December 2012 References  Devin J. Starlanyl   for

Ablin JN, Oren A, Cohen S et al. 2012. Prevalence of fibromyalgia in the Israeli population: a population-based study to estimate the prevalence of fibromyalgia in the Israeli population using the London Fibromyalgia Epidemiology Study Screening Questionnaire (LFESSQ). Clin Exp Rheumatol. [Nov 21 Epub ahead of print]. “Fibromyalgia represents the tip of the iceberg of chronic pain in the general population. We have attempted to estimate the prevalence of fibromyalgia in the Israeli population, using the London Fibromyalgia Epidemiology....The prevalence of the fibromyalgia syndrome in the Israeli population is considerable and constitutes a significant health care issue. The prevalence is similar to that observed in other western populations. Based on this tool, over 25% of fibromyalgia cases appear to be among males, a proportion higher than generally appreciated.” [This is the same proportion of male FM patients I encountered. DJS]

Akkaya N, Akkaya S, Atalay NS et al. 2012. Assessment of the relationship between postural stability and sleep quality in patients with fibromyalgia. Clin Rheumatol. [Nov 21 Epub ahead of print]. “Worse postural performance and fall risk found in the fibromyalgia patients compared to controls were related with the sleep quality in the last 24 h and level of fatigue.”

Alvarez TL, Kim EH, Vicci VR et al. 2012. Concurrent vision dysfunctions in convergence insufficiency with traumatic brain injury. Optom Vis Sci. 89(12):1740-1751. “Convergence insufficiency without simultaneous visual or vestibular dysfunctions was observed in about 9% of the visually symptomatic TBI (traumatic brain injury) civilian population studied. A thorough visual and vestibular examination is recommended for all TBI patients.”

Boelens OB, Scheltings MR, Houterman S et al. 2012. Randomized clinical trial of trigger point infiltration with lidocaine to diagnose anterior cutaneous nerve entrapment syndrome. Br J Surg. [Nov 23 Epub ahead of print]. “Entrapped branches of intercostal nerves may contribute to the clinical picture in some patients with chronic abdominal pain. Pain reduction following local infiltration in these patients was based on an anesthetic mechanism and not on a placebo or a mechanical (volume) effect.”

Bovaira M, Penarrocha M, Penarrocha M. et al. 2012. Radiofrequency treatment of cervicogenic headache. Med Oral Patol Cir Bucal. [Dec 10 Epub ahead of print]. This study revealed three areas of severe facial pain originating in other locations: one each in cervical roots C2 and C3 and one from an atlantoaxial joint level trigger point.  They were all treated with pulsed radiofrequency The first two patients had 30-50% relief versus baseline after one year, the third had complete pain relief for 5 months, after which the pain returned. [Nothing was done to correct the perpetuating factors. DJS]

Campos RP, Vazquez MI. 2012. The impact of fibromyalgia on health-related quality of life in patients according to age. Rheumatol Int. [Nov 15 Epub ahead of print]. “Previous studies show controversial results regarding the influence of age on health-related quality of life (HRQOL) in patients with Fibromyalgia (FM)....   it is important to control age effect on HRQOL to determine the specific impact of FM. Controlling the age effect on the HRQOL with standardized scores, elderly (over 60) women with FM have less impact of the disease on the physical and social dimensions of the HRQOL than younger patients”.

Castro-Sanchez AM, Mataran-Penarrocha GA, Lopez-Rodriguez MM et al. 2012. Gender Differences in Pain Severity, Disability, Depression, and Widespread Pressure Pain Sensitivity in Patients with Fibromyalgia Syndrome without Comorbid Conditions. Pain Med. [Nov 21 Epub ahead of print]. “To determine the differences in pain, disability, depression, and pressure sensitivity between men and women with fibromyalgia syndrome (FMS), and to analyze the relationship between pain and pressure sensitivity in FMS.....Women with FMS showed higher pain severity and lower PPT than men, whereas men exhibited longer duration of symptoms and disability. In men with FMS, the intensity of ongoing pain was positively correlated to pressure hyperalgesia over the neck. This study suggests that FMS could show a different phenotype in women and men and confirm that women exhibit lower PPT than men.” [No check for TrPs.]

