Skip to main content
Log in

Diagnosis, etiology, and therapy of fibromyalgia

  • Original Articles
  • Published:
Comprehensive Therapy

Conclusion

FMS is an entity and an illness. The symptoms, and the mechanisms responsible for them, are very real. Recognition that these mechanisms are important in all distressed patients results in proper diagnosis and treatment. Study of FMS has provided better understanding of a variety of symptoms experienced by distressed patients, and legitimizes its existence. Incorporation of cognitive-behavioral training into treatment programs may improve outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Martinez JE, Ferraz MB, Sato EI, et al. Fibromyalgia versus rheumatoid arthritis: a longitudinal comparison of the quality of life.J Rheumatol. 1995;22(2):270–274.

    PubMed  CAS  Google Scholar 

  2. Hadler NM. The dangers of the diagnostic process: iatrogenic labeling as in the fibrositis paralogism. In: Hadler NM, ed.Occupational Musculoskeletal Disorders. New York: Raven Press; 1993:16–33.

    Google Scholar 

  3. Wilke WS. Fibromyalgia: more than a label.Cleve Clin J Med. 1996;63:87–89.

    PubMed  CAS  Google Scholar 

  4. Wolfe F, Anderson J, Harkness D, Bennett RM, Caro XJ, Goldenberg DL, et al. A prospective, longitudinal, multicenter study of service utilization and costs in fibromyalgia.Arthritis Rheum. 1997;40:1560–1570.

    Article  PubMed  CAS  Google Scholar 

  5. Gustafsson M, Gaston-Johannson F. Pain intensity and health locus of control: a comparison of patients with fibromyalgia and rheumatoid arthritis.Patient Educ Counseling. 1996;29(2):179–188.

    Article  CAS  Google Scholar 

  6. Moldofsky H, Scarisbrick P, England R, Smythe H. Musculoskeletal symptoms and non-REM sleep disturbance in patients with ‘fibrositis syndrome’ and healthy subjects.Psychosom Med. 1975;37:341–351.

    PubMed  CAS  Google Scholar 

  7. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia.Arthritis Rheum. 1990;33:19–31.

    Article  Google Scholar 

  8. Fibromyalgia: the Copenhagen declaration.Lancet. 1992;340:663–664.

    Google Scholar 

  9. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the multicenter criteria committee.Arthritis Rheum. 1990;33:160–172.

    Article  PubMed  CAS  Google Scholar 

  10. Wolfe F. Fibromyalgia: the clinical syndrome.Rheum Dis Clin North Am. 1989;15:1–18.

    PubMed  CAS  Google Scholar 

  11. Wolfe F, Cathey MA, Kleinheksel SM. Fibrositis (fibromyalgia) in rheumatoid arthritis.J Rheumatol. 1984;11:814–818.

    PubMed  CAS  Google Scholar 

  12. Wolfe F, Cathey MA, Klienheksel SM, et al. Psychological status in primary fibrositis and fibrositis associated with rheumatoid arthritis.J Rheumatol. 1984;11:500–506.

    PubMed  CAS  Google Scholar 

  13. Yunus MB, Masi AT, Caalabro JJ, et al. Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls.Semin Arthritis Rheum. 1981;11:151–171.

    Article  PubMed  CAS  Google Scholar 

  14. Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population.Arthritis Rheum. 1995;38:19–28.

    Article  PubMed  CAS  Google Scholar 

  15. Wolfe F. The relation between tender points and fibromyalgia symptom variables: evidence that fibromyalgia is not a discrete disorder in the clinic.Ann Rheum Dis. 1997;56:268–271.

    Article  PubMed  CAS  Google Scholar 

  16. Croft P, Schollum J, Silman A. Population study of tender point counts and pain as evidence of fibromyalgia.BMJ. 1994;309:696–699.

    PubMed  CAS  Google Scholar 

  17. Moldofsky H, Scarisbrick P. Induction of neurasthenic musculoskeletal pain syndrome by selective sleep stage deprivation.Psychosom Med. 1976;38:35–44.

