Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016053 (fibromyalgia)
 4,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There are four types of prostatitis, including type I (acute bacterial prostatitis), type II (chronic bacterial prostatitis), type III (chronic prostatitis/chronic pelvic pain syndrome, or CP/CPPS), and type IV (asymptomatic inflammatory prostatitis). These prostatitis conditions account for approximately 2 million office visits each year to primary care physicians and urologists. The annual cost to treat prostatitis is approximately $84 million. Compared with control subjects, men with prostatitis incur significantly greater costs, predominantly due to increased outpatient visits and pharmacy expenses. CP/CPPS is the most common type of prostatitis. The condition is characterized by chronic, idiopathic pelviperineal pain. Due to the lack of effective treatments for CP/CPPS, the per-person costs associated with the condition are substantial and are similar to those reported for peripheral neuropathy, low back pain, fibromyalgia, and rheumatoid arthritis. Costs appear to be higher in men with more severe symptoms. Indirect costs (eg, work and productivity loss) are incurred by many patients with CP/CPPS. Identification of effective treatments for CP/CPPS would be expected to substantially reduce the costs associated with the condition.
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PMID:Economic impact of chronic prostatitis. 1851 19

This article reviews the pharmacologic and clinical evidence supporting the use of antidepressant drugs for treating painful rheumatologic conditions. Clinical studies have shown that tricyclic antidepressants, even at low doses, have analgesic effects in rheumatologic conditions equivalent to those of serotonin and noradrenalin reuptake inhibitors, but are less well tolerated. Selective serotonin reuptake inhibitors may also have analgesic effects, but higher doses are required to achieve analgesia in conditions such as fibromyalgia and low back pain. Antidepressant drugs may be useful in painful rheumatologic conditions, but in some studies the analgesic effects of antidepressants may be associated with functional impairment, sleep disorders, and fatigue. Further studies are required to determine antidepressants' analgesic mechanism of action and the specific role they should play in the management of chronic painful rheumatologic conditions.
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PMID:Antidepressant use in painful rheumatic conditions. 1863 85

Reprinted with permission from British Medical Journal, 2:1434-1438, 1950. Much confusion exists on this subject. Some years ago the main difficulty was to appear credible when attributing such well-known conditions as lumbago, fibrositis, and sciatica to so recent a discovery as a disk lesion. Now that the diagnosis has become widely accepted, medical men have found themselves in a therapeutic quandary. Traditional measures such as drugs (apart from analgesics), radiant heat, diathermy, massage, exercises, injecting nodules, and "taking the waters" have suddenly lost their last vestige of theoretical justification. Little has so far come forward to replace these abandoned types of "treatment", and the distress of doctors and patients is heightened when they find out that the only radical treatment is an operation - by no means always successful - warranted only in extreme cases. This therapeutic nihilism is quite unjustified, for there are a number of simple treatments, none a panacea, each with its due proportion of successes. Few patients prove unrelievable if conservative means are intelligently employed, and it is only for some of these few that surgery need to be contemplated at all. J Orthop Sports Phys Ther 1990;12(4):163-169.
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PMID:Refresher course for general practitioners: the treatment of lumbar disk lesions. 1879 76

Various peripheral and spinal mechanisms have been hypothesized to contribute to pain amplification and chronicity. However, the role of the brain in chronic pain states remains to be fully elucidated. Functional brain imaging techniques, such as positron emission tomography and functional magnetic resonance imaging, have frequently been used to investigate brain activity during acute/experimental pain perception, which has helped to establish the notion of the human pain network. In the context of chronic pain, the assessment of brain chemistry (by way of spectroscopy) and brain morphology is of growing interest, and there is a quickly expanding body of evidence that persons with chronic pain conditions, including chronic low back pain, chronic tension-type headache, and fibromyalgia, display changes in global and regional brain morphology. It has been suggested that prolonged nociceptive input to the brain might induce functional and morphologic maladaptive processes that in turn further exacerbate the experience of chronic pain. Alternatively, morphologic changes might predispose toward vulnerability to develop a chronic pain state. The purpose of this review is to examine current literature regarding altered brain morphology in patients with various chronic pain states, summarize these findings, and evaluate their implications for our understanding of the pathophysiology of chronic pain.
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PMID:Variations in brain volume and regional morphology associated with chronic pain. 1900 38

