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Costa de Miranda, Renata, Eduardo S. Paiva, Silvia Maria Suter Correia Cadena, Anna Paula Brandt, and Regina Maria Vilela. "Polyphenol-Rich Foods Alleviate Pain and Ameliorate Quality of Life in Fibromyalgic Women." International Journal for Vitamin and Nutrition Research 87, no. 1-2 (March 2017): 66–74. http://dx.doi.org/10.1024/0300-9831/a000253.
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Abstract. Objectives: The present study aimed to describe the antioxidant dietary intake of patients with fibromyalgia and explore the association of the results with glutathione status, pain, quality of life, and socioeconomic status. Methods: 38 fibromyalgic female patients and 35 female controls (mean age = 48.6 ± 8.1 and 47.6 ± 10.0 years, respectively) were evaluated. The number of tender points, pain threshold, quality of life, physical activity, socioeconomic status, nutritional status, intake of antioxidant micronutrients and foods with high total antioxidant capacity, and total salivary glutathione were evaluated. Results: The number of tender points, pain threshold, and quality of life were worse in the fibromyalgia group. The consumption of vegetable juices was more common among women with fibromyalgia and consumption of red wine and beer were more common among healthy women. The adjusted mean intakes of antioxidant vitamins as well as selenium were higher for the control group (p ≤ 0.01). There was no difference for salivary levels of glutathione between the groups and no correlation for intake of antioxidant micronutrients and pain or quality of life among fibromyalgic women. However, intake of foods rich in polyphenols was associated with lower numbers of tender points (coffee, r = – 0.346; pear, r = – 0.331) and better quality of life (red fruits, r = – 0.342; dark chocolate, r = – 0.404) in the fibromyalgic group. In these women, associations between glutathione levels and food intake, pain or quality of life were not found. Conclusion: This study indicated that antioxidant protection from bioactive compounds present in fruit and vegetables could have an adjuvant role in fibromyalgia treatment.
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Arroita, A., A. Barreiro, K. Ugarte, N. Losada, P. Rico, R. Touzon, and M. D. M. Lopez. "Psychiatric Comorbidity in Fibromyalgia." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70842-9.
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Introduction:Fibromyalgia is an entity that affects approximately 2% of the population, mainly women.According to many studies, approximately half of women with fibromyalgia have a history of traumatic events during childhood or adulthood.Affective disorders before and after fibromyalgia diagnosis are particularly frequent.Materials and methods:Comprehensive review of the scientific literature (Medline, Psychoinfo, Medex) on psychiatric comorbidity in women diagnosed with fibromyalgia published over the last three years.Results:40-60% of women diagnosed with fibromyalgia report sexual abuse during childhood or adulthood; A higher percentage of women (over 70%) report other kinds of physical or emotional trauma.Fibromyalgia has been linked to mood disorders in 50-70% of patients. More precisely, it appears in combination with major depression in 20% of cases. To a lesser but still noteworthy extent, women with fibromyalgia are also diagnosed with dysthymia, anxiety disorders, phobias or panic disorders.Conclusion:Despite the common characteristics of these patients there is no such thing as a “fibromyalgic personality”.As for comorbidity, mood disorders are highly prevalent, more specifically depression, even though no direct relationship has been established between them. Fibromyalgia symptoms are more acute in patients with comorbid psychiatric disorders.
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Albers, Jessica. "Osteopathie mindert Schmerzen bei Fibromyalgie." osteopathisch Zeitschrift für Osteopathen 01, no. 02 (August 2017): 62–63. http://dx.doi.org/10.1055/s-0043-113306.
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ZusammenfassungRandomisierte kontrollierte Studie zur Effektivität zweier osteopathischer Behandlungsansätze für Schmerz, Druckschmerzgrenzen und Schwere der Erkrankung bei Patienten mit Fibromyalgie.[Albers J, Schmidt T, Wellmann K, Jäkel A. Effectiveness of two osteopathic treatment approaches on pain, pressure pain threshold and disease severity in patients with fibromyalgia – a randomized controlled trial. In: Complementary Medicine Research (zur Publikation angenommen)]
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Schweiger, Vittorio, Alvise Martini, Paola Bellamoli, Katia Donadello, Carlo Schievano, Giovanna D. Balzo, Piercarlo Sarzi-Puttini, Massimo Parolini, and Enrico Polati. "Ultramicronized Palmitoylethanolamide (um-PEA) as Add-on Treatment in Fibromyalgia Syndrome (FMS): Retrospective Observational Study on 407 Patients." CNS & Neurological Disorders - Drug Targets 18, no. 4 (July 17, 2019): 326–33. http://dx.doi.org/10.2174/1871527318666190227205359.
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Background: Fibromyalgia syndrome is a chronic multifaceted disease characterized by widespread pain, muscle stiffness, fatigue, unrefreshing sleep and cognitive disorders. To date, no medication has been shown to significantly improve pain, associated symptoms and Quality of Life in fibromyalgic patients. Methods: In this retrospective observational study, we analyzed data regarding 407 patients with diagnosis of fibromyalgia syndrome who between 2013 and 2016 have been prescribed orally ultramicronized palmitoylethanolamide tablets (Normast® Epitech Group SpA, Saccolongo, Italy) regardless of the concomitant pharmacological therapy (add-on treatment). Results: Regarding efficacy, in the 359 analyzed patients, the change over time in Visual Analogue Scale pain score was statistically significant, ranging from 75.84 (±15.15) to 52.49 (±16.73) (p<0.001). Regarding quality of life, the change over time in Fibromyalgia Impact Questionnaire score was statistically significant, ranging from 68.4 (±14.1) to 49.1 (±19.6) (p<0.001). In the treated population, only 36 patients (13,7%) reported Adverse Events predominantly of gastrointestinal type (diarrhea, dyspepsia, bloating, constipation, vomiting). Globally, 151 patients (57,63%) left the treatment due to inefficacy. Conclusion: The results of ultramicronized palmitoylethanolamide treatment in this retrospective analysis represent an important step for the development of a new and well-tolerated therapy for fibromyalgia syndrome, mostly suitable for these patients who need long-term treatments. Further methodologically stronger studies will be necessary to validate our observation.
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Dolcino, Marzia, Elisa Tinazzi, Antonio Puccetti, and Claudio Lunardi. "Gene Expression Profiling in Fibromyalgia Indicates an Autoimmune Origin of the Disease and Opens New Avenues for Targeted Therapy." Journal of Clinical Medicine 9, no. 6 (June 10, 2020): 1814. http://dx.doi.org/10.3390/jcm9061814.
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Fibromyalgia is a chronic disorder characterized by widespread pain and by several non-pain symptoms. Autoimmunity, small fiber neuropathy and neuroinflammation have been suggested to be involved in the pathogenesis of the disease. We have investigated the gene expression profile in peripheral blood mononuclear cells obtained from ten patients and ten healthy subjects. Of the 545,500 transcripts analyzed, 1673 resulted modulated in fibromyalgic patients. The majority of these genes are involved in biological processes and pathways linked to the clinical manifestations of the disease. Moreover, genes involved in immunological pathways connected to interleukin-17 and to Type I interferon signatures were also modulated, suggesting that autoimmunity plays a role in the disease. We then aimed at identifying differentially expressed Long non-coding RNAs (LncRNAs) functionally connected to modulated genes both directly and via microRNA targeting. Only two LncRNAs of the 298 found modulated in patients, were able to target the most highly connected genes in the fibromyalgia interactome, suggesting their involvement in crucial gene regulation. Our gene expression data were confirmed by real time PCR, by autoantibody testing, detection of soluble mediators and Th-17 polarization in a validation cohort of 50 patients. Our results indicate that genetic and epigenetic mechanisms as well as autoimmunity play a pivotal role in the pathogenesis of fibromyalgia.
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Buyukbese, MA, ON Pamuk, OA Yurekli, and N. Yesil. "Effect of fibromyalgia on bone mineral density in patients with fibromylagia and rheumatoid arthritis." Journal of Postgraduate Medicine 59, no. 2 (2013): 106. http://dx.doi.org/10.4103/0022-3859.113825.
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Abdellaoui, Selma, Bilal Bengana, Abdenour Boukabous, and Salima Lefkir-Tafiani. "Fibromyalgia, a finally recognized disease." Batna Journal of Medical Sciences (BJMS) 7, no. 1 (May 2, 2020): 6–9. http://dx.doi.org/10.48087/bjmsra.2020.7102.
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La fibromyalgie est un syndrome douloureux chronique associé à une diminution du seuil douloureux. L’absence d’éléments objectifs cliniques ou paracliniques explique les difficultés diagnostiques. Les critères de classification établis par le Collège américain de rhumatologie (ACR) de 2010 révisés en 2016 nécessitent la conjonction d’un score de syndrome douloureux de plus de trois mois et d’un score de sévérité. Ils comportent toutefois certaines limites, en particulier le nombre élevé de symptômes. L’évaluation de la fibromyalgie peut étudier de manière individuelle les divers symptômes, mais sa nature multidimensionnelle nécessite de préférer des méthodes d’évaluation globale, telles que le questionnaire d’impact de la fibromyalgie qui est un index composite explorant les différents symptômes de la FM. Cet article dresse l’état des connaissances présentes sur la fibromyalgie, sa place nosographique, son diagnostic positif, les recommandations diagnostiques pratiques et la prise en charge thérapeutique et sociale appropriée aux patients qui en souffrent.
