at a time. She worked up to five minutes and then 30.

"It took a year of slowly progressing to find the work, rest, play balance," she said. "Exercise was the key."

For Bryant, a mix of muscle relaxers and exercises has helped her to get her life back. At the height of her pain, she couldn't even walk from the parking lot into the grocery store. With her pain under control, Bryant recently took a road trip to the Grand Canyon.

"I have it under control today so long as I get my exercise and take my medications," she said. "What I really want people to know is that fibromyalgia really exists. I want those people who have it to be their own advocate and know they can get better."