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

Clinical data are producted which appear to show that the response to therapy of myofascial pain dysfunction syndrome (MPDS) is much less favorable when the patient has been involved in a road traffic or similar accident which precipiated the condition. Reasons for this difference and the differences between postinjury MPDS and nonpostinjury MPDS patients may be a consequence of litigation and, in addition, may be due to the personality of the patient. Evidence to support this hypothesis is seen when the condition is compared with such disorders as low back pain. Further research is needed to explore the etiology and treatment implications of these differences.
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PMID:Postinjury myofascial pain dysfunction syndrome: its etiology and prognosis. 27 48

Using 31P nuclear magnetic resonance, the following parameters were determined in the resting musculus erector spinae of five patients suffering from chronic low back pain, five patients with fibromyalgia, and five healthy controls: Inorganic phosphate (Pi), phosphocreatine (PCr), ATP gamma, ATP alpha, ATP beta. The intracellular pH was derived from the chemical shift of Pi referenced to the PCr resonance. In addition, the Pi-Index was calculated according to the formula: Pi/(Pi + PCr). We discovered a tendency towards a shift of the Pi resonance in the alcalic direction, which was the larger, the stronger muscle spasm was found on palpation. The pH showed the most reliable relationship to the clinical status of muscle spasm. The surprising finding that there is no acidification within the spasmed muscle indicates that generalized hypoxia does not exist in this tissue. This has already been shown with PO2 measurements. An intracellular acidification is only recorded during maximal isometric contraction. Thus, ischemia cannot be responsible for pain experienced during muscle spasm.
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PMID:[Recording muscle spasm in the musculus erector spinae using in vivo 31P magnetic resonance spectroscopy in patients with chronic lumbalgia and generalized tendomyopathies]. 147 7

In the last 30 years antidepressant drugs have been used increasingly in the treatment of patients with chronic pain. This article reviews the results of some 40 placebo-controlled studies. It is difficult to make comparisons between the various studies because they often differ in terms of pain conditions, patient selection, antidepressant drug used, dosages, trial design, etc. However, in spite of this heterogeneity and other methodological problems it is clear that a wide range of pain conditions are responsive to antidepressant drug treatment, in particular: headache, migraine, facial pain, neurogenic pain, fibrositis, and probably arthritis and rheumatoid arthritis. More data need to be gathered in cancer pain, and in other conditions such as low back pain for which no, or very limited, effect has been shown. The beneficial effects of antidepressant drugs is in most cases of a mild to moderate degree, some time lag is necessary before it is completely manifest, and it tends to persist over time if drug treatment is continued in the long term. Strong evidence of efficacy is not evident for all the antidepressants, and there are probably significant differences in this respect between various drugs. The effect of a drug on pain does not seem necessarily to be related to its effect on mood. Further studies are needed to clarify this topic, and it will be necessary to examine specific pain conditions, compare different antidepressants, with reference to each other and to placebo, further investigate the role of drug plasma concentrations and control for the presence of concomitant psychiatric disturbances and for organic lesions responsible for the pain symptomatology.
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PMID:The use of antidepressants in the treatment of chronic pain. A review of the current evidence. 172 71

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

The incidence of 14 different vegetative and functional symptoms in patients with generalized tendomyopathy (fibromyalgia), chronic low back pain syndrome, and healthy controls was compared. The presence of these symptoms was a common finding in patients with generalized tendomyopathy. Although not so frequent, a number of these symptoms was also found in patients with chronic low back pain syndrome. Our findings suggest that presence of 7 or more symptoms is typical for generalized tendomyopathy and could be used as an additional criterium for diagnosis and classification of this disease. Further prospective studies are needed for confirming the hypothesis that chronic low back pain syndrome could lead to generalized tendomyopathy.
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PMID:[Comparative studies of the incidence of vegetative and functional disorders in backache and generalized tendomyopathies]. 183 13

Low back pain and fibromyalgia represent two of the most common disorders in developed countries. On the whole, up to 75% of the general population has, at some time, suffered from low back pain. A percentage ranging between 5 and 10% of them develops a chronic illness. In most countries, the incidence rate per year of low back pain is 5%. Most low back pain episodes occur between the ages of 25 and 55 years. Most studies have not found any clear influence between genders and frequency of low back pain. There is a relationship between low back pain and occupation, with those who have physically demanding jobs being more at risk. As regards fibromyalgia, the prevalence rates range between 6 and 20%, with a higher frequency among females and between the ages of 25 and 55 years. The direct and indirect costs of low back pain approach $24 billion per year in the U.S. It is in view of its high prevalence among populations of developed countries, of its heavy psychosocial and financial implications, and of the burden imposed on health services, that low back pain represents a severe public health problem.
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PMID:Epidemiology and social costs of low back pain and fibromyalgia. 183 74