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Ghib, L. J., A. Barcic, A. D. Bilous, I. Cozma, M. M. Tamas, I. Filipescu, I. Felea, et al. "THU0456 THE “JOINT CRITERIA” FOR FIBROMYALGIA DIAGNOSIS IN RHEUMATOID ARTHRITIS PATIENTS: RELIABILITY COMPARED TO THE 2010 ACR CLASSIFICATION CRITERIA FOR FIBROMYALGIA." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 465.1–465. http://dx.doi.org/10.1136/annrheumdis-2020-eular.3285.
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Background:A significant proportion of rheumatoid arthritis (RA) patients have concomitant fibromyalgia (FM) (1). Associated FM diagnosis in RA patients can determine worse treatment outcomes compared to patients without FM (1). A difference between tender joint count (TJC) and swollen joint count (SJC) ≥7, also named the ”joint criteria” was proposed as being diagnostic for FM in patients with RA. The ”joint criteria” were validated against the 1990 ACR Classification Criteria for FM and are easy to apply to patients with RA (2). Since then, the 2010 ACR Classification criteria for FM, which include somatic symptoms besides pain sensitivity, were developed and validated.Objectives:We aimed to determine the reliability of the joint criteria for fibromyalgia in RA compared to the ACR 2010 Classification Criteria for FM and to compare RA patients diagnosed with FM (FRA) to those without FM in terms of clinical variables.Methods:We performed a cross-sectional study on RA patients who presented in our department during a 3 months period. Tender joint count (TJC), swollen joint count (SJC), patient global assessment of disease activity (PGA) were determined. DAS28 scores were calculated using CRP. We applied the 2010 ACR Classification Criteria and the joint criteria for FM diagnosis. Kappa agreement coefficient was used to determine the reliability of the joint criteria against the 2010 ACR Classification Criteria for FM in patients with RA. Differences between groups were assessed using Mann-Whitney U test for numerical data or Chi square test for ordinal data.Results:We included 100 consecutive RA patients, 84% female, with a mean age of 57.3(12) years and mean disease duration of 14(9) years. Twenty-four patients (24%) had associated FM according to the ACR 2010 Classification Criteria and 22 (22%) patients satisfied the joint criteria for associated FM. The level of agreement between the joint criteria and the ACR 2010 classification criteria for FM was kappa=0.66, p< 0.001, with a sensitivity of 70% and a specificity of 93%. FRA patients had similar demographic and disease characteristics compared to RA patients. Patients with FRA according to the joint criteria had significantly higher PGA, DAS28, and HAQ scores, but similar CRP values and SJC compared to RA patients (Table 1).Table 1.Demographic and clinical data of FRA and RA patientsVariableFRAn=22RAn=78p-valueAge (years)60 (10.7)59 (12.2)0.093Disease Duration (years)13.3 (13)12.2 (7.5)0.589ACPA seropositivity(%)69550.1SJC2(4)2(4)0.7CRP (g/dl)12.8(14.2)8.1(13.7)0.06DAS28CRP4 (1.7)3.5 (1.2)0.009HAQ1.75 (0.5)1 (0.7)<0.001PGA (mm)70(11)44(23)<0.001Data are expressed as mean (SD) or median (IQR)FRA- Fibromyalgic Rheumatoid Arthritis; RA- Rheumatoid Arthritis;ACPA- Anti- citrullinated Protein Antibodies; CRP- C-reactive Protein; SJC- Swollen Joint Count;DAS28CRP- Disease Activity Score; HAQ- Health Assessment Questionnaire; PGA- Patient Global AssessmentConclusion:The joint criteria are diagnostic for FM in RA patients with moderate reliability compared to the ACR 2010 Classification criteria. When diagnosed with the joint criteria, FRA patients have higher disease activity scores despite having similar clinical and laboratory inflammatory markers compared to RA patients.References:[1]Wolfe F, Michaud K. Severe rheumatoid arthritis (RA), worse outcomes, comorbid illness, and sociodemographic disadvantage characterize RA patients with fibromyalgia. J Rheumatol. 2004;31(4):695–700.[2]Pollard LC, Kingsley GH, Choy EH, Scott DL. Fibromyalgic rheumatoid arthritis and disease assessment. Rheumatology 2010;49(5):924–8.Disclosure of Interests: :None declared
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Sumpton, Janice E., and Dwight E. Moulin. "Fibromyalgia: Presentation and Management with a Focus on Pharmacological Treatment." Pain Research and Management 13, no. 6 (2008): 477–83. http://dx.doi.org/10.1155/2008/959036.
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Fibromyalgia is a condition with widespread muscle pain. Prevalence studies showed that 2% to 7% of the population have fibromyalgia, which affects approximately one million Canadians. Fibromyalgia is most common in women, but it also involves men and children. As with most chronic illnesses, the causes of fibromyalgia are unknown. However, recent research supports underlying abnormalities in the central nervous system, which supports fibromyalgia as a chronic disease state and valid clinical entity. Pain is the primary symptom, often accompanied by overwhelming fatigue, sleep dysfunction and cognitive impairment. In 1990, the American College of Rheumatology developed diagnostic criteria for the diagnosis of fibromyalgia. Lifestyle changes, including pacing of activities and aerobic exercise, are very important in managing fibromyalgia symptoms. Emotional and behavioural therapy can also be helpful. Controlled trials of antidepressants, gabapentinoids, tramadol, zopiclone and sodium oxybate have shown effectiveness in fibromyalgia patients. Pregabalin and duloxetine were recently approved in the United States. Effective management of fibromyalgia is complex and requires a multidisciplinary treatment approach. Response and tolerance of different therapeutic interventions vary from patient to patient. Recent advances in the pathophysiology of fibromyalgia offer hope for new and improved therapies in the management of this disabling condition.
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Monserratsanz, J., A. Movasat, M. D. Sosa Reina, A. M. Gomez Lahoz, C. Bohórquez, A. Pérez Gómez, L. Ruiz, et al. "AB0035 TWO DIFFERENT ABNORMAL BEHAVIORS IN CD4+T LYMPHOCYTES IN FIBROMYALGIA PATIENTS AND FIBROMYALGIA ASSOCIATED TO SJÖGREN’S SYNDROME." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1320–21. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5524.
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Background:Primary fibromyalgia syndrome is a prevalent rheumatic condition characterized by widespread pain and whose etiopathogenesis is not well understood. Fibromyalgia can also be secondary to other rheumatic diseases like Sjogren’s syndrome; however, its relation to this disease is unknown. It has been suggested that the immune system is involved in their pathogenesis. The role of activation stages and cytokines profiles of CD4+T lymphocytes in fibromyalgia or fibromyalgia secondary to Sjogren´s syndrome are completely unclear and could play a key role in the pathophysiology of these diseases.Objectives:The objective of this study is to investigate the counts and distribution of the CD4+T lymphocyte activation subsets and their pattern of cytokine production in women with primary fibromyalgia, fibromyalgia secondary to Sjogren´s, Sjogren´s syndrome and healthy controls (HC). The counts and distribution of naïve (TN), central memory (TCM), effector memory (TEM) and effector (TE) CD4+T lymphocyte subsets were analyzed in these diseases. Furthermore, we investigated their pattern of IL-4, IL-10, IL-17A, IFNγ, and TNFα production.Methods:Counts and distribution of CD4+T subsets (TN, TCM, TEM, TE)and their cytokine producing capacity were measured using multiparametric flow cytometry in peripheral blood mononuclear cells (PBMC) from 20 primary fibromyalgia, 15 fibromyalgia associated to Sjögren and 15 primary Sjögren patients and 15 female controls. Fibromyalgia and/or Sjögren’s syndrome were diagnosed based on ACR criteria. CD4+T cell activation stages were analyzed by the expression of the CD3, CD4, CD45RA, CD27 and CCR7 antigens. Cytokine CD4+T producing cells subsets were assayed stimulating PBMC during 6 hours, fixed, permeabilized and simultaneously stained with IL-4, IL-10, IL-17A, IFNγ, and TNFα intracellular cytokines.Results:Fibromyalgia patients showed a significant increase in the CD4+T, TNand TCMcells counts with compared to fibromyalgia secondary to Sjogren, Sjogren´s syndrome and HC. The counts of IL-17A, IL-4 and IFNγ producing CD4+T cells were increased in fibromyalgia patients with respect to HC. However, only IL17A and IFNγ, but not IL-4 producing CD4+T lymphocytes were increased with respect fibromyalgia secondary to Sjogren. These alterations were due to an increment of TEMIL-17A, TCMand TEMIL-4 and TNTCMand TEMIFNγ producing CD4+T cell subsets in fibromyalgia patients. Furthermore, IFNγ producing CD4+T cells were decreased in fibromyalgia secondary to Sjogren´s with respect to fibromyalgia patients and HC. Counts of TNTNFα producing CD4+ T cells were increased in fibromyalgia with respect fibromyalgia secondary to Sjogren. IL-10 producing CD4+T cells were normal in fibromyalgia but decreased in fibromyalgia secondary to Sjogren.Conclusion:Fibromyalgia patients show an abnormal circulating activation stages of CD4+T cells, as well as, express unusual elevated counts of CD4+T cells producing IL-17A, IL-4 and IFNγ. These alterations could differentiate two different pathologic and inflammatory behaviors of the T cell compartment between fibromyalgia and fibromyalgia secondary to Sjogren patients.References:[1]T helper 1 response is correlated with widespread pain, fatigue, sleeping disorders and the quality of life in patients with fibromyalgia.. Guggino G et al, Clin Exp Rheumatol. 2019.[2]A Comparative Study of Fibromyalgia, Rheumatoid Arthritis, Spondyloarthritis, and Sjögren’s Syndrome. Bucourt E et al, Pain Med. 2019Disclosure of Interests:None declared
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de la Coba, Pablo, Stephen Bruehl, and Gustavo A. Reyes del Paso. "Addition of Slowly Repeated Evoked Pain Responses to Clinical Symptoms Enhances Fibromyalgia Diagnostic Accuracy." Pain Medicine 21, no. 12 (December 18, 2019): 3479–87. http://dx.doi.org/10.1093/pm/pnz346.
