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

Chronic pain states are common in the general population. Genetic factors can explain a significant amount of the variability in the perception of pain. Fibromyalgia syndrome (FMS) and related conditions are syndromes characterized by generalized pain sensitivity as well as a constellation of other symptoms. Family studies show a strong familial aggregation of FMS and related conditions, suggesting the importance of genetic factors in the development of these conditions. Recent evidence suggests a role for polymorphisms of genes in the serotoninergic, dopaminergic and catecholaminergic systems in the pathogenesis of FMS and related conditions. Environmental factors may trigger the development of these disorders in genetically predisposed individuals. Future large well-designed studies are needed to further clarify the role of genetic factors in FMS and related conditions. The knowledge of these gene polymorphisms may help with better subgrouping of FMS patients and in designing a more specific pharmacologic treatment approach.
Best Pract Res Clin Rheumatol 2007 Jun
PMID:Genetics of chronic pain states. 1760 98

Chronic painful muscle conditions include non-inflammatory and inflammatory illnesses. This review is focused on chronic non-inflammatory pain conditions such as myofascial pain syndrome (MPS) and fibromyalgia syndrome (FM), and will not discuss metabolic, genetic or inflammatory muscle diseases such as McArdle's disease, muscular dystrophy, polymyositis, dermatomyositis, or inclusion body myositis.
Best Pract Res Clin Rheumatol 2007 Jun
PMID:Future perspectives: pathogenesis of chronic muscle pain. 1760 1

Patient questionnaires are the quantitative tools available to rheumatologists to monitor their patients' health status and responses to therapy. The Health Assessment Questionnaire (HAQ) and its derivatives have been shown to be the most significant predictors of functional and work disability, costs, joint replacement surgery, and mortality; generally at higher levels of significance than joint counts, radiographs, and laboratory tests. Every encounter of a patient with a rheumatologist provides an opportunity to collect data. Yet patient questionnaires, which can be used in all rheumatic diseases, including osteoarthritis, systemic lupus erythematosus, fibromyalgia, scleroderma, and ankylosing spondylitis, are not included in routine care by most rheumatologists. Questionnaires can be adapted to include a simple subjective-objective-assessment-plan (SOAP) clinical encounter note that helps with data entry and also provides all the necessary information for clinical decision making in one sheet of paper. Data that are feasible to collect in clinical care provide the optimal approach to assessing quantitatively how patients are doing. If data are not collected and recorded, that opportunity, on that day, is lost forever. Rheumatologists would find it valuable to adapt questionnaires to the care they provide for all their patients, to document and improve the care they provide, and add quantitative data to standard clinical care.
Best Pract Res Clin Rheumatol 2007 Aug
PMID:Monitoring outcomes of arthritis and longitudinal data collection in routine care using a patient questionnaire that incorporates a clinical note on one piece of paper. 1767 24

A multidimensional health assessment questionnaire (MDHAQ) is useful in standard care of patients with all rheumatic diseases in a busy clinical setting. The MDHAQ was adapted from the classical health assessment questionnaire (HAQ) for feasibility in standard clinical care, with reduction of the number of activities from 20 to 10, visual analog scales (VAS) as 21 circles rather than 10 cm lines, availability of all core data set patient self-report measures and scoring templates on the front side, and a review of systems symptom checklist and review of recent medical history on the reverse side of a single page. Scoring templates are also available for routine assessment of patient index data (RAPID) scores, based on a composite of the three patient reported outcome (PRO) measures from the core data set included on the HAQ and MDHAQ, physical function pain, and patient estimate of global status. Flow sheets illustrating use of the MDHAQ in standard clinical care of patients with various rheumatic diseases, including psoriatic arthritis, systemic lupus erythematosus, ankylosing spondylitis, gout, scleroderma, vasculitis, fibromyalgia, inflammatory bowel disease arthritis, Behcet's syndrome, and familial Mediterranean fever, are presented to illustrate use of this simple questionnaire to add to clinical decisions and document patient courses and outcomes in standard clinical care of patients with all rheumatic diseases.
Best Pract Res Clin Rheumatol 2007 Aug
PMID:Can a Multi-Dimensional Health Assessment Questionnaire (MDHAQ) and Routine Assessment of Patient Index Data (RAPID) scores be informative in patients with all rheumatic diseases? 1767 33

This chapter summarizes current evidence from recently published systematic reviews of land- and water-based exercise therapies for musculoskeletal conditions. The aim is to present an overview of the evidence and highlight gaps where more research is still needed. This is not a systematic review, but a systematic search of the literature and a summary of results of the best, most recent systematic reviews evaluating interventions for musculoskeletal conditions. There have been two previous summaries of systematic reviews of evidence for exercise therapies in musculoskeletal conditions. We have updated these searches, and additionally considered the evidence for the clinical effectiveness of exercise in fibromyalgia and chronic widespread pain and of hydrotherapy and water-based exercise treatments on pain and disability.
Best Pract Res Clin Rheumatol 2008 Jun
PMID:Land- and water-based exercise therapies for musculoskeletal conditions. 1851 96

