Fibromyalgia Syndrome In Patients Research Articles

Relationship Between Chronic Spontaneous Urticaria and Fibromyalgia Syndrome

Aim: Autoimmunity, peripheral nerve dysfunction, and neurogenic inflammation are common mechanisms in chronic spontaneous urticaria (CSU) and fibromyalgia syndrome (FMS). We aimed to detect the prevalence of FMS in patients with CSU and to determine whether this prevalence was affected by the severity of urticaria, and dermatology life quality.
 Material and Methods: Fifty-three patients with CSU and 49 controls were enrolled in this prospective, controlled, cross-sectional study. The severity of CSU was assessed using Urticaria Activity Scores (UAS), and Dermatology Life Quality Index (DLQI) scores were recorded. The 2016 fibromyalgia diagnostic criteria were used for the diagnosis of FMS, and FMS-related functional disability was assessed using the Fibromyalgia Impact Questionnaire (FIQ).
 Results: Fibromiyalgia prevalence and the FIQ scores were higher in the CSU group than in the control (p=0.033 and p=0.004, respectively). There was no statistically significant difference between the urticaria durations and UAS of CSU with and without FMS (p>0.05), but DLQI scores were statistically significantly higher in CSU with FMS (p=0.007). A statistically significant moderate positive correlation was present between DLQI and FIQ, Widespread Pain Index, and Symptom Severity Scale scores (r=0.500, r=0.408, r=0.469, r=0.507, respectively).
 Conclusions: The prevalence of FMS and the disability due to FMS was increased in CSU. Furthermore, the FMS prevalence was not affected by the duration and severity of urticaria; however, it was associated with decreased quality of life.

Exploring the prevalence and clinical impact of fibromyalgia syndrome in patients with shoulder diseases: a cross-sectional study.

Fibromyalgia (FM) is a musculoskeletal syndrome characterised by widespread chronic pain often associated with systemic manifestations such as mood disturbances, persistent fatigue, unrefreshed sleep, and cognitive impairment, substantially impacting patients' health-related quality of life. Based on this background, this study aimed to evaluate the prevalence of FM syndrome in patients referring to an outpatient clinic in a central orthopaedic institute for a painful shoulder. The demographic and clinical characteristics of patients fulfilling the criteria for FM syndrome were also correlated with the severity of symptoms. Consecutive adult patients referring to the shoulder orthopaedic outpatient clinic of the ASST Gaetano Pini-CTO, Milan, Italy, to undergo a clinical evaluation were assessed for eligibility in an observational, cross-sectional, monocentric study. Two hundred-one patients were enrolled: 103 males (51.2%) and 98 females (48.8%). The mean age ± standard deviation (SD) of the patients was 55.3 ± 14.3 years in the whole population. Of all the patients, 12 (5.97%) fulfilled the 2016 FM syndrome criteria based on the FM severity scale (FSS). Of these, 11 were females (91.7%, p=0.002). The mean age (SD) was 61.3 (10.8) in the positive criteria sample. Patients with positive criteria had a mean FIQR of 57.3 ± 16.8 (range 21.6-81.5). We found that FM syndrome is more frequent than expected in a cohort of patients referring to a shoulder orthopaedic outpatient clinic, with a prevalence rate (6%) more than double that of the general population (2%).

A Descriptive Study of Fibromyalgia Syndrome and Low Disease Activity Rheumatoid Arthritis

Objectives: To evaluate fibromyalgia syndrome in patients with rheumatoid arthritis (RA) with low disease activity. Settings and sampling: From January 2022 to February 2023, this descriptive research was carried out at Lady Reading Hospital in Peshawar. Based on the ACR 2010 criteria for RA, patients with rheumatoid arthritis were enrolled in the study. Clinical Disease Activity Index (CDAI) scores between 2.5 and 10 were considered mild disease activity, indicating that the disease was of low severity. Based on the 2016 ACR criteria for the diagnosis of fibromyalgia, fibromyalgia syndrome was identified. Results: A total of 78 patients were recruited, and 46 (58.9%) of them were female. Age ranged from 20 to 70 years, with a mean of 41.3±10.6 years. 17 individuals (21.8%) had the fibromyalgia syndrome. Conclusion: Due to the broad discomfort associated with inflammation, substantial disease activity may make a fibromyalgia diagnosis easier. Hence, before diagnosing FMS in a RA patient, strict disease activity management should be taken into account. Keywords: Rheumatoid Arthritis, Low Disease Activity, Fibromyalgia Syndrome,

Which Patients with Carpal Tunnel Syndrome are More Associated with Fibromyalgia Syndrome?