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Abstract Objective Fibromyalgia is a chronic pain syndrome characterized by central sensitization. A novel protocol based on slowly repeated evoked pain (SREP) appears to be a useful marker of pain sensitization in fibromyalgia patients. Whether SREP enhances diagnostic accuracy beyond key clinical symptoms that characterize fibromyalgia has not been examined. Methods Fifty fibromyalgia patients, 30 rheumatoid arthritis patients, and 50 healthy individuals were evaluated to assess clinical pain, as well as fatigue, insomnia, pain catastrophizing, and negative mood. The SREP protocol consisted of a series of nine low-intensity painful pressure stimuli of five seconds’ duration with 30-second interstimulus intervals. SREP sensitization was indexed by increases in pain intensity ratings across stimuli. Results SREP sensitization was observed in fibromyalgia but not in rheumatoid arthritis or healthy individuals. As expected, fibromyalgia patients exhibited a more negative psychosocial profile than did rheumatoid arthritis patients and healthy individuals. SREP was positively associated with clinical pain, fatigue, insomnia, and catastrophizing, but not with negative mood. SREP discriminated fibromyalgia cases from rheumatoid arthritis and healthy individuals even when current clinical pain was included in the analysis. Combining fatigue, insomnia, and SREP led to near perfect diagnostic accuracy (99%) in differentiating fibromyalgia from healthy individuals and 86.3% accuracy in discriminating fibromyalgia from rheumatoid arthritis. Conclusions These results provide further evidence of SREP as a marker of pain sensitization in fibromyalgia and suggest that it captures aspects of fibromyalgia not fully captured by clinical features. Combining SREP with assessment of clinical features could potentially improve fibromyalgia diagnosis.
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Boissevan, Michael D. "Psychological Research in Fibromyalgia: The Search for Explanatory Phenomena." Pain Research and Management 1, no. 1 (1996): 51–57. http://dx.doi.org/10.1155/1996/759023.
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This article reviews four areas of psychological research in fibromyalgia. First, the literature on depression in fibromyalgia shows that although the preponderance of studies demonstrate that fibromyalgia patients are more depressed than comparable medical patients, rigorous disconfirming evidence exists. Thus the role of depression in fibromyalgia remains unclear because consistent levels of depression are not found either between samples or between subjects. Second, the role of pain perception in fibromyalgia shows that fibromyalgia patients are consistently more responsive to aversive stimulation than other subjects with chronic pain. This pattern of hyper-responsiveness appears to be generalized, rather than localized to tender points. These results are discussed in terms of potential central nervous system mechanisms. Third, original research in clinical cognitive psychology is presented that shows that fibromyalgia patients do not appear to demonstrate cognitive biases which are distinct from myofascial pain. Although extremely preliminary, these results argue against a unique psychological explanation for fibromyalgia symptoms. Fourth, neuropsychological research demonstrates a pattern of generalized inhibition of information processing that emulates that observed in depressive illness, except that fibromyalgia patients tend not to show the compromise in right hemisphere processing seen in depression. This suggests that cognitive abnormalities in fibromyalgia may be distinct from those seen in depression. The psychological research reviewed suggests that central nervous system anomalies may be implicated in the syndrome of fibromyalgia, but the evidence for motivated or affective psychological involvement in the syndrome remains equivocal. Suggestions are provided for future research.
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Krupa, Anna Julia, Krzysztof Wojtasik Bakalarz, Jarosław Woroń, Marcin Siwek, and Jerzy Wordliczek. "Pharmacotherapy of fibromyalgia – current knowledge." BÓL 22, no. 1 (May 27, 2021): 36–45. http://dx.doi.org/10.5604/01.3001.0014.9019.
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Fibromyalgia is a chronic pain syndrome, which affects 2–4% of the general population. Despite its substantial prevalence in the community, the underlying pathophysiology of fibromyalgia remains largely unknown, and the diagnosis is made using symptom-based criteria. As a result, patients may be classified as suffering from fibromyalgia in spite of differing in the pathogenesis of their complaints. Therefore it is no surprise, that the efficacy of pharmacotherapy of fibromyalgia remains limited. This work aims to provide a summary of current knowledge based on trials which assessed the efficacy of fibromyalgia pharmacotherapy. The drugs with the highest amount of research proving their efficacy in reducing fibromyalgia symptoms are duloxetine, milnacipran, pregabalin and amitriptyline. Studies documenting the efficacy of venlafaxine, gabapentin and antidepressants other than serotonin and noradrenalin reuptake inhibitors are smaller in number. Data obtained in trials verifying the effects of selective serotonin reuptake inhibitors, tramadol or cannabinoids are too sparse to draw any clear conclusions. There are reports indicating that opioids (other than tramadol) are contradicted in fibromyalgia, the use of selective serotonin reuptake inhibitors seems disputable too, due to the risk of inducing a change in the pain phenotype. There is a lack of data suggesting the efficacy of nonsteroid anti-inflammatory drugs in fibromyalgia. Furthermore, there are individual studies showing beneficial effects of other drugs and dietary supplements or combinations thereof in patients with fibromyalgia. In summary, the obtained data show that the amount of medicines whose efficacy in fibromyalgia has been verified in numerous studies is limited. More studies exploring the pathophysiology of fibromyalgia and trials verifying the effects of pharmacotherapy are needed to achieve the optimal efficacy of fibromyalgia pharmacotherapy.
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MAES, M., I. LIBBRECHT, F. VAN HUNSEL, A. H. LIN, S. BONACCORSO, F. GOOSSENS, I. De MEESTER, et al. "Lower serum activity of prolyl endopeptidase in fibromyalgia is related to severity of depressive symptoms and pressure hyperalgesia." Psychological Medicine 28, no. 4 (July 1998): 957–65. http://dx.doi.org/10.1017/s0033291798006801.
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Background. The aims of the present study were to examine serum activities of peptidases, i.e. prolyl endopeptidase (PEP) and dipeptidyl peptidase IV (DPP IV), in patients with fibromyalgia and to examine the effects of subchronic treatment with sertraline on these variables.Method. Serum PEP and DPP IV activity were measured in 28 normal volunteers and 21 fibromyalgia patients, classified according to the American College of Rheumatology criteria. Tenderness at tender points was evaluated by means of dolorimetry. Fibromyalgia patients had repeated measurements of serum PEP and DPP IV both before and after repeated administration of sertraline or placebo for 12 weeks.Results. Patients with fibromyalgia had significantly lower serum PEP activity than normal volunteers. There were significantly negative correlations between serum PEP activity and severity of pressure hyperalgesia and the non-somatic, cognitive symptoms of the Hamilton Depression Rating Scale. Fibromyalgia patients with severe pressure hyperalgesia had significantly lower PEP activity than normal controls and fibromyalgia patients with less severe hyperalgesia. Fibromyalgia patients with severe non-somatic depressive symptoms had significantly lower serum PEP activity than normal volunteers. There were no significant changes in serum DPP IV activity in fibromyalgia. There were no significant effects of repeated administration of sertraline on serum PEP and DPP IV activity in patients with fibromyalgia.Conclusions. The results show that fibromyalgia, and aberrant pain perception and depressive symptoms in fibromyalgia are related to lower serum PEP activity. It is hypothesized that lower serum PEP activity may play a role in the biophysiology of fibromyalgia through diminished inactivation of algesic and depression-related peptides.
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Rigamonti, Antonello E., Graziano Grugni, Marco Arreghini, Paolo Capodaglio, Alessandra De Col, Fiorenza Agosti, and Alessandro Sartorio. "GH Responsiveness to Combined GH-Releasing Hormone and Arginine Administration in Obese Patients with Fibromyalgia Syndrome." International Journal of Endocrinology 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/3106041.
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Reportedly, fibromyalgia (FM) is frequently associated with reduced IGF-1 levels and GH hyporesponsiveness to different GH stimulation tests. Since there is a high prevalence of obesity in FM, and obesity itself is characterized by hyposomatotropism, the aim of this study was to assess IGF-1 levels and GH responsiveness in sixteen severely obese women suffering from FM, who, subdivided into two subgroups on the basis of their age-dependent IGF-1 values (> or <−2 SDS), underwent the combined GHRH plus arginine test. Four out of 16 obese women with FM (25%) had low IGF-1 SDS values, 2 cases of this subgroup (12.5%) failing also to normally respond to the test. Among patients with normal GH responses, 4 showed a delayed GH peak. The subgroup with low IGF-1 SDS values had higher BMI than that with normal IGF-1 SDS. GH peak and area under the curve were not correlated with CRP, ESR, or tender point score, while significant correlations were found with fat-free mass and fat mass. In conclusion, this study shows the existence of a high prevalence of GH-IGF-1 dysfunction in patients with both FM and obesity, presumably as a consequence of the obese rather than fibromyalgic condition.
