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Query: UMLS:C0016053 (
fibromyalgia
)
4,687
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
This review starts with a clinical description of the most common unspecific environmental diseases, such as Multiple Chemical Sensitivities (MCS), Idiopathic Environmental Intolerances (IEI) and Sick Building Syndrome (SBS). These syndromes are very controversial discussed between scientific medicine and "clinical ecology". In addition, they have fundamental similarities to
Chronic Fatigue Syndrome
(
CFS
) and
Fibromyalgia
. Finally the spectrum of therapeutic approaches is discussed.
...
PMID:[The non-specific environmental syndromes MCS (Multiple Chemical Sensitivity), IEI (Idiopathic Environmental Intolerance) and SBS (Sick Building Syndrome)]. 988 60
Fibromyalgia
is a chronic pain syndrome, more common in women. Its prevalence is estimated around 2% in the general population, and up to 20% among rheumatology outpatients. Besides musculoskeletal pain, symptoms as fatigue and sleep disturbance are considered characteristic. Research criteria have been set up, but their seemingly preciseness is unable to distinguish clearly between
fibromyalgia
and other functional somatic syndromes (
chronic fatigue syndrome
, irritable bowel syndrome) and psychiatric disorders (depression, anxiety), with which a striking comorbidity is documented. The diagnosis of
fibromyalgia
does not theoretically require the exclusion of muscle, joint, or metabolic diseases, but in clinical practice this problem proves to be of crucial importance. There are numbers of pathophysiological hypothesis for
fibromyalgia
, but none of them is fully satisfying: muscle is probably innocent; sleep disturbance, although sometimes considered a landmark of the syndrome, is unspecific; stress response studies show subtle anomaly; psychiatric disorders may represent factors of vulnerability and perpetuation rather than causes. We propose to include some of these etiological contributors in vicious circles leading to a "final common pathway" characterized by generalized hyperalgesia. Treatments of
fibromyalgia
, whether pharmacological (antidepressants) or psychological (cognitive-behavioral therapies) are of little efficacy, and the global prognosis of
fibromyalgia
is poor. However, the outcome might prove better outside the specialized clinics in which studies of chronic sufferers with severe abnormal illness behaviors are done. The social consequences of the popularization of the diagnosis of
fibromyalgia
should not be neglected.
...
PMID:[Fibromyalgia. A critical review]. 992 93
The initial data from this study indicate that there are clearly identifiable chronic muscle pain conditions in the form of localized pain; myofascial pain or regional pain conditions; and
fibromyalgia
or generalized pain conditions. A clear difference exists between the prevalence of these conditions in male and female patients, with a higher percentage of female patients suffering generalized pain problems and temporomandibular problems. Generalized or localized pain appears to be an individual variant of a similar problem and pain patients may have a genetically determined vulnerability associated with bacterial toxins, particularly within the genitourinary tract. It appears that in
fibromyalgia
there is an underlying genetic factor that causes abnormalities in the muscle metabolic cycle, and preliminary data suggest that lipid anomalies predispose to
fibromyalgia
and possibly
chronic fatigue syndrome
. Patients report infectious events at/or around onset in more than 60 percent of cases. Seventy percent of fibromyalgic cases report orofacial pain.
...
PMID:Chronic orofacial muscle pain: a new approach to diagnosis and management. 992 97
Fibromyalgia syndrome
(
FMS
) is recognizable syndrome characterized by chronic, diffuse pain, an absence of inflammatory or structural muscloskeletal abnormalities, and a range of symptoms that include fatigue, and sleep and mood disturbances. Physical examination and laboratory testing are unrevealing, except for the presence of pain on palpation of characteristic soft-tissue sites, the tender points. Despite the recognition of
FMS
by the World Health Organization, it remains a controversial condition and its existence as a distinct entity remains uncertain. However, the concept of
FMS
is a useful one, allowing many investigations to be avoided and appropriate advice on treatment to be given.
FMS
may overlap with symptoms of, and the patient further impaired by, anxiety and depression. The term
FMS
dose not imply causation and merely describes the most common symptoms. Many patients with
chronic fatigue syndrome
(CFS) fulfill the criteria of
FMS
and represent one end of a spectrum of presentation. Evidence for triggering viral infection and the lower level of serum acylcarnitine, observed in CFS patients, is lacking in the majority of patients with
FMS
. These findings are suggestive to be distinctively another disorders between
FMS
and CFS.
...
PMID:[Fibromyalgia syndrome]. 1007 6
Neuropsychiatric diseases viewed as multifaceted expression of a dysfunctional brain in which atypical responses are evoked by various sensory inputs. Disease entities have traditionally been classified according to the predominant manifestation ( ) without regard to the overlapping features of many of the diseases (+/-). Thus, mild to moderate pain, mood, cognitive, and neurosomatic symptoms are frequently present in
chronic fatigue syndrome
(
CFS
) patients.
Fibromyalgia syndrome
(
FMS
) is listed as an example of a predominantly chronic pain syndrome. Affect (mood) disorders include depression (Depress.), anxiety, panic reactions, blunted affect, mania, etc. Schizophrenia (Schizo.) is listed as an example of a major cognitive psychosis. Autism as well as various forms of dementia would be included in this category. Irritable bowel syndrome (IBS) is an example of a neurosomatic disease.