The objectives of the study were identification, quality evaluation and summary of RCTs on complementary and alternative medicine as defined by the National Institute of Health with the exception of dietary and nutritional supplements. A computerized search of databases from 1990 (year of publication of the ACR criteria for fibromyalgia) to July 2007 was performed. The RCTs were assessed by a methodological quality score. A total of 23 RCTs issued from 1992 to 2007 on acupuncture, balneotherapy, thermotherapy, magnetic therapy, homeopathy, manual manipulation, mind-body medicine, diet therapy and music therapy were identified. The RCTs had an average group size of 25 with the number of groups ranging from two to four. The quality score assessment of the RCTs yielded a mean score of 51 out of 100. The average methodological quality of the identified studies was fairly low. Best evidence was found for balneotherapy/hydrotherapy in multiple studies. Positive results were also noted for homeopathy and mild infrared hyperthermia in 1 RCT in each field. Mindfulness meditation showed mostly positive results in two trials and acupuncture mixed results in multiple trials with a tendency toward positive results. Tendencies for improvement were furthermore noted in single trials of the Mesendieck system, connective tissue massage and to some degree for osteopathy and magnet therapy. No positive evidence could be identified for Qi Gong, biofeedback, and body awareness therapy.
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PMID:Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia. 2751 81

Fibromyalgia (FM) is a challenging condition, but the management of patients with FM is becoming facilitated by new medications that act in what are thought to be some of most important pathophysiological features in this syndrome. However, it is of pivotal importance that an interdisciplinary approach is used to improve pain, fatigue, sleep and other domains to improve quality of life. Here, we present elements of management that the solo practitioner can tackle, focussing in the formally approved drugs for FM and other drugs commonly used in this condition. Further, the elements of an ideal multidisciplinary team are presented, and on how to incorporate their recommendations for the treatment of FM.
Best Pract Res Clin Rheumatol 2010 Jun
PMID:Rational treatment of fibromyalgia for a solo practitioner. 2053 68

Musculoskeletal conditions are universally prevalent among all age and gender groups, across all socio-demographic strata of society. Their impact is pervasive yet this is not widely recognised at the level of health policy and priority. Musculoskeletal conditions are a diverse group of disorders with regard to pathophysiology but are linked anatomically and by their association with pain and impaired physical function; encompassing a spectrum of conditions, including inflammatory diseases such as rheumatoid arthritis or gout; age-related conditions such as osteoporosis and osteoarthritis; common conditions of unclear aetiology such as back pain and fibromyalgia; and those related to activity or injuries such as occupational musculoskeletal disorders, sports injuries or the consequences of falls and major trauma. The increasing number of older people and the changes in lifestyle throughout the world with increasing obesity and reduced physical activity mean that the burden on people and society will increase dramatically. The growing awareness of the burden increases the need for accurate measurement and assessment of the burden as well as measurement of the impact of any public health action. This chapter considers theoretical and practical issues relevant to measuring the buden of musculoskeltal conditions in populations, societies and individuals.
Best Pract Res Clin Rheumatol 2010 Dec
PMID:How to measure the impact of musculoskeletal conditions. 2166 21

The study of the descriptive epidemiology of chronic widespread pain (CWP) in several countries is of interest, as the occurrence of this condition varies among different populations. However, reports of pain prevalence are not consensual: it is clear that chronic musculoskeletal pain is frequent all over the world, varying from 4.2% to 13.3%. The reasons for the prevalence differences in CWP might include genetic and/or environmental factors. Multifactorial aetiopathogenesis of CWP and fibromyalgia syndrome (FMS) certainly includes genetic susceptibility and environmental influences. The risk factors for the occurrence and maintenance of CWP/FMS include female gender, increasing age, family history of chronic pain, several causes of distress, obesity and poorest mental and/or physical status. On the other hand, risk factors that negatively influence the outcome of CWP/FMS are: high levels of psychological distress, presence of somatisation, presence of fatigue, poor sleep, higher number of painful sites and pain intensity, poorest mental status and functional capacity, presence of co-morbid conditions and highest number of primary-care consultations. Mild alcohol consumption and individualised social support seem to have a protective effect on the outcome of CWP/FMS.
Best Pract Res Clin Rheumatol 2010 Dec
PMID:Generalised musculoskeletal pain syndromes. 2166 29

Mechanisms underlying chronic pain differ from those underlying acute pain. In chronic pain states, central nervous system (CNS) factors appear to play particularly prominent roles. In the absence of anatomical causes of persistent pain, medical sub-specialities have historically applied wide-ranging labels (e.g., fibromyalgia (FM), irritable bowel syndrome, interstitial cystitis and somatisation) for what now is emerging as a single common set of CNS processes. The hallmark of these 'centrally driven' pain conditions is a diffuse hyperalgesic state identifiable using experimental sensory testing, and corroborated by functional neuroimaging. The characteristic symptoms of these central pain conditions include multifocal pain, fatigue, insomnia, memory difficulties and a higher rate of co-morbid mood disorders. In contrast to acute and peripheral pain states that are responsive to non-steroidal anti-inflammatory drugs (NSAIDs) and opioids, central pain conditions respond best to CNS neuromodulating agents, such as serotonin-norepinephrine reuptake inhibitors (SNRIs) and anticonvulsants.
Best Pract Res Clin Rheumatol 2011 Apr
PMID:Central pain mechanisms in chronic pain states--maybe it is all in their head. 2209 91


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