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

During the past five years, there have been a number of controlled reports regarding the possible association of fibrositis with psychologic disorders. The results of these studies are quite different, which is not surprising in view of the differences in patient populations and study instruments used. We gave the Diagnostic Interview Schedule to 82 patients with fibrositis and to control subjects, and we found an association of depression with fibrositis. Depression was also more common in first-degree relatives of patients with fibrositis. However, in most instances, the depression antedated fibrositis by more than one year, indicating a possible psychobiologic association, rather than a casual one.
Am J Med 1986 Sep 29
PMID:Psychologic studies in fibrositis. 346 11

Fibrositis is a disorder of musculoskeletal pain and aching with at least a five to one female-to-male ratio. It is most commonly seen between the ages of 40 and 60, and has a prevalence in the clinic of 6 to 15 percent. Its most common mode of presentation involves generalized musculoskeletal pain and aching, but articular pain, axial skeletal pain, myalgias, and neurovascular complaints sometimes predominate. All patients have multiple areas of local tenderness called "tender points" that are easily identified during physical examination, and are diagnostic. Essential symptoms of fibrositis are disturbed sleep, morning stiffness, and fatigue. Additional rheumatic symptoms include subjective swelling, paresthesias, and numbness. Headaches and irritable bowel syndrome are common nonrheumatic complaints. Modest improvement follows treatment by tricyclic agents such as low-dose cyclobenzaprine and amitriptyline, by physical measures, and by reduction in stress. Remission occurs in 20 percent of patients, but is generally short-lived.
Am J Med 1986 Sep 29
PMID:The clinical syndrome of fibrositis. 346 12

Demographics and health service utilization were studied for 81 patients with fibrositis during 1985. Patients reported high levels of pain, mild disability, and moderate impairment of global health. Work disability was limited and only 6.3 percent described themselves as disabled. Employed patients were able to work full work weeks. Utilization of outpatient medical services was increased compared with that of control subjects and national averages during the study year, but was consistent with other rheumatic disorders such as osteoarthritis and low back pain. Medication usage was limited and seemed appropriate. Very high hospitalization rates were noted prior to diagnosis of fibrositis, both for musculoskeletal and non-musculoskeletal hospitalizations, but these rates dropped during the post-diagnosis study year.
Am J Med 1986 Sep 29
PMID:Socioeconomic impact of fibrositis. A study of 81 patients with primary fibrositis. 346 13

The diagnostic criteria for fibrositis and primary fibromyalgia are similar to those for myofascial pain syndromes due to trigger points. Tender points in muscles are likely to be myofascial trigger points; nonmuscular tender points clearly are not myofascial trigger points, but may be areas of tenderness referred from such trigger points. Myofascial trigger points refer pain to a distance and restrict range of motion of the muscle. They are associated with a palpable taut band that exhibits a local twitch response of the muscle, and they are responsive to treatment. Persistence of myofascial trigger points is due to perpetuating factors that can usually be corrected. Although their number is unknown, it is likely that some patients who are diagnosed as having fibrositis/fibromyalgia have multiple myofascial trigger points aggravated by a powerful perpetuating factor and also have a systemic disease process independent of the myofascial trigger points. Since myofascial pain syndromes are treatable, these patients would benefit greatly by identification and relief of the myofascial component of their pain.
Am J Med 1986 Sep 29
PMID:Fibrositis/fibromyalgia: a form of myofascial trigger points? 346 15

The features of fibromyalgia (fibrositis) in children are similar to those in adults with the syndrome. Both juveniles and adults report diffuse musculoskeletal aches and/or stiffness with typical modulating factors. Moreover, they have no systemic manifestations, and routine laboratory studies yield normal results. On physical examination in both children and adults, multiple soft-tissue tender points are evident at characteristic, symmetric sites but with no evidence of arthritis.
Am J Med 1986 Sep 29
PMID:Fibromyalgia (fibrositis) in children. 349 Jan 80

Fibromyalgia syndromes are common noninflammatory, painful musculoskeletal disorders that vary in the extent and intensity of involvement. The biologic gradient of musculoskeletal pain varies from no or few symptoms and tender points in the majority of persons to generalized fibromyalgia with multiple tender points. Standardized criteria are needed in order to categorize different strata of the biologic gradient of fibromyalgia syndromes and differentiate them from other conditions. Both the sensitivity and specificity of criteria should be high. The course and prognosis of fibromyalgia syndromes are not yet known. Limited clinical data suggest three basic patterns: remitting-intermittent; fluctuating-continuing; and progressive. However, course patterns need to be derived scientifically. Multiple host and environmental factors seem to contribute to the onset and course of fibromyalgia syndromes, and these require definition. Generalized fibromyalgia syndromes share many constitutional manifestations with other common functional disorders, e.g., irritable bowel syndrome and tension headache syndrome, which suggest common underlying psychoneurophysiologic mechanisms in a subset of patients. Progress made in fibromyalgia research will find application in many dysfunctional syndromes without obvious organ pathology.
Am J Med 1986 Sep 29
PMID:Concepts of illness in populations as applied to fibromyalgia syndromes. 353 80

