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

The diagnosis of a primary fibromyalgia syndrome (PFS) which is supported mainly by clinical-anamnestic elements is, in many cases, finally established in the generalized stadium of the disease. It would be generally desirable to discover potentially endangered patients and to define "risk groups". During this study a case-by-case retrospective analysis of all available data sources (specialist's and hospital reports) has been conducted on 61 PFS-patients of a general practice. A further clarification diagnosis resulted in 75% of the cases suffering from general exhaustion. In over 50% of the examined patients diagnostic details referred to chronic lumbar and cervical spine syndromes. It is well possible that chronic cervical and lumbar spine as well as psychovegetative exhaustion syndromes predispose the generation of a PFS under consideration of a corresponding personality profile and other factors or it may even be a disease by itself. In every general practice the respective tender points of suspected patients should be examined and they should be questioned as to the basic symptoms of this disease.
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PMID:[Primary fibromyalgia syndrome--diagnostic statistics from primary care]. 150 57

The influence of maximum exercise has been studied in 10 patients with primary fibromyalgia syndrome (PFS) and 10 healthy sedentary control persons. The exercise consisted of a bicycle ergometertest and a steptest, both till exhaustion. In both tests, the mean maximum workload of the PFS patients was lower than that of the controls. Significantly lower values of serum creatinekinase, myoglobin, cortisol, epinephrine and norepinephrine were found in PFS patients. A striking finding was a lower heart rate in PFS patients compared to the controls under the same workload. The lower (nor)epinephrine concentration together with the lower heart rate suggests a disturbance of the sympathetic activity in PFS patients. The preliminary conclusion is that there is a disturbed reactivity of the sympathetic system as well as of the HPA axis in PFS.
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PMID:Physiological effects of exhaustive physical exercise in primary fibromyalgia syndrome (PFS): is PFS a disorder of neuroendocrine reactivity? 157 Apr 85

Nine patients with primary fibromyalgia participated. The patients were studied prior to, during and immediately after 4 identical periods of exercise (bicycle ergometer) each performed 30 min after injection with saline, repeated saline, an opioid and naloxone. All substances were given epidurally, except for naloxone which was given intravenously. Finally, with the patients resting in bed, lignocaine was injected epidurally. Physiological variables, general exertion, dyspnoea, lower extremity exhaustion, pain and tender points in the lower half of the body were examined. Resting pain and tender points diminished significantly after the opioid injection. Lignocaine completely abolished resting pain and tender points. Lower extremity exhaustion was reduced by the opioid. General exertion and dyspnoea were unaffected by the opioid. In conclusion the results support the hypothesis that the pain in fibromyalgia is of peripheral nociceptive or spinal origin. We raise the hypothesis that the fatigability is, at least partly, due to inhibition because of pain.
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PMID:Diagnostic epidural opioid blockade in primary fibromyalgia at rest and during exercise. 259 95

This paper traces the history of disturbed sleep, deep pain and exhaustion from biblical times to the present. This historical review provides the stage for the papers that follow in this volume on fibrositis syndrome.
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PMID:Fibrositis syndrome: a historical perspective. 269 79

Aerobic fitness was evaluated in 25 women with fibrositis, by having them exercise to volitional exhaustion on an electronically braked cycle ergometer. Compared with published standards, greater than 80% of the fibrositis patients were not physically fit, as assessed by maximal oxygen uptake. Compared with matched sedentary controls, fibrositis patients accurately perceived their level of exertion in relation to oxygen consumption and attained a similar level of lactic acidosis, as assessed by their respiratory quotient and ventilatory threshold. Exercising muscle blood flow was estimated by 133xenon clearance in a subgroup of 16 fibrositis patients and compared with that in 16 matched sedentary controls; the fibrositis patients exhibited reduced 133xenon clearance. These results indicate a need to include aerobic fitness as a matched variable in future controlled studies of fibrositis and suggest that the "detraining phenomenon" may be of relevance to the etiopathogenesis of the disease.
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PMID:Aerobic fitness in patients with fibrositis. A controlled study of respiratory gas exchange and 133xenon clearance from exercising muscle. 270 29

A diffuse distribution of characteristic sites of tenderness is recognized to be a distinctive feature of the fibromyalgia/fibrositis syndrome, and is often associated with general symptoms such as exhaustion, stiffness, and irritability to external and internal stimuli. Equally important, and more common, is the development of similar tenderness at precisely the same sites in referred pain syndrome. The distribution of points is clumped, i.e., restricted to the appropriate region, and the general symptoms are lacking. The usual sites of origin are often unknown to the patient, because they lie deep in the cervical or lower lumbar spine. The clumped pattern of points is therefore very helpful in diagnosis and therapy.
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PMID:Referred pain and tender points. 294 31