Chronic pain represents one of the most important public health problems and, in addition to classical analgesics, antidepressants are an essential part of the therapeutic strategy. This article reviews available evidence on the efficacy and safety of antidepressants in major chronic pain conditions; namely, neuropathic pain, headaches, low back pain, fibromyalgia, irritable bowel syndrome (IBS) and cancer pain. Studies, reviews and meta-analyses published from 1991 to March 2008 were retrieved through MEDLINE, PsycINFO and the Cochrane database using numerous key words for pain and antidepressants. In summary, evidence supports the use of tricyclic antidepressants in neuropathic pain, headaches, low back pain, fibromyalgia and IBS. The efficacy of the newer serotonin and norepinephrine reuptake inhibitors is less supported by evidence, but can be recommended in neuropathic pain, migraines and fibromyalgia. To date, evidence does not support an analgesic effect of serotonin reuptake inhibitors, but beneficial effects on well-being were reported in several chronic pain conditions. These results are discussed in the light of current insights in the neurobiology of pain, the reciprocal relationship between pain and depression, and future developments in this field of research.
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PMID:Antidepressants for the treatment of chronic pain. 1909 3

This study aims to investigate features of different diseases with low back pain misdiagnosed as spondyloarthropathy so as to improve the accuracy of diagnosis for spondyloarthropathy. The clinical and laboratory data of 24 cases misdiagnosed as spondyloarthropathy in recent 3 years were comparatively and retrospectively analyzed. The diagnostic accuracy of the European Spondyloarthropathy Study Group (ESSG) criteria, Amor criteria, and the combination of them in these misdiagnosed cases was also analyzed. The final diagnoses of these 24 cases were listed below: four malignant tumors (retroperitoneal adipose sarcoma, advanced gastric carcinoma, ovarian papillary epithelioma, acute lymphocytic leukemia), six benign tumors (two parathyroid adenoma with hyperparathyroidism, one intraspinal lipoma, intraspinal ependymomas, sacral tubulocyst, and intraspinal schwannoglioma, respectively). The other 14 cases included fibromyalgia syndrome (3), osteitis condensans (3), diffuse idiopathic skeletal hyperostosis (2), lumbar intervertebral disk protrusion (1), congenital scoliosis (1), Wilson's disease (1), ochronosis (1), Fanconi syndrome (1) and hypophosphatemic rachiopathy (1). Among patients with tumor, all except three patients had persistent low back pain without morning stiffness, which aggravated at night and could not be relieved by rest or exercise. The symptoms could not be relieved by administration of multiple nonsteroidal anti-inflammatory drugs. Eleven patients had inflammatory low back pain defined by Calin. Of the total misdiagnosed cases, 54.17-83.33% could be prevented by application of ESSG criteria or Amor criteria, or a combination of them. From the data, we could see that the clinical features of different diseases with low back pain were different from each other and from those of spondyloarthropathy. The various criteria for spondyloarthropathy may be more effective in combination, along with other clinical information like these clinical features.
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PMID:Comparative study on low back pain misdiagnosed as spondyloarthropathy. 1944 45

Inadequately treated acute and chronic pain remains a major cause of suffering and dissatisfaction in pain therapy. A cause for the variable success of pharmacologic pain therapy is the different genetic disposition of patients to develop pain or to respond to analgesics. The patient's phenotype may be regarded as the result of synergistic or antagonistic effects of several genetic variants concomitantly present in an individual. Variants modulate the risk of developing painful disease or its clinical course (e.g., migraine, fibromyalgia, low back pain). Other variants modulate the perception of pain (e.g., OPRM1 or GCH1 variants conferring modest pain protection by increasing the tone of the endogenous opioid system or decreasing nitric oxide formation). Other polymorphisms alter pharmacokinetic mechanisms controlling the local availability of active analgesic molecules at their effector sites (e.g., decreased CYP2D6 related prodrug activation of codeine to morphine). In addition, genetic variants may alter pharmacodynamic mechanisms controlling the interaction of the analgesic molecules with their target structures (e.g., opioid receptor mutations). Finally, opioid dosage requirements may be increased depending on the risk of drug addiction (e.g., DRD2 polymorphisms decreasing the functioning of the dopaminergic reward system). With the complex nature of pain involving various mechanisms of nociception, drug action, drug pharmacology, pain disease and possibly substance addiction, a multigenic or even genome wide approach to genetics could be required to base individualized pain therapy on the patient's genotype.
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PMID:Genetic modulation of the pharmacological treatment of pain. 1961 6

