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

In an overview of the problem of occupational muscle pain the evidence indicates that injury is more common the greater the load and the worse the posture in which the work is performed. The commonest are backstrains or ligament or joint damage due to overuse. Fatigue is associated with alterations in energy metabolites in muscle while pain is often due to microscopical damage to the cellular architecture. The progress of pathological changes in muscle following occupational injury may be similar to those seen in primary fibromyalgia (fibrositis) because of a final common pathway involving calcium-induced secondary damage. Occupational muscle pain frequently occurs in the muscles supporting the upper limb girdle and head in workers engaged in repetitively performing skilled manipulations or activities requiring high or sustained mental concentration. It is suggested that both occupational myalgia of this kind may be due to an imbalance in the use of muscles for postural activity (holding or supporting fine movements) compared to phasic use in dynamic work. While there are undoubtedly muscular indications of damage these may be secondary to alterations in (unconscious) central motor control mechanisms.
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PMID:Hypotheses of peripheral and central mechanisms underlying occupational muscle pain and injury. 328 51

Fibrositis (fibromyalgia) is a common disorder, but is often not considered or diagnosed by clinicians. It is characterized by widespread musculoskeletal pain and aching, disturbed sleep, fatigue, morning stiffness, and local tenderness. The presence of multiple (seven or more) tender points and widespread pain or aching are necessary and sufficient conditions for diagnosis. Fibrositis occurs in a "primary" form, but most commonly in association with other rheumatic diseases where it is a concomitant condition. The designation "myofascial pain syndrome" has replaced older concepts of localized fibrositis, and is considered a separate entity.
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PMID:Fibrositis, fibromyalgia, and musculoskeletal disease: the current status of the fibrositis syndrome. 329 21

Muscle fatigue is the most disabling symptom in primary fibromyalgia (PF), which in addition is characterized by generalised pain and muscle stiffness. In order to assess whether the fatigue is of central and/or peripheral origin, skeletal muscle function was studied by measuring maximum voluntary hand grip strength, and by measuring various contraction characteristics in the adductor pollicis muscle after electrical stimulation of the ulnar nerve. The PF-patients were also studied after a regional sympathetic blockade of the forearm with guanethidine. A lower hand grip strength was found in the PF-patients compared to the controls, before as well as during the sympathetic blockade. The developed force, measured during electrical stimulation, did not differ between patients and controls. A lower muscle relaxation rate was found in the PF-patients. The relaxation rate increased in the PF-patients during the sympathetic blockade. The results indicate both a central and a peripheral cause of muscle dysfunction. Activity in the muscle sympathetic system may be one link in the chain of events that leads to muscular symptoms in PF.
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PMID:Skeletal muscle function in primary fibromyalgia. Effect of regional sympathetic blockade with guanethidine. 337 44

Fibrositis is a disorder of musculoskeletal pain and aching with at least a five to one female-to-male ratio. It is most commonly seen between the ages of 40 and 60, and has a prevalence in the clinic of 6 to 15 percent. Its most common mode of presentation involves generalized musculoskeletal pain and aching, but articular pain, axial skeletal pain, myalgias, and neurovascular complaints sometimes predominate. All patients have multiple areas of local tenderness called "tender points" that are easily identified during physical examination, and are diagnostic. Essential symptoms of fibrositis are disturbed sleep, morning stiffness, and fatigue. Additional rheumatic symptoms include subjective swelling, paresthesias, and numbness. Headaches and irritable bowel syndrome are common nonrheumatic complaints. Modest improvement follows treatment by tricyclic agents such as low-dose cyclobenzaprine and amitriptyline, by physical measures, and by reduction in stress. Remission occurs in 20 percent of patients, but is generally short-lived.
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PMID:The clinical syndrome of fibrositis. 346 12

The clinical symptoms of 55 patients with primary fibromyalgia (PF) were studied and compared with 30 patients with rheumatoid arthritis (RA). The PF patients expressed a more intense feeling of illness than did the RA patients. Stiffness occurred just as often in PF as in RA. Trigger points occurred less frequently in RA patients. Muscular fatigue appeared to be one of the most disabling symptoms in PF. Neurophysiological studies indicated that the fatigue was at least partly of central origin. Ischemic forearm exercise test gave no evidence of impaired glycogenolysis. Laboratory investigation revealed normal 25-hydroxyvitamin D, cobalamin, folate, estrogen, testosterone, and myoglobin in the PF patients.
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PMID:Primary fibromyalgia. A clinical and laboratory study of 55 patients. 346 25