...
PMID:Stealth viruses as neuropathogens. 1015 Jan 89
Fibromyalgia
was almost completely absent from an urban affluent population compared with poor urban and rural communities. Seventeen percent of Gulf War veterans with soft tissue syndromes had
fibromyalgia
, a much higher rate than was seen in previous studies of rheumatic disease in the military population. A state of central hyperexcitability in the nociceptive system was reported in
fibromyalgia
. Altered functioning of the stress-response system has been further documented in
fibromyalgia
and
chronic fatigue syndrome
. Administration of growth hormone to patients with
fibromyalgia
who have low levels of insulin-like growth factor 1 resulted in improvement in their symptoms and tenderness. An association between
chronic fatigue syndrome
and initial infections was demonstrated. A correlation between particular immunologic abnormalities and measures of disease severity was documented in
chronic fatigue syndrome
. Concomitant
fibromyalgia
in other rheumatic diseases was a major contributor to poor quality of life. A favorable outcome of
fibromyalgia
in children was reported; the majority of patients improved over 2 to 3 years of follow-up. Treatment of patients with
fibromyalgia
continues to be of limited success.
...
PMID:Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome. 1031 15
A complaint of persistent, debilitating fatigue in an adolescent, accompanied by symptoms that meet the recently adopted criteria for
chronic fatigue syndrome
(
CFS
), presents a difficult challenge for the clinician. This article describes the diagnostic criteria for
CFS
and
fibromyalgia
, and discusses the epidemiology, etiology, and management of these conditions.
...
PMID:Chronic Fatigue Syndrome and Fibromyalgia in Adolescence. 1035 Jul 71
Conditions such as
chronic fatigue syndrome
(
CFS
),
fibromyalgia
, and several others belong to the group of disorders in which both physiologic and psychologic factors are substantially involved, and in some cases there may be no real distinction between the two. However, primary patient assessment usually employs an array of clinical tools, and only after known physiologic factors are excluded is the patient referred for psychologic or psychiatric evaluation. This chapter suggests that clinical evaluation should initially include both physiologic and psychosocial assessment, which would minimize the division and greatly improve the efficacy of the treatment.
...
PMID:One Test Too Many: Toward an Integrated Approach to Psychosomatic Disorders. 1036 30
The term functional somatic syndrome has been applied to several related syndromes characterized more by symptoms, suffering, and disability than by consistently demonstrable tissue abnormality. These syndromes include multiple chemical sensitivity, the sick building syndrome, repetition stress injury, the side effects of silicone breast implants, the Gulf War syndrome, chronic whiplash, the
chronic fatigue syndrome
, the irritable bowel syndrome, and
fibromyalgia
. Patients with functional somatic syndromes have explicit and highly elaborated self-diagnoses, and their symptoms are often refractory to reassurance, explanation, and standard treatment of symptoms. They share similar phenomenologies, high rates of co-occurrence, similar epidemiologic characteristics, and higher-than-expected prevalences of psychiatric comorbidity. Although discrete pathophysiologic causes may ultimately be found in some patients with functional somatic syndromes, the suffering of these patients is exacerbated by a self-perpetuating, self-validating cycle in which common, endemic, somatic symptoms are incorrectly attributed to serious abnormality, reinforcing the patient's belief that he or she has a serious disease. Four psychosocial factors propel this cycle of symptom amplification: the belief that one has a serious disease; the expectation that one's condition is likely to worsen; the "sick role," including the effects of litigation and compensation; and the alarming portrayal of the condition as catastrophic and disabling. The climate surrounding functional somatic syndromes includes sensationalized media coverage, profound suspicion of medical expertise and physicians, the mobilization of parties with a vested self-interest in the status of functional somatic syndromes, litigation, and a clinical approach that overemphasizes the biomedical and ignores psychosocial factors. All of these influences exacerbate and perpetuate the somatic distress of patients with functional somatic syndromes, heighten their fears and pessimistic expectations, prolong their disability, and reinforce their sick role. A six-step strategy for helping patients with functional somatic syndromes is presented here.
...
PMID:Functional somatic syndromes. 1068 Dec 98
Soldiers returning from the Gulf War in 1991 described a range of symptoms, including some consistent with the
chronic fatigue syndrome
,
fibromyalgia
, and multiple chemical sensitivity. Well-defined adverse health events attributable to service in the Gulf occurred. However, controlled epidemiological studies in Gulf War veterans and controls describe significant excesses of symptoms that were not clearly associated with pathologic disease. At least 12% of veterans currently receive some form of disability from the Department of Veterans Affairs. A number of reports outline theories proposed to explain the excess, but few are scientifically supported. Management guidelines for this spectrum of disorders resembles that of many of "emerging overlap syndromes," including multiple chemical sensitivity,
chronic fatigue syndrome
, and
fibromyalgia
. They include the establishment of a trusting doctor-patient relationship, negotiations around a common ground of scientific and etiologic beliefs, non-labeling of the disorder, and work toward recovery in the absence of clear etiologic answers.
...
PMID:Gulf War illnesses: causation and treatment. 1039 Jun 95
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