The objective of this study is to study the prevalence of musculoskeletal complaints and disorders in a rural area in Iran. Interviews were conducted in randomly selected subjects from five villages in Tuyserkan County, northwestern part of Iran. The three phases of stage 1 Community Oriented Program for Control of Rheumatic Diseases were done during the same day. A total of 614 houses was visited, 1,565 persons interviewed, and 1,192 persons examined. Musculoskeletal complaints during the past 7 days were detected in 66.6% (shoulder 22.7%, wrist 17.4%, hands and fingers 14.9%, hip 13.9%, knee 39.2%, ankle 19.6%, toes 12.7%, cervical spine 17.9%, and dorsolumbar spine 41.9%). Degenerative joint diseases were detected in 20.5% (cervical spondylosis 2.2%, knee osteoarthritis [OA] 19.3%, hand OA 2.7%, and hip OA 0.13). Low back pain was detected in 23.4%, soft tissue rheumatism in 2.2%, rheumatoid arthritis in 0.19%, ankylosing spondylitis in 1.1%, systemic lupus erythematosus in 0.06%, and fibromyalgia in 0.06%. The prevalence of rheumatic complaints in rural Iran is very high and needs attention in the curricula of medical schools and in the planning of rural health care by the government.
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PMID:The prevalence of musculoskeletal complaints in a rural area in Iran: a WHO-ILAR COPCORD study (stage 1, rural study) in Iran. 1962 18

Acupuncture is increasingly used as an alternative or complementary therapy for the treatment of pain. It is well tolerated, with a low risk of serious adverse effects. Traditional and modern acupuncture techniques may result in reported improvement in pain patterns. Research on acupuncture has had a number of limitations, including: incomplete understanding of the physiologic effects of acupuncture; ineffective blinding of participants; unclear adequacy of acupuncture "dose;" difficulty in identification of suitable sham or placebo treatments; and the use of standardized treatment regimens rather than the individualized approach that characterizes most acupuncture practice. Controlled trials have been published regarding acupuncture for lumbar, shoulder, and neck pain; headache; arthritis; fibromyalgia; temporomandibular joint pain; and other pain syndromes. Enough data are available for some conditions to allow systematic evaluations or meta-analyses. Based on published evidence, acupuncture is most likely to benefit patients with low back pain, neck pain, chronic idiopathic or tension headache, migraine, and knee osteoarthritis. Promising but less definitive data exist for shoulder pain, fibromyalgia, temporomandibular joint pain, and postoperative pain. Acupuncture has not been proven to improve pain from rheumatoid arthritis. For other pain conditions, there is not enough evidence to draw conclusions.
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PMID:Acupuncture for pain. 2094 79

Several diseases, including the functional somatic syndromes (FSS), are characterized by pain involving locomotive structures. These disorders include low back pain, neck-shoulder-arm syndrome and fibromyalgia. FSS patients are convinced that their illness is not a psychosomatic disorder, being instead a bodily disease. Therefore, physicians such as orthopedic surgeons play an important role in supporting patients suffering from FSS with locomotive pain, because these patients expect their physicians to treat them for a physical, rather than a psychological disorder. The author investigated the patient-doctor relationship in the examination room of a hospital, and designated pain combined with a depressive state characterized by agitation and helplessness, a common complaint made by FSS and psychosomatic disorder patients, 'painful depression'. Pain and depression influence each other and trigger a vicious downward spiral termed the 'pain-depression deflation spiral'. Generally, orthopedic surgeons can achieve good relationships with FSS patients with locomotive structure pain, despite suspicion of psycho-social factors. It is concluded that physical examinations and treatments by orthopedic surgeons, conducting physical examinations only, can serve as a very good psychosomatic approach to painful depression/FSS patients.
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PMID:[Treatment of low back pain (pain of locomotive organs)]. 1976 17


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