Objective: In this study, it was aimed to detect the presence of Fibromyalgia Syndrome (FMS) and related factors in patients diagnosed by Carpal Tunnel Syndrome (CTS). Materials and Methods: Demographic data and the features of CTS were noted by applying face-to-face questionnaire method. The existence of FMS in patients with CTS was investigated using the 2016 American College of Rheumatology (ACR) Fibromyalgia Diagnostic criteria. The Fibromyalgia Impact Questionnaire (FIQ) was introduced to patients diagnosed with FMS. Then, the correlations between the incidence of FMS in CTS patients, the presence of FMS and the hand with CTS, the severity of CTS and the existence of FMS, the presence of FMS and the duration of CTS symptoms, and finally CTS severity and FIQ were concurrently examined. Results: 151 patients included in the study. Bilateral CTS was detected in 89 (58.9%) patients. CTS was mild in 55 (36.4%), moderate in 87 (57.6%), and severe in 9 (6.0%) patients. Concomitant FMS was detected in 73 (48.3%) of all CTS patients. FMS rate is higher in patients with bilateral CTS (p=0.001). No significant relevance was observed between the severity of CTS and the presence of FMS (p = 0.864). The median duration of CTS symptoms with FMS patients was 24 (1-240) months; this period was found to be 12 (1-120) months in those without FMS. No significant relations between the presence of FMS and the duration of CTS symptoms were encountered (p = 0.073). The severity of CTS and FIQ demonstrated no significant difference (p=0.955). Conclusion: The case of FMS is high in specially bilaterally CTS patients. The fact that there may be common points in the pathogenesis of these two diseases suggests that it should be considered for diagnosis and treatment.

"Zooming" in the association between rosacea and fibromyalgia syndrome: ıs it worth mentioning?

We aimed to detect the frequency of fibromyalgia syndrome in patients with rosacea and determine whether this frequency was affected by the severity of rosacea and the quality of life. In this prospective, controlled, cross-sectional study, a total of 94 consecutive rosacea cases and 87 age- and sex-matched controls were enrolled. The severity of rosacea was assessed in light of the findings of the National Rosacea Society Ethics Committee. Dermatology Life Quality Index and Rosacea-specific Quality-of-Life instrument had been applied to the cases of rosacea. The diagnosis of fibromyalgia syndrome was established according to the 2016 revised fibromyalgia diagnostic criteria, and the Fibromyalgia Impact Questionnaire was used to determine the functional disability. The frequency of fibromyalgia syndrome was higher in the rosacea group than in the control group (p=0.01), and Dermatology Life Quality Index and Rosacea-specific Quality-of-Life instrument were higher in patients with rosacea with fibromyalgia syndrome (p=0.006 and p=0.004, respectively). A statistically significant weak positive correlation was observed between Dermatology Quality-of-Life Index, Rosacea-specific Quality-of-Life instrument, and Fibromyalgia Impact Questionnaire; symptom severity scale scores; and fibromyalgia score (r=0.35, r=0.259, and r=0.32 and r=0.376, r=0.305, and r=0.312, respectively). The patients with rosacea have higher rates and disability scores of fibromyalgia syndrome than healthy controls, independent of rosacea severity, and quality of life is correlated with fibromyalgia scores. We might point out that fibromyalgia syndrome accompanying rosacea has more restrictions in their daily routine activities than rosacea alone. As such, physicians should be aware of the possible coexistence of rosacea and fibromyalgia syndrome.

The frequency of fibromyalgia in familial Mediterranean fever and its impact on the quality of life.