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Freitas, Rodrigo Pegado de Abreu, Maria Helena Constantino Spyrides, José Guilherme da Silva Santa Rosa, Ranulfo Fiel Pereira Pessoa de Carvalho, and Maria Bernardete Cordeiro de Sousa. "Mapping the body distribution of pain perception in fibromyalgia." Revista Neurociências 22, no. 2 (June 30, 2014): 227–33. http://dx.doi.org/10.34024/rnc.2014.v22.8094.
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Background. Fibromyalgia is a syndrome characterized for persistent and debilitating disorder marked by chronic widespread pain. Objective. We aim to create a virtual body representation of peripheral pain to pressure in fibromyalgia patients. Method. Fifty adult subjects, aged 32-71 years, who fulfill the American College of Rheumatology (ACR) criteria for fibromyalgia and forty-two healthy volunteers, were recruited. Pain sensitivity was performed on the 18 points identified by ACR. Algometry was carried out to record threshold and tolerance to pain quantified in kg/cm2. Functionality was evaluated by Fibromyalgia Impact Questionnaire (FIQ). Differences in percent were used to enlarge the correspondent body part in fibromyalgia group using a 3D MAX® Software. Results. Significant difference between FIQ (p<0.0001), pain threshold (fibromyalgia 1.8±0.4; control 4.7±1.2) and tolerance (fibromyalgia 2.52±0.5; control 5.91±1.5) was found between the groups (p<0.0001). The body pain representation in fibromyalgia group is different than control, showing that pain perception increases is mainly in cervical, thoracic, arms, gluteus and over the knees. Conclusion. It is possible to create a virtual body pain image of fibromyalgia using algometry. This may contribute to build a specific body representation of this syndrome and to contribute to better information for clinical management and diagnosis.
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Martinez-Lavin, Manuel. "Fibromyalgia: When Distress Becomes (Un)sympathetic Pain." Pain Research and Treatment 2012 (September 19, 2012): 1–6. http://dx.doi.org/10.1155/2012/981565.
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Fibromyalgia is a painful stress-related disorder. A key issue in fibromyalgia research is to investigate how distress could be converted into pain. The sympathetic nervous system is the main element of the stress response system. In animal models, physical trauma, infection, or distressing noise can induce abnormal connections between the sympathetic nervous system and the nociceptive system. Dorsal root ganglia sodium channels facilitate this type of sympathetic pain. Similar mechanisms may operate in fibromyalgia. Signs of sympathetic hyperactivity have been described in this condition. Genetic factors and/or distressful lifestyle may lead to this state of sympathetic hyperactivity. Trauma and infection are recognized fibromyalgia triggers. Women who suffer from fibromyalgia have catecholamine-evoked pain. Sympathetic dysfunction may also explain nonpain-related fibromyalgia symptoms. In conclusion, in fibromyalgia, distress could be converted into pain through forced hyperactivity of the sympathetic component of the stress response system.
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Wan, Betsy, Sarah Gebauer, Joanne Salas, Christine K. Jacobs, Matthew Breeden, and Jeffrey F. Scherrer. "Gender-Stratified Prevalence of Psychiatric and Pain Diagnoses in a Primary Care Patient Sample with Fibromyalgia." Pain Medicine 20, no. 11 (April 22, 2019): 2129–33. http://dx.doi.org/10.1093/pm/pnz084.
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Abstract Objective Comorbid psychiatric and pain-related conditions are common in patients with fibromyalgia. Most studies in this area have used data from patients in specialty care and may not represent the characteristics of fibromyalgia in primary care patients. We sought to fill gaps in the literature by determining if the association between psychiatric diagnoses, conditions associated with chronic pain, and fibromyalgia differed by gender in a primary care patient population. Design Retrospective cohort. Setting and Subjects Medical record data obtained from 38,976 patients, ≥18 years of age with a primary care encounter between July 1, 2008, to June 30, 2016. Methods International Classification of Diseases–9 codes were used to define fibromyalgia, psychiatric diagnoses, and conditions associated with chronic pain. Unadjusted associations between patient demographics, comorbid conditions, and fibromyalgia were computed using binary logistic regression for the entire cohort and separately by gender. Results Overall, 4.6% of the sample had a fibromyalgia diagnosis, of whom 76.1% were women. Comorbid conditions were more prevalent among patients with vs without fibromyalgia. Depression and arthritis were more strongly related to fibromyalgia among women (odds ratio [OR] = 2.80, 95% confidence interval [CI] = 2.50–3.13; and OR = 5.19, 95% CI = 4.62–5.84) compared with men (OR = 2.16, 95% CI = 1.71–2.71; and (OR = 3.91, 95% CI = 3.22–4.75). The relationship of fibromyalgia and other diagnoses did not significantly differ by gender. Conclusions Except for depression and arthritis, the burden of comorbid conditions in patients with fibromyalgia is similar in women and men treated in primary care. Fibromyalgia comorbidities in primary care are similar to those found in specialty care.
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Marín Mejía, Fabiana, Evelyn Colina Gallo, and Iván Leonardo Duque Vera. "Danza terapéutica y ejercicio físico. Efecto sobre la fibromialgia." Hacia la promoción de la salud 24, no. 1 (January 1, 2019): 17–27. http://dx.doi.org/10.17151/hpsal.2019.24.1.3.
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Boulis, Michael, Mary Boulis, and Daniel Clauw. "Magnesium and Fibromyalgia: A Literature Review." Journal of Primary Care & Community Health 12 (January 2021): 215013272110384. http://dx.doi.org/10.1177/21501327211038433.
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Fibromyalgia, a widespread chronic pain disorder, imposes a multitude of hardships on patients and their communities. Supplements, specifically magnesium supplements, have been widely used by fibromyalgia patients in an attempt to control their symptoms. The aim of this work is to investigate if the widespread use of magnesium in fibromyalgia is supported by evidence in the literature. This review provides a layout of the studies examining the correlation between body magnesium levels and fibromyalgia. Furthermore, it elaborates on the trials testing the effectiveness of magnesium in treating different clinical parameters of fibromyalgia.
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Liu, Wen, Laura Zahner, and Yunxia Wang. "Qigong Exercise in Patients With Fibromyalgia." Journal of Evidence-Based Complementary & Alternative Medicine 18, no. 1 (November 8, 2012): 80–85. http://dx.doi.org/10.1177/2156587212464652.
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Fibromyalgia syndrome presents with widespread chronic pain and other symptoms. Approaches in alternative medicine offer promising results in managing fibromyalgia symptoms. Qigong exercise is a mind–body therapy originating in Chinese medicine that can benefit patients with fibromyalgia. We report 2 case studies of patients with fibromyalgia who completed a 6-week Qigong exercise program. In both cases, patients’ fibromyalgia symptoms improved after the Qigong exercise program. The patient in case 1 also experienced a drastic decline in the serial measurement of CA-125 (a biomarker for ovarian cancer) after the 6-week Qigong exercise. In case 2, the patient’s uncontrolled crying also significantly improved. These observations indicate that Qigong exercise can bring about wide-ranging benefits to patients with fibromyalgia.
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Kumbhare, Dinesh, Sara Ahmed, and Scott Watter. "A narrative review on the difficulties associated with fibromyalgia diagnosis." Therapeutic Advances in Musculoskeletal Disease 10, no. 1 (December 7, 2017): 13–26. http://dx.doi.org/10.1177/1759720x17740076.
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Fibromyalgia presents a clinical enigma as its pathophysiology is not well understood and its symptoms are nonspecific and overlap with many disorders, making its diagnosis a challenge for clinicians and researchers. Efforts have been made to develop a set of diagnostic criteria for this disorder. However, these criteria rely heavily on expert clinician opinion and produce a large heterogeneity within the diagnosed population. With no present specific technique reflecting the underlying pathophysiology of fibromyalgia, a definitive diagnosis of fibromyalgia remains elusive. This review discusses some problems and challenges associated with fibromyalgia diagnosis and presents some novel findings on the pathophysiological nature of fibromyalgia.
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GARCIA, JUAN J., and EDUARDO ORTEGA. "Soluble fractalkine in the plasma of fibromyalgia patients." Anais da Academia Brasileira de Ciências 86, no. 4 (December 2014): 1915–17. http://dx.doi.org/10.1590/0001-3765201420130081.
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Fibromyalgia is a form of non-articular rheumatism in which inflammatory cytokines seem to be involved. However, there is still no analytical specific diagnostic criterion for this disease. The aim was to examine a possible role of fractalkine as a biomarker in fibromyalgia. Plasma levels of soluble fractalkine were compared between women diagnosed with fibromyalgia (n=17) and healthy women (n=10) as controls. Fractalkine released by monocytes was also evaluated. Fibromyalgia patients showed lower plasma fractalkine than healthy women. Since most inflammatory pathologies show elevated plasma levels of soluble fractalkine, the results may contribute towards a differential diagnosis for fibromyalgia.