The essential symptoms of fibrositis--widespread aching and pain, disturbed sleep, morning stiffness, and fatigue--are common in both rheumatic and nonrheumatic patients. But the essential sign of fibrositis--widespread local tenderness over specific anatomic sites ("tender points")--is rare in any patients except those with fibrositis. Clinical criteria for the diagnosis of fibrositis rely heavily on a high tender point count in the presence of characteristic fibrositic symptoms. Multiple tender points are uncommon in normal subjects and in those with rheumatic and nonrheumatic disorders. The tender point count thus also serves to distinguish fibrositis from other musculoskeletal diseases.
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PMID:Development of criteria for the diagnosis of fibrositis. 353 85

Sixty-two patients with fibromyalgia were randomly assigned to receive 25 mg of amitriptyline at night, 500 mg of naproxen twice daily, both amitriptyline and naproxen, or placebo in a 6-week, double-blind trial. Amitriptyline was associated with significant improvement in all outcome parameters, including patient and physician global assessments, patient pain, sleep difficulties, fatigue on awakening, and tender point score. Patients taking the combined naproxen-amitriptyline regimen experienced minor, but not significant, improvement in pain when compared with patients who took amitriptyline alone. Amitriptyline, or amitriptyline and naproxen, is an effective therapeutic regimen for patients with fibromyalgia.
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PMID:A randomized, controlled trial of amitriptyline and naproxen in the treatment of patients with fibromyalgia. 353 11

Fibrositis is a misnomer for a very common form of nonarticular rheumatism. The name implies an inflammatory process in fibroconnective tissue which has never been verified. The symptoms of fibrositis are ill-defined musculoskeletal pain made worse by stress, cold, noise and unaccustomed exercise; there is usually a significant element of depression, nonrestorative sleep, chronic fatigue and early morning stiffness. Results of physical examination are strikingly normal, apart from painful tender spots which are remarkably consistent in location from patient to patient. It is important to realize that fibrositis can complicate diseases such as rheumatoid arthritis and systemic lupus erythematosus, where its prompt recognition is essential in averting inappropriate medication. Drug therapy alone is seldom effective in alleviating symptoms; a carefully planned education program is necessary to readjust both psyche and soma.
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PMID:Fibrositis: misnomer for a common rheumatic disorder. 616 73

Twenty-two patients with fibrositis, selected from a general medical outpatient population by a screening questionnaire and subsequent evaluation, were compared with age-, sex-, and clinic-matched patients without fibrositis. Although there was a high prevalence of musculoskeletal complaints in both groups, the fibrositis patients had a uniform constellation of symptoms, including axial pain, severe aching and stiffness, morning fatigue, and modulation by specific factors. They also had a higher incidence of tension headache and irritable bowel syndrome. The use of a dolorimeter demonstrated that fibrositis patients had many more areas of localized tenderness than control patients, but also that fibrositis patients did not have diffusely diminished pain threshold and tolerance. Using the criteria of this study, fibrositis appears to be a common and readily definable syndrome within the spectrum of soft tissue rheumatism.
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PMID:Clinical characteristics of fibrositis. I. A "blinded," controlled study of symptoms and tender points. 634 7

Detailed clinical study of 50 patients with primary fibromyalgia and 50 normal matched controls has shown a characteristic syndrome. Primary fibromyalgia patients are usually females, aged 25-40 yr, who complain of diffuse musculoskeletal aches, pains or stiffness associated with tiredness, anxiety, poor sleep, headaches, irritable bowel syndrome, subjective swelling in the articular and periarticular areas and numbness. Physical examination is characterized by presence of multiple tender points at specific sites and absence of joint swelling. Symptoms are influenced by weather and activities, as well as by time of day(worse in the morning and the evening). In contrast, symptoms of psychogenic rheumatism patients have little fluctuation, if any, and are modulated by emotional rather than physical factors. In psychogenic rheumatism, there is diffuse tenderness rather than tender points at specific sites. Laboratory tests and roentgenologic findings in primary fibromyalgia are normal or negative. Primary fibromyalgia should be suspected by the presence of its own characteristic features, and not diagnosed just by the absence of other recognizable conditions. This study has also shown that primary fibromyalgia is a poorly recognized condition. Patients were usually seen by many physicians who failed to provide a definite diagnosis despite frequent unnecessary investigations. A guideline for diagnosis of primary fibromyalgia, based upon our observations, is suggested. Management is usually gratifying in these frustrated patients. The most important aspects are a definite diagnosis, explanation of the various possible mechanisms responsible for the symptoms, and reassurance regarding the benign nature of this condition. A combination of reassurance, nonsteroidal antiinflammatory drugs, good sleep, local tender point injections, and various modes of physical therapy is successful in most cases.
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PMID:Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls. 694 96


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