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

Given the lack of objective physical measures for assessing fibromyalgia syndrome (FS), the role of pain assessment is particularly important. The role of psychological factors is controversial among FS patients. This study was designed to better understand the relationship between pain behaviors and psychological variables. Specifically, this study (1) refined a pain behavior observation (PBO) methodology for use with FS patients, (2) determined whether stretching is a valid pain behavior, and (3) assessed whether psychological variables including self-efficacy and/or depression can predict pain behaviors after controlling for disease severity and age. The 73 FS subjects meeting the American College of Rheumatology classification system completed questionnaires measuring self-efficacy, depression, and pain. Trained physicians conducted tender-point examinations. Subjects were video-taped using a standardized procedure. Two trained raters independently coded all pain behaviors. Kappa coefficients and correlations among pain behaviors and self-reported pain indicated that the PBO method was both reliable and valid. However, the newly defined pain behavior 'stretching' was found to be negatively associated with self-reported pain. Hierarchical multiple regression (MR) analyses revealed that depression did not predict pain behavior over and above myalgic scores and age; however, in 3 separate MR analyses, self-efficacy for function, pain, and other symptoms each predicted pain behavior over and above myalgic scores and age. This study indicated that the original pain behavior scoring methodology is appropriate for use with the FS population and should not be modified to include the pain behavior 'stretching'. Self-efficacy was related to pain behavior while depression was not among this FS sample.
Pain 1994 Dec
PMID:Self-efficacy and pain behavior among subjects with fibromyalgia. 770 12

Muscle pain has been associated with magnesium (Mg) and selenium (Se) deficiency: magnesium and selenium status were investigated in fibromyalgia (FM). Erythrocyte (E), leucocyte (L) and serum (S) magnesium, serum selenium and zinc, and vitamin B1, B2, A or E status were assessed in 22 patients with fibromyalgia and in 23 age-matched healthy controls. LMg is significantly increased (P < 0.05) and EMg slightly decreased in fibromyalgia. These magnesium abnormalities are associated with previously-reported impairment of thiamin metabolism. Antioxidant status (as well as plasma malondialdehyde) is unchanged in fibromyalgia and serum selenium levels, slightly but not significantly correlated with serum magnesium, is normal.
Magnes Res 1994 Dec
PMID:Selenium and magnesium status in fibromyalgia. 778 92

The primary fibromyalgia syndrome (Weichteilrheumatismus) shows a circadian rhythm of the symptoms and, moreover, a seasonality of pain severeness. Although the pathophysiologic mechanisms are unknown, the circadian variations are well documented in the literature; the seasonality of pain is sometimes clinically reported. In a study on "healthy" workers, the seasonality of this disease is reported.
Chronobiol Int 1994 Dec
PMID:Fibromyalgia: chronobiological aspects. 789 98

Objective. This paper reviews the major pain measurement methods used with adult patients with rheumatoid arthritis, osteoarthritis, and fibromyalgia. Methods and Results. The most frequently used measures are numerical and verbal rating (category) scales of pain intensity and affect. However, visual analogue scales and composite measures are preferable to category scales because they may be subjected to parametric statistical analyses and may be associated with greater sensitivity to treatment-related changes over time. Measurement of overt motor behaviors and pain threshold levels provides important information that cannot be assessed with rating scales. It also allows one to determine whether there are discrepancies between patients' ratings of their pain experiences and their behaviors. Measurement of psychophysiologic parameters are used to understand better how markers of immune system activity may mediate the relationships between psychological and environmental factors and patients' pain experiences. Conclusions. It is necessary to use multiple pain measurement methods for clinical and research purposes. These should include at least two measures of pain intensity and affect as well as a measure of pain behavior.
Arthritis Care Res 1993 Dec
PMID:Pain measurement in arthritis. 791 13

This study was designed to assess the reliability and validity of a Pain Behavior Observation method with fibromyalgia syndrome (FS) subjects and to determine the factors which predict pain behavior among FS subjects. Fifty-eight female FS subjects participated in the videotaped Pain Behavior Observation method. Subjects also completed the McGill Pain Questionnaire (MPQ), the Arthritis Impact Measurement Scale (AIMS), and the Symptoms Checklist-90-Revised (SCL-90-R). Pain behavior totals were derived using the Pain Behavior Observation method of McDaniel et al. (1986). Results indicated that the scoring method of Keefe and Block (1982) developed for use with back pain patients was more generalizable to this FS sample. Total pain behavior score using the Keefe and Block scoring method was correlated with self-report pain. Interrater reliability ranged from 0.9 to 0.99. Hierarchical multiple regression analyses revealed that age and physical disability predicted the total pain behaviors. The Pain Behavior Observation method appears a valid pain measurement technique independent of depression among FS patients. Directions for future research are discussed.
Pain 1993 Dec
PMID:Pain behavior predictors among fibromyalgia patients. 812 95