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Gracely, Richard H., Marta Ceko, and M. Catherine Bushnell. "Fibromyalgia and Depression." Pain Research and Treatment 2012 (November 19, 2012): 1–9. http://dx.doi.org/10.1155/2012/486590.
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Fibromyalgia and depression might represent two manifestations of affective spectrum disorder. They share similar pathophysiology and are largely targeted by the same drugs with dual action on serotoninergic and noradrenergic systems. Here, we review evidence for genetic and environmental factors that predispose, precipitate, and perpetuate fibromyalgia and depression and include laboratory findings on the role of depression in fibromyalgia. Further, we comment on several aspects of fibromyalgia which support the development of reactive depression, substantially more so than in other chronic pain syndromes. However, while sharing many features with depression, fibromyalgia is associated with somatic comorbidities and absolutely defined by fluctuating spontaneous widespread pain. Fibromyalgia may, therefore, be more appropriately grouped together with other functional pain disorders, while psychologically distressed subgroups grouped additionally or solely with affective spectrum disorders.
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Hesselink, J. M. Keppel. "Topical phenytoin in a case of severe fibromyalgia: ex juvantibus proof for fibromyalgia as a localized non-length dependent small fiber neuropathy." Archives of Medical Case Reports and Case Study 2, no. 1 (November 22, 2019): 01–02. http://dx.doi.org/10.31579/2692-9392/002.
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We present a case of a 52-year old woman suffering from severe fibromyalgia, unable to manage even the lightest of housework, she gradually became crippled and her life became a ‘couch potato’ in patient’s own words. Treatment with topical phenytoin (5% titrated up to 15%) transformed her life, pain nearly vanished, and she became active, looking for a job, doing housework and she can walk rapidly. One explanation of this phenomenon could be that a number of patients suffering from fibromyalgia and having tender points suffer from localized length non-dependent small fiber neuropathy, and this pathology can be found in the skin above the tender points.
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Gaudreault, Nathaly, and Pierre Boulay. "Cardiorespiratory fitness among adults with fibromyalgia." Breathe 14, no. 2 (June 2018): e25-e33. http://dx.doi.org/10.1183/20734735.019717.
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This review presents and addresses the conflicting results on cardiorespiratory fitness among adults with fibromyalgia. The heterogeneity in study designs, symptom severity and the assessment protocols might partly explain these conflicting results. It also presents the possible relationship between cardiorespiratory fitness and exercise prescription, attrition from exercise/rehabilitation programmes and independence with activities of daily living.Cardiorespiratory fitness might impact aerobic exercise and independence in daily activities of patients with fibromyalgia, which is often concomitantly diagnosed in patients with sleep disordered breathing, including patients with obstructive sleep apnoea. Therefore, cardiorespiratory fitness evaluation should be considered by general and respiratory physicians as well as physiotherapists who treat patients diagnosed with fibromyalgia for more accurate diagnosis, exercise prescription and monitoring of patients’ status.Key pointsAdults with fibromyalgia often present with reduced cardiorespiratory fitness.Reduced cardiorespiratory fitness might have an important impact on functional capacity and quality of life.Adults with fibromyalgia who have a secondary condition affecting their ventilatory anaerobic threshold and/or V′O2peak, for example chronic obstructive pulmonary disease, might present with a greater reduction of their cardiorespiratory fitness which may not be entirely related to their lung disease.Educational aimsTo better understand the cardiorespiratory fitness results among adults with fibromyalgia in general, and when taking into account differences in assessment protocol (maximal versus submaximal testing protocol; cycle ergometer versus treadmill testing protocol) and symptom severity (fibromyalgia severity level).To better understand how cardiorespiratory fitness among adults with fibromyalgia could: 1) assist in exercise prescription; 2) minimise dropout rates from exercise/rehabilitation programmes; and 3) promote independence with activities of daily living.To learn why fibromyalgia might be important to consider in adults who have concurrent fibromyalgia and lung disease.
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Pinto, A. M., C. Costa, A. T. Pereira, M. Marques, J. A. Pereira da Silva, and A. Macedo. "Unraveling pathways to depression in fibromyalgia, the role of perseverative negative thinking and negative affect." European Psychiatry 33, S1 (March 2016): S207. http://dx.doi.org/10.1016/j.eurpsy.2016.01.496.
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IntroductionSeveral studies have demonstrated a strong link between fibromyalgia, negative affect (NA) and depression. However, it remains unclear why some fibromyalgia patients get depressed while others do not and, primarily, which mechanisms account for this difference. We hypothesize that, besides clinical features, the engagement in dysfunctional strategies like perseverative negative thinking (PNT) followed by an amplification of NA levels may increase the risk of fibromyalgia patients experiencing depressive symptoms.Objective/AimsTo explore the serial mediator effect of PNT and NA on the relationship between fibromyalgia symptoms and depressive symptoms.MethodsHundred and three women with fibromyalgia (mean age 47.32 ± 10.63) completed the Portuguese version of the Revised-Fibromyalgia Impact Questionnaire, Perseverative Thinking Questionnaire, Profile of Mood States and Beck Depression Inventory-II. The association between the variables was investigated via Pearson correlations and serial multiple mediation.ResultsThe estimated model was significant [F (3.86) = 57.318, P < .001] explaining 66.66% of depressive symptoms variance. The total effect of fibromyalgia symptoms on depressive symptoms was of .4998 (SE = 0.0795, P < 0.001; CI > 0.3417 and < 0.6578), with a significant direct effect of 0.1911 (SE = 0.0653; CI > 0.0614 and < 0.3209). The total indirect effects were of 0.3086 (SE = 0.0619; CI > 0.2033 < 0.4458). Three significant specific indirect effects were found.ConclusionThe effect of fibromyalgia symptoms on depressive symptoms is partially operated through cognitive interference/unproductiveness, which in turn influences NA levels. Such findings highlight the crucial role of these constructs in the relationship between fibromyalgia symptoms and depressive symptoms and the urge to address them when treating individuals reporting greater fibromyalgia symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Kilic, O., O. Taycan, C. Aksoy Poyraz, T. C. Erol, O. Tecer, H. M. Emul, V. Sar, and M. Ozmen. "Childhood trauma, dissociation in patients with fibromyalgia and rheumatoid arthritis." European Psychiatry 26, S2 (March 2011): 382. http://dx.doi.org/10.1016/s0924-9338(11)72090-9.
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IntroductionThe contribution of childhood trauma and dissociation to the unknown pathophysiology of fibromyalgia has been the subject of considerable debate.ObjectivesTo assess and compare the relationship of childhood trauma and somatoform dissociation between patients with fibromyalgia and rheumatoid arthritis both of which are characterized by chronic pain and disability.AimsEarly life and prolonged trauma may affect brain modulatory circuitry of pain and emotions. The findings of relationship between traumatic events, dissociation and fibromyalgia can lead to a better understanding of the etiology and suggest new treatment modalities.MethodsThirty-one patients with fibromyalgia and 19 patients with rheumatoid arthritis were enrolled in the study. All participants were asked to fill in the Childhood Trauma Questionnaire, Somatoform Dissociation Questionnaire and Dissociation Questionnaire.ResultsPhysical neglect score was higher in fibromyalgia group than rheumatoid arthritis group (p < 0.05) although there was no significant difference between two groups in other subscores of childhood trauma and the rest of the dissociation scores. Total trauma scores were positively correlated with dissociation scores in fibromyalgia group whereas this correlation was not seen in rheumatoid group.ConclusionsAmong childhood trauma types, physical neglect seems to have a more important role in fibromyalgia than rheumatoid arthritis. Fibromyalgia may be related to early life stress or prolonged trauma, affecting brain modulatory circuitry of pain and emotions in genetically susceptible individuals.
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Tu, Cheng-Hao, Cheng-Li Lin, Su-Tso Yang, Wei-Chih Shen, and Yi-Hung Chen. "Hormonal Contraceptive Treatment May Reduce the Risk of Fibromyalgia in Women with Dysmenorrhea: A Cohort Study." Journal of Personalized Medicine 10, no. 4 (December 14, 2020): 280. http://dx.doi.org/10.3390/jpm10040280.
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Dysmenorrhea is the most common gynecological disorder for women in the reproductive age. Study has indicated that dysmenorrhea might be a general risk factor of chronic pelvic pain and even chronic non-pelvic pain, such as fibromyalgia. We used the Longitudinal Health Insurance Database 2000 from the Taiwan National Health Research Institutes Database to investigate whether women with dysmenorrhea have a higher risk of fibromyalgia and whether treatment of dysmenorrhea reduced the risk of fibromyalgia. The dysmenorrhea cohort was matched with a non-dysmenorrhea cohort at a 1:1 ratio based on gender, age, and the year of entry study by frequency matching. Multivariable Cox proportional hazard regression models were used to assess the risk of fibromyalgia, with controlling for potential confounding variables such as age, comorbidities, and medication use. After controlling confounding variables, results revealed that women with dysmenorrhea have a significantly higher risk of fibromyalgia than women without dysmenorrhea. However, only treatment of dysmenorrhea with hormonal contraceptives reduce the risk of fibromyalgia. These results indicated that dysmenorrhea may be a risk factor of fibromyalgia, whereas personalized medicine for treatment of dysmenorrhea may be the key to reduce the risk of fibromyalgia. Future studies are needed to identify the causes and prevention strategies in detail.