Cheng ST, Chow PK, Song YQ et al. 2012. Mental and Physical Activities Delay Cognitive Decline in Older Persons with Dementia. Am J Geriatr Psychiatry. [Nov 5 Epub ahead of print].  “Mahjong and TC can preserve functioning or delay decline in certain cognitive domains, even in those with significant cognitive impairment.”

Deakon RT. 2012. Chronic musculoskeletal conditions associated with the cycling segment of the triathlon; prevention and treatment with an emphasis on proper bicycle fitting. Sports Med Arthrosc. 20(4):200-205. “Cycling-related injuries account for 20% of all injuries occurring during triathlons. Traumatic injuries caused by falls or accidents are thankfully rare but can be highly variable and very serious in nature. The best approach to these injuries is prevention. The majority of complaints arising from cycling are due to overuse or poor technique. The knee joint, lower back, neck, and Achilles tendon are the most frequently affected anatomic sites. Anterior knee pain, lower back and neck myofascial pain, iliotibial band friction syndrome, and Achilles tendonitis are the most common diagnoses. Initial treatment should always use rest, ice, compression, and elevation. Muscle strengthening and stretching as well as other physical modalities are helpful in the subacute setting. The need for surgery is rare. Improper bike fit contributes to the causation of a significant number of these conditions. Bike geometry may also be altered to alleviate symptoms.”

Eftekhar-Sadat B, BabaeiGhazani A, Zeinolabedinzadeh V. 2012. Evaluation of dry needling in patients with chronic heel pain due to plantar fasciitis. Foot (Edinb). [Nov 28 Epub ahead of print]. This study from Iran found that although dry needling did not seem to improve range of motion of ankle joint in dorsiflexion or plantar extension, it helped improve pain significantly and should be tried before more invasive forms of treatment are attempted. [Other TrPs could have been involved in the Ankle ROM, including TrPs in the tibialis anterior, anterior gluteus minimus, peroneus muscles and ankle retinaculua. All involved muscles must all be treated with manual therapy, electoceutical modalities such as ultrasound, stretch and spray and other noninvasive alternatives and perpetuating factors brought under control before anything more invasive is considered. DJS]

Fors EA, Landmark T, Bakke O. 2012. Contextual and time dependent pain in fibromyalgia: An explorative study. BMC Res Notes. 5(1):644. “Little is known about contextual effects on chronic pain, and how vulnerability factors influence pain in different contexts. We wanted to examine if fibromyalgia (FM) pain varied between two social contexts, i.e. at home versus in a doctor office, when it was measured the same day, and if pain was stable for 14 years when measured in similar contexts (doctor office). Our secondary aim was to explore if pain vulnerability factors varied in the two different contexts.....Pain and pain predictors seem to vary by contexts and time, with less pain at home than to a doctor the same day, but with unchanged pain in the same context after 14 years. Thus, contextual pain cues should be accounted for when pain is measured and treated, e.g. by focusing more on home-measured pain and by optimizing the doctor office context. This explorative study should be followed up by a larger full-scale study.

Friedberg F, Williams DA, Collinge W. 2012. Lifestyle-oriented non-pharmacological treatments for fibromyalgia: a clinical overview and applications with home-based technologies. J Pain Res. 5:42535. Many of these treatments help and are cost-effective. [It is unfortunate that co-existing conditions such as myofascial trigger points, insulin resistance and other illnesses were not considered, although the study was basically aimed at controlling some common perpetuating factors. DJS]   

Guven H, Cilliler AE, Comoglu SS. 2012. Cutaneous allodynia in patients with episodic migraine. Neurol Sci. [Nov 23 Epub ahead of print].  “The results of present study revealed that cutaneous allodynia was rather frequent in episodic migraine, particularly in patients having longer disease duration. Higher frequency of allodynia in women and its association with menstrually related migraine may be related to the effects of hormonal factors on cutaneous pain thresholds and central sensitization. Association of nausea and phonophobia with allodynia may be interpreted as the common pathways are shared in the development of these symptoms.”

