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

In a pilot study, the effectiveness of the S2-receptor blocker ketanserin was investigated in patients receiving concurrent physiotherapy for primary fibromyalgia. This combined treatment was compared with physiotherapy alone. In the group treated with ketanserin, a significant reduction in spontaneous pain was observed, and the painfulness of "tender points" also decreased markedly. The patients experienced a significant improvement in the quality of sleep, the feeling of being rested after sleep, and psychological well-being in the evening. Significant improvement was also recorded on the Zerssen Mood Scale and the Erlanger Anxiety Scale. In the group receiving physiotherapy alone, the improvements were far less marked and usually were below the significance level. These results are now being verified in a double-blind, randomized trial.
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PMID:[Blocking of S2 receptors--a new treatment principle in generalized tendomyopathy (fibromyalgia)?]. 205 18

A prospective study of 71 patients with fibromyalgia (Yunus 1981 criteria) experience improved quality of life and management of pain after treatment at a pain school for one year. There was no significant improvement in total pain score (VAS) and sickness impact profile (SIP) for these patients compared with 71 paired controls with fibromyalgia matched by age and sex. The need for health care services was reduced and more patients from the pain school group returned to work. The main programme in the pain school classes consisted of information on chronic, non-malignant pain, psychomotoric physiotherapy and group therapy. The pupils evaluated all three items as important, with group dynamics as most beneficial. Good results have also been achieved in other chronic, non-malignant patients. Organized and structural pain management programmes in pain school classes have a favourable cost benefit profile and we recommend more use of such classes in the Norwegian health care system.
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PMID:[Pain school. Therapeutic offers to patients with fibromyalgia and other non-malignant pain problems]. 206 81

There continues to be an emerging body of literature related to fibromyalgia and the related conditions chronic fatigue syndrome and myofascial pain. During the past year, the most notable contributions included a large multicenter study providing new diagnostic criteria for the classification of fibromyalgia and clinical studies describing the overlap of fibromyalgia, chronic fatigue syndrome, and myofascial pain. Pathophysiologic studies were often preliminary and uncontrolled but the focus of these studies on abnormal nociception, neurohormones, and muscle metabolism provides an exciting hypothesis to unify pain, fatigue, and sleep disturbances, the primary symptoms of fibromyalgia. Unfortunately, new therapeutic trials were neither innovative nor especially encouraging.
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PMID:Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome. 206 4

Myofascial pain and dysfunction is the primary diagnosis in a large proportion of facial pain complaints. Myofascial disease can present in the form of trigger points, fibromyositis, myositis, muscle spasm, and muscle weakness. The purpose of this study is to research for quantifiable physiological differences between groups of normal subjects and myofascial pain dysfunction (MPD) patients. The first specific aim was to determine the opening of the jaw at which maximal isometric tension can be produced by the jaw closing muscles, with the hypothesis that this opening of maximal tension would be less for a group of MPD patients than for a group of normal subjects being tested. The second aim was to test the hypothesis that the maximal isometric bite forces for the two groups would differ. Patients with mandibular dysfunction are reported to have a lower maximal bite than normal subjects. Bite force was measured with the T-Scan system. An 80 micron horseshoe-shaped sensor connected to a dedicated IBM XT computer recorded the data. A self-contained printer produced the hard copy for later analysis. Vertical dimension or jaw opening was increased in 0.5-mm increments using double flat plane appliances standardized by the Relator. A MANOVA was used for statistical analysis of the data. MPD patients had significantly higher bite forces at 8.0, 8.5, 9, and 9.5 mm. Normal subjects had higher force values at 5.0 mm. There was no significant difference in mean maximal bite force between groups.
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PMID:Length-tension relations of the masticatory elevator muscles in normal subjects and pain dysfunction patients. 207 94

Fibromyalgia syndrome is a frequent condition. It mainly affects middle-aged women, who complain of diffuse pain in the proximal limb girdles and trunk, morning stiffness, unrefreshing sleep, tiredness, and fear, without abnormal physical findings on examination. This review considers the currently evaluated diagnostic criteria and recent research data, which suggest that fibromyalgia in fact is most probably primarily a brain disturbance involving neurohormonal abnormalities and impaired deep sleep. Effective and ineffective therapies are discussed.
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PMID:[Fibromyalgia syndrome, a frequently misdiagnosed entity]. 218 44