    PubMed  CAS  Google Scholar 

  18. Moldofsky H. Sleep and fibrositis syndrome.Rheum Dis Clin North Am. 1989;15:91–103.

    PubMed  CAS  Google Scholar 

  19. Wolfe F, Russell RJ, Vipraio G, Ross K, Anderson J. Serotonin levels, pain thresholds and fibromyalgia symptoms in the general population.J Rheumatol. 1997;24:555–559.

    PubMed  CAS  Google Scholar 

  20. Russell IJ. Neurohormonal: abnormal laboratory findings related to pain and fatigue in fibromyalgia.J Musculoskel Pain. 1995;3:59–65.

    Article  Google Scholar 

  21. Russell IJ, Orr MD, Littman B, Vipraio GA, Alboukerk D, Michalek JE, et al. Elevated cerebrospinal fluid levels of substance P in patients with the fibromyalgia syndrome.Arthritis Rheum. 1994;37:1593–1601.

    Article  PubMed  CAS  Google Scholar 

  22. Bradley LA, Alberts KR, Alarcon GS, Alexander MT, Mountz JM, Weigent DA, et al. Abnormal brain regional cerebral blood flow and cerebrospinal fluid levels of substance P in patients and non-patients with fibromyalgia (abstract).Arthritis Rheum. 1996;39(Suppl 9):S212.

    Google Scholar 

  23. Hudson JI, Hudson MS, Pliner LF, Goldenberg DL, Pope HG Jr. Fibromyalgia and major affective disorders: a controlled phenomenology and family history study.Am J Psychiatry. 1985;142:441–446.

    PubMed  CAS  Google Scholar 

  24. Boisset-Pioro MH, Esdaile JM, Fitzcharles M-A. Sexual and physical abuse in women with fibromyalgia syndrome.Arthritis Rheum. 1995;38:235–241.

    Article  PubMed  CAS  Google Scholar 

  25. Wilke WS, Mackenzie AH. Proposed pathogenesis of fibrositis.Cleve Clin Q. 1985;52(2):147–154.

    PubMed  CAS  Google Scholar 

  26. Yunus MB. Towards a model of pathophysiology of fibromyalgia: aberrant central pain mechanisms with peripheral modulation (editorial).J Rheumatol. 1992;19(6):846–850.

    PubMed  CAS  Google Scholar 

  27. Griep EN, Boersma JW, de Kloet ER. Pituitary release of growth hormone and prolactin in the primary fibromyalgia syndrome.J Rheumatol. 1994;21:2125–2130.

    PubMed  CAS  Google Scholar 

  28. Bennett RM, Clark SR, Campbell SM, Burckhardt CS. Low levels of somatomedin C in patients with the fibromyalgia syndrome.Arthritis Rheum. 1992;35:1113–1116.

    Article  PubMed  CAS  Google Scholar 

  29. Crofford LJ, Pillemer SR, Kalogeras KT, Cash JM, Michelson D, Kling MA, et al. Hypothalamic-pituitary-adrenal axis perturbation in patients with fibromyalgia.Arthritis Rheum. 1994;37:1583–1592.

    Article  PubMed  CAS  Google Scholar 

  30. Clauw DJ, Sabol M, Radulovic D, Wilson B, Katz P, Baraniuk J. Serum neuropeptides in patients with both FMS and chronic fatigue syndrome (abstract).J Musculoskel Pain. 1995;3(suppl 1):79.

    Google Scholar 

  31. Wilke WS, Fouad-Tarazi FM, Cash JM, Calabrese LH. The connection between chronic fatigue syndrome and neurally mediated hypotension.Cleve Clin J Med. 1998;65:261–265.

    PubMed  CAS  Google Scholar 

  32. Yunus MB, Kalyan-Raman UP, Masi HE, Aldag JC. Electron microscopic studies of muscle biopsy in primary fibromyalgia syndrome: a controlled and blinded study.J Rheumatol. 1989;16:97–101.

    PubMed  CAS  Google Scholar 

  33. Mountz JM, Bradley L, Modell J, Alexander R, Aaron L, Stewart K, et al. Fibromyalgia in women.Arthritis Rheum. 1995;38(7):926–938.

    Article  PubMed  CAS  Google Scholar 

  34. Sorensen J, Graven-Nielsen G, Henriksson KG, Bengtsson M, Arendt-Nielsen L. Hyperexcitability in fibromyalgia.J Rheumatol. 1998;25:152–155.