The purpose of the study was to investigate whether fibromyalgia patients (n = 50) differed from patients with rheumatoid arthritis (n = 22) and ankylosing sponylitis (n = 31) with respect to pain experience, pain coping and fatigue. A high general pain intensity level was recorded by the McGill Pain Questionnaire (p < 0.01) and the visual analogue scale (p < 0.01) in the fibromyalgia group compared to the other groups. The pain was of continuous duration in the fibromyalgia patients while the rheumatoid arthritis and ankylosing spondylitis patients experienced intermittent pain. A high correlation between sensory and affective pain rating indexes was determined in all patient groups (p < 0.01). No statistically significant difference between the groups in pain coping was recorded. A high frequency of reported gastrointestinal problems (p < 0.01) and high intensity of fatigue (p < 0.01) were seen in the fibromyalgia group compared to the other groups. In the fibromyalgia group there was no correlation between the sleep problems and fatigue intensity. Thus, the fibromyalgia patients differed from the other groups in reporting frequently shoulder and upper arm pain, continuous pain, higher levels of fatigue and pain intensities as well as high frequency of gastrointestinal problems.
Clin Rheumatol 1993 Dec
PMID:Pain and fatigue in patients with rheumatic disorders. 812 15

This article describes the use of combining spectral electromyographic signal techniques with phosphorus magnetic resonance (31P-NMR) spectroscopy for the purpose of studying muscle disorders. The quantification of muscle fatigue by electromyographic spectral variables such as the median frequency is summarized. Its development as a laboratory and clinical tool is presented, with an emphasis toward its potential as an assessment procedure. Similarly, the use of 31P-NMR spectroscopy for noninvasive measurement of phosphate metabolites and intracellular pH during fatigue are described. The limitations of this procedure are presented and compared with surface electromyographic techniques. Suggestions are made for combining these techniques for the purpose of monitoring muscle metabolic and electrophysiologic changes in situ during fatiguing exercises. A recent study in which these techniques were combined to evaluate the underlying mechanisms of fatigue in patients with fibromyalgia is described.
Phys Ther 1993 Dec
PMID:Combined use of surface electromyography and 31P-NMR spectroscopy for the study of muscle disorders. 824 97

90 clients with uncertain symptoms and diagnosis, especially clients with pain in the musculoskeletal system or with minor neurotic symptoms, were examined by a psychiatrist ordered by Skedsmo Social Security Office. The number of clients with the diagnosis fibromyalgia was strongly reduced. The number of clients with somatic diagnosis increased from three to nine, and three cases of psychosis, not earlier diagnosed as such, were recorded. The number of clients on sick leave was reduced considerably. Rehabilitation for employment was proposed to many clients. The evaluation had little impact on clients applying for a disability pension. For 28 clients the examination resulted in necessary and important treatment. As a whole the examination produced the best results among clients under the age of forty.
Tidsskr Nor Laegeforen 1993 Dec 10
PMID:[Use of psychiatrists in security matters]. 766 97

In this article, serologic tests and other procedures widely used to establish diagnoses of patients with rheumatic diseases are discussed. Musculoskeletal conditions are among the most common seen by physicians, and the current practice of including extensive laboratory tests and imaging procedures is not only ineffective but frequently results in misdiagnosis and inappropriate treatment. The approach outlined should provide treatment that is not only cost-effective but is directed to relief of symptoms and preservation of function, which are the primary goals of the patient and physician in the management of musculoskeletal problems. The costs in diagnosis of most patients with musculoskeletal pain often are considerably greater than the costs of treatment, which might be a reasonable consideration if expensive diagnostic studies would provide meaningful specificity regarding treatment. Many results, however, are misleading, for example, phenomena seen in at least 1% of the population, such as elevated ESR, rheumatoid factor titer, ANA, elevated uric acid, and Lyme Borreliosis titer, may be seen in individuals whose primary problem is fibromyalgia. In view of the fact that treatment is generally based on clinical observations, a considerable reduction in diagnostic studies might considerably reduce costs of patient care, without adversely affecting results and outcomes.
Prim Care 1993 Dec
PMID:A pragmatic approach to cost-effective use of laboratory tests and imaging procedures in patients with musculoskeletal symptoms. 831 81

One hundred and seven women participated in a clinical study of an age-stratified random sample of sewing machine operators compared to a group of auxiliary nurses and home helpers. Four groups, according to years of being a sewing machine operator, consisted of: (controls) 25; (0-7 years) 21; (8-15 years) 25; and (more than 15 years) 36. The numbers of the main clinical diagnoses in the four groups were: cervicobrachial fibromyalgia (myofascial pain syndrome) 2, 4, 11, 24; cervical syndrome 0, 1, 3, 10; and rotator cuff syndrome 1, 1, 6, 11. The observed exposure-response relationship between clinical outcomes and years as a sewing machine operator was maintained when adjusting for current exposure to musculoskeletal strain and other potential confounders. Muscle palpation proved to be a reproducible examination with kappa values around 0.70.
Am J Ind Med 1993 Dec
PMID:Musculoskeletal disorders of the neck and upper limb among sewing machine operators: a clinical investigation. 831 Oct 99


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