Hauser W, Bohn D, Kuhn-Becker H et al. 2012. Is the association of self-reported childhood maltreatments and adult fibromyalgia syndrome attributable to depression? A case control study. Clin Exp Rheumatol. [Nov 6 Epub ahead of print]. Systematic reviews of case-control studies demonstrated an association between self-reported childhood sexual and physical abuse and fibromyalgia syndrome (FMS). We tested in a case-control study if the association of self-reported childhood maltreatments in childhood and in adult FMS-patients is attributable to depression....Reports of FMS-patients some on childhood maltreatments were biased by depressed mood. However, the difference in self-reported childhood sexual abuse between adult FMS-patients and population controls was not attributable to depression.

Jeon JH, Jung YJ, Lee JY et al. 2012. The effect of extracorporeal shock wave therapy on myofascial pain syndrome. Ann Rehabil Med. 36(5):665-674. “The ESWT (extracorporeal shock wave therapy) in patients with MPS (myofascial pain syndrome) in trapezius muscle are as effective as TPI (trigger point injections) and TENS (transcutaneous electrical nerve stimulation) for the purpose of pain relief and improving cervical range of motion.”

Jerschow E, McGinn AP, de Vos G. et al. 2012. Dichlorophenol-containing pesticides and allergies: results from the US National Health and Nutrition Examination Survey 2005-2006. Ann Allergy Asthma Immunol. 109(6):420-425. “High urine levels of dichlorophenols are associated with the presence of sensitization to foods in a US population. Excessive use of dichlorophenols may contribute to the increasing incidence of food allergies in westernized societies. [We must be diligent about being more aware and concerned about our environment. As we pollute it, it pollutes us. DJS]

Ji HM, Kim HJ, Han SJ. 2012. Extracorporeal shock wave therapy in myofascial pain syndrome of upper trapezius. Ann Rehabil Med. 36(5):675-680. “ESWT (extracorporeal shock wave therapy) in myofascial pain syndrome of upper trapezius is effective to relieve pain after four times therapies in two weeks. But further study will be required with more patients, a broader age range and more males.”

Katz RS. P956: Learning disability in fibromyalgia patients: FMS patients report more language and spatial difficulties. Presented at: American College of Rheumatology 2012 Annual Meeting; Nov 10-14, Washington.  Fibromyalgia patients report more learning disability symptoms than patients with rheumatoid arthritis. Patients with FM, RA, systemic lupus erythematosus and healthy controls were compared in a survey of reading, writing, body awareness/spatial relationships and oral expressive language. Patients with FM had worse reading and oral expressive language scores than controls, and worse scores in all areas than RA and SLE groups.  They made mistakes such as skipping words or lines; in remembering what they read; understanding the main concept or details of the story; in grammar or punctuation; with tendency to be clumsy or uncoordinated; with hand-eye coordination; in finding the right words to say in a conversation; or in getting to the point of a conversation. This can make it very challenging to learn, especially in a school situation, or in a job.  [This can make life difficult in general.  It is good to understand that this is part of the problem. The spatial manifestations may be part of the use if the alternate kynurenine metabolic pathway and quinolinic acid production in FM.  The clumsiness and hand-eye coordination may be associated with myofascial trigger point proprioceptive concomitants. Patients were not screened for co-existing TrPs. DJS]

Klaver-Krol EG, Zwarts MJ, Ten Klooster PM et al. 2012. Abnormal muscle membrane function in fibromyalgia patients and its relationship to the number of tender points. Clin Exp Rheumatol. [Nov 22 Epub ahead of print]. “Fibromyalgia (FM) is a disorder characterized by chronic widespread pain in soft tissues, especially in muscles. Previous research has demonstrated a higher muscle fibre conduction velocity (CV) in painful muscles of FM patients. The primary goal of this study was to investigate whether there is also a difference in CV in non-painful, non-tender point (TP) related muscles between FM patients and controls. The secondary goal was to explore associations between the CV, the number of TPs and the complaints in FM....The results demonstrate abnormally high muscle membrane conduction velocity in FM, even in non-TP muscles. In addition, a relationship has been found between the high membrane velocity and the number of TPs. [These authors considered tender points and trigger points to be the same. DJS]