Cells of the immune system synthesize prolactin and express mRNA and receptors for that hormone. Interleukin 1, interleukin 6, gamma interferon, tumor necrosis factor, platelet activator factor, and substance P participate in the release of prolactin. This hormone is involved in the pathogenesis of adjuvant arthritis and restores immunocompetence in experimental models. In vitro studies suggest that lymphocytes are an important target tissue for circulating prolactin. Prolactin antibodies inhibit lymphocyte proliferation. Prolactin is comitogenic with concanavalin A and induces interleukin 2 receptors on the surface of lymphocytes. Prolactin stimulates ornithine decarboxylase and activates protein kinase C, which are pivotal enzymes in the differentiation, proliferation, and function of lymphocytes. Cyclosporine A interferes with prolactin binding to its receptors on lymphocytes. Hyperprolactinemia has been found in patients with systemic lupus erythematosus. Fibromyalgia, rheumatoid arthritis, and low back pain patients present a hyperprolactinemic response to thyrotropin-releasing hormone. Experimental autoimmune uveitis, as well as patients with uveitis whether or not associated with spondyloarthropathies, and patients with psoriatic arthritis may respond to bromocriptine treatment. Suppression of circulating prolactin by bromocriptine appears to improve the immunosuppressive effect of cyclosporine A with significantly less toxicity. Prolactin may also be a new marker of rejection in heart-transplant patients. This body of evidence may have an impact in the study of rheumatic disorders, especially connective tissue diseases. A role for prolactin in autoimmune diseases remains to be demonstrated.
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PMID:Prolactin, immunoregulation, and autoimmune diseases. 206 74

In 900 randomly selected individuals, 50-70 years old, we examined the prevalence over the preceding 12-month period of rheumatic complaints of more than 6 weeks' duration. We found them to represent a major health problem, with an overall prevalence of 37.8%, the predominant diagnoses being subacromial shoulder pain (6.7%), neck pain (6.5%), low back pain (6.3%), osteo-arthrosis (8.5%), and arthralgia (4.9%). With a prevalence of 1.0%, primary fibromyalgia was as common as rheumatoid arthritis (0.7%) and other chronic arthritides (1.1%). The prevalences of the different diagnoses were higher among participants whose data were obtained from personal investigation by a physician than among non-participants where data were obtained by interview, letter, and scrutiny of case records. The odds ratio from incurring more than one rheumatic disease was higher for subacromial shoulder pain and lowest for arthralgia and osteo-arthrosis.
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PMID:The commonest rheumatic complaints of over six weeks' duration in a twelve-month period in a defined Swedish population. Prevalences and relationships. 261 26

Demographics and health service utilization were studied for 81 patients with fibrositis during 1985. Patients reported high levels of pain, mild disability, and moderate impairment of global health. Work disability was limited and only 6.3 percent described themselves as disabled. Employed patients were able to work full work weeks. Utilization of outpatient medical services was increased compared with that of control subjects and national averages during the study year, but was consistent with other rheumatic disorders such as osteoarthritis and low back pain. Medication usage was limited and seemed appropriate. Very high hospitalization rates were noted prior to diagnosis of fibrositis, both for musculoskeletal and non-musculoskeletal hospitalizations, but these rates dropped during the post-diagnosis study year.
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PMID:Socioeconomic impact of fibrositis. A study of 81 patients with primary fibrositis. 346 13

Chronic rheumatic pain syndromes such as the fibrositis syndrome, 'whiplash' syndrome, low back pain syndrome and regional pain syndrome are common clinical disorders of unknown cause. The presence of tender points in predictable anatomical locations is essential to their diagnosis. Exaggerated dermatographia or flare response to mechanical stimulation is also a commonly observed physical finding. Dermatographia is thought to be a local axon reflex mediated phenomenon, and, as such, is a component of the neurogenic inflammatory response. Because neurogenic inflammation may be mediated by polymodal nociceptors we examined the flare response to topical capsaicin, a chemical method of stimulating local axon reflexes, in 12 patients with chronic rheumatic pain syndromes and in 10 controls. There was a significant correlation (rs = 0.61; p less than 0.01) between the area of flare induced by mechanical stimulation and the area of flare induced by chemical stimulation for all subjects. Patients with chronic rheumatic pain syndromes had a lower threshold for capsaicin-induced flare responses compared with controls. They also had larger flares at capsaicin concentrations of 0.02 and 0.033 mg/mL (p less than 0.05) applied as 20 microL aliquots over 30 minutes. It is concluded that neurogenic flare responses are increased in patients with chronic rheumatic pain syndromes.
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PMID:Neurogenic flare responses in chronic rheumatic pain syndromes. 349 68


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