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Fibromyalgia Community Newsletter #19
Friday, April 19, 2002
Subscription update: 1533 members and 23 new members. Welcome!
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Featured link: We Are FMily support group. Features chat rooms, special guest
chats and message boards. This group has been in existence for over 6 years.
Check it out:
http://tigihiggins.tripod.com/Index.html
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it here</a>
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Featured class: Coping with Fibromyalgia "Coping with Fibromyalgia" is an online
course offered through Suite101.com's Suite University aimed at covering the
basics of dealing with FMS, from diagnosis (and finding the right doctor)
through coping with the physical and emotional aspects, traditional and
alternative treatments, pitfalls of applying for disability and more. The course
runs from May 27 through June 27. It includes 8 lessons with resources
(including a link to your site), and a highly interactive discussion area for
students and instructor to discuss the many aspects of FMS.
There is a text, "Inside Fibromyalgia" by Dr. Mark Pellegrino as well as a large
resource area for additional resources. For more information see
http://www.suite101.com/course.cfm/16603/seminar
AOL users: <a href="http://www.suite101.com/course.cfm/16603/seminar">Read
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This week's news:
1) Resource - Fibromyalgia: It's Not All In Your Head!
2) Abstract - Efficacy of Low Power Laser Therapy in Fibromyalgia
3) Article - Bush Administration Rolls Back Rules Protecting Private Medical
Records
4) Abstract - Quantitative and qualitative perceptual analysis of cold
dysesthesia and hyperalgesia in fibromyalgia
5) Resource - Chronic Fatigue Syndrome: Advances in Epidemiologic, Clinical, and
Basic Science Research
6) Abstract - Use of complementary and alternative treatments by individuals
with fibromyalgia syndrome
7) Article - New Guideline for Arthritis Pain Emphasizes Earlier Effective
Treatment
8) Abstract - Dietary fiber intake in patients with myofascial face pain
9) Resource - Information on reactive hypoglycemia
10) Abstract - Randomised trial of acupuncture compared with conventional
massage and "sham" laser acupuncture for treatment of chronic neck pain
11) Article - FMS sufferer's story
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1) Resource - Fibromyalgia: It's Not All In Your Head!
While some symptoms of depression may overlap, research has shown that
fibromyalgia is not a psychiatric disorder.
Read this article by Lisa Lorden at
http://fmaware.org/patient/research/inyourhead.htm
AOL users: <a href="http://fmaware.org/patient/research/inyourhead.htm">Read
it here</a>
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2) Abstract - Efficacy of Low Power Laser Therapy in Fibromyalgia: A
Single-blind, Placebo-controlled Trial.
Lasers Med Sci 2002;17(1):57-61 Gur A, Karakoc M, Nas K, Cevik R, Sarac J, Demir
E.
Physical Medicine and Rehabilitation, School of Medicine, Dicle University,
Diyarbakir, Turkey.
PMID: 11845369
Low energy lasers are widely used to treat a variety of musculoskeletal
conditions including fibromyalgia, despite the lack of scientific evidence to
support its efficacy.
A randomised, single-blind, placebo-controlled study was conducted to evaluate
the efficacy of low-energy laser therapy in 40 female patients with
fibromyalgia.
Patients with fibromyalgia were randomly allocated to active (Ga-As) laser or
placebo laser treatment daily for two weeks except weekends. Both the laser and
placebo laser groups were evaluated for the improvement in pain, number of
tender points, skinfold tenderness, stiffness, sleep disturbance, fatigue, and
muscular spasm.
In both groups, significant improvements were achieved in all parameters (p<
0.05) except sleep disturbance, fatigue and skinfold tenderness in the placebo
laser group (p>0.05). It was found that there was no significant difference
between the two groups with respect to all parameters before therapy whereas a
significant difference was observed in parameters as pain, muscle spasm, morning
stiffness and tender point numbers in favour of laser group after therapy
(p<0.05). None of the participants reported any side effects.