Concomitant fibromyalgia syndrome (FMS) has been known to be more frequent in patients with several rheumatic diseases. In this study, our aim was to investigate the prevalence of FMS in patients with familial Mediterranean fever (FMF), to analyze the possible factors related to this frequency, and to evaluate the impact of FMS on the functionality and quality of life (QoL) of the patients with FMF. One hundred cases with FMF and 100 controls were included to this case-control study. FMS coincidence was investigated in all participants according to revised 2016 classification criteria. Demographic features, FMF disease duration, FMF gene mutations, drugs used, attack frequency per year, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum fibrinogen levels were recorded. FMF disease severity was assessed by International Severity Scoring System for Familial Mediterranean Fever (ISSF). For the assessments of QoL and functioning, FMF-QoL, Short form 36 (SF-36), and Health Assessment Questionnaire-Disability Index (HAQ-DI) were used, and for the assessment of FMS impact, the fibromyalgia impact questionnaire (FIQ) were used. We found an FMS frequency of 33% in patients with FMF in our study using the current FMS classification criteria. This result was significantly higher than in age- and gender-similar controls (6% FMS frequency; P < 0.05). The number of woman patients and FMF disease duration were significantly higher in patients with FMF + FMS than in patients with only FMF (P < 0.001). There was no significant difference in ISSF scores, ESR, CRP, and fibrinogen levels, management regimens, and FMF gene mutation distributions between FMF + FMS and FMF groups. FMF attack frequency was reported as significantly higher in FMF + FMS patients than in others (P < 0.000). In spite of similar FMF-QoL scores, there were significant differences in HAQ-DI and SF-36 scores between groups (P < 0.05). Higher impact of FMS presented negative correlation with functioning and general health, and positive correlation with QoL in FMF + FMS (P < 0.05). Concomitant FMS was a common clinical problem in patients with FMF regardless of the severity and characteristics of FMF. The FMS impact may affect function and QoL in patients of FMF. Considerations of the FMS component in the management of FMF may contribute to the holistic approach to FMF.

Impact of Fibromyalgia Syndrome on the Severity of Migraine Without Aura

Background: Migraine is a common neurological disorder associated with periodical disability and impaired quality of life. Recent large epidemiological studies have shown high levels of concurrency between fibromyalgia syndrome (FMS) and migraine. Objectives: Due to the possible relationship between migraine and FMS, we aimed to measure the effect of FMS on the severity of migraine without aura (MWO). Methods: This is a cross-sectional study of 80 patients with MWO who were referred to Isfahan Al-Zahra Clinic of Neurology. To monitor the patients, the researcher asked them to complete the demographic data and questionnaires, including FSQ-P for diagnosis FMS, HIT-6 for the severity of migraine headache, and MSQ for measuring the quality of life, with their written consent. Results: Of 80 patients with MWO, 22.5% suffered from FMS. Based on our study, elderly patients with MWO were more likely to be affected by FMS. Additionally, the average quality of life score in the migraineurs with FMS was significantly lower than the migraineurs without FMS. According to our findings, the severity of migraine was not significantly different between patients with and without FMS. In addition, age (OR = 1.1, 95% CI = 1.006-1.2, P &lt; 0.001] and quality of life (OR = 1.03, 95% CI = 1.002 - 1.07, P = 0.04) were the predictive factors for FMS in patients suffering from migraine. Conclusions: The findings of this study may support that the presence of FMS had no effect on the severity of migraine; however, further studies are needed to clarify this claim.

Evaluation of the Fibromyalgia and Related Risk Factors in Patients with Advanced Kidney Failure Undergoing Hemodialysis.

Fibromyalgia syndrome (FMS) is defined as widespread and persistent pain in the musculoskeletal system. There are limited reports regarding the prevalence of fibromyalgia syndrome in patients with advanced kidney failure undergoing regular hemodialysis. Therefore, this study aimed to evaluate the prevalence of fibromyalgia syndrome and its risk factors in a large proportion of patients under the hemodialysis condition. In this cross-sectional study, 293 patients who were admitted to the hemodialysis ward were evaluated for fibromyalgia syndrome in an educational hospital. The questionnaire was designed according to symptom severity score (SS score) and widespread pain index (WPI) criteria. The correlation between FMS and various variables, including demographic, clinical, and biochemistry biomarkers, was also precisely calculated by logistic regression. Data were analyzed using SPSS v.17 statistics software. The results showed that, of 293 hemodialysis patients, 130 patients (44.4%) had fibromyalgia, the mean age of patients with and without fibromyalgia was 61.09 ± 15.36 and 53.49 ± 15.38 years old, respectively (P = 0.001). Moreover, there was a significant difference in terms of gender among patients with fibromyalgia syndrome (P = 0.001). To note, there was no significant relationship between the kidney failure etiopathogenesis, duration of dialysis, body mass index (BMI), Kt/v index, history of peritoneal dialysis, and laboratory parameters with fibromyalgia in hemodialysis patients (P > 0.05). However, our findings revealed that both age and gender could be considered as the predictor variables associated with fibromyalgia in patients undergoing hemodialysis. Taken together, in this study, we found that age and gender would be the critical factors in terms of the fibromyalgia syndrome in patients undergoing hemodialysis.

