This issue of our newsletter focuses on Fibromyalgia. There are many good resources for information on fibromyalgia on the web; here are some of them.

Fibromyalgia Overview

"Fibromyalgia: What Clinicians Need to Know – a comprehensive article by Gary W. Jay, MD, FAAPM"
This article reviews the recent research into the diagnosis and etiology of FM, as well as updated treatment guidelines.
If your doctor doesn’t know very much about fibromyalgia, this is a good article to take along to your next appointment. This is useful information for patients to know as well. Please note: this article is on 5 pages separate pages. If you want to print the entire article, you will need to use the Print button at the top of each of the pages.


“Fibromyalgia Considered Lifelong Central Nervous System Disorder”
A prominent researcher and fibromyalgia expert presented evidence for the central nervous system as the origin of the pain in fibromyalgia. “For a poorly understood and under-diagnosed chronic pain condition, these findings are encouraging and will help clinicians and researchers focus their attention on the underlying problems causing fibromyalgia – the central nervous system.”

"Objective evidence that small-fiber polyneuropathy underlies some illnesses currently labeled as fibromyalgia"
On the other hand, this paper shows “that some patients with chronic pain labeled as fibromyalgia have unrecognized SFPN, a distinct disease that can be tested for objectively and sometimes treated definitively.”

"The Use of Polysymptomatic Distress Categories in the Evaluation of Fibromyalgia (FM) and FM Severity"
Using the Polysymptomatic Distress scale to evaluate the severity of fibromyalgia symptoms, these researchers found that even Mild and Moderate scores on the scale correlated with the full range of symptoms. The authors write, “By definition, FM cannot be diagnosed unless the score on the Polysymptomatic Distress (PSD) scale is at least 12…. We established PSD severity categories of none (0-3), mild (4-7), moderate (8-11), severe (12-19), and very severe (20-31). Categories were statistically distinct, and a generally linear relationship between PSD categories and covariate severity was noted. PSD categories are clinically relevant and demonstrate FM type symptoms over the full range of clinical illness. Although FM criteria can be clinically useful, there is no clear-cut symptom distinction between FM (+) and FM (-), and PSD categories can aid in more effectively classifying patients.”

"Researchers Compare Twins’ DNA To Discover Fibromyalgia Diagnosis"
“Researchers from King’s College London are trying to develop an effective strategy to diagnose fibromyalgia by comparing the DNA of twins in which one has the disease and the other one does not. [They] hope it will lead to identification of a biomarker which could be developed into a blood test. As well as enabling the condition to be diagnosed more effectively, [their work] could help to ‘stratify’ patients into groups depending on disease severity, which will help in clinical trials of potential new treatments. It might even help ...predict how the condition will progress...”

Fibromyalgia Treatment Options

“Patients who respond to treatment with Lyrica for pain will likely respond by weeks 3 or 4”
Recently published research suggests that if symptoms have not noticeably improved in this time, it may be wise to consider a different approach.

“Cholecalciferol injection may reduce fatigue, musculoskeletal pain in patients with fibromyalgia”
“Patients with fibromyalgia may have improvements in fatigue and musculoskeletal pain by increasing vitamin D levels through monthly, intramuscular cholecalciferol injection, according to recently presented research.” Patients with fibromyalgia were more deficient in vitamin D than were matched groups of patients with either rheumatoid arthritis or osteoarthritis. When the vitamin D deficiency was corrected, all patients showed improvements in pain and fatigue, but improvements in the fibromyalgia group were greater than in the other two groups.

"Researchers Report Fibromyalgia as a Common Disorder in Obstructive Sleep Apnea Patients"
Patients with fibromyalgia symptoms may also have undetected sleep apnea. In some patients, if the sleep apnea is treated effectively the fibromyalgia symptoms are greatly improved. Notably, 74% of the patients with fibromyalgia who had undedected sleep apnea were men.

More Resources

There are many good websites with information about Fibromyalgia. Here are some of them.

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