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Hennard, Janet. "A Protocol and Pilot Study for Managing Fibromyalgia with Yoga and Meditation." International Journal of Yoga Therapy 21, no. 1 (September 1, 2011): 109–21. http://dx.doi.org/10.17761/ijyt.21.1.ah8r9t4x57p6247p.
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Fibromyalgia is a chronic syndrome characterized by widespread pain, sleep disturbance, stiffness, fatigue,headache, and mood disorders. Recent research has resulted in an improved understanding of fibromyalgia and its possible causes. This article highlights some of the current research, discusses a strategy for using yoga and meditation as a therapy for fibromyalgia sufferers, and presents the results of a preliminary 8-week study using yoga and meditation to help manage fibromyalgia symptoms. The study of 11 participants found significant improvement in the overall health status of the participants and in symptoms of stiffness, anxiety, and depression. Significant improvements were also seen in the reported number of days "felt good" and number of days "missed work" because of fibromyalgia. Nonsignificant improvements were seen in measures of pain, fatigue, and how one felt in the morning. Effect sizes were medium to large for most tested areas. This study supports the benefits of yoga and meditation for individuals with fibromyalgia and encourages further research to explore their use as standard therapies for fibromyalgia.
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Ghib, Linda-Jessica, Laura Muntean, Maria-Magdalena Tamas, and Simona Rednic. "CONCOMITANT FIBROMYALGIA IN RHEUMATOID ARTHRITIS: CHALLENGES IN DIAGNOSIS AND DISEASE ASSESSMENT." Romanian Journal of Rheumatology 25, no. 3 (September 30, 2016): 147–54. http://dx.doi.org/10.37897/rjr.2016.3.8.
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Fibromyalgia, characterized by chronic generalized pain and multiple somatic symptoms, is frequently associated with rheumatoid arthritis. This association causes worse disease outcomes and poses challenges in rheumatoid arthritis disease assessment. Recent studies found that fibromyalgia is a disease continuum. Varying degrees of symptoms can be present in patients with rheumatoid arthritis even if they do not satisfy diagnosis criteria for fibromyalgia. Classification criteria for fibromyalgia are recommended for use in research, but in clinical practice diagnosis should be based on physician judgment. Rheumatoid arthritis disease activity scores should be used with caution in patients with concomitant fibromyalgia because they are disproportionately high based on subjective variables, not inflammation. Other means of assessing disease activity such as ultrasonography or inflammation markers can be employed when trying to distinguish between inflammatory and non-inflammatory pain in patients with rheumatoid arthritis and concomitant fibromyalgia.
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Corsalini, Massimo, Di Venere Daniela, Rapone Biagio, Stefanachi Gianluca, Laforgia Alessandra, and Pettini Francesco. "Evidence of Signs and Symptoms of Craniomandibular Disorders in Fibromyalgia Patients." Open Dentistry Journal 11, no. 1 (February 14, 2017): 91–98. http://dx.doi.org/10.2174/1874210601711010091.
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Objective: The purpose of this study is to highlight the evidence of signs and symptoms of craniomandibular disorders (CMD) in patients suffering from fibromyalgia. Materials and Method: The study has been carried out from May 2011 to May 2015, recruiting a sample of fibromyalgia patients at the Department of Neurophysiopathology at the hospital Policlinico in Bari. Among the 150 examined patients, 60 of them have been diagnosed to suffer from fibromyalgia and 27 accepted to be investigated with a gnathologic examination at the Dental School at the University of Bari. Results: 24 patients (88.9%) were women and 3 (11.1%) men; from 26 to 66 years old (average age, 39). 14 patients (51.9%) were affected by primary fibromyalgia, the remaining 13 (48.1%) by secondary fibromyalgia, mainly associated with hypothyroidism (29.6%). VAS average score was about 8 ± 1.85. The frequency of pain was daily in 15 patients (55.6%); twice a week in 10 patients (37.03%) and a few times a month in 2 patients (7.4%). 11 patients (40.7%) attributed the onset of fibromyalgia to a specific instigating event. In addition, from the gnathologic anamnesis, 11 patients (40,7%) reported a painful symptom in the head-neck region, especially in the frontal region, in the neck, in the masseter muscle and ATM. VAS average score was 3.4 ± 2.8, significantly lower than the one referring to the fibromyalgia pain. The gnathological examination found CMD signs and symptoms in 18 patients (66.7%). Concerning the prevalence of CMD, in type I fibromyalgia, myofascial pain was more frequent (5 patients), whereas in type II fibromyalgia, what was more frequent was a dislocation with reduction (3 patients). Conclusion: Based on clinic experience, we can affirm that some patients with CMD report pain in other regions. It is difficult to distinguish the CMD forms directly correlated to fibromyalgia from those engendered by parafunctional activities; hence the need is to resolve the fibromyalgia syndrome adopting a multidisciplinary approach.
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Hasselroth, Rebecka, Gunilla Björling, Carina Faag, and Catarina Nahlén Bose. "“Can Someone as Young as You Really Feel That Much Pain?” – A Survey on How People With Fibromyalgia Experience Healthcare in Sweden." SAGE Open Nursing 7 (January 2021): 237796082110261. http://dx.doi.org/10.1177/23779608211026145.
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Background Research show that fibromyalgia has low credibility in healthcare, leading to poor treatment, lack of knowledge and disinterest. Therefore, people with fibromyalgia feel frustration, fear, anxiety and disappointment. Objective: The aim of this study was to explore the experiences of people with fibromyalgia in their encounters with healthcare personnel in Sweden. Method: A cross-sectional design, where 409 people with fibromyalgia answered an anonymous online patient-reported experience measure, developed specific for the study, with six closed questions and one open-ended question. Descriptive statistics were analysed by response frequencies. Correlation analysis were performed between demographic and clinical variables with the answers from the closed questions. Free-text answers were analysed with content analysis. Results: A third experienced the treatment as bad (34%) and that they were not being taken seriously (30.5%). Almost half (47%) always or mostly felt fear of seeking healthcare related to fibromyalgia and that the health care personnel did not understand their diagnosis (46%). The majority (54%) experienced that the health care personnel did not understand how fibromyalgia affected them or how they could help them. The findings were confirmed in the free-text answers that were categorized into: Scepticism and disregard, Ignorance and disinterest and Professionalism and empathy. There were positive significant correlations between age and five of the questions (ρ = .105–.181, p < .05–p < .01), indicating that lower age is correlated with a worse experience. Furthermore, the duration of fibromyalgia showed a significant correlation with feeling afraid of seeking healthcare because of fibromyalgia (ρ = .144, p < .01), the shorter duration, the greater was the fear of seeking healthcare. Conclusion: As a third of patients with fibromyalgia had bad experiences with healthcare, especially younger patients, knowledge about fibromyalgia needs to be increased and the patients should be taken seriously and treated respectfully, as well as given adequate support.
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Metyas, Samy, Christina Chen, Anne Quismorio, Noor Abdo, and Kevin Kamel. "Improvement of Nerve Fiber Density in Fibromyalgia Patients Treated with IVIg." Current Rheumatology Reviews 16, no. 4 (December 24, 2020): 280–84. http://dx.doi.org/10.2174/1573397115666191106120622.
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Results: Small fiber neuropathy and fibromyalgia are two conditions that share overlapping features. Although various treatments are available for use in fibromyalgia, the response often remains unsatisfactory. Prior studies have shown that in small fiber neuropathy of autoimmune etiology, intravenous immunoglobulin (IVIg) holds promise as an effective treatment. Methods: Herein we report the use of IVIg in 7 patients who have both fibromyalgia and small fiber neuropathy. Skin punch biopsy evaluating the nerve fiber density was performed prior to diagnosis and after 6 months of IVIg therapy in each individual. Patients’ symptoms were obtained via a fibromyalgia questionnaire pre- and post-treatment. Results and Conclusion: At the end of 6 months therapy, overall patients reported fewer fibromyalgia symptoms and skin biopsy demonstrated improvements as well. This retrospective pilot study suggests IVIg is a viable potential therapy in a subset of fibromyalgia patients who have small fiber neuropathy.
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Compagnoni, Riccardo, Roberta Gualtierotti, Francesco Luceri, Fabio Sciancalepore, and Pietro Simone Randelli. "Fibromyalgia and Shoulder Surgery: A Systematic Review and a Critical Appraisal of the Literature." Journal of Clinical Medicine 8, no. 10 (September 21, 2019): 1518. http://dx.doi.org/10.3390/jcm8101518.