Our study suggests that laser therapy is effective on pain, muscle spasm,
morning stiffness, and total tender point number in fibromyalgia and suggests
that this therapy method is a safe and effective way of treatment in the cases
with fibromyalgia.
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3) Article - Bush Administration Rolls Back Rules Protecting Private Medical
Records President Bush's Department of Health and Human Services has proposed
changing rules that currently protect patients' medical privacy. The Bush
administration proposal would make it more difficult for patients to determine
in advance who uses their health information and for what purposes.
Current regulations, put in place by the Clinton Administration, require
patients to provide written consent before health care providers disclose their
records to doctors, hospitals, pharmacies, or insurance companies. The Bush
administration would eliminate those requirements, instead saying that patients
must be informed at some point that their records have been disclosed. In
addition, the new Bush rules would make it easier for researchers to view your
private medical records.
The insurance industry hailed the Bush administration decision, since it gives
insurance companies greater access to patients' private medical records. The
insurance industry donated more than $1.6 million to Bush's campaign in 2000.
But privacy advocates blasted the proposal. The decision "cuts the legs off the
privacy regulation," said Janlori Goldman, director of Georgetown University's
Health Privacy Project. [Washington Post; 3/22/02; Center for Responsive
Politics]
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4) Abstract - Quantitative and qualitative perceptual analysis of cold
dysesthesia and hyperalgesia in fibromyalgia.
Pain 2002 Mar;96(1-2):177-87 Berglund B, Harju EL, Kosek E, Lindblom U.
Institute of Environmental Medicine, Karolinska Institutet and Department of
Psychology, Stockholm University, SE-106 91, Stockholm, Sweden PMID: 11932073
Somatosensory perception thresholds, perceived intensity, and quality of
perceptions were assessed in 20 women with fibromyalgia syndrome (FMS) and in
20 healthy age-matched female controls. All patients and controls scaled
perceived intensity and described perceived quality of randomized thermal (Thermotest)
and tactile (von Frey filaments) stimulation. Perceived intensity was scaled by
free-number magnitude estimation and interindividual comparability was
accomplished by Master Scaling. Perceived quality was assessed by choosing
verbal descriptors from a list. Thenar was used as a reference for each modality
tested. All patients were able to reliably scale perceived intensity at thenar,
as well as in pain-affected body areas.
Perception thresholds for cold pain, heat pain, cold-pain tolerance and
heat-pain tolerance were significantly lower in patients than controls. For cold
and tactile stimulation, the master scaled perceived intensities were
significantly higher in patients' pain-affected areas, whereas for warmth/heat
stimulation, the intensities were significantly lower. In the qualitative
perceptual analysis the most striking and significant finding was the aberration
of cold-evoked perceptions in all patients: most stimuli in the range of 30-10
degrees C were reported as heat or other paresthetic or dysesthetic perceptions.
The perceptual quality of warmth, and of touch, did not differ from the
controls. Another aberration was observed in the nociceptive range of thermal
and of tactile stimulation as significantly more frequent pain-related
descriptors than in controls. This indicates a general nociceptive facilitation
in addition to the lower thermal pain thresholds.
The combination of cold hyperesthesia, cold dysesthesia, and multimodal
hyperalgesia suggests a selective pathophysiology at a particular level of
integration, possibly in the insular cortex. It is suggested that the
aberrations revealed by the supraliminal sensory evaluation may be generic for
FMS. Particularly, the aberrations established in all patients for perceived
quality and intensity in the cold sensory channel may be an additional
diagnostic criterion.
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5) Resource - Chronic Fatigue Syndrome: Advances in Epidemiologic, Clinical, and
Basic Science Research
Chronic Fatigue Syndrome: Advances in Epidemiologic, Clinical, and Basic Science
Research highlights the presentations and issues discussed at the Fourth Annual
International Conference of the American Association of Chronic Fatigue Syndrome
(CFS). You will explore the strengths and weaknesses of current case definitions
of CFS and how these can be improved. Also, you will examine how to distinguish
CFS from similar ailments such as fibromyalgia and multiple chemical
sensitivity. This book puts different therapeutic modalities to the test, and
addresses the neurological and psychiatric manifestations associated with CFS.