Lee SJ, Kim DY, Chun MH et al. 2012.  The effect of repetitive transcranial magnetic stimulation on fibromyalgia: a randomized sham-controlled trial with 1-mo follow-up. Am J Phys Med Rehabil. 91(12):1077-1085. “In the low-frequency group, the Beck Depression Inventory scores significantly decreased from baseline to 1 mo after rTMS. The visual analog scale and Korean version of the Fibromyalgia Impact Questionnaire scores significantly decreased immediately after rTMS. In the high-frequency group, the visual analog scale and Beck Depression Inventory scores were significantly decreased immediately after rTMS....

Low-frequency rTMS may play a role in the long-term treatment of fibromyalgia. Notably, the findings of this study are the first to show that the right dorsolateral prefrontal cortex or the left motor cortex rTMS could have an antidepressive and pain-modulating effect in patients with fibromyalgia.”

Liu X, Miller YD, Burton NW et al. 2012. The effect of Tai Chi on health-related quality of life in people with elevated blood glucose or diabetes: a randomized controlled trial. Qual Life Res. [Nov 10 Epub ahead of print]. “The aim was to assess the effects of a Tai Chi-based program on health-related quality of life (HR-QOL) in people with elevated blood glucose or diabetes who were not on medication for glucose control.”  “The findings show that this Tai Chi program improved indicators of HR-QOL including physical functioning, role physical, bodily pain and vitality in people with elevated blood glucose or diabetes who were not on diabetes medication.”

Malin K, Littlejohn GO. 2012. Psychological control is a key modulator of fibromyalgia symptoms and comorbidities. J Pain Res. 5:463-471. “FM patients use significantly different control styles compared with healthy individuals. Levels and type of psychological control buffer mood, stress, fatigue, and pain in FM. Control appears to be an important "up-stream" process in FM mechanisms and is amenable to intervention.”

Marcus DA, Bernstein CD, Constantin JM et al. 2012. Impact of Animal-Assisted Therapy for Outpatients with Fibromyalgia. Pain Med. [Nov 21 Epub ahead of print]. “Animal-assisted therapy using dogs trained to be calm and provide comfort to strangers has been used as a complementary therapy for a range of medical conditions. This study was designed to evaluate the effects of brief therapy dog visits for fibromyalgia patients attending a tertiary outpatient pain management facility compared with time spent in a waiting room.  Brief therapy dog visits may provide a valuable complementary therapy for fibromyalgia outpatients.”

Marcus DA, Richards KL, Chambers JF et al. 2012. Fibromyalgia Family and Relationship Impact Exploratory Survey. Musculoskeletal Care. [Nov 21 Epub ahead of print]. Fibromyalgia is frequently associated with impairments in activities of daily living and work disability. Limited data have investigated the impact of fibromyalgia on relationships with family and friends.....Half of participants endorsed that fibromyalgia had mildly to moderately damaged relationship(s) with their spouse(s)/partner(s) or contributed to a break-up with a spouse or partner. Half of participants scored as not being satisfied with their current spouse/partner relationship, with satisfaction negatively affected by the presence of mood disturbance symptoms and higher fibromyalgia severity. Relationships with children and close friends were also negatively impacted for a substantial minority of participants....In addition to physical impairments that are well documented among individuals with fibromyalgia, fibromyalgia can result in a substantial negative impact on important relationships with family and close friends.

Mohammad A, Carey JJ, Storan E et al. 2012. High Prevalence of Fibromyalgia in Patients with HFE-related Hereditary Hemochromatosis. J Clin Gastroenterol. [Nov 21 Epub ahead of print]. “This study reveals a high prevalence of FMS (43%) among subjects with HFE-related hemochromatosis. Prospective studies are needed to better understand the risk factors for FMS in such patients.”

