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Query: UMLS:C0016053 (fibromyalgia)
 4,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During a 5 month, double blind crossover study of the clinical effect of cyclobenzaprine on 7 patients with fibrositis, weekly measurements were done of plasma beta-endorphin (endorphin, prostaglandin E (PGE) and catecholamines). Endorphin levels were normal but varied with tender point tenderness. Mean plasma dopamine and PGE were elevated. Norepinephrine was normal to very high while epinephrine levels were continuously low to normal. We conclude that patients with fibrositis have a neurotransmitter plasma profile like other chronic pain states having stress and increased vasomotor activity with the possible exception of having low circulating epinephrine. This disparity may mark a failure of central nervous system pain modulation in fibrositis.
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PMID:The plasma endorphin, prostaglandin and catecholamine profile of patients with fibrositis treated with cyclobenzaprine and placebo: a 5-month study. 253 82

Twenty patients with fibromyalgia syndrome and 20 patients with rheumatoid arthritis (RA) were assessed as outpatients over a 3 day period with respect to peak and trough levels of plasma cortisol, growth hormone, prolactin, ACTH and thyroid stimulating hormone. Patients with fibromyalgia syndrome had loss of diurnal variation in plasma cortisol (trough levels 347.3 +/- 254.7 vs 232.8 +/- 70.0 nmol/l, p less than 0.001) compared with RA patients. Thirty-five percent (7/20) of patients with fibromyalgia syndrome and only 5 percent (1/20) of those with RA exhibited abnormal dexamethasone suppression tests (p less than 0.001). No differences were noted in the diurnal variation of other hormones tested. Beck Depression Inventory scores were similar in both groups and no patient exhibited clinical evidence of depression. These data suggest alteration in the pituitary hypothalamic axis with respect to cortisol secretion in fibromyalgia syndrome, perhaps as a consequence of chronic pain.
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PMID:Diurnal hormone variation in fibromyalgia syndrome: a comparison with rheumatoid arthritis. 260 9

Myofascial pain syndrome is a regional muscle pain disorder that is the most common physical diagnosis causing chronic pain. The complex symptoms, concomitant disorders, and frequent behavioral and psychosocial contributing factors make this disorder frequently overlooked and difficult to treat. Once recognized, management programs involving rehabilitating the affected muscles and controlling the contributing factors are effective if long-term compliance is maintained by the patient.
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PMID:Myofascial pain syndrome. 265 82

Primary fibromyalgia remains a controversial and puzzling condition. The diagnosis is based on subjective symptoms, exclusionary criteria and the presence of tender points. Much of the discussion of primary fibromyalgia centers on physical or psychological bases for the etiology, exacerbation and maintenance of the symptoms. An alternative to the current dichotomous way of conceptualizing primary fibromyalgia is presented based on a multiaxial perspective that integrates physical, psychosocial and behavioral factors creating an empirically derived taxonomy. The utility of this approach is illustrated from research with groups of patients with chronic pain. The implications of the multiaxial taxometric approach for understanding primary fibromyalgia and its treatment are described.
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PMID:Primary fibromyalgia is greater than tender points: toward a multiaxial taxonomy. 269 87

Rheumatology centers report that chronic pain patients with myofascial pain (fibrositis) are prone to psychiatric pathology. However, the distribution of DSM-III diagnoses in this population is unknown. This distribution is reported for 238 chronic pain patients with fibrositis. Statistical comparisons of men and women were also made with regard to the prevalence of each diagnosis, and the results were compared to published DSM-III diagnoses prevalence data for mixed chronic pain patients and rheumatology fibrositis patients. In our sample, women with fibrositis were equally as likely as men with fibrositis to have current depression. Within the general chronic pain population, women are more likely to have current depression. The incidence of current major depression and current and past major depression was much lower in our fibrositis sample than that reported by rheumatology programs. These results indicate that there may be psychiatric differences between chronic pain patients with and without fibrositis. Fibrositis patients in rheumatology programs may also be psychiatrically different from chronic pain program patients with fibrositis.
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PMID:DSM-III diagnoses of patients with myofascial pain syndrome (fibrositis). 273 Mar 4

