Muscle Biopsy Findings in Primary Fibromyalgia and Other Forms of Nonarticular Rheumatism

Yunus, Muhammad B.; Kalyan‐Raman, Uma P.

doi:10.1016/s0889-857x(21)00037-5

Cited by 66 publications

(5 citation statements)

References 12 publications

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“…Hidden musculoskeletal inflammation manifested also by elevated CRP levels cannot be ruled out in some of our patients 14. Yet, CRP levels did not change significantly among our patients, alluding to the possibility that the elevated CRP levels were not related to causes responding to systemic steroids.…”

Section: Discussionmentioning

confidence: 52%

Effect of intramuscular depot betamethasone injection in patients with fibromyalgia and elevated C-reactive protein levels

Dirawi

2022

Journal of Investigative Medicine

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Fibromyalgia is characterized by diffuse musculoskeletal pain and fatigue. There are limited data about systemic steroid treatment of patients with fibromyalgia in the English literature. Patients with fibromyalgia with ongoing diffuse musculoskeletal pain despite standard treatment, extreme fatigue and elevated C-reactive protein (CRP) levels without evidence of synovitis, or other source of inflammation, were asked to participate in our study. After consent, demographic, clinical and laboratory parameters in addition to body mass index were documented. These patients were interviewed and asked to answer the Revised Fibromyalgia Impact Questionnaire (FIQR) just prior, 1 and 4 weeks following 14 mg depot betamethasone intramuscular injection. Twenty-three patients were recruited and 21 completed the study. 19 patients were women with mean age of 42±10.12 and CRP level of 14.1±3.96 mg%, and all had negative rheumatoid factor and antinuclear antibodies. All patients had significant improvement in all of the FIQR parameters, at 1 and 4 weeks, except memory, anxiety and balance. It can be concluded that systemic intramuscular depot betamethasone injection seems to have a favorable effect in patients with fibromyalgia with elevated CRP levels for at least 4 weeks.

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Section: Discussionmentioning

confidence: 52%

Effect of intramuscular depot betamethasone injection in patients with fibromyalgia and elevated C-reactive protein levels

Dirawi

2022

Journal of Investigative Medicine

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“…11,12 Muscle biopsies have shown evidence of hypoxia, which could be due to increased muscle pressure interfering with small blood vessel flow. 13,14 Yunus and Kalyan-Raman 14 reviewed controlled studies regarding muscle biopsies in FMS patients and concluded that results are negative by the usual light microscopic, histochemical, and electron microscopic examinations. Henriksson 15 found muscle fiber degeneration and hypoxia in resting muscles with a decrease in high-energy phosphates.…”

Section: Discussionmentioning

confidence: 99%

“…The pain in FMS may be due to tight, hypertense muscles 11,12 . Muscle biopsies have shown evidence of hypoxia, which could be due to increased muscle pressure interfering with small blood vessel flow 13,14 …”

Section: Discussionmentioning

confidence: 99%

Muscle Pressure Correlates With Pain Levels in Fibromyalgia Patients

Katz,

Adler,

Small

et al. 2024

J Clin Rheumatol

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Background/Objective We evaluated patients with fibromyalgia syndrome (FMS) to determine whether there is a correlation between pain scores based on a 0- to 10-point visual analog scale (VAS) and muscle pressure. Methods One hundred forty-two patients who satisfied the American College of Rheumatology classification criteria for FMS and 38 non-FMS controls comprised the study groups. Muscle pressure was measured in mm Hg using a pressure gauge attached to a no. 22 needle inserted into the midportion of the trapezius muscle. The muscle pressure was then correlated with the VAS pain score of 0 to 10, some with an increment of 0.5. A second muscle pressure was obtained from 19 patients at a subsequent visit, which was compared with their pain scores. Results The mean (SD) pain score for 142 patients with FMS was 6.6 (SD, 1.84) on a 0- to 10-point VAS. The mean pain score in the non-FMS subjects was 0.7 (SD, 1.26). The mean muscle pressure in the FMS group was 32.9 (SD, 6.57) mm Hg. The mean muscle pressure in the non-FMS subjects was 10.6 (SD, 3.85) mm Hg. The calculated Pearson correlation coefficient for muscle pressure versus pain score was 0.8312 (p < 0.0001). This indicates a highly significant association between subjects' muscle pressure and pain scores. For the repeat muscle pressures, the change in muscle pressure was correlated with the change in pain score, and the resulting Pearson correlation coefficient was 0.9255 (p < 0.0001). These results again indicate a highly significant association between subjects' muscle pressure and pain scores. Conclusion The results show that increased muscle pressure may be a significant cause of pain in FMS, and the etiology of the pain may have a large peripheral component in addition to a centralized origin of the pain.

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“…Derived from both Latin (fi bra -fi ber) and Greek words (myo-muscle and algos -pain), it literally means "pain in the muscle and fi brous tissues". 12 Since then, the studying of fi bromyalgia has gathered momentum. A Medline literature review found that the total number of medical articles dealing with fi bromyalgia/FMS has increased 5-fold during this past decade, 13 with non rheumatology journals publishing substantially more articles compared to a decade ago.…”

Section: History In Briefmentioning

confidence: 99%

Clinical Aspects and Management of Fibromyalgia Syndrome

Chong

Ng²

2009

Ann Acad Med Singap

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Fibromyalgia syndrome (FMS) is a chronic and debilitating musculoskeletal pain disorder of unknown aetiology with usual accompanying features of fatigue, sleep disturbances and stiff- ness. Its place in medical textbooks was controversial with rheumatologists holding the helm of its management for many years. Over the last decade, abnormalities have been identified at multiple levels in the peripheral, central, and sympathetic nervous systems as well as the hypothalomo-pitutary-adrenal axis stress response system. With the elucidation of these pathways of pain, FMS is known more as a central sensitivity syndrome. This led to tremendous increment in interest in both pharmacological and non-pharmacological treatment of FMS. The United States Food and Drug Administration (FDA) has also successively approved 3 drugs for the management of fibromyalgia – pregabalin, duloxetine and milnacipran. Non-pharmacological modalities showed aerobic exercise, patient education and cognitive behavioural therapy to be most effective. Overall, management of FMS requires a multi-disciplinary approach. Key words: Aetiology, Fibromyalgia-Fibromyositis Syndromes, History, Pain syndrome

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Muscle Biopsy Findings in Primary Fibromyalgia and Other Forms of Nonarticular Rheumatism

Cited by 66 publications

References 12 publications

Effect of intramuscular depot betamethasone injection in patients with fibromyalgia and elevated C-reactive protein levels

Effect of intramuscular depot betamethasone injection in patients with fibromyalgia and elevated C-reactive protein levels

Muscle Pressure Correlates With Pain Levels in Fibromyalgia Patients

Clinical Aspects and Management of Fibromyalgia Syndrome

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