    PubMed  CAS  Google Scholar 

  35. Mikkelsson M, Latikka P, Kautainen H, Isomeri R, Isomaki H. Muscle and bone pressure pain threshold and pain tolerance in fibromyalgia patients and controls.Arch Dis Phys Med Rehabil. 1992;73:814–818.

    CAS  Google Scholar 

  36. Wallace DJ, Schwartz E, Chi-Lin H, Peter JB. The ‘rule out lupus’ rheumatology consultation: clinical outcomes and perspectives.J Clin Rheumatol. 1995;1:158–164.

    Article  CAS  PubMed  Google Scholar 

  37. Morand EF, Miller MH, Whittingham S, Littlejohn GO. Fibromyalgia syndrome and disease activity in systemic lupus erythematosus.Lupus. 1994;3:187–191.

    Article  PubMed  CAS  Google Scholar 

  38. Middleton JD, McFarland JE, Lipsky TE. The prevalence and clinical impact of fibromyalgia in systemic lupus erythematosus.Arthritis Rheum. 1994;37:1181–1188.

    Article  PubMed  CAS  Google Scholar 

  39. Gladman DD, Urowitz MD, Gaugh J, MacKinnon A. Fibromyalgia is a major contributor to quality of life in lupus.J Rheumatol. 1997;24:2145–2148.

    PubMed  CAS  Google Scholar 

  40. Vitali C, Tavoni A, Neri R, Castriogiovanni P, Pasero G, Bombardieri S. Fibromyalgia features in patients with primary Sjögren’s syndrome: evidence of a relationship with psychological depression.Scand J Rheumatol. 1989;18:21–27.

    Article  PubMed  CAS  Google Scholar 

  41. Buskila D, Gladman DD, Langvitz P, Urowitz, Smythe HA. Fibromyalgia in HIV infection.J Rheumatol. 1990;17(9):1202–1206.

    PubMed  CAS  Google Scholar 

  42. Wolfe F, Cathey MA, Kleinheksel SM. Fibrositis (fibromyalgia) in rheumatoid arthritis.J Rheumatol. 1994;11:814–818.

    Google Scholar 

  43. Langevitz P, Buskila D, Finkelstein R, et al. Fibromyalgia in familial Mediterranean fever.J Rheumatol. 1994;21:1335–1337.

    PubMed  CAS  Google Scholar 

  44. Goodman SR, Vonfeldt JN, Callegari PE. The prevalence of fibromyalgia in osteoarthritis patients.Arthritis Rheum. 1995;38(suppl):R28.

    Google Scholar 

  45. Dinnerman H, Steere AC. Lyme disease associated with fibromyalgia.Ann Intern Med. 1992; 17:281–285.

    Google Scholar 

  46. Helfenstein M, Feldman D, Sato EI. Prevalence of the fibromyalgia syndrome (FS) in patients diagnosed as suffering from repetitive strain injuries (RSI).J Rheumatol. 1998;25(suppl 52):15.

    Google Scholar 

  47. Petri M, Steckroth J. Fibromyalgia, not active SLE, explains fatigue, HAQ scores, disability and depression scores.Arthritis Rheum. 1996;39(suppl):S68.

    Google Scholar 

  48. Wang B, Gladman DD, Urowitz MB. Fatigue in lupus is not correlated with disease activity.J Rheumatol. 1998;25:892–895.

    PubMed  CAS  Google Scholar 

  49. Calvo-Alen J, Bastian HM, Straton KV, Burgard SL, Mikhail IS, Alarcon GS. Identification of patient subsets among those presumptively diagnosed with, referred, and/or followed-up for systemic lupus erythematosus at a large tertiary care center.Arthritis Rheum. 1995;38:1475–1484.

    Article  PubMed  CAS  Google Scholar 

  50. Urrows S, Affleck G, Tennen H, Higgins P. Unique clinical and psychological correlates of fibromyalgia tender points and joint tenderness in rheumatoid arthritis.Arthritis Rheum. 1994;37:1513–1520.