The clinical features of 60 female adolescents (mean age 15 +/- 0.3 years) presenting consecutively to a rheumatologist are reviewed. Thirty-five per cent met criteria for well-defined chronic pain syndromes, 19 having fibrositis syndrome and two having a reflex sympathetic dystrophy syndrome. Other diagnoses were inflammatory arthritis (30%), anterior knee pain syndromes (13.3%), tendinitis (8.3%) and miscellaneous conditions (13.3%). The high prevalence of chronic pain syndromes in this patient group is highlighted and an approach to management is suggested.
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PMID:Female adolescent rheumatological presentations: the importance of chronic pain syndromes. 273 Apr 66

Recent studies indicate the relevance of psychological factors in the pathogenesis of primary fibromyalgia, although the results sometimes differ. Most of the studies investigated personality features and depression. Beyond these our study investigates defense mechanisms and illness behavior in primary fibromyalgia comparing them with those of psychogenic pain patients and with controls. All patients (fibromyalgia n = 47, psychogenic pain n = 63, controls n = 84) completed German adaptations of the Defense Mechanisms Inventory (DMI) and the Illness Behavior Questionnaire (IBQ) and the "Questionnaire of Psychosomatic Disease-Patterns" (FAPK). The two chronic pain groups show a high conformity: Reduced relation to reality, emotional vacancy in relationships, aggression restraint are the predominant personality features. Immature defense mechanisms and abnormal illness behavior are predominant. Somatic pain and its hypochondrical pursuit substitute the tackling of seemingly unsolvable life problems. Conclusions for the management of fibromyalgia patients are outlined.
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PMID:[Personality markers, defense behavior and illness concept in patients with primary fibromyalgia]. 273 55

We studied tenderness at 75 unilateral anatomic locations in 10 fibromyalgia patients and 10 normal control subjects to determine which sites best identified patients with fibromyalgia. Using a dolorimeter, the mean amount of pressure required to elicit tenderness was significantly lower in patients than in controls at 19 sites (P less than 0.001). Of the previously proposed tender points, only 2 were included in those 19 best discriminating points. Fifteen of the 19 best discriminating points were clustered in regions around the anterior shoulder, anterior chest, posterior scapula, and medial knee. The 19 sites that we have identified best separate patients with fibromyalgia from controls, although the discriminating power of these sites in other chronic pain syndromes will require further study. Examination of specific regions may be more useful clinically than the exact anatomic sites within these regions.
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PMID:Tenderness in 75 anatomic sites. Distinguishing fibromyalgia patients from controls. 316 64

We investigated the use of pain measures in chronic pain syndromes with and without explicable organic cause by correlating scores obtained from the Visual Analog Scale and from subscales of the McGill Pain Questionnaire in patients with either inflammatory arthritis or primary fibrositis. We confirmed the finding that patients with fibrositis, despite having significantly less demonstrable pathology, report more pain on a significant number of measures. In patients with arthritis, we observed large positive correlations between scores on different pain measures, supporting the hypothesis that these scores validly measure pain secondary to tissue injury. In the fibrositis group, however, significantly lower correlations, and one even strongly negative, were found between scores on different measures. We suggest that commonly used pain measures which have been shown to be valid to study patients with demonstrable pathology may be less valid for measurement of pain in patients with syndrome such as fibrositis, whose pain may be different or more complex than that of patients with explicable organic basis.
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PMID:Differing correlations between pain measures in syndromes with or without explicable organic pathology. 317 56

In a previous study, Ahles et al. [1] compared the MMPI results of primary fibromyalgia, rheumatoid arthritis and non-pain control participants. The purpose of the present study was to reanalyze the original data using the contemporary norms of Colligan et al. [5]. The reanalysis revealed that the pattern of group differences remained the same; however, the number of primary fibromyalgia patients classified as 'psychologically disturbed' was appreciably reduced. These data have clinical relevance in that the incidence of psychopathology in chronic pain patients may be overestimated because of the use of outdated norms. Additionally the data have theoretical relevance in that a large number of patients who present with pain in the absence of a known organic pathology do not present evidence of psychopathology.
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PMID:The use of contemporary MMPI norms in the study of chronic pain patients. 345 54


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