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

In the eyes of a person with fibromyalgia syndrome, their pain and other symptoms are real. By the time a patient seeks medical care for fibromyalgia, they will have probably endured criticism and misunderstandings about the invisible nature of their symptoms. Patients are genuinely disturbed that their bodies are not performing up to par, while at the same time, their family, friends and employers are placing demands on them that can't be met. No one would want to be placed in such a frustrating and painful predicament, so naturally this situation becomes the driving force for fibromyalgia patients who are seeking medical advice. Unfortunately, lack of understanding about the neurophysiology of chronic pain syndromes and the advent of evidence-based medicine leads to restricted care for patients who really need a physician's help. The best prescription for aiding people with fibromyalgia undoubtedly includes a physician with an open mind on treatment options.
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PMID:Is fibromyalgia a distinct clinical entity? The patient's evidence. 1056 77

Multimodal pain management programmes have been used for chronic pain conditions such as low back pain or headache for many years with good results. However their effectiveness for treating fibromyalgia has only recently been established and with respect to long-term outcome the evidence is still not convincing. Recent findings, about abnormalities in pain control and neuroendocrine systems, help to understand the symptomatology of fibromyalgia and give theoretical support for these treatment concepts. They might also explain why secondary phenomena like depression, anxiety, deconditioning and disability can make it harder to treat the condition at a chronic stage. The ingredients of such multimodal programmes are described and evidence for their effectiveness is presented.
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PMID:Pain management strategies and team approach. 1056 81

Fibromyalgia has been known by French rheumatologists for more than 15 years. However, only recently have teaching and basic, clinical and epidemiological research been developed on this topic in France. Management of the fibromyalgia patient should benefit from this recent evolution, all the more so since the French government took action to facilitate the medical treatment of chronic pain and to support the development of algology in France.
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PMID:Fibromyalgia as a national issue: the French example. 1056 83

Fibromyalgia is a chronic soft tissue pain syndrome characterized by the presence of widespread musculosceletal aching, tender points at characteristic sites, fatigue and poor sleep. Associated disorders are restless leg syndrome, irritable bowel syndrome, irritable bladder syndrome, cognitive dysfunction, cold intolerance, multiple sensitivities and dizziness. Despite the superficial appearance of normality, many fibromyalgia patients have difficulties with remaining competitive in the work force. Impressive resurgence of research had been done about fibromyalgia in a better understanding in the neurobiology of chronic pain. The results demonstrate that sensory disorders processing at a central level are in part involved in fibromyalgia. These findings also influence the management of the disease with the tendency to a multidisciplinary therapeutical concept.
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PMID:[Panalgesia and the fibromyalgia concept]. 1063 67

In this article, a number of hormones and neuropeptides regulating pain, well-being and stress are shown to play important roles in the association between stress perception and nociception. Derangements in the stress axis may be induced by a variety of factors in which life events, personality, psychosocial circumstances and gender all may contribute. When such derangements are long-lasting, probably several neuroendocrine modifications are induced, giving rise to many of the symptoms seen in chronic pain syndromes including fibromyalgia.
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PMID:[Stress can induce neuroendocrine disorders and pain]. 1064 44

The aims of this study were: (1) to compare two groups of patients with chronic pain conditions (work-related muscular pain, mainly low back pain, and fibromyalgia) in general coping and pain-specific coping; (2) to examine the relationship between general and pain-specific coping and, (3) to examine the influence of state-trait anxiety on general and pain-specific coping. The sample included 80 individuals (range=19-70 years; mean=47; SD=9.9), who were patients at two pain management clinics for examination of their physical and psychosocial health conditions and consideration on disability pension. The patients were asked to respond to theStrategies to Handle Stress Questionnaire, theCoping Strategies Questionnaireand theState-Trait Anxiety Inventory. Patients with fibromyalgia scored significantly higher on T-anxiety and adopted <<problem-solving>> (p<0.01) and <<catharsis>> (p<0.05) less often and <<religion>> more often (p<0.01) than patients with work-related muscular pain in coping with stressful situations in general. No differences were revealed in pain-related coping between the groups. T-anxiety was positively correlated to pain-related <<catastrophizing>> (p<0.001) and negatively to abilities to control and reduce pain (p<0.05 andp<0.01, respectively). The correlation between general and pain-specific coping was weak to moderate. In conclusion, patients with fibromyalgia scored significantly higher on trait-anxiety and seem to interpret stressful situations as more threatening than patients with work-related muscular pain. Anxiety seems to be of central importance for coping with chronic pain. Anxiety-prone patients with fibromyalgia might benefit from psychological support in the process of coping with pain. Copyright 1998 The British Infection Society. All rights reserved.
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PMID:Anxiety and coping in patients with chronic work-related muscular pain and patients with fibromyalgia. 1070 Mar 26