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Fibromyalgia is a common musculoskeletal syndrome characterized by chronic widespread pain and other systemic manifestations, which has demonstrated a contribution to higher postoperative analgesic consumption to other surgeries such as hysterectomies and knee and hip replacements. The aim of this review is to search current literature for studies considering the impact of fibromyalgia on clinical outcomes of patients undergoing shoulder surgery. A systematic literature review was conducted in PubMed/Medline, Embase, and ClinicalTrials.gov in February 2019. Studies were selected based on the following participants, interventions, comparisons, outcomes, and study design criteria: adult patients undergoing surgery for shoulder pain (P); diagnosis of fibromyalgia (I); patients without fibromyalgia (C); outcome of surgery in terms of pain or analgesic or non-steroidal anti-inflammatory drugs consumption (O); case series, retrospective studies, observational studies, open-label studies, randomized clinical trials, systematic reviews and meta-analyses were included (S). Authors found 678 articles, of which four were found eligible. One retrospective study showed that patients with fibromyalgia had worse clinical postoperative outcomes; two retrospective studies reported a higher opioid prescription in patients with fibromyalgia and one prospective observational study found that a higher fibromyalgia survey score correlated with lower quality of recovery scores two days after surgery. The scarce and low-quality evidence available does not allow confirming that fibromyalgia has an impact on postoperative outcomes in shoulder surgery. Future studies specifically focusing on shoulder surgery outcomes may help improvement and personalization of the management of patients with fibromyalgia syndrome (PROSPERO 2019, CRD42019121180).
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Erdrich, Sharon, Jason A. Hawrelak, Stephen P. Myers, and Joanna E. Harnett. "A systematic review of the association between fibromyalgia and functional gastrointestinal disorders." Therapeutic Advances in Gastroenterology 13 (January 2020): 175628482097740. http://dx.doi.org/10.1177/1756284820977402.
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Background: Fibromyalgia and functional gastrointestinal disorders (FGID) including irritable bowel syndrome (IBS) are common conditions presenting in clinical settings and are more prevalent in women. While the relationship between IBS and fibromyalgia has been demonstrated, a review of the prevalence of the broader group of FGID in adults with fibromyalgia has not been undertaken. The aim of this review was to systematically review the published literature, identifying the comorbidity of FGID in people with fibromyalgia, and to discuss the clinical implications, limitations of current research and areas of interest for future research Methods: Medline, Embase, CINAHL and Web of Science were searched during June 2019. Results were screened for original research articles meeting established criteria for identification of FGID in adults diagnosed with fibromyalgia. Results: A total of 14 studies involving 1340 adults with fibromyalgia, 363 healthy controls and 441 adults with other pathologies were included in this review. Only 1 of the 14 studies included surveyed the full range of FGID . Functional gut disorders were matched to Rome II criteria for reporting and comparison. In addition to increased abdominal pain and functional bloating or gas, IBS of mixed-pattern and constipation-types appear to be more prevalent than diarrhoea-predominant IBS in adults with fibromyalgia. Conclusion: This review confirms previous reports that IBS is common in people living with fibromyalgia and suggests that IBS-mixed and constipation types predominate. An association with a range of FGID other than IBS is suggested, but data are limited. Research exploring the association between fibromyalgia and functional gastrointestinal dysfunction beyond IBS are warranted.
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Morsy, Khalid M. "Post Dural Puncture Headache in Fibromyalgia after Cesarean Section: A Comparative Cohort Study." July 2016 6;19, no. 6;7 (July 14, 2016): E871—E876. http://dx.doi.org/10.36076/ppj/2016.19.e871.
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Background: Patients of chronic pain syndromes like fibromyalgia (FMS) when subjected to spinal anesthesia are theoretically more liable to post dural puncture headache (PDPH) as they have enhanced central nervous system sensitization and decreased descending inhibition. Objective: The current study aims to verify the incidence and chronicity of PDPH in FMS patients. Study Design: Case control study. Methods: In a comparative control study, 70 fibromyalgia patients were scheduled for an elective cesarean delivery fibromyalgia group or Group 1. Group 2 included 70 women scheduled for elective cesarean delivery who had no history of chronic pain and is used as a control group. Both groups were compared regarding the incidence of development of PDPH in the first postoperative 48 hours and the persistence of PDPH for 7 days or more. Settings: Women’s Health Hospital, Assiut University, antenatal Clinic. Results: The fibromyalgia group reported more PDPH (18 patients, 25.7%) as compared to the control group (10 patients, 14.3%), P < 0.01. PDPH persisted for 7 or more days in 8 patients in the fibromyalgia group (11.4%) while, it persisted in 2.86% of the control patients. PDPH continued for more than 3 months in 2 patients in the fibromyalgia group (2.86%) Limitations: Difficulty in calculating the dose of analgesics as patients with fibromyalgia may use other analgesics due to musculoskeletal pain. Conclusion: Dural puncture increases the incidence of PDPH in fibromyalgia patients in comparison with normal controls without increasing other postoperative side effects. Key Words: Fibromyalgia, cesarean section, post dural puncture headache, spinal anesthesia
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Rodgers, Joy L., and Mari L. Zapata Ramos. "Is it Real? Qualitative Framing Analyses of the Depiction of Fibromyalgia in Newspapers and Health Websites." Californian Journal of Health Promotion 11, no. 3 (December 1, 2013): 48–61. http://dx.doi.org/10.32398/cjhp.v11i3.1541.
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Purpose: This two-phase project employed qualitative framing analyses to explore how fibromyalgia has been framed in some of the top sources of U.S. health information and how these sources address treatments related to fibromyalgia. Methods: Phase 1 of the project examined 95 stories and articles published between January 1, 2007, and October 15, 2010, in eight elite U.S. newspapers and five mosttrafficked health websites to determine the dominant framing of fibromyalgia in each source. Phase 2 analyzed 146 stories and articles published between January 1, 2007, and May 15, 2013, in 15 topcirculation U.S. daily print and online newspapers and five popular health websites. Phase 2 was conducted to examine changes in the dominant framing of fibromyalgia since Phase 1, and identify new frames in the ongoing debate about whether fibromyalgia is a medical or mental condition. Results: Project findings suggest a lessening in the debate insofar as the overall media representation shifted from a depiction of fibromyalgia as a mental to a medical condition. Moreover, changes found between the two phases in the identification of the frames demonstrate the evolving public discussion surrounding fibromyalgia amid FDA approval of drugs specifically for the treatment of the condition. Conclusion: Thus, the marketing of fibromyalgia-specific drugs may be a factor contributing to the legitimization of the controversial condition.
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Bohr, Tom. "Letter to the Editor." Guides Newsletter 7, no. 3 (May 1, 2002): 3. http://dx.doi.org/10.1001/amaguidesnewsletters.2002.mayjun02.
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Abstract The author of this letter responds to an article regarding fibromyalgia in the July/August 2001 issue of The Guides Newsletter and notes an error in the article's assertion that fibromyalgia patients are not more likely to have psychiatric disorders than are other patients with chronic pain (eg, rheumatoid arthritis) because of an error in a previous study (the Alabama fibromyalgia research group). The author of the letter asserts that 27 studies show excess psychopathology in fibromyalgia patients; the few articles that support a diagnosis of fibromyalgia are dated and somewhat weak in terms of methodology. In fact, the Alabama study suffered from referral bias at academic centers and has been refuted by at least two other groups that found that fibromyalgia patients do not seem to have excess psychopathology because the studies were conducted at academic medical centers and therefore suffer from the typical tertiary care referral bias associated with more severely affected patients. The letter writer also highlights the original article's assertion that 14% to 23% of fibromyalgia patients receive a formal diagnosis of somatization. This is a large group of patients, the writer suggests, and a less restrictive diagnosis of “undifferentiated somatoform disorder” or “pain disorder” would increase the incidence. Finally, further discussions of fibromyalgia should address the excess incidence of abuse (sexual, physical, and emotional) during the early life of these patients.
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Peres, MFP, E. Zukerman, CA Senne Soares, EO Alonso, BFC Santos, and MHW Faulhaber. "Cerebrospinal Fluid Glutamate Levels in Chronic Migraine." Cephalalgia 24, no. 9 (September 2004): 735–39. http://dx.doi.org/10.1111/j.1468-2982.2004.00750.x.
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Both preclinical and clinical data link glutamate to the migraine pathophisiology. Altered plasma, platelets and cerebrospinal (CSF) glutamate levels have been reported in migraine patients. Chronic migraine is comorbid with several conditions. It has been recently shown chronic migraine comorbidity with fibromyalgia. The objective of this study was to study cerebrospinal fluid glutamate levels in chronic migraine patients with and without fibromyalgia. We studied 20 chronic migraine patients, with and without fibromyalgia, compared to age-sex matched controls. CSF glutamate levels were measured by HPLC. CSF glutamate demonstrated significantly higher levels in patients with fibromyalgia compared to those without fibromyalgia. Patients overall had higher CSF glutamate levels than controls. Mean pain score correlated with glutamate levels in chornic migraine patients. Tender points, the hallmark of fibromyalgia, can be considered as pressure allodynia, and is probably mediated by central sensitization, with increase in CSF glutamate levels. We postulate chronic migraine patients with fibromyalgia, in addition to have more disabling headaches, suffer from a more severe central sensitization process. This subtype of patients may respond to medications modulating glutamate receptors. Headache intensity correlate with glutamate levels in chronic migraine patients.
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Fernández-Ávila, D. G., D. Rincón-Riaño, and J. Gutiérrez. "THU0467 CONCEPTS AND PERCEPTIONS ABOUT FIBROMYALGIA DIAGNOSIS, MONITORING AND TREATMENT AMONG COLOMBIAN RHEUMATOLOGISTS, PHYSIATRIST AND PAIN PHYSICIAN." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 470.1–471. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5213.