Effects of fibromyalgia syndrome in patients with diffuse systemic sclerosis: Evaluation with 2010 American college of rheumatology criteria set

Effects of fibromyalgia syndrome in patients with diffuse systemic sclerosis: Evaluation with 2010 American college of rheumatology criteria set

Does the fibromyalgia affect the quality of life in the patients with inflammatory bowel disease

Background and aims: Data on the soft tissue rheumatism, especially fibromyalgia syndrome is limited in inflammatory bowel disease. Our aim in our study is to determine the prevalence of fibromyalgia syndrome and to evaluate the impact of it on quality of life in inflammatory bowel disease.&#x0D; Methods: 60 ulcerative colitis and 34 Crohn's disease patients were included. 2010/2011 and 2016 American College of Rheumatology criteria were used for fibromyalgia syndrome diagnosis. Fibromyalgia impact survey was applied to the all patients.&#x0D; Results: According to the American Colloge of Rheumatology-2010/2011 criteria, fibromyalgia syndrome frequencies were determined as 29.8% in inflammatory bowel disease, 23.4% in Crohn’s disease and 33.3% in ulcerative colitis (P ˃ 0.05). The frequency of fibromyalgia syndrome was significantly higher in inflammatory bowel disease and especially more in female. There was no significant difference between ulcerative colitis and Crohn’s disease in terms of widespread-pain-index, somatic-symptom-severity and fibromyalgia syndrome scores. Fibromyalgia impact scores were found significantly higher in those with fibromyalgia syndrome in inflammatory bowel disease, ulcerative colitis and Crohn’s disease.&#x0D; Conclusions: This is the first study to show the frequency of fibromyalgia syndrome in patients with inflammatory bowel disease in Turkish population. Fibromyalgia syndrome has been shown to be increased in inflammatory bowel disease patients and more in ulcerative colitis and female. The quality of life is more affected in inflammatory bowel disease patients with fibromyalgia syndrome.

Evaluation of fibromyalgia syndrome in patients with rosacea.

Objectives This study aims to investigate the frequency of fibromyalgia syndrome (FMS) in rosacea patients and the relationship between disease disability score of FMS and quality of life score of rosacea.Patients and methods This cross-sectional controlled clinical trial was performed between December 2017 and December 2018. One hundred female rosacea patients (mean age 43.2±10.1; range, 21 to 65 years) and 100 age- and sex-matched control subjects (mean age 41.2±11.1; range, 22 to 68 years) with no history of skin disease and systemic diseases including diabetes, cardiovascular, renal and hepatic diseases were recruited. Dermatology Life Quality Index (DLQI) scores were calculated using a 10-item self-administered questionnaire. The diagnosis of FMS was established according to 2010 American College of Rheumatology diagnostic criteria. Fibromyalgia Impact Questionnaire (FIQ) was used to determine the clinical severity and functional disability, while Visual Analog Scale (VAS) was used to determine pain severity in the patients with FMS.Results The frequency of FMS in patient group was significantly higher than control group (p=0.019). The mean duration of FMS in patient group was significantly higher than control group (p=0.001). There was no significant difference in terms of the age of onset of FMS, FIQ and VAS scores between groups (p=0.53, p=0.54, p=0.07, respectively). DLQI scores were significantly correlated with FIQ scores in the patient group (r=0.43, p=0.008).ConclusionThe frequency of FMS in rosacea patients was significantly higher than control subjects without any skin disease and there was a correlation between disability score of FMS and quality of life score of rosacea. Investigating fibromyalgia symptoms in rosacea patients may be helpful for providing patient-based therapeutic approaches where neurologically based treatments may also be beneficial for rosacea.