Primary fibrositis syndrome is a painful musculoskeletal disorder of unknown cause. Although numerous hypotheses have been proposed to explain its clinical features, few studies have demonstrated a reproducible tissue abnormality in this condition. Recently, five reports of cutaneous immunoreactant deposition in primary fibrositis syndrome have become available and form the basis of this review. Four of these reports have described immunoglobulin G deposition at the dermal-epidermal junction of sun-exposed skin with a prevalence ranging from 12 to 76 percent. One study reported immunoglobulin M deposition in the dermal vasculature of patients with primary fibrositis syndrome. The reasons for the lack of uniformity in reported prevalence rates and types of skin immunofluorescence in primary fibrositis syndrome are unknown but are assumed to be due to differences in patient populations and immunofluorescence techniques between reporting centers. These factors are discussed in detail and speculations as to the significance of these skin findings are expressed, particularly with respect to the concept of enhanced vascular permeability in these patients.
Am J Med 1986 Sep 29
PMID:Immunofluorescent studies of skin in primary fibrositis syndrome. 353 83

Cardiovascular fitness training has been suggested as a treatment for the fibrositis/fibromyalgia syndrome. Thirty-four patients with fibrositis/fibromyalgia who met Smythe's original criteria were randomly assigned to enter either a cardiovascular fitness training program or a program consisting only of flexibility exercises. Patients met in supervised groups three times weekly for a 20-week observation period. The cardiovascular fitness group underwent gradual heart rate-elevated training using a bicycle ergometer and achieved a 29.1 +/- 24.4 percent increase in peak work capacity at 170 beats per minute (PWC-170). Patients undergoing flexibility training had a net reduction in their PWC-170 scores of 4.3 +/- 9.4 percent. Patients in the cardiovascular fitness group had statistically significant improvements in the visual analogue pain scale of current pain intensity; total myalgic scores in which pain thresholds at five fibrositic tender points selected for acceptable intra-rater and inter-rater reliability were measured using a dolorimeter; percentage total body area affected as measured by self-administered pain diagrams; and patients' and physicians' global assessment scores. Psychologic profiles as measured by Symptom Checklist-90R also improved in the cardiovascular fitness group compared with the flexibility training group. It is concluded that cardiovascular fitness training is feasible in patients with fibrositis/fibromyalgia and that such training improves subjective measurements of pain-reporting behavior. A theoretic basis for improvements in pain measurement scales and psychologic profiles is discussed in light of recent literature.
Am J Med 1986 Sep 29
PMID:Role of physical fitness training in the fibrositis/fibromyalgia syndrome. 353 84

The essential symptoms of fibrositis--widespread aching and pain, disturbed sleep, morning stiffness, and fatigue--are common in both rheumatic and nonrheumatic patients. But the essential sign of fibrositis--widespread local tenderness over specific anatomic sites ("tender points")--is rare in any patients except those with fibrositis. Clinical criteria for the diagnosis of fibrositis rely heavily on a high tender point count in the presence of characteristic fibrositic symptoms. Multiple tender points are uncommon in normal subjects and in those with rheumatic and nonrheumatic disorders. The tender point count thus also serves to distinguish fibrositis from other musculoskeletal diseases.
Am J Med 1986 Sep 29
PMID:Development of criteria for the diagnosis of fibrositis. 353 85

Although the myofascial pain dysfunction syndrome has a multiple aetiology, faulty vertical dimension is a frequent cause of muscular pain among wearers of full dentures. Furthermore, it has been found that the restoration of a physiological free-way space in such cases, using a method which is based upon cephalometric analysis of the gonial angle, often leads to a dramatic remission of pain. The present investigation was prompted by curiosity as to what the underlying algogenic mechanisms in these cases might be; and how a change in the vertical dimension should so modify them as to result in the disappearance of the pain symptoms. The study is necessarily of a speculative nature, and makes use of two representative cases, one of which was adjudged to have too little free-way, and the other too much. Principles of neuromuscular physiology are applied in attempting to explain the clinical phenomena involved, as well as to find a reason for certain electro-myographic artefacts noted in one of the cases, which would appear to call into question the notion that muscular hyperactivity, per se, is responsible for muscular pain. Potgieter, Monteith & Kemp (1983) have presented an hypothesis that the amount of free-way space present in an individual is an expression of the contractile power of the masseter and medial pterygoid muscles. They have also devised a method whereby, through cephalometric analysis, the optimal amount of free-way may be determined for an edentulous patient during denture construction. Furthermore, they have stated that their method has proved particularly effective in the treatment of denture-wearers presenting with symptoms of the myofascial pain dysfunction syndrome. However, in the light of this syndrome's multifactorial aetiology one must assume that only those symptoms which are related to a faulty free-way space are at issue. The purpose of the present investigation is to examine the latter assertion; and by the application of the suggested method of cephalometric analysis to two representative cases, attempt to explain the phenomenon in terms of neuromuscular mechanisms. Of the two cases to be examined, one was found to have too much free-way, while the other had been provided with too little. Both had presented with symptoms of severe muscle pain.
J Oral Rehabil 1984 Sep
PMID:The role of the free-way space in the generation of muscle pain among denture-wearers. 623 19


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