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Background:Fibromyalgia is a chronic disease characterized by the presence of widespread and persistent musculoskeletal pain associated with a variety of symptoms. The concepts and perceptions around diagnosis and treatment of fibromyalgia among physicians are not objectively known. The purpose of this study is to obtain objective data through a survey and describe the concepts and perceptions about the diagnosis, treatment and treatment of fibromyalgia among colombian rheumatologists, physiatrist and pain physiciansObjectives:The main purpose of this study is to obtain objective data on this subject and describe the concepts and perceptions about the diagnosis, treatment and monitoring of FM among colombian rheumatologists, physiatrist and pain physicians.Methods:Cross-sectional study. Through a focus group in which two rheumatologists and one expert in qualitative research methods participated, a survey was designed to evaluated the perceptions and concepts that rheumatologists, physiatrist and pain physicians have on the diagnosis and treatment of fibromyalgia. The survey was self-applied anonymously through the internet.Results:Survey applied to 139 rheumatologists, 99 physiatrist and 81 pain physicians. 35 rheumatologists (25.2 %), 17 physiatrist (17.1 %) and 58 pain physicians (71.6 %) consider that there is not enough evidence to recognize fibromyalgia as a disease. 45 rheumatologists (32.4 %), 86 physiatrist (86 %) and 73 pain physicians (90.1 %) consider that the 1990 ACR (American college of Rheumatology) criteria are not sufficient to diagnose fibromyalgia, despite the fact more than 90% of them use the criteria as a tool to approach the diagnosis when suspecting fibromyalgia. The most formulated medications for managing fibromyalgia are antidepressants and is used by more than 80% of the respondents, followed by antiepileptics in pain physician (88.9%) but less than physiatrists and rheumatologists (66.6 % and 64.7 % respectively), and analgesic much more for pain physician and physiatry and less for rheumatologists (84 %, 75.7 % and 26.6 % respectively). All respondents consider that the patient with fibromyalgia should have a multidisciplinary approach. Most doctors of the three specialties believe that physiatrist should be the leaders of interdisciplinary management in the treatment of fibromyalgia patients.Conclusion:We present objective information on the perceptions of fibromyalgia among a group of Colombian rheumatologists, physiatrist and pain physician, documenting a frequent use of the ACR 1990 classification criteria. As regards treatment, a high percentage use of antidepressants and antiepileptic. Most believe that physiatrist should be the leaders of interdisciplinary management in the treatment of fibromyalgia patients.References:[1]Mu R, Li C, Zhu J-X, Zhang X-Y, Duan T-J, Feng M, et al. National survey of knowledge, attitude and practice of fibromyalgia among rheumatologists in China. Int J Rheum Dis. 2013;16:258–63.[2]Arshad A, Kong KO. Awareness and perceptions of fibromyalgia syndrome: a survey of Malaysian and Singaporean rheumatologists. Singapore Med J. 2007;48:25–30.[3]Arshad A, Kong KO, Ooi KK. Awareness and perceptions of fibromyalgia syndrome: a survey of southeast asian rheumatologists. J Clin Rheumatol. 2007;13:59–62.[4]Bloom S, Ablin JN, Lebel D, Rath E, Faran Y, Daphna-Tekoah S, et al. Awareness of diagnostic and clinical features of fibromyalgia among orthopedic surgeons. Rheumatol Int. 2013;33:927–31.[5]Clark P, Paiva ES, Ginovker A, Salomón PA. A patient and physician survey of fibromyalgia across Latin America and Europe. BMC Musculoskelet Disord. 2013;14:188.Disclosure of Interests: :None declared
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Becker, Susanne, and Petra Schweinhardt. "Dysfunctional Neurotransmitter Systems in Fibromyalgia, Their Role in Central Stress Circuitry and Pharmacological Actions on These Systems." Pain Research and Treatment 2012 (October 2, 2012): 1–10. http://dx.doi.org/10.1155/2012/741746.
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Fibromyalgia is considered a stress-related disorder, and hypo- as well as hyperactive stress systems (sympathetic nervous system and hypothalamic-pituitary-adrenal axis) have been found. Some observations raise doubts on the view that alterations in these stress systems are solely responsible for fibromyalgia symptoms. Cumulative evidence points at dysfunctional transmitter systems that may underlie the major symptoms of the condition. In addition, all transmitter systems found to be altered in fibromyalgia influence the body's stress systems. Since both transmitter and stress systems change during chronic stress, it is conceivable that both systems change in parallel, interact, and contribute to the phenotype of fibromyalgia. As we outline in this paper, subgroups of patients might exhibit varying degrees and types of transmitter dysfunction, explaining differences in symptomatoloy and contributing to the heterogeneity of fibromyalgia. The finding that not all fibromyalgia patients respond to the same medications, targeting dysfunctional transmitter systems, further supports this hypothesis.
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Penfold, Sarah, Emily St Denis, and Mir Nadeem Mazhar. "The association between borderline personality disorder, fibromyalgia and chronic fatigue syndrome: systematic review." BJPsych Open 2, no. 4 (July 2016): 275–79. http://dx.doi.org/10.1192/bjpo.bp.115.002808.
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BackgroundOverlap of aetiological factors and demographic characteristics with clinical observations of comorbidity has been documented in fibromyalgia syndrome, chronic fatigue syndrome (CFS) and borderline personality disorder (BPD).AimsThe purpose of this study was to assess the association of BPD with fibromyalgia syndrome and CFS. The authors reviewed literature on the prevalence of BPD in patients with fibromyalgia or CFS and vice versa.MethodsA search of five databases yielded six eligible studies. A hand search and contact with experts yielded two additional studies. We extracted information pertaining to study setting and design, demographic information, diagnostic criteria and prevalence.ResultsWe did not identify any studies that specifically assessed the prevalence of fibromyalgia or CFS in patients with BPD. Three studies assessed the prevalence of BPD in fibromyalgia patients and reported prevalence of 1.0, 5.25 and 16.7%. Five studies assessed BPD in CFS patients and reported prevalence of 3.03, 1.8, 2.0, 6.5 and 17%.ConclusionsMore research is required to clarify possible associations between BPD, fibromyalgia and CFS.
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Santo, Adriana de Sousa do Espírito, Pamela Cristina Mango, Ana Assumpção, Juliana Ferreira Sauer, and Amélia Pasqual Marques. "Fibromyalgia: is there association between balance and pain? a pilot study." Fisioterapia e Pesquisa 21, no. 1 (March 2014): 27–33. http://dx.doi.org/10.1590/1809-2950/341210114.
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Studies of balance and risk factors for falling typically focus on the elderly population or on individuals with musculoskeletal pain. Although fibromyalgia is associated with intrinsic factors that predispose to falls (pain, depression, fatigue), few studies have researched balance and falls in this syndrome. The aim of this study was to verify the association between balance, balance self-efficacy and pain in women with and without fibromyalgia, and verify the association between Berg Balance Scale and Activities-specific Balance Confidence Scale (ABC Scale). The sample consisted of 48 women aged between 40 and 59 years, divided into two groups: Fibromyalgia group (n=22) and Control group (n=26) with asymptomatic people. Balance was assessed by Berg Balance Scale, balance self-efficacy by the ABC Scale and pain by the visual analog scale. Mean scores for pain, Berg and ABC Scale were 5.4 cm (SD 2.6), 55 (interquartile range 54-56), and 54.6 (SD 26.6) respectively for Fibromyalgia group, and 0 cm, 56 (interquartile range 55-56), and 89.4 (SD 14.4) respectively for Control group. Statistically significant differences were found in balance on comparing both groups (p=0.000 for Berg Balance Scale and 0.009 for ABC Scale) with lower values for Fibromyalgia group. In Fibromyalgia group, pain was negatively correlated with balance (r=-0.48, p=0.020) and balance self-efficacy (rs=-0.56, p=0.006). Correlation between Berg Balance Scale and ABC Scale was found only in the Fibromyalgia group (rs =0.55, p=0.007). There are associations between poor balance and pain, and poor balance and decreased balance self-efficacy in women with fibromyalgia. There is an association between scales in the Fibromyalgia group.
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Gremillion, Richard B. "Fibromyalgia." Physician and Sportsmedicine 26, no. 4 (April 1998): 55–65. http://dx.doi.org/10.3810/psm.1998.04.867.
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McGough, Greta. "Fibromyalgia." Nursing Standard 26, no. 24 (February 15, 2012): 30. http://dx.doi.org/10.7748/ns2012.02.26.24.30.p7550.
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Wilke, William S. "Fibromyalgia." Postgraduate Medicine 100, no. 1 (July 1996): 153–70. http://dx.doi.org/10.3810/pgm.1996.07.14.
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Bair, Matthew J., and Erin E. Krebs. "Fibromyalgia." Annals of Internal Medicine 172, no. 5 (March 3, 2020): ITC33. http://dx.doi.org/10.7326/aitc202003030.
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Brauer, Sandra. "Fibromyalgia." Australian Journal of Physiotherapy 54, no. 4 (2008): 286. http://dx.doi.org/10.1016/s0004-9514(08)70014-x.
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Dadabhoy, Dina, and Daniel Clauw. "Fibromyalgia." Current Rheumatology Reviews 1, no. 3 (November 1, 2005): 231–42. http://dx.doi.org/10.2174/157339705774612328.
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