Fibromyalgia
Fibromyalgia is a disease of the muscles. It is defined as "a common nonarticular rheumatic syndrome characterized by myalgia and multiple points of focal muscle tenderness to palpation (trigger points). Muscle pain is typically aggravated by inactivity or exposure to cold. This condition is often associated with general symptoms, such as sleep disturbances, fatigue, stiffness, headaches, and occasionally depression. There is significant overlap between fibromyalgia and the chronic fatigue syndrome (fatigue syndrome, chronic). Fibromyalgia may arise as a primary or secondary disease process. It is most frequent in females aged 20 to 50 years." (From Adams et al., Principles of Neurology, 6th ed, p1494-95)".[1]
Etiology/causation
The cause is not clear; however, "patients with fibromyalgia experience pain differently from the general population".[2]
Low vitamin D levels may be associated with nonspecific musculoskeletal pain.[3]
Genetics
Using self-report of "Chronic Widespread Pain" (CWP) as a surrogate marker for fibromyalgia, the Swedish Twin Registry suggests a modest genetic contribution:[4][5]
- Monozygotic twins with CWP have a 15% chance that their twin sibling has CWP
- Dizygotic twins with CWP have a 7% chance that their twin sibling has CWP
Abnormal sleep
Fibromyalgia is associated with alpha sleep.[6] However, it is unclear if this abnormal sleep pattern causes or follows fibromyalgia.
Diagnosis
Differential diagnosis
A cohort study found that widespread pain significantly increased risk of subsequent diagnosis of cancer, especially breast cancer and prostate cancer.[7] The biological reason for this association is not clear.
Treatment
Pregabalin is approved for use in the United States by the Food and Drug Administration (FDA) for fibromyalgia. Pregabalin benefits about 1 of every 6 people who use it if they are similar to the patients in a randomized controlled trial. In this trial, 29% of the patients who took the drug had a reduction in their pain versus 13% of the patients who took placebo.[8]
References
- ↑ National Library of Medicine. Fibromyalgia. Retrieved on 2007-11-13.
- ↑ Abeles AM, Pillinger MH, Solitar BM, Abeles M (2007). "Narrative review: the pathophysiology of fibromyalgia". Ann. Intern. Med. 146 (10): 726–34. PMID 17502633. [e]
- ↑ Plotnikoff GA, Quigley JM (2003). "Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain". Mayo Clin. Proc. 78 (12): 1463–70. PMID 14661675. [e]
- ↑ Kato K, Sullivan P, Evengård B, Pedersen N (2006). "Importance of genetic influences on chronic widespread pain". Arthritis Rheum. 54 (5): 1682-6. DOI:10.1002/art.21798. PMID 16646040. Research Blogging.
- ↑ Kato K, Sullivan P, Evengård B, Pedersen N (2006). "Chronic widespread pain and its comorbidities: a population-based study". Arch. Intern. Med. 166 (15): 1649-54. PMID 16908799.
- ↑ Roizenblatt S, Moldofsky H, Benedito-Silva AA, Tufik S (2001). "Alpha sleep characteristics in fibromyalgia". Arthritis Rheum. 44 (1): 222–30. DOI:<222::AID-ANR29>3.0.CO;2-K 10.1002/1529-0131(200101)44:1<222::AID-ANR29>3.0.CO;2-K. PMID 11212164. <222::AID-ANR29>3.0.CO;2-K Research Blogging.
- ↑ McBeth J, Silman AJ, Macfarlane GJ (2003). "Association of widespread body pain with an increased risk of cancer and reduced cancer survival: a prospective, population-based study". Arthritis Rheum. 48 (6): 1686–92. DOI:10.1002/art.10973. PMID 12794837. Research Blogging.
- ↑ Crofford LJ, Rowbotham MC, Mease PJ, et al (2005). "Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial". Arthritis Rheum. 52 (4): 1264–73. DOI:10.1002/art.20983. PMID 15818684. Research Blogging.