Controversies in fibromyalgia and related conditions:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
1996
|
| Series: | Rheumatic disease clinics of North America
22,2 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XII S., S. 219 - 410 graph. Darst. |
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Record in the Search Index
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| adam_text | CONTROVERSIES IN FIBROMYALGIA
AND RELATED CONDITIONS
CONTENTS
Preface xi
Don L. Goldenberg
Fibromyalgia and Chronic Fatigue Syndrome: Similarities
and Differences 219
Dedra Buchwald
Chronic fatigue syndrome (CFS) and fibromyalgia (FM) are clini¬
cal conditions characterized by a variety of nonspecific symptoms
including prominent fatigue, myalgia, and sleep disturbances.
There are no diagnostic studies or widely accepted pathogenic,
explanatory models for either illness. Despite remarkably differ¬
ent diagnostic criteria, CFS and FM have many demographic and
clinical similarities. Although few differences exist in the domains
of symptoms, examination findings, laboratory tests, functional
status, psychosocial features, and psychiatric disorders, FM ap¬
pears to represent an additional burden of suffering among those
with CFS.
Is There Muscle Pathology in Fibromyalgia Syndrome? 245
Robert W. Simms
Although fibromyalgia syndrome appears to have existed in liter¬
ature since the eighteenth century, the pathophysiology of this
vexing and controversial condition remains obscure. Because
muscle pain has been the central symptom of fibromyalgia syn¬
drome, studies of muscle have long interested investigators. Al¬
though controversy persists, the weight of evidence from studies
that are methodologically sound suggests that muscles are not
abnormal in the condition. This article critically examines re¬
ported studies of muscle in fibromyalgia syndrome and proposes
future directions for research in this area.
RHEUMATIC DISEASE CLINICS OF NORTH AMERICA
VOLUME 22 • NUMBER 2 • MAY 1996 V
Evidence That Abnormalities of Central Neurohormonal
Systems Are Key to Understanding Fibromyalgia and
Chronic Fatigue Syndrome 267
Leslie J. Crofford and Mark A. Demitrack
Fibromyalgia (FM) and chronic fatigue syndrome (CFS) fall into
the spectrum of what might be termed stress associated syndromes
by virtue of frequent onset after acute or chronic stressors and
apparent exacerbation of symptoms during periods of physical
or emotional stress. These illnesses also share perturbation of
the hypothalamic pituitary adrenal axis and sympathetic stress
response systems. In this article, the authors discuss the specific
neurohormonal abnormalities found in FM and CFS and potential
mechanisms by which dysfunction of neurohormonal stress re¬
sponse systems could contribute to vulnerability to stress associ¬
ated syndromes and to the symptoms of FM and CFS.
The Relationship Between Fibromyalgia and
Major Depressive Disorder 285
James I. Hudson and Harrison G. Pope, Jr
Is fibromyalgia associated with major depressive disorder? If so,
what is the nature of this association? In an attempt to address
these questions, the authors review studies of patients with fi¬
bromyalgia, examining phenomenology, personal and family his¬
tory of psychiatric and medical disorders, response to antidepres
sant medications, and results of laboratory tests. Although this
evidence is not entirely consistent, the great majority of studies
favor an association between fibromyalgia and major depressive
disorder. These findings cannot be explained by the hypothesis
that fibromyalgia causes depression or vice versa. Therefore, it
appears most likely that both disorders share some unknown
common etiologic factor.
Trigger Points and Tender Points: One and the Same?
Does Injection Treatment Help? 305
Joanne Borg Stein and Joel Stein
Trigger points are defined as areas of muscle that are painful to
palpation and are characterized by the presence of taut bands
and the generation of a referral pattern of pain. Tender points are
areas of tenderness occurring in muscle, muscle tendon junction,
bursa, or fat pad. When tender points occur in a widespread
manner, they are usually considered characteristic of fibromyal¬
gia. Trigger points, which typically occur in a more restricted
regional pattern, are indicative of myofascial pain syndrome.
In some patients the two phenomena may coexist, and overlap
syndromes can occur. Although experienced examiners can gen¬
erally identify the same tender points, interrater reliability of
trigger points has been low in most studies. There is continued
controversy regarding the defining characteristics and homogene¬
ity of myofascial pain because of the variability of the examina¬
tion findings. In appropriately selected patients, it appears that
Vi CONTENTS
myofascial trigger point injections can be helpful in decreasing
pain and improving range of motion in conjunction with a com¬
prehensive exercise and rehabilitation program.
