Fibromyalgia 1993 - Medical Litigation News

FIBROMYALGIA 1993

The American College of Rheumatology 1990

CRITERIA[1]:

Widespread pain in combination with

Tenderness at 11 or more of the 18 specific tender point sites.

Any accompanying abnormalities on xray or laboratory investigation are irrelevant. These criteria identified nearly 90% of patients with fibromyalgia and excluded all but 19% of those suffering from disorders which could be confused with fibromyalgia.

MRI studies normal

Magnetic Resonance Imaging has been added to the list of investigations - biochemical, histological, xray -which are unable to demonstrate an abnormality in the muscles of fibromyalgia sufferers[2].

Why are tender points tender?

Electromyography (experimental recording the electrical activity in muscles) demonstrated that tender areas of muscle contained muscle fibres which were in a state of spontaneous contraction[3]. They proposed that this spontaneous contraction arose out of an overactivity of the sympathetic nervous system, which normally automatically controls the activity of muscles in the internal organs.

Additional clinical features

As well as lower pain threshold, sufferers have tenderness of skinfolds, increased skin redness in response to pressure, and greater resistance to compression of some muscles[4].

Disturbed sleep and muscle pain

The deepest stage (four) of sleep is disturbed in fibromyalgia[5]. This is the stage in which most growth hormone is produced by the body. Growth hormone is necessary for the repair and maintenance of healthy muscles.

Quality of life

Women with fibromyalgia scored lower on various measurements of quality of life than women with rheumatoid arthritis, permanent ostomies, chronic obstructive lung disease and insulin dependent diabetes[6].