Fibromyalgia Syndrome in Chronic Disabling Occupational Musculoskeletal Disorders

Howard, Krista; Mayer, Tom G.; Neblett, Randy; Perez, Yoheli; Cohen, Howard; Gatchel, Robert J.

doi:10.1097/jom.0b013e3181fc838d

Cited by 24 publications

(12 citation statements)

References 35 publications

(36 reference statements)

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“…39,42,44 There were significantly more female subjects in the CSS group, which also confirms previous studies that have found female gender to be a risk factor for many CSSs. 10,20,28,32,36 Of those patients diagnosed with a CSS, the most frequent diagnoses were tension headaches/migraines (39%), myofascial pain syndrome (39%), fibromyalgia (31%), IBS (15%), TMD (12%), PTSD (12%), and restless leg syndrome (8%). Chronic fatigue syndrome (4%), interstitial cystitis (4%), chronic regional pain syndrome (2%), and multiple chemical sensitivities (1%) were diagnosed relatively infrequently.…”

Section: Discussionmentioning

confidence: 99%

The Central Sensitization Inventory (CSI): Establishing Clinically Significant Values for Identifying Central Sensitivity Syndromes in an Outpatient Chronic Pain Sample

Neblett

Cohen

Choi

et al. 2013

The Journal of Pain

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509

537

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Central Sensitization (CS) is a proposed physiological phenomenon in which central nervous system neurons become hyper-excitable, resulting in hypersensitivity to both noxious and non-noxious stimuli. The term Central Sensitivity Syndrome (CSS) describes a group of medically-indistinct (or nonspecific) disorders, such as fibromyalgia, chronic fatigue, and irritable bowel, for which CS may be a common etiology. In a previous study, the Central Sensitization Inventory (CSI) was introduced as a screening instrument for clinicians to help identify patients with a CSS. It was found to have high reliability and validity (test-retest reliability = 0.82; Cronbach’s alpha = 0.88). The present study investigated a cohort of 121 patients who were referred to a multidisciplinary pain center, which specialized in the assessment and treatment of complex pain and psychophysiological disorders, including CSSs. A large percentage of patients (n = 89, 74%) met clinical criteria for one or more CSSs, and CSI scores were positively correlated with the number of diagnosed CSSs. A Receiver Operating Characteristic (ROC) analysis determined that a CSI score of 40 out of 100 best distinguished between the CSS patient group and a non-patient comparison sample (n = 129) (AUC= 0.86, Sensitivity = 81%, Specicifity = 75%). PERSPECTIVE The Central Sensitization Inventory (CSI) is a new self-report screening instrument to help identify patients with Central Sensitivity Syndromes, including fibromyalgia. The present study investigated CSI scores in a heterogeneous pain population, with a large percentage of CSSs, and a normative non-clinical sample, to determine a clinically-relevant cutoff value.

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Section: Discussionmentioning

confidence: 99%

The Central Sensitization Inventory (CSI): Establishing Clinically Significant Values for Identifying Central Sensitivity Syndromes in an Outpatient Chronic Pain Sample

Neblett

Cohen

Choi

et al. 2013

The Journal of Pain

Self Cite

509

537

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“…The extreme severity group was also more likely to be female. Female gender is a known risk factor for CSSs …”

Section: Discussionmentioning

confidence: 99%

“…Female gender is a known risk factor for CSSs. 5,[32][33][34][35] The non-CSS sample was found to be relatively evenly distributed among the severity levels, compared to the CSS sample, which skewed toward the higher severity ranges. The mean CSI score for the non-CSS patient group (M = 44.9) was higher than expected and was higher than the previously published chronic pain sample with no CSS diagnoses (M = 39.0) 3 (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

Establishing Clinically Relevant Severity Levels for the Central Sensitization Inventory

et al. 2016

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“…All of these environmental events increase stress exposure (defined as the external events themselves) and distress (defined by the individual's physiological and emotional responses to stressful events). Increased distress is also a consequence of the chronic pain of FMS itself and its cost to normal work, family, and social functioning [4, 5]. This distress may be greater in those individuals with specific biological predispositions that alter function of the two main stress pathways, the sympathetic (adrenergic) and hypothalamic-pituitary-adrenal (HPA) axes [6].…”

Section: Introductionmentioning

confidence: 99%

Genetics and Gene Expression Involving Stress and Distress Pathways in Fibromyalgia with and without Comorbid Chronic Fatigue Syndrome

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Tadler

et al. 2012

Pain Research and Treatment

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In complex multisymptom disorders like fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS) that are defined primarily by subjective symptoms, genetic and gene expression profiles can provide very useful objective information. This paper summarizes research on genes that may be linked to increased susceptibility in developing and maintaining these disorders, and research on resting and stressor-evoked changes in leukocyte gene expression, highlighting physiological pathways linked to stress and distress. These include the adrenergic nervous system, the hypothalamic-pituitary-adrenal axis and serotonergic pathways, and exercise responsive metabolite-detecting ion channels. The findings to date provide some support for both inherited susceptibility and/or physiological dysregulation in all three systems, particularly for catechol-O-methyl transferase (COMT) genes, the glucocorticoid and the related mineralocorticoid receptors (NR3C1, NR3C2), and the purinergic 2X4 (P2X4) ion channel involved as a sensory receptor for muscle pain and fatigue and also in upregulation of spinal microglia in chronic pain models. Methodological concerns for future research, including potential influences of comorbid clinical depression and antidepressants and other medications, on gene expression are also addressed.

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Fibromyalgia Syndrome in Chronic Disabling Occupational Musculoskeletal Disorders

Abstract: Of this cohort, 23.2% patients met criteria for fibromyalgia. Patients with fibromyalgia were found to show greater psychosocial distress and significantly poorer rates of work return and work retention 1-year postrehabilitation.

Cited by 24 publications

References 35 publications

The Central Sensitization Inventory (CSI): Establishing Clinically Significant Values for Identifying Central Sensitivity Syndromes in an Outpatient Chronic Pain Sample

The Central Sensitization Inventory (CSI): Establishing Clinically Significant Values for Identifying Central Sensitivity Syndromes in an Outpatient Chronic Pain Sample

Establishing Clinically Relevant Severity Levels for the Central Sensitization Inventory

Genetics and Gene Expression Involving Stress and Distress Pathways in Fibromyalgia with and without Comorbid Chronic Fatigue Syndrome

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