How is sleep disturbance related to fibromyalgia? Sleep disturbance is one of the most common complaints of patients with fibromyalgia. It was initially described as “nonrestorative sleep.” Some patients were shown to have an intrusion of alpha rhythms into their stage-IV sleep (“alpha-delta” sleep). However, the same electroencephalographic pattern is often seen in other chronically …
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What are the proposed pathophysiologic mechanisms for fibromyalgia? Fibromyalgia is associated with an augmentation of sensation. Pathophysiologic explanations for fibromyalgia have ranged from primarily central, to a combination of central and peripheral, to primarily peripheral. Here are some examples: • Fibromyalgia is a variation of an affective disorder. This idea was based on its common association …
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Is exercise useful in the treatment of fibromyalgia and myofascial pain syndrome? Yes. The most consistent improvement in fibromyalgia and myofascial pain syndrome occurs with exercise. The exercise hormonal response is abnormal in patients with fibromyalgia (increase in growth hormone concentration, the opposite of normal response), so the frequency and intensity of exercise needs to …
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What are some other interventions that have been studied for the treatment of fibromyalgia? There is a large series investigating the role of diet in treating fibromyalgia. Some studies promote a raw vegetarian diet; others tout Chlorella pyrenoides (algae) as a dietary supplement. Monosodium glutamate and aspartame have both been implicated in producing symptoms common to fibromyalgia …
Role of physical therapy modalities in the treatment of myofascial pain Most studies documenting the efficacy of physical therapy modalities are anecdotal and include relatively small subject numbers. They suggest the efficacy of transcutaneous electrical nerve stimulation (TENS), balneotherapy, ice, massage, ischemic compression (acupressure), and biofeedback in the treatment of myofascial pain. Low-power laser has …
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What treatments are commonly used for fibromyalgia and for myofascial pain? A combination of physical, anesthesiologic, and pharmacologic techniques are employed. Some of the most common treatments involve lidocaine injection or dry-needling of trigger points. These approaches are based on the concept that trigger points represent areas of local muscle spasm. However, the efficacy of …
What laboratory investigations are useful in fibromyalgia? All laboratory values in fibromyalgia are used for exclusionary purposes. There are no characteristic chemical, electrical, or radiographic laboratory abnormalities. However, several consistent investigational serum markers of the disease have been reported in the literature. An increase in cytokines, with a direct relationship between pain intensity and interleukin-8, …