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

Forty-two patients with primary fibromyalgia were randomized into a 20-week program consisting of either cardiovascular fitness (CVR) training or simple flexibility exercises (FLEX) that did not lead to enhanced cardiovascular fitness. Patients were supervised by the same medical fitness instructors. Patients in neither group had contact with members of the other group, and were blinded as to the exercise taught to the alternative group. Groups met for 60 minutes 3 times each week. The compliance rate was 90%. Thirty-eight patients completed the study (18 with CVR training and 20 with FLEX). Blind assessments (standardized in preliminary trials to achieve acceptable inter-rater agreement) were performed by the same 2 examiners. After 20 weeks, patients receiving CVR training showed significantly improved cardiovascular fitness scores compared with those receiving FLEX training (t[35] = -4.22, P less than 0.003). Logistic regression analysis showed clinically and statistically significant improvements in pain threshold scores, which were measured directly over fibrositic tender points, in patients undergoing CVR (t[35] = 2.21, P less than 0.04). There was also a trend toward improvement in pain scores (visual analog scale) in the CVR group, but this did not reach statistical significance. There was no improvement in the percentage of body area affected by fibrositic symptoms or the number of nights per week or hours per night of disturbed sleep (self-report inventories). However, compared with the FLEX group, the CVR-trained patients improved significantly in both patient and physician global assessment scores.(ABSTRACT TRUNCATED AT 250 WORDS)
Arthritis Rheum 1988 Sep
PMID:A controlled study of the effects of a supervised cardiovascular fitness training program on the manifestations of primary fibromyalgia. 304 73

The prevalence of fibrositis was determined in 100 patients with subclinical or biochemical primary hypothyroidism. Nineteen patients reported symptoms of joint and/or muscle pain with stiffness. Five of these patients presented 7 or more tender points on examination, thus allowing a diagnosis of fibrositis to be made in only 5% of the total group. Symptomatic improvement after thyroid hormone replacement occurred in 10 of the 19 patients, including 3 of those with fibrositis. There were no significant changes in tender points. Our data indicate that fibrositis is uncommon in patients with primary hypothyroidism despite the frequent occurrence of symptoms suggestive of this syndrome.
J Rheumatol 1988 Sep
PMID:Fibrositis and primary hypothyroidism. 305 73

The nail fold capillary morphology and blood flow were examined by capillaroscopy in 10 patients with primary fibromyalgia. Only slight morphological anomalies such as moderate enlargement of capillary loops and variations in calibre were found. No obvious correlation emerged between capillary morphology and the duration of the disease, smoking, or history of Raynaud's phenomenon. Three patients with a history of Raynaud's phenomenon showed sluggish capillary flow correlated with subnormal skin temperature during registration. The findings suggest that marked generalized capillary abnormality such as that often involving the nail fold capillaries in many connective tissue disorders is not a prominent feature of primary fibromyalgia.
Clin Rheumatol 1988 Sep
PMID:Nail fold capillaroscopy findings in patients with primary fibromyalgia. 322 83

Women predominate at all ages among patients diagnosed as having primary fibromyalgia. Of 100 patients reviewed, the average age at onset of fibromyalgia was 46. Of 65 patients in whom menopause occurred before diagnosis of fibromyalgia, the average age at menopause was 42, and most of these women had menopause related to surgery and insufficient estrogen therapy. Estrogen deficit is, thus, a prominent promoting factor in the majority of fibromyalgia patients and is likely to have an effect on sleep, mood, and anxiety state. These emotional responses may subsequently be somatized as pain. Therefore, estrogen therapy should be added to the treatment armamentarium for fibromyalgia in selected patients.
Postgrad Med 1986 Sep 15
PMID:Fibromyalgia and menopause. Examination of the relationship. 346 50

The fibrositis/fibromyalgia syndrome is one of the commonest forms of musculoskeletal pain seen in clinical practice. It is diagnosed on the basis of widespread pain accompanied by the physical finding of multiple tender points in remarkably reproducible locations. Accompanying the pain are two symptoms commonly associated with the "systemic" rheumatic disorders, namely morning stiffness and easy fatigability. Unlike the classical rheumatic diseases, however, fibrositis is not responsive to anti-inflammatory medications, including corticosteroids. Current therapeutic strategies, which are only partly successful, are aimed at modifying those factors that seemingly influence the severity and course of the condition; such afferent features include sleep disturbance, overuse syndromes, mechanical stress, psychic stress, and other causes of chronic pain. Major unresolved issues center around the assessment of functional disability in fibrositis and the apparent relationship to trauma in some patients. Until more is known about the underlying pathogenesis of this common condition, significant progress will be thwarted.
Am J Med 1986 Sep 29
PMID:Current issues concerning management of the fibrositis/fibromyalgia syndrome. 346 5