A common complaint among patients with fibrositis syndrome is exhaustion and fatique. It was therefore felt desirable to evaluate the muscle strength of these patients compared with normal subjects. Maximum isometric and isokinetic strength of knee extension was measured in 15 patients and 15 healthy matched subjects, using an isokinetic dynamometer (Cybex II). Maximum isometric strength at various knee extension angles (90 degrees, 60 degrees and 30 degrees degrees) was significantly (p less than 0.001) lower in the fibrositis group than in controls, a reduction of approximately 58-66%. Maximum isokinetic strength at various knee extension velocities (30-240 degrees per second) was also significantly (p less than 0.01) lower in the fibrositis group than in controls, the reduction being approximately 41-51%. In conclusion, isometric and isokinetic muscle strength is found to be lower in patients with fibrositis syndrome than in healthy subjects.
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PMID:Isometric and isokinetic muscle strength in patients with fibrositis syndrome. New characteristics for a difficult definable category of patients. 347 55

CFIDS (chronic fatigue and immune disfunction syndrome) is also known as CFS (chronic fatigue syndrome), CEBV (chronic Epstein-Barr virus), M.E. (myalgic encephalomyelitis), yuppie flu and by other names. It is a complex illness characterized by incapacitating fatigue (experienced as exhaustion and extremely poor stamina), neurological problems and a constellation of symptoms that can resemble many disorders, including; mononucleosis, multiple sclerosis, fibromyalgia, AIDS-related complex (ARC) and autoimmune diseases such as lupus. These symptoms tend to wax and wane, but any often severely debilitating and may last for many months or years. All sections of the population (including children) are at risk, but women under 45 seem to be most susceptible. The investigators suggest that CFIDS results from dysfunction of the immune system. The exact nature of this dysfunction is not yet well defined, but it can generally be viewed as an unregulated or overactive state which is responsible for most of the symptoms. There is also evidence of some immune suppression in CFIDS. None of the treatments is consistently satisfactory, but some may be helpful: psychotherapy, physiotherapy, exercise programs, acupunctures, small doses of antidepressants, etc.
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PMID:[The chronic fatigue syndrome]. 790 Apr 53

Previous studies have shown decreased voluntary muscle strength and endurance in patients with fibromyalgia. The aim of this study was to determine to what extent this is due to lack of exertion. The twitch interpolation technique was used to determine the degree of central activation and estimate the "true" quadriceps muscle strength in patients with fibromyalgia and age and sex matched controls. Subjects hereafter performed an endurance test consisting of repetitive contractions at 50% of estimated "true" muscle strength of four seconds duration followed by a six second rest until exhaustion, or maximally for 40 minutes. Twitch decline and increases in mean rectified EMG were used as objective markers of fatigue. The estimated "true" muscle strength was 82 (SD 26) Nm in 20 patients with fibromyalgia compared with 133 Nm (SD 28) Nm in the 21 controls (p < 0.001). The "true" muscle strength per cm2 midthigh cross sectional area was lower 0.50 (SD 0.15) Nm/cm2 in the patients compared with 0.74 (SD 0.15) Nm/cm2 in the controls (p < 0.001). The decline over time in twitch sizes was similar in the two groups. The mean rectified EMG signal at a fixed force level of 50% of "true" muscle strength increased similarly in the two groups. Relaxation rates and contraction rates also increased equally in the two groups. In conclusion, a reduction of the estimated muscle strength per area unit of about 35% was found in the patients with fibromyalgia. This might be secondary to physical inactivity or neuroendocrine factors. No differences in changes in the neurophysiological indices associated with fatigue were found between the two groups.
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PMID:Muscle strength, voluntary activation, twitch properties, and endurance in patients with fibromyalgia. 808 79

This study aimed at evaluating the influence of submaximal isometric contraction on pressure pain thresholds (PPTs) in 14 fibromyalgia (FM) patients and 14 healthy volunteers, before and after skin hypoesthesia. PPTs were determined with pressure algometry over m. quadriceps femoris before, during and following an isometric contraction. Maximum voluntary contraction (MVC) was assessed using a computerized dynamometer. A contraction of 22% MVC on average was held until exhaustion (max. 5 min) and PPTs were assessed every 30 sec. A local anesthetic cream and a control cream were applied following a double-blind design and PPTs were reassessed. In healthy volunteers PPTs increased during contraction (P < 0.001), then decreased after the end of contraction (P < 0.001) but remained above precontraction values during the 5 min of post-contraction assessments (P < 0.001). In FM patients PPTs decreased in the middle of the contraction period (P < 0.05) and remained below precontraction levels during the rest of the contraction period (P < 0.05) and during the 5 min of post-contraction assessment (immediately post-contraction NS; 2.5 min post-contraction P < 0.01; 5 min post-contraction P < 0.05). The normalized PPTs were significantly lower in patients than in controls during contraction (start P < 0.01; middle P < 0.001; end P < 0.001) and at all times during post-contraction assessments (P < 0.001). Anesthetic cream raised PPTs at rest in controls (P < 0.01) but not in FM patients, and did not influence contraction or post-contraction PPTs in either group. Therefore, the increased pressure pain sensibility in FM patients is more pronounced deep to the skin. The observed decrease of PPTs during isometric contraction in FM patients could be due to sensitization of mechanonociceptors caused by muscle ischemia and/or dysfunction in pain modulation during muscle contraction.
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PMID:Modulation of pressure pain thresholds during and following isometric contraction in patients with fibromyalgia and in healthy controls. 878 4


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