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

Generalized tendomyopathy (GTM), or fibromyalgia (FM), is a disease characterized by wide-spread pain in the musculoskeletal system which usually begins at a single site, e.g., as low-back pain or cervical syndrome, and develops into generalized pain over months or years. The disorder affects primarily women, beginning around the age of 35 and reaching its peak during or after the menopause. Its etiology is still unknown. Secondary forms are observed particularly in rheumatoid arthritis. In order to get more information on FM we determined the local metabolic rate of glucose in vivo in the skeletal muscle (lumbar region) with dynamic 18F-FDG positron emission tomography (PET). 2 healthy volunteers and 6 female patients with FM reaching in age from 31 to 53 years were scanned. As 18F-FDG PET scanning is a metabolic tool, it is crucial to observe standardized conditions of metabolic steady-state. We used, therefore, the hyperinsulinemic euglycemic insulin clamp technique to stimulate the myogenic glucose uptake under stable plasma-glucose levels. The local metabolic rates of glucose utilization were estimated with a non-linear least squares fit on the 3 compartment 18F-FDG-model. A lumped constant of 0.67 was assumed. Under glucose clamp conditions patients with FM showed a significantly (p < 0.001) lower metabolic rate of glucose (4.3 +/- 1.1) mumol/100 g tissue/min compared with normal volunteers (8.5 +/- 2.3 mumol/100 g/min). Due to a significantly (p < 0.005) increased glucose backflow from tissue into the vascular space (k2 in the kinetic model) the rate of phosphorylation was markedly reduced in patients with FM.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Determination of regional rate of glucose metabolism in lumbar muscles in patients with generalized tendomyopathy using dynamic 18F-FDG PET]. 147 8

The aim of this study was to describe which complaints patients themselves regard as the cause of sickness certification. During one week in April 1986, 1,379 patients in Buskerud county, Norway, filled in a form after receiving an initial certificate of illness or a continuation certificate from a general practitioner. International Classification of Primary Care (ICPC) no. 1-29 was used to classify the patients' symptoms and complaints. More than half of the patients (53%) considered pain in the musculoskeletal system, particularly back pain (22%), as the reason for their sickness certification. Physical work load was assumed to be a contributory cause to the complaints by 66% of the patients certified sick because of back pain, 58% of those certified sick due to cervical spine and shoulder symptoms, and 72% of those with myalgia, fibrositis (ICPC no. L18, L19). 29% of the patients meant that their health problems could have been prevented, and 15% reported that they could have continued work if their jobs had been adjusted because of their condition.
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PMID:[What symptoms and complaints result in sick-listing? ICPC-coding of patients' own opinion in general practice]. 150 66

Lumbar subcutaneous nodules (LSNs) have been associated with fibrositis but are distinct from painful myalgic trigger points and tender points. One hundred and twenty-six adults (53 males and 73 females) were examined for LSNs. LSNs varied in size from a +/- 3 mm 'corn kernel' (15/47) to +/- 5 mm 'pea' (21/47) to +/- 10 mm, 'grape' (11/47), occurred singly (22/47) and in clusters of two to seven uni- and bilaterally. Eight of 47 LSNs overlying the posterior superior iliac spines (PSIS) were tender. The results of a cross-tabular analysis using disease as the independent variable and presence or absence of LSNs as the dependent, found no differences (chi 2 = 1.06, df = 2). LSNs occur near the PSIS in approximately 25% of white adults, are rarely a cause of back pain, and should seldom require biopsy.
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PMID:Non-fibrositic lumbar subcutaneous nodules: prevalence and clinical significance. 183 23

We studied the pain, Stanford Health Assessment Questionnaire functional disability, pain/disability ratio, and psychological scores in 1,522 patients with rheumatic disease with 7 distinct disorders. Individual differences between patients were more striking than differences among diagnostic groups. Patients with rheumatoid arthritis (RA) had the greatest disability, least pain, lowest pain/disability ratio, and least abnormal psychological scores. Highest pain and psychological distress was noted in low back pain, neck pain, and fibromyalgia (axial disorders). Disability in activities of daily living was as high in fibromyalgia as in RA, but low in axial skeletal disorders. There appears to be a continuum for disability that begins with axial but not articular disease (neck and back pain) and ends with multiple articular and periarticular involvement (RA and fibromyalgia).
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PMID:Pain, disability, and pain/disability relationships in seven rheumatic disorders: a study of 1,522 patients. 183 15

Articles describing motor function in five chronic musculoskeletal pain conditions (temporomandibular disorders, muscle tension headache, fibromyalgia, chronic lower back pain, and postexercise muscle soreness) were reviewed. It was concluded that the data do not support the commonly held view that the pain of these conditions is maintained by some form of tonic muscular hyperactivity. Instead, it seems clear that in these conditions the activity of agonist muscles is often reduced by pain, even when this does not arise from the muscle itself. On the other hand, pain causes small increases in the level of activity of the antagonist. As a consequence of these changes, force production and the range and velocity of movement of the affected body part are often reduced. To explain how such changes in the behaviour come about, we propose a neurophysiological model based on the phasic modulation of excitatory and inhibitory interneurons supplied by high-threshold sensory afferents. We suggest that the "dysfunction" that is characteristic of several types of chronic musculoskeletal pain is a normal protective adaptation and is not a cause of pain.
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PMID:The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity. 186 21