A Cost Effective Approach to the Diagnosis and Treatment of
Fibromyalgia 323
Glenn A. McCain
Fibromyalgia syndrome can now be confidently diagnosed using
the positive feature of the patient s illness. It is no longer solely
a diagnosis of exclusion. A number of other syndromes and
diseases that present with myalgia or weakness may be confused
with fibromyalgia. A simple algorithm is presented to aid in cost
effective work up of these difficult patients. Similarly, a stepwise
approach to treatment that is based on functional outcome mea¬
sures is presented in an attempt to foster a rational approach to
use of published treatment modalities.
Multidisciplinary Group Programs To Treat
Fibromyalgia Patients 351
Robert M. Bennett
Fibromyalgia is a complex pain syndrome that is multifactorial
in the generation of symptoms. Current ideas on etiology favor
the development of a central pain sensitization state that is driven
by nociceptive impulses from muscle and other soft tissues. The
resulting state of chronic pain leads to physiologic arousal that in
turn generates many of the symptoms that are characteristic of the
total syndrome. The secondary symptoms due to physiologic
arousal are often amenable to modification through the techniques
of cognitive behavioral therapy. Multidisciplinary education in the
areas of sleep hygiene, pacing, aerobic exercise, stretching, stress
reduction, and therapeutic options provides fibromyalgia patients
with more control and enhances their interaction with clinicians.
Multidisciplinary group treatment programs are ideally a comple¬
ment to individualized therapy, not a substitute.
Fibromyalgia and Work Disability: Is Fibromyalgia
a Disabling Disorder? 369
Frederick Wolfe and Joshua Potter
Fibromyalgia appears to be an increasingly important source of
disability claims and payments. Twenty five percent of patients
seen in rheumatology clinics have received disability payments.
Yet fibromyalgia is a clinical rather than a legal construct, and
there remain very important limitations regarding the reliability
and validity of diagnosis and severity assessments outside of the
clinic and in the medicolegal setting. Even so, preparation of
disability assessments that cover key requirements can provide
substantial assistance to disability adjudicators.
CONTENTS Vii
What Is the Future of Fibromyalgia? 393
Don L. Goldenberg
This article discusses the future of fibromyalgia, including the
current state of the art and potential future pathophysiologic
studies. Suggestions are provided in regard to future therapeutic
trials, longitudinal and outcome studies, and the role of the rheu¬
matology community in this common disorder.
Index 407
Subscription Information Inside back cover
viii CONTENTS
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| physical | XII S., S. 219 - 410 graph. Darst. |
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| series2 | Rheumatic disease clinics of North America |
| spelling | Controversies in fibromyalgia and related conditions Don L. Goldenberg, guest ed. Philadelphia [u.a.] Saunders 1996 XII S., S. 219 - 410 graph. Darst. txt rdacontent n rdamedia nc rdacarrier Rheumatic disease clinics of North America 22,2 Fibromyalgie Fibromyalgie gtt Moeheidssyndroom gtt Fibromyalgia Fibromyalgie (DE-588)4184710-6 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Fibromyalgie (DE-588)4184710-6 s DE-604 Goldenberg, Don L. Sonstige oth Rheumatic disease clinics of North America 22,2 (DE-604)BV000625464 22,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007202263&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Controversies in fibromyalgia and related conditions Rheumatic disease clinics of North America Fibromyalgie Fibromyalgie gtt Moeheidssyndroom gtt Fibromyalgia Fibromyalgie (DE-588)4184710-6 gnd |
| subject_GND | (DE-588)4184710-6 (DE-588)4143413-4 |
| title | Controversies in fibromyalgia and related conditions |
| title_auth | Controversies in fibromyalgia and related conditions |
| title_exact_search | Controversies in fibromyalgia and related conditions |
| title_full | Controversies in fibromyalgia and related conditions Don L. Goldenberg, guest ed. |
| title_fullStr | Controversies in fibromyalgia and related conditions Don L. Goldenberg, guest ed. |
| title_full_unstemmed | Controversies in fibromyalgia and related conditions Don L. Goldenberg, guest ed. |
| title_short | Controversies in fibromyalgia and related conditions |
| title_sort | controversies in fibromyalgia and related conditions |
| topic | Fibromyalgie Fibromyalgie gtt Moeheidssyndroom gtt Fibromyalgia Fibromyalgie (DE-588)4184710-6 gnd |
| topic_facet | Fibromyalgie Moeheidssyndroom Fibromyalgia Aufsatzsammlung |
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