    Article  PubMed  CAS  Google Scholar 

  51. Drosos AA, Andonopoulos AP, Lagos G, Angelopoulos NV, Moutsopoulos HM. Neuropsychiatric abnormalities in primary Sjögren’s syndrome.Clin Exp Rheumatol. 1989;7:207–209.

    PubMed  CAS  Google Scholar 

  52. Mauch E, Volk C, Kratzsch G, Krapf H, Kornhuber HH, Laufen H, Hummel KG. Neurological and neuropsychiatric dysfunction in primary Sjögren’s syndrome.Acta Neurol Scand. 1994;89:31–35.

    PubMed  CAS  Google Scholar 

  53. Smyth HA, Buskila B, Gladman DD. Performance of scored palpation, a point count, and dolorimetry in assessing unsuspecting non-articulate tenderness.J Rheumatol. 1993;20:352–357.

    Google Scholar 

  54. Wilke WS. Treatment of ‘resistant’ fibromyalgia.Rheum Dis Clin North Am. 1995;21(1):247–260.

    PubMed  CAS  Google Scholar 

  55. Goldenberg DL. Treatment of fibromyalgia syndrome.Rheum Dis Clin North Am. 1989;15:61–67.

    PubMed  CAS  Google Scholar 

  56. Granges G, Ziko P, Littlejohn GO. Fibromyalgia syndrome: assessment of the severity of the condition 2 years after diagnosis.J Rheumatol. 1994;21:523–529.

    PubMed  CAS  Google Scholar 

  57. McCain GA, Bell DA, Mai F, et al. A controlled study of the effects of a supervised cardiovascular fitness training program on the manifestations of the primary fibromyalgia syndrome.Arthritis Rheum. 1988;31:1135–1141.

    Article  PubMed  CAS  Google Scholar 

  58. Nichols DS, Glenn TM. Effects of aerobic exercise on pain perception, affect and level of disability in individuals with fibromyalgia.Phys Ther. 1994;74:327–332.

    PubMed  CAS  Google Scholar 

  59. Carette S, McCain GA, Bell DA, et al. Evaluation of amitriptyline in primary fibrositis: a double blind, placebocontrolled study.Arthritis Rheum. 1986;29:655–659.

    Article  PubMed  CAS  Google Scholar 

  60. Jaeschke R, Adachi J, Guyatt G, et al. Clinical usefulness of amitriptyline in fibromyalgia: the results of 23 N of 1 randomized controlled trials.J Rheumatol. 1991;18:447–451.

    PubMed  CAS  Google Scholar 

  61. Quimby LG, Gratwick GM, Whitney CA, et al. A randomized trial of cyclobenzaprine for the treatment of fibromyalgia.J Rheumatol. 1989;16(suppl 19):140–143.

    Google Scholar 

  62. Reynolds WJ, Moldofsky H, Saskin P, et al. The effects of cyclobenzaprine on sleep physiology and symptoms in patients with fibromyalgia.J Rheumatol. 1991;18:452–454.

    PubMed  CAS  Google Scholar 

  63. Goldenberg D, Mayskiy M, Mossey C, Ruthazer R, Schmid C. A randomized double blind crossover trial of fluoxetine and amitriptyline in the treatment of fibromyalgia.Arthritis Rheum. 1996;39(11):1852–1859.

    Article  PubMed  CAS  Google Scholar 

  64. Burckhardt CS, Mannerkorpi K, Hedenberg L, et al. A randomized controlled clinical trial of education and physical training for women with fibromyalgia.J Rheumatol. 1994;21:714–719.

    PubMed  CAS  Google Scholar 

  65. Buckelew S, et al. The effects of biofeedback and exercise on fibromyalgia: a controlled trial.Arch Phys Med Rehabil. 1992;73:980.

    Google Scholar 

  66. Goldenberg DL, Kaplan KH, Nadeau MG, et al. A controlled study of a stress-reduction, cognitive-behavioral treatment program in fibromyalgia.J Musculoskel Pain. 1994;2:53–66.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Ang, D., Wilke, W.S. Diagnosis, etiology, and therapy of fibromyalgia. Compr Ther 25, 221–227 (1999). https://doi.org/10.1007/BF02889623

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02889623

Keywords

Navigation