The finding of multiple tender points is essential to the diagnosis of the fibrositis/fibromyalgia syndrome. Recent studies have shown that the tender point count seems to correlate with the presence of fibrositis symptoms, and can distinguish fibrositic from normal subjects. Although tender points are present in normal subjects, fibrositis patients have far more tender points that are much more tender. Further work is necessary to establish the reliability of tender point measurement, and to investigate and monitor changes in the tender point count with time or therapy.
Am J Med 1986 Sep 29
PMID:Is the tender point concept valid? 346 6

Primary fibromyalgia syndrome, also inappropriately called "fibrositis," is a clinically recognizable nonarticular rheumatic condition with diffuse and chronic musculoskeletal aching and stiffness, accompanied by exaggerated tenderness at characteristic sites on physical examination. Results of muscle biopsy from 12 well-defined cases of primary fibromyalgia syndrome without any history of trauma have been published recently. Light microscopic examination revealed no evidence of inflammation. Histochemical analysis demonstrated type II fiber atrophy in seven patients and the "moth-eaten" appearance of type I fibers in five patients. Electron microscopic findings were most impressive, and included myofibrillar lysis with deposition of glycogen and abnormal mitochondria, as well as subsarcolemmal accumulation of glycogen and mitochondria in all 12 patients and papillary projections of sarcolemmal membrane in 11 patients. Mechanisms of these significant muscle changes in primary fibromyalgia syndrome are uncertain but may include subclinical injury of muscle spasm.
Am J Med 1986 Sep 29
PMID:Pathologic changes in muscle in primary fibromyalgia syndrome. 346 7

Patients with the fibrositis syndrome experience moderately severe musculoskeletal discomfort, mood changes associated with nonrestorative sleep, and tenderness to palpation at specific body sites. There is no characteristic abnormal laboratory finding in these patients to help identify the population. A report by Moldofsky and Warsh (Pain 1978; 5: 65-71) of low serum levels of free tryptophan in patients with severe fibrositis syndrome is intriguing but remains unexplained. Those data plus the observation by Hudson et al (Am J Psychiatry 1985; 142: 441-446; Biol Psychiatry 1984; 19: 1489-1493) that patients with fibrositis syndrome exhibit an increased prevalence of anxiety and depression suggest a number of possible avenues for further study. They include potential alterations in the homeostasis of catecholamines, corticosteroids, serotonin, aromatic amino acids, platelet membrane receptor levels, and the activity of platelet membrane monoamine oxidase. Among these possibilities, evidence is now available that suggests an increased production of catecholamines in fibrositis syndrome.
Am J Med 1986 Sep 29
PMID:Is there a metabolic basis for the fibrositis syndrome? 346 8

Fibrositis is considered primary when there is no associated underlying disorder, and secondary when it occurs in patients with underlying rheumatic or other organic disease. Since fibrositis has become better defined, the list of underlying disorders has grown, and its identification requires careful diagnostic study. The differentiation of primary and secondary fibrositis has therapeutic implications. Secondary fibrositis should respond to treatment of the underlying disorder, whereas the primary syndrome may require additional management directed to the musculoskeletal pain and sleep and emotional disturbances commonly recognized as major manifestations of this syndrome.
Am J Med 1986 Sep 29
PMID:Secondary fibrositis. 346 9

Fibrositis (fibromyalgia) is best treated by attaining patient acceptance of and compliance with a comprehensive treatment program. This includes education, physical therapy, muscle and mental relaxation, examination and adjustment of goals and priorities, and pacing of activities, as well as pharmacotherapeutics. Of the medications in use, anti-inflammatory agents with a high degree of analgesia are more effective than "pure" anti-inflammatory agents. Tricyclic derivatives are beneficial muscle relaxants. The use of long-acting agents improves compliance and is therefore favored. Local agents are of adjunctive value in some cases. Double-blind, placebo-controlled studies show cyclobenzaprine to be an effective medication in the treatment of fibrositis (fibromyalgia).
Am J Med 1986 Sep 29
PMID:Pharmacotherapeutics in fibrositis. 346 10


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