Presence of Fibromyalgia Syndrome and Its Relationship with Clinical Parameters in Patients with Axial Spondyloarthritis

Background: Fibromyalgia syndrome (FMS) is a disorder with a population prevalence of 1% to 5%. There are insufficient data in the literature on the incidence of FMS in patients with axial spondyloarthritis (SpA), with only a limited number of studies conducted. Objectives: The aim of this study was to determine the presence of FMS in patients diagnosed with axial SpA and to investigate the effect of this coexistence on clinical and laboratory assessments in patients with ankylosing spondylitis. Study Design: This research involved a retrospective analysis of prospectively collected data. Setting: The research took place in an outpatient rheumatology clinic. Methods: This study included 125 patients diagnosed with axial SpA according to the Assessment of Spondyloarthritis International Society criteria. The presence of FMS was investigated according to the 2010 American College of Rheumatology criteria. Pain during activity, resting, and at night was examined using the Visual Analog Scale. Ankylosing Spondylitis Disease Activity Scores were used for assessment of disease activity, Ankylosing Spondylitis Quality of Life Scale was used for quality of life, Bath Ankylosing Spondylitis Functional Index was used for functionality, and Pittsburgh Sleep Quality Index was used for sleep quality. Results: Incidence of FMS was 29.6% in the study population, which consisted of patients who were all diagnosed with axial SpA. Comparison of patient groups with and without FMS revealed no statistically significant differences in age, weight, body mass index, marital status, family history, and smoking history (P &gt; .05), with a higher rate of female patients in the group with FMS at 55% (P &lt; .05). Ankylosing Spondylitis Disease Activity Score-C-Reaktif Protein, Ankylosing Spondylitis Disease Activity Score-Erythyrocyte Sedimentation Rate, Ankylosing Spondylitis Quality of Life Scale, Bath Ankylosing Spondylitis Functional Index, Pittsburgh Sleep Quality Index, and Visual Analog Scale pain scores were significantly higher in the group with FMS (P &lt; .05). Limitation: The study involved a limited number of patients. Conclusions: FMS is observed in one-third of patients with axial SpA. The presence of FMS negatively affects quality of life, functional status, sleep quality, disease activity, and pain level of patients with ankylosing spondylitis. The possibility for coexistence of FMS should be kept in mind when determining the treatment protocols for patients with axial spondyloarthritis, and adjunctive treatment should be given if necessary

Determination of fibromyalgia syndrome in patients with non-cardiac chest pain in accordance with 1990 and 2010 diagnostic criteria

To determine the frequency of Fibromyalgia syndrome (FMS) in accordance with the American College of Rheumatology (ACR) 1990 and ACR 2010 FMS classification criteria, also to assess the pain intensity, functional and emotional status of patients whoare admitted to the cardiology clinic with a complaint of chest pain without a cardiologic pathology. 107 female patients with chest pain, who admitted to cardiology polyclinic after discarding cardiac chest pain, directed to Physical Medicine and Rehabilitation polyclinic, were included to the study. All patients were assessed in terms of age, height, weight, body mass index (BMI), chronic pain duration, Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), Widespread Pain Index (WPI), Symptom Severity Scale (SS) and Back Anxiety Depression Scale (BADS). The ACR was assessed according to the 1990 and 2010 FMS classification criteria. It was found that 3(2.8%) of these patients met only the 1990 criteria, 3(2.8%) only met the 2010 criteria and 16(15%) met both the 1990 and 2010 criteria, but 85(79.4) did not meet any of the criteria. The number of tender points, WPI, SS and FIQ values of the clinical and functional evaluation parameters of FMS were higher in the FMS group and this result was statistically significant (p

