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)

Trigger points (TP) are objectively demonstrable foci in muscles. They are painful on compression and trigger pain in a referred area. This area may be the only locus of complaint in humans. In dogs we cannot prove the existence of referred zones of pain. Therefore, we can only diagnose a TP-induced claudication if we cannot find bone, joint, or neurologic abnormalities, and we do find TP that disappear after treatment together with the original lameness. Several methods have been developed to demonstrate TP existence objectively. These are pressure algometry, pressure threshold measurements, magnetic resonance thermography, and histology. In humans, 71% of the TP described are acupuncture points. TP treatment consists of TP stimulation with non-invasive or invasive methods such as dry needling or injections. In the dog, ten TP are described in two categories of clinical patients. First, those with one or few TP reacting favorably on treatment (+/- 80% success in +/- 2-3 weeks). Second, those with many TPs reacting badly on treatment. Most probably the latter group are fibromyalgia patients.
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PMID:Trigger point therapy. 158 47

Twenty-eight patients with primary fibromyalgia participated in the study. Eight patients received a stellate ganglion blockade with bupivacaine, and 14 days later an intravenous regional sympathetic blockade with guanethidine. The remaining patients served as controls and were randomly allocated to receive either a sham (placebo) injection with physiologic saline superficial to the stellate ganglion (n = 10) or bupivacaine intramuscularly (n = 10). The efficiency of the stellate ganglion blockade was evaluated by measuring skin blood flow (using a laser Doppler flowmeter), skin temperature, and skin conductance responses ('sympathogalvanic reflex'). Trigger and tender points (TePs) were counted, and rest pain in the arm, shoulder and neck evaluated at intervals up to 4 h after the injection. The guanethidine blockade was evaluated 24 h after the injection by counting TePs and by assessment of rest pain in the hand and forearm. The results indicate that a complete sympathetic blockade, produced by a stellate ganglion blockade, markedly reduced the number of TePs and produced a marked decrease in rest pain. The guanethidine blockade reduced the number of TePs, but had no effect on rest pain. The reduction in pain and TePs produced by a sympathetic blockade may be due to an improvement in microcirculation. Sympathetic activity may, in some patients, contribute to the pathogenesis of primary fibromyalgia.
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PMID:Regional sympathetic blockade in primary fibromyalgia. 338 May 57

Trigger points in painful muscle are a characteristic sign in patients with primary fibromyalgia. The MDO oxygen electrode was used to evaluate oxygenation in the subcutaneous tissue and in trigger points in the trapezius and brachioradial muscles. Ten patients and 8 normal controls were studied. The results in the patients were abnormal, with scattered or slalom-slope histograms, indicating low tissue oxygenation. The controls were normal, except in one case. The conclusion is that in patients with primary fibromyalgia, the muscle oxygenation is abnormal or low, at least in the trigger point area of the muscles.
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PMID:Muscle tissue oxygen pressure in primary fibromyalgia. 346 5

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

Pressure threshold is the minimal pressure (force) which induces pain. The pressure threshold meter (PTM) is a force gauge with a rubber disc of 1 cm2 surface. The instrument has been proven to be useful in clinical practice for quantification of deep muscle tenderness. Trigger points, fibrositis, myalgic spots, activity of arthritis as well as assessment of sensitivity to pain can be diagnosed by PTM. This study therefore established standards for pressure threshold as well as the reproducibility and validity of measurement in 24 male and 26 female normal volunteers at 9 sites. Muscles frequently afflicted by trigger points were examined. The deltoid was chosen as a reference since it is rarely a site for trigger points. Comparison of corresponding muscles on opposite sides failed to demonstrate significant differences (except for 1 muscle in females). These identical results obtained over muscles of opposite sides proved the excellent reproducibility and validity of pressure threshold measurement. Results serve as a reference for clinical diagnosis of abnormal tenderness and for documentation of treatment results. The sensitivity of individual muscles varies. Therefore the results presented should be kept in mind when diagnosis of pathological tenderness by palpation is attempted.
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PMID:Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. 361 75

Trigger points are defined as areas of muscle that are painful to palpation and are characterized by the presence of taut bands and the generation of a referral pattern of pain. Tender points are areas of tenderness occurring in muscle, muscle-tendon junction, bursa, or fat pad. When tender points occur in a widespread manner, they are usually considered characteristic of fibromyalgia. Trigger points, which typically occur in a more restricted regional pattern, are indicative of myofascial pain syndrome. In some patients the two phenomena may coexists, and overlap syndromes can occur. Although experienced examiners can generally identify the same tender points, interrater reliability of trigger points has been low in most studies. There is continued controversy regarding the defining characteristics and homogeneity of myofascial pain because of the variability of the examination findings. In appropriately selected patients, it appears that myofascial trigger point injections can be helpful in decreasing pain and improving range of motion in conjunction with a comprehensive exercise and rehabilitation program.
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PMID:Trigger points and tender points: one and the same? Does injection treatment help? 886 Aug 1