To study relations between neural and immune activity in patients with chronic pain, we correlated regional cerebral blood flow measured with [(15)O]butanol positron emission tomography to immune function in five patients with fibromyalgia. Partly replicating previous data in healthy volunteers, natural killer cell activity correlated negatively with right hemisphere activity in the secondary somatosensory and motor cortices as well as the thalamus. Moreover, natural killer cell activity was negatively and bilaterally related to activity in the posterior cingulate cortex. Thus, immune parameters were related to activity in brain areas involved in pain perception, emotion, and attention. Implicated from a small study population, these strong neuro-immune associations are discussed in view of recent findings concerning mechanisms and adaptive values in immuno-cortical communication and regulation.
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PMID:Neuroimmune relations in patients with fibromyalgia: a positron emission tomography study. 1071 24

Fibromyalgia and widespread pain were common in Gulf War veterans with unexplained illness referred to a rheumatology clinic. Increased tenderness was demonstrated in the postmenstrual phase of the cycle compared with the intermenstrual phase in normally cycling women but not in users of oral contraceptives. Patients with fibromyalgia had high levels of symptoms that have been used to define silicone implant-associated syndrome. Tender points were found to be a common transient finding associated with acute infectious mononucleosis, but fibromyalgia was an unusual long-term outcome. The common association of fibromyalgia with other rheumatic and systemic illnesses was further explored. A preliminary study revealed a possible linkage of fibromyalgia to the HLA region. Patients with fibromyalgia were found to have an impaired ability to activate the hypothalamic pituitary portion of the hypothalamic pituitary adrenal axis as well as the sympathoadrenal system, leading to reduced corticotropin and epinephrine response to hypoglycemia. Much interest has been expressed in the literature on the possible role of autonomic dysfunction in the development or exacerbation of fatigue and other symptoms in chronic fatigue syndrome. Mycoplasma genus and mycoplasma fermentans were detected by polymerase chain reaction in patients with chronic fatigue syndrome. It was reported that myofascial temporomandibular disorder does not run in families. No major therapeutic trials in fibromyalgia, chronic fatigue syndrome, or myofascial pain syndrome were reported over the past year. The effectiveness of cognitive behavioral therapy and behavior therapy for chronic pain in adults was emphasized. A favorable outcome of fibromyalgia and chronic fatigue syndrome in children and adolescents was reported.
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PMID:Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome. 1075 Oct 14

Patient readiness to adopt new beliefs and coping responses to pain may predict response to multidisciplinary or cognitive-behavioral pain treatments that emphasize changes in beliefs and coping behaviors. According to the transtheoretical model of change, individuals go through specific stages in the process of changing maladaptive behaviors. Based on this model, Kerns et al. (1997) (Kerns RD, Rosenberg R, Jamison RN, Caudill MA, Haythornthwaite J. Readiness to adopt a self-management approach to chronic pain: the Pain Stages of Change Questionnaire (PSOCQ). Pain 1997;72:227-234) developed a measure of readiness to adopt a self-management approach to pain problems (the Pain Stages of Change Questionnaire; PSOCQ) and provided preliminary data supporting the validity of the measure. The current study sought to further evaluate the PSOCQ by determining the generalizability of these preliminary findings and the ability of the PSOCQ to classify persons with chronic pain into specific stages of readiness to self-manage pain. One hundred ten patients with diverse chronic pain problems, and 119 patients with fibromyalgia completed the PSOCQ and two measures of pain-related beliefs and coping prior to entry into two separate multidisciplinary pain programs. The internal consistency and concurrent validity of the PSOCQ subscales were largely replicated, supporting the validity of the subscales as measures of readiness to self-manage pain. However, the PSOCQ demonstrated less utility as a tool for classifying individuals into one of four specific stages of readiness to adopt a self-management approach. This result may be due to the classification procedure used in the current study, the characteristics of the samples in the study, specific limitations of the measure, and/or limitations in the applicability of the transtheoretical model of change to patients with chronic pain.
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PMID:Further evaluation of the pain stages of change questionnaire: is the transtheoretical model of change useful for patients with chronic pain? 1081 55

We describe a family of 6 (2 parents and 4 children), evaluated 6 and 8 years after a minor car accident for chronic pain. A near identical complex of multiple physical, constitutional, and psychological symptoms were shared by all family members, all of whom bore the diagnosis of fibromyalgia. The case was brought to court after nearly a decade of symptomatology and extensive use of the health care system. The minor compensation awarded was consumed ultimately by legal fees. Psychosocial/personality issues and iatrogenic and medico-legal contributions in the evolution and resolution of the legal claim are discussed.
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PMID:Chronic pain in a family of 6 in the context of litigation. 1081 74


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