Validation of the Greek Version of the Fibromyalgia Rapid Screening Tool

The Fibromyalgia Rapid Screening Tool (FiRST) is a brief, simple, and straightforward self-administered questionnaire that was developed by Perrot etal. for the detection of fibromyalgia syndrome in patients with diffuse chronic pain. The aim of our study was to develop and validate the Greek version of FiRST. The study was set up as a prospective observational study. The original French version of FiRST was adapted into Greek using forward and backward translation. Patients with chronic diffuse pain with a clinical diagnosis of fibromyalgia and osteoarthritis based on the criteria of the American College of Rheumatology were invited to participate to the study. Of the 101 patients who met our inclusion criteria, 42 were diagnosed with fibromyalgia and 59 with osteoarthritis. The 2 groups did not differ significantly regarding gender and pain characteristics (duration, intensity). Cronbach's alpha coefficient was 0.79. Receiver operating characteristic analysis showed an area under the curve of 89% (95% confidence interval=83 to 95%; SE: 0.032, P<0.001). At a cutoff score of ≥5, FiRST showed a sensitivity of 86%, a specificity of 83%, a positive predictive value of 78%, and a negative predictive value of 89%. The intraclass coefficient for the test-retest reliability was 0.96. The Greek version of FiRST is a valid screening tool for fibromyalgia in daily practice.

Prevalence of Fibromyalgia Syndrome and Its Correlations with Arrhythmia in Patients with Palpitations.

It is aimed to determine the prevalence of fibromyalgia syndrome (FMS) and its correlations with arrhythmia in patients with palpitations. Sixty-two patients who underwent electrophysiological study (EPS) due to palpitation complaints in Cardiology department and 40 healthy controls were included in the study. The precise diagnosis of arrhythmia was established using EPS. All participants were screened for FMS using American College of Rheumatology 2010 Fibromyalgia diagnostic criteria. Clinical assessments included measurement of severity of pain, fatigue and morning fatigue with visual analog scale (VAS), functional status with Fibromyalgia Impact Questionnaire (FIQ), and anxiety/depression with Hospital Anxiety and Depression Scale (HAD). FMS was diagnosed in 22 of the 62 patients (36%), and 4 of the 40 healthy controls (10%) (p 0.05). EPS+ patients with FMS had higher fatigue levels, HAD and FIQ scores than EPS- patients, although statistically insignificant. HV durations were statistically longer in the EPS- subgroup (p < 0.05) but other EPS data were similar. FMS frequency and HAD anxiety scores were found to be higher in patients with palpitation complaints. However, we found no association between arrhythmia, EPS parameters and FMS. In our clinical practice we should keep in mind to carry out assessments in terms of FMS in patients with palpitation.

Frequency of fibromyalgia syndrome in patients with central serous chorioretinopathy.

To ınvestigate frequency of fibromyalgia syndrome (FMS) among patients with central serous chorioretinopathy (CSCR). The study included 83 patients with CSCR and 201 age- and sex-matched healthy controls; the mean age was 47.5 ± 11.3 years in the CSCR group (18 women; 21.7%) and 47.2 ± 11.2 years in the control group (44 women; 21.9%). All participants were assessed for FMS based on 2010 American College of Rheumatology diagnostic criteria and for depression and anxiety with the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). FMS was diagnosed in 35 patients (42.2%) from the CSCR group and in 21 individuals (10.4%) from the control group (p<0.001). It was found in 77.77% of the women (14/18) and 32.3% of the men (21/65) in the CSCR group and in 22.7% of the women (10/44) and 7.0% of the men (11/157) in the control group. Familial stress, BDI and BAI scores were higher in the patients with FMS than in those without. When independent risk factors were evaluated by logistic regression analysis, it was found that only the presence of familial stress was a significant risk factor for FMS. Patients with CSCR should be assessed for the presence of FMS, and this should be taken into consideration when developing a treatment plan. Further studies with a larger sample size are needed to clarify the relationship between FMS and CSCR.

FIBROMYALGIA OR CHRONIC WIDESPREAD PAIN: DOES IT MATTER?