Fibromyalgia (FM) is a syndrome of unknown etiology characterized by chronic wide spread pain, increased tenderness to palpation and additional symptoms such as disturbed sleep, stiffness, fatigue and psychological distress. While medication mainly focus on pain reduction, physical therapy is aimed at disease consequences such as pain, fatigue, deconditioning, muscle weakness and sleep disturbances and other disease consequences. We systematically reviewed current treatment options in the treatment of fibromyalgia. Based on evidence from randomized controlled trials cardiovascular fitness training importantly improves cardiovascular fitness, both subjective and objective measures of pain as well as subjective energy and work capacity and physical and social activities. Based on anecdotal evidence or small observational studies physiotherapy may reduce overloading of the muscle system, improve postural fatigue and positioning, and condition weak muscles. Modalities and whole body cryotherapy may reduce localized as well as generalized pain in short term. Trigger point injection may reduce pain originating from concomitant trigger points in selected FM patient. Massage may reduce muscle tension and may be prescribed as a adjunct with other therapeutic interventions. Acupuncture may reduce pain and increase pain threshold. Biofeedback may positively influence subjective and objective disease measures. TENS may reduce localized musculoskeletal pain in fibromyalgia. While there seems to be no single best treatment option, physical therapy seem to reduce disease consequences. Accordingly a multidisciplinary approach combining these therapies in a well balanced program may be the most promising strategy and is currently recommended in the treatment of fibromyalgia.
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PMID:Physical therapy in the treatment of fibromyalgia. 1102 38

Myofascial pain syndrome is characterized by the presence of discreet, hypersensitive nodules known as trigger points. A myofascial trigger point is a hyperirritable locus within a taut band of skeletal muscle, located in the muscle and/or fascia (1). They are palpable within muscles as cord-like bands within a sharply circumscribed area of extreme tenderness. Trigger points are found most commonly in muscles involved in postural support.
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PMID:Identifying and injecting myofascial trigger points. 2008 61

Chronic muscle pain syndrome is one of the main causes of musculoskeletal pathologies requiring treatment. Many terms have been used in the past to describe painful muscular syndromes in the absence of evident local nociception such as myogelosis, muscle hardening, myalgia, muscular rheumatism, fibrositis or myofascial trigger point with or without referred pain. If it persists over six months or more, it often becomes therapy resistant and frequently results in chronic generalized pain, characterized by a high degree of subjective suffering. Myofascial pain syndrome (MPS) is defined as a series of sensory, motor, and autonomic symptoms caused by a stiffness of the muscle, caused by hyperirritable nodules in musculoskeletal fibers, known as myofascial trigger points (MTP), and fascial constrictions. Fibromyalgia (FM) is a chronic condition that involves both central and peripheral sensitization and for which no curative treatment is available at the present time. Fibromyalgia shares some of the features of MPS, such as hyperirritability. Many treatments options have been described for muscle pain syndrome, with differing evidence of efficacy. Extracorporeal Shockwave Treatment (ESWT) offers a new and promising treatment for muscular disorders. We will review the existing bibliography on the evidence of the efficacy of ESWT for MPS, paying particular attention to MTP (Myofascial Trigger Point) and Fibromyalgia (FM).
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PMID:Update on the efficacy of extracorporeal shockwave treatment for myofascial pain syndrome and fibromyalgia. 2636 97

There is good evidence supporting that people with fibromyalgia syndrome (FMS) exhibit central sensitization. The role of peripheral nociception is under debate in FMS. It seems that widespread pain experienced in FMS is considered multiple regional pains; therefore, several authors proposed that muscles play a relevant role in FMS. Trigger points (TrPs) have long been a contentious issue in relation to FMS. Preliminary evidence reported that the overall spontaneous pain is reproduced by referred pain from active TrPs, suggesting that FMS pain is largely composed of pain arising, at least partially, from TrPs. Finally, there is preliminary evidence suggesting that management of TrPs is able to modulate the CNS and is effective for reducing pain in FMS, although results are conflicting and future studies are clearly needed.
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PMID:Myofascial pain and fibromyalgia: two different but overlapping disorders. 2729 46


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