Oztürk O, Tek M, Seven H. 2012. Temporomandibular disorders in scuba divers - an increased risk during diving certification training. J Craniofac Surg. 23(6):1825-1829. The design and fit of a mouthpiece on SCUBA can increase the risk of developing TMJD and TrPs as the diver is constantly struggling to attain mouthpiece stability.

Panton L, Simonavice E, Williams K et al. 2012. Effects of Class IV Laser Therapy on Fibromyalgia Impact and Function in Women with Fibromyalgia. J Altern Complement Med. [Nov 23 Epub ahead of print]. “This study provides evidence that LHT (laser heat therapy) may be a beneficial modality for women with FM in order to improve pain and upper body range of motion, ultimately reducing the impact of FM.”

Proctor SL, Estroff TW, Empting LD et al. 2012. Prevalence of Substance Use and Psychiatric Disorders in a Highly Select Chronic Pain Population. J Addict Med. [Nov 5 Epub ahead of print].  “Certain populations of patients with complex nociceptive, neuropathic, and myofascial pain syndromes may have a lower prevalence of substance use disorders than the general population. They also have concurrent psychiatric disorders, which should be evaluated and treated concomitantly as part of their chronic pain treatment. Despite the low prevalence of substance use disorders, these patients must be continuously monitored for abuse, misuse, and diversion of their medication. The low prevalence may be attributable to the severity of their illness, the patients' inability to achieve pain relief and obtain pain medications easily, and their persistence in pursuing accurate diagnoses and treatment. A major limitation of this study was that it relied on self-report and there were no urine drug screens to report.”

Przekop P, Haviland MG, Zhao Y et al. 2012. Self-reported physical health, mental health, and comorbid diseases among women with irritable bowel syndrome, fibromyalgia, or both compared with healthy control respondents. J Am Osteopath Assoc. 112(11):726-735. “Physicians often encounter patients with functional pain disorders such as irritable bowel syndrome (IBS), fibromyalgia (FM), and their co-occurrence.... Respondents with IBS reported fewer traumatic and major life stressors and better health (ratings and comorbidity data) than respondents with FM or respondents with IBS plus FM. Overall, respondents with both diseases reported the worst stressors and physical-mental health profiles and reported more diagnosed medical, pain, and psychiatric comorbidities....The results revealed statistically significant, relatively large differences in perceptions of quality of life measures and health profiles among the respondents in the control group and the 3 clinical groups.”

Rauck R, Busch M, Marriot T. 2012. Effectiveness of a heated lidocaine/tetracaine topcial patch for pain associated with myofascial trigger points: results of an open-label pilot study. Pain Pract.  [Dec 10 Epub ahead of print]. “The heated lidocaine/tetracaine patch has potential utility as a noninvasive pharmacological approach for managing MTP pain. Further studies are warranted.” [This may be a helpful treatment for one or two trigger points, although perpetuating factors must still be brought under control. DJS]

Roehrs T, Diederichs C, Gillis M et al. 2012. Nocturnal sleep, daytime sleepiness and fatigue in fibromyalgia patients compared to rheumatoid arthritis patients and healthy controls: A preliminary study. Sleep Med. [Nov 10 Epub ahead of print]. “Women with FM have similar nocturnal sleep disturbance as those with RA (rheumatoid arthritis), but FM patients report greater self-rated daytime sleepiness and fatigue than RA and HC, which did not correspond to the relatively low level of objectively determined daytime sleepiness of FM patients. These findings suggest a generalized hyperarousal state in FM.”

Seo HG, Bang MS, Chung SG et al. 2012. Effect of electrical stimulation on botulinum toxin A therapy in patients with chronic myofascial pain syndrome: A 16-week randomized double-blinded study. Arch Phys Med Rehabil. [Oct 31 Epub ahead of print]. Short-term electrical stimulation may affect reduction in pain after BTX-A injection at TrPs in patients with chronic MPS on the neck and shoulder regions. Based on the results, it seems that sensory electrical stimulation was superior to motor electrical stimulation as an adjuvant therapy of BTX-A injection in the patients with chronic MPS. Further studies are warranted to investigate the method facilitating the effect of BTX-A on MPS.