The question whether Fibromyalgia syndrome (FMS) is a distinct clinical entity in the context of chronic widespread pain (CWP) have remained challenging after decades of research and several diagnostic criteria that have attempted to clarify FMS. A recent study has raised more challenges on the issue, proposing that diagnosis of FMS in patients representing with CWP is not informative or helpful for clinical practice and such a differentiation will provide little or no significance regarding the choice of effective and safe therapies. This proposal will be further discussed here by reviewing the recent advances in the field of pain medicine. These advances have collectively provided compelling evidence that all individuals with chronic pain, even those classically categorized as originating from peripheral/nociceptive origins have common central contributions to their pain and associated comorbidities. The recent understanding of the pain mechanisms has also provided important implications on classification and management of pain. Centrally acting agents have been recommended as first-line treatment options for FMS and potential use of these agents has been expanded to other chronic pain disorders. After having reviewed the recent advances in the pain field, distinction between CWP and FMS still seems not to be useful in clinical practice, as effective treatment in an individual patient might be much guided by dominant underlying mechanisms rather than specific diagnosis the patient is suffering. The conditions representing with CWP in the absence of definitive objective confirmation may then be classified under one heading such as “CWP”, “chronic pain syndrome” or “central pain”, when considering their similar pattern of clinical presentation, commonality of central sensitization to their pathophysiology and their similar response to centrally acting analgesics. Future research should be directed toward classification of CWP based on the validated measurements of different aspects of pain. Such a classification may help clinicians identify the patients who will preferentially respond to peripheral or centrally acting analgesics and may therefore assist in advancing a more individualized and pain mechanism focused treatment in the clinical setting.

Is it necessary to strictly diagnose fibromyalgia syndrome in patients with chronic widespread pain?

The applicability of the American College of Rheumatology (ACR) 1990 and 2010 criteria for the diagnosis of fibromyalgia syndrome (FMS) was determined in 284 patients with chronic widespread pain (CWP) including those with regional and systemic painful disorders. On the basis of initial evaluation, patients were classified into three groups. Group 1, those without any comorbid disease (N = 105), group 2, those having regional non-inflammatory painful disorders (N = 104), and group 3, those with a diagnosis of an inflammatory rheumatic disease (N = 75). Overall, 65 % of the patients fulfilled the 1990 criteria, while 94 % of them fulfilled the 2010 criteria. Almost all of the patients (97 %) with CWP did meet at least one of the criteria set, regardless of whether they have accompanying painful disorders. Widespread pain index (WPI), symptom severity scale (SS), and fibromyalgia impact questionnaire (FIQ) scores were found to be significantly higher in the patients who satisfied the 1990 criteria than those who did not (P < 0.001). Tender point counts were found to be significantly correlated with WPI, SS, FIQ, and Beck depression inventory (BDI) scores (P < 0.001). The findings of the study support the suggestion that FMS is just a continuum of CWP, rather than a distinct diagnostic entity. As treatment of FMS is usually identical with that of CWP, strict diagnosis of FMS will provide little or no significance from the viewpoint of clinical practice. We suggest that future research should be directed toward classification of CWP to provide guidance to clinicians in selecting effective therapies.

Is a new perspective for definition and diagnostic criteria of fibromyalgia in early stage cancer patients necessary?

Fibromyalgia is a most common pain syndrome characterized by the presence of chronic widespread pain and tenderness with manual palpation. However there is no enough data about frequent of fibromyalgia syndrome in patients with cancer. How often FM is being used in oncological practice and how we are managing this case by medical oncologists. Widespread pain index and symptom severity scale are not clear enough in patients with cancer when ACR-2010 diagnostic criteria for FM are considered. In conclusion, there is it may more prevalence of fibromyalgia in patients with cancer. For the diagnosis of fibromyalgia, be new diagnostic criteria for early-stage cancer patients.

Fibromyalgia Syndrome in Patients with Nasal Septum Deviation

AbstractObjectives: Some studies conducted with patients with obstructive sleep apnea syndrome [OSAS] have suggested an association between sleep-disordered breathing [SDB] and fibromyalgia syndrome [FMS]. Nasal septum deviation [NSD] is a common physical disorder of the nose and it manifests itself with similar complaints, like respiratory distress and headache, as in patients with OSAS. The aim of this study was to determine the frequency of FMS in patients with NSD.Methods: Consecutive patients, 18 to 60 years old, evaluated in an academic otorhinolaryngology outpatient clinic were prospectively recruited for this study. Patients with nasal septal deviation were included in the nasal septum deviation group. Patients without nasal symptom deviation were recruited to serve as controls. All recruited cases were assessed by a single physiatrist for FMS. The FMS diagnosis was made on the basis of the 1990 American College of Rheumatology Research Classification Criteria.Results: One hundred ninety-nine cons...