Fibromyalgia syndrome is characterized by generalized musculoskeletal pain and abnormal sensitivity to palpation of characteristic myofascial areas. We evaluated its prevalence in the 673 patients seen as first consultations in a hospital rheumatological outpatient clinic during one year, and we made an automatized review of the Spanish literature about this condition in the last 17 years. We found 70 cases (10.4%) of fibromyalgia syndrome, none of which had been referred to the hospital with this diagnosis. We report their clinical features. In our bibliographical search we found only one article describing this condition. We conclude that it is a common clinical syndrome, unknown in nonspecialized milieus. Generally, the patients are inadequately diagnosed and treated, and/or referred to hospital.
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PMID:[Fibromyalgia syndrome (fibrositis): as frequent as it is unknown]. 218 52

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 term fibromyalgia, though often used, is not justified since no fibrosis has been shown on the histological level. The aim of this article is to make a critical analysis of the semiology usually attributed to fibromyalgias, to cite the main related syndromes whose nosology is often unclear (benign myalgic encephalomyelitis, epidemic neuromyasthenia, diffuse idiopathic multifocal pain syndrome, chronic fatigue, AMP desaminase deficiency, etc.), to prefer the purely descriptive term of "persistent, diffuse myalgia with no recognized organic etiology". According to the author's experience, a psychological etiology is detectable in only 25% of the cases. Morphological or functional muscular abnormalities are sometimes found, but their significance is not well known. A real multifactorial vicious circle partly explains the physiopathological complexity.
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PMID:[Does fibromyalgia exist?]. 218 44

Polymyalgia rheumatica is a syndrome that occurs in the elderly and is characterized by pain and stiffness involving the neck, the shoulder girdle, and the hip girdle. The aching should be present for greater than one month. Polymyalgia rheumatica may be more common than reported. The etiology remains unknown. There is generally little found pathologically in this disease. The physical examination is often not impressive. Synovitis may be a main contributing factor to many of the symptoms seen in patients with polymyalgia rheumatica. Symptoms often do not correlate with physical findings. Polymyalgia rheumatica must be differentiated from many conditions since the diagnosis remains entirely clinical. Osteoarthritis, flu syndromes, inflammatory myopathies, fibromyalgia, and depression all have features that may mimic polymyalgia rheumatica. Malignancies and infections may also be difficult to separate from polymyalgia rheumatica. Polymyalgia rheumatica may also be extremely difficult to differentiate from seronegative rheumatoid arthritis in patients older than 50 years. Although some patients with polymyalgia rheumatica have underlying giant cell arteritis, the majority apparently do not. The distinction between polymyalgia rheumatica and giant cell arteritis cannot be made on the basis of laboratory studies and relies solely on clinical symptoms and physical findings. Although nonsteroidal antiinflammatory medications may control symptoms in patients with mild disease, most patients with polymyalgia rheumatica require low-dose corticosteroids. The tapering schedule for the corticosteroids is contingent upon the response of symptoms and laboratory parameters. Polymyalgia rheumatica usually follows a benign course with almost complete response to an adequate treatment program. Recently, there have been several studies suggesting that the course of polymyalgia rheumatica may not be as short and simple as once proposed. Nevertheless, many patients may be completely weaned from corticosteroids. Other agents have been used in this disease, but for the most part their use remains somewhat controversial. Patients must be monitored carefully. Most patients do well, and treatment is effective.
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PMID:Polymyalgia rheumatica. 218 54

The fibromyalgia syndrome (FMS) is an extraarticular rheumatic disease. Typical features are the chronic, polytopic pain in the musculoskeletal system and the provocation of pain by pressure on defined tender points. Mainly medium age women are affected by the disease. In histomorphological studies of muscle tissue non-specific changes were demonstrated, which were thought to be due to ischemia. Furthermore, sleep disturbance and a reduced pain threshold, which may be related to psychological factors, are discussed in the etiology. In FMS a primary and a secondary form related to other diseases can be differentiated. The treatment consists mainly of behaviour therapy and physiotherapy.
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PMID:[Fibromyalgia syndrome. Current contributions to the etiology, diagnosis and therapy of so-called "soft tissue rheumatism"]. 220 20


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