A 25-year-old woman was admitted in our hospital with back pain and both hip joint pain. Pain was abruptly occurred from the beginning of March 1990. Physical examination revealed wide spread pain (occipital area, both shoulder, lumber area, bilateral gluteal area, inguinal area, both Achilles-plantar area) and more than 12 tender points (occiput, trapezius, second rib, supraspinatus, gluteal, greater trochanter, hip joints, pubic bone). Laboratory examination showed no abnormal findings except ANF (1:160). Any examination including X-ray, bone scintigraphy, CT and MRI did not disclose spondylitis, sacroiliitis and enthesopathy. She was diagnosed as primary fibromyalgia/fibrositis syndrome. Treatment with maprotine hydrochloride (30 mg/day) and phenobarbital (120 mg/day) brought approximately 1/3 reduction of pain and tenderness. Psychoanalysis revealed that she had psychological conflicts against her parents and her colleagues at the work. EEG showed a borderline record with irregular basic pattern and 14 & 6 Hz positive burst at the sleep stage. Although the newly proposed criteria for the classification of fibromyalgia was proposed by ACR, fibromyalgia/fibrositis syndrome has been seldom discussed in the Japanese literature. As this syndrome is frequently associated with various rheumatic diseases, hypothyroidism and malignant diseases, we should pay much more attention to understand this syndrome.
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PMID:[Fibromyalgia (fibrositis) syndrome--a case report]. 192

Many factors are known to play a role in the pathogenesis of generalized tendomyopathy (GTM), or fibromyalgia. While the secondary forms develop along with known diseases, particularly rheumatoid arthritis, the cause of primary GTM is often not well understood. The fact that this disorder usually appears first at a single site, e.g., as low-back pain or cervical syndrome in which poor posture or malformation of the spine can be observed, gives rise to the theory that local changes in the spine or the joints are particular underlying causes of the initial manifestation. As the disorder becomes generalized, however, psychological causes predominate. Psychosocial factors in particular seem to further the process of generalization. Therapy can take many forms. Above all, it calls for an understanding attitude on the part of the managing physician and, whenever, possible, elimination of likely causal factors. Analgesics and antiinflammatories are often inadequate; antidepressants and neuroleptics provide more effective relief. Moreover, intensive physiotherapy and psychotherapy are necessary. GTM in many cases is resistant to treatment despite intensive management, although it often subsides naturally after age 60. Recognizing GTM is of great importance in order to initiate appropriate treatment promptly, avoid incorrect diagnoses and their consequences, e.g., repeat surgery, and to prevent premature disability.
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PMID:[Generalized tendomyopathy. II: Pathogenesis and therapy]. 218 26

Generalized tendomyopathy (GTM), or fibromyalgia, is a disorder characterized by diffuse pain in the musculoskeletal apparatus which usually begins at a single site, e.g., as low-back pain or cervical syndrome, and develops into generalized pain over months or years. It is accompanied by increased tenderness at characteristic tender points, although the pain threshold on the whole is reduced. In addition to the main symptoms (pain in the musculoskeletal system, tenderness at the tender points), autonomic and functional symptoms are almost invariably present and are often accompanied by pathological psychological findings such as neuroses and depression. To date, no reliable laboratory parameters or pathognomonic histological findings have been identified. The disorder affects primarily women, beginning around the age of 35 and reaching its peak during or after the menopause. It also affects young people and those over age 60, although it is much less common in these cases. Secondary forms are observed particularly in rheumatoid arthritis. The differential diagnosis must first distinguish primary GTM from the secondary forms. There must also be further differentiation between internal and psychiatric disorders and primary GTM. This can be achieved in many cases by careful clinical diagnosis, although a more complete examination is sometimes required.
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PMID:[Generalized tendomyopathy. I: Clinical aspects, follow-up and differential diagnosis]. 218 25

The article presents a one-year material of 41 women and 59 men with chronic low-back disorders. Patients who had undergone back surgery and patients with inflammatory disease, fibromyalgia and somatoform disorders were excluded. Median age was 39 years, and median time off work was 16 months. Neurological deficits were found in the lower extremities in 48%. Of the 48 patients with calf symptoms, 60% had neurological deficits. Of 22 patients with thigh symptoms, 45% had neurological deficits, and such deficits were found in 30% of the 30 patients with back pain only. Relevant roentgenographic findings were obtained in 84%; decreased disc height, osteoarthritic facet joints, end-plate fracture, narrow bony canal, disc bulge and disc prolapse. It is concluded that, in the evaluation of low-back disorders, survey x-ray examination is a valuable and necessary supplement to a detailed history and thorough clinical examination.
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PMID:[Symptoms and findings in chronic low back pain. Significance of symptom localization and radiographic findings]. 252 86

The purpose of cognitive-behavioral therapy is to teach individuals the skills necessary to control pain and disability as well as to believe that they can successfully employ these skills. Cognitive-behavioral therapy has been used successfully in patients with back pain and rheumatoid arthritis and represents a potentially effective intervention for patients with primary fibromyalgia. This article describes cognitive-behavioral treatment procedures, presents 2 experimental designs that may be used in randomized, controlled clinical trials of cognitive-behavioral therapy in patients with primary fibromyalgia and identifies the methodological features that should be included in the trials.
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PMID:Cognitive-behavioral therapy for primary fibromyalgia. 269 72


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