Srikuea R, Symons TB, Long DE et al. 2012. Fibromyalgia is associated with altered skeletal muscle characteristics which may contribute to post-exertional fatigue in post-menopausal women. Arthritis Rheum. [Nov 1 Epub ahead of print]. “Peripheral mechanisms i.e. altered muscle fiber size distribution and decreased capillary density may contribute to post-exertional fatigue in subjects with FM. Understanding these defects in fibromyalgic muscle may provide valuable insight for treatment.” [The authors of this study from Thailand may have been looking at co-existing myofascial trigger points. DJS]

Tekin L, Akarsu S, Durmuş O et al. 2012. The effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial. Clin Rheumatol. [Nov 9 Epub ahead of print]. “The present study shows that the dry needling treatment is effective in relieving the pain and in improving the quality of life of patients with MPS.”

Thompson JM. 2012. Exercise in muscle pain disorders. PM R. 4(11):889-893. “Muscle pain disorders range from local or regional (myofascial pain) to widespread (fibromyalgia). Many people with muscle pain have decreased fitness. Exercise intolerance is a common feature as well, and yet exercise plays an important role in the treatment of muscle pain disorders. Results of studies have shown repeatedly, via multiple modes and methods of delivery, that exercise is at least as effective as the best pharmacologic treatments. An understanding by clinicians and their patients of the unique benefits of a carefully crafted exercise program is one step in the successful management of these often frustrating muscle pain disorders.” Mayo School of Graduate Medical Education

Wolfe F, Walitt BT, Katz RS et al. 2012. Longitudinal patterns of analgesic and central acting drug use and associated effectiveness in fibromyalgia. Eur J Pain. [Nov 21 Epub ahead of print].  “We describe the changing pattern of analgesic and new central acting drug (NCAD) use (pregabalin, duloxetine, milnacipran) in fibromyalgia and measure NCAD effectiveness in clinical practice....There is a changing pattern of drug treatment in fibromyalgia, consisting mostly of decreased NSAID and amitriptyline use and an increase in NCAD. Drug costs are substantially higher because of NCAD use, but we found no evidence of clinical benefit for NCAD compared with prior therapy.

Yang CM, Chen NC, Shen HC et al. 2012. Guideline of neuropathic pain treatment and dilemma from neurological point of view. Acta Neurol Taiwan. 21(3):136-144. “Neuropathic pain is a complicated symptomatic disease as migraine in recent years. Not because the pain character differed from the nociceptive inflammatory symptoms but because of its complexity of mechanisms. Though peripheral sensitization, ectopic discharge, central sensitization, central re-organization and loss of inhibition play part of roles in mechanisms, however, based on this mechanistic treatment, the outcome still disappointed physicians and patients, exampled as central post-stroke central pain (CPSP). The pain reduction is far less than the expectation from patients and physician's under-treatment frequently occur due to the fear of adverse effects or off-label use of these anti-neuropathic pain drugs. Therefore, a multidisciplinary procedure including non-pharmacological management, rehabilitation program, careful explanation, stepwise pain reduction, daily diary record, and tailored individual planning for medications are helpful in treating this kind of sufferers. Pharmacological treatment is the mainstream in post-herpetic neuralgia (PHN), diabetic peripheral neuropathic pain (DPNP), central post-stroke pain (CPSP), trigeminal neuralgia (TN), complex regional pain syndrome (CRPS), cancer pain, failed back syndrome etc, while polypharmacy is still the major prescriptions facing such kind of miserable patients. The tricyclic antidepressants (TCA), gamma-aminobutyric acid (GABA), voltage-dependent calcium channel blockers, selective non-epinephrine reuptake inhibitor (SNRI), opioid or morphine etc, are still evidence-based medicines (EBM) but with different outcome for individuals.” 

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