"Chronic Fatigue Syndrome - Advances in Epidemiologic, Clinical, and Basic
Science Research" - Edited by Roberto Patarca-Montero, MD, PhD E.M. Papper
Laboratory of Clinical Immunology, University of Miami School of Medicine,
Miami, Florida - Haworth Press - 274 pp. with Index. $69.95 hard (ISBN:
0-7890-0697-9); $29.95 soft (ISBN: 0-7890-0821-1).
To order, go to:
http://www.haworthpressinc.com/Orderform
AOL users: <a href="http://www.haworthpressinc.com/Orderform">Read
it here</a> or call 1-800-HAWORTH and indicate CODE HEC25.
For more information: http://listserv.nodak.edu/scripts/wa.exe?A2=ind0003c&L=co-cure&F=&S=&P=3644
AOL users: <a href=http://listserv.nodak.edu/scripts/wa.exe?A2=ind0003c&L=co-cure&F=&S=&P=3644>Read
it here</a>
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6) Abstract - Use of complementary and alternative treatments by individuals
with fibromyalgia syndrome.
J Am Acad Nurse Pract 2000 Aug;12(8):311-6 Barbour C.
PMID: 11930451
Although muscle pain is the primary complaint of patients with fibromyalgia,
there are myriad associated symptoms that cause them to seek healthcare.
Some individuals try alternative treatments when conventional medicine does not
provide symptom relief. A questionnaire was developed to collect information
regarding complementary treatments and their effectiveness.
Sixty individuals visited the researcher's web page and completed and submitted
an online questionnaire on fibromyalgia.
Literature, heat, walking, vitamins, and massage were the interventions tried
most frequently. Literature, aromatherapy, support groups, heat, and massage
were rated the most effective.
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7) Article - New Guideline for Arthritis Pain Emphasizes Earlier Effective
Treatment The American Pain Society (APS) has released a new pain management
guideline that emphasizes earlier targeted treatment. It is the first
evidence-based, multidisciplinary clinical guideline for treating acute and
chronic pain associated with arthritis. The APS hopes that these guidelines will
be integrated into clinical practice by primary care practitioners and primary
arthritis specialists to provide a continuity of effective pain management,
particularly for those suffering from chronic arthritis pain.
"Chronic arthritis pain is more complex [than acute arthritic pain] since it
involves interactions among the biological, psychological, and social factors
that influence pain and function," said Ada Jacox, RN, PhD, chair of the APS
Clinical Guideline Development Committee.
"Until now, it has not been clear how dangerous chronic pain can be with regard
to its effects on psychologic and physiologic well being, including detrimental
effects on immune function," added Arthur Lipman, PharmD, co-chair of the APS
Guideline Committee.
Taking a page from the infection control specialists, pain experts are beginning
to adopt a "hit early, hit hard" mantra with these guidelines. The full text of
this clinical guideline can be obtained on the APS Web site at
http://www.ampainsoc.org/pub/arthritis.htm
AOL users: <a href="http://www.ampainsoc.org/pub/arthritis.htm">Read
it here</a>
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8) Abstract - Dietary fiber intake in patients with myofascial face pain.
Journal: J Orofac Pain 2002 Winter;16(1):39-47 Authors: Raphael KG, Marbach JJ,
Touger-Decker R.
Affiliation: University of Medicine and Dentistry of NJ, NJ Medical School:
Dept. of Psychiatry, NJ Dental School: Dept. of Oral Pathology, Biology, and
Diagnostic Sciences, 183 South Orange Avenue, UBSB Room F1512, Newark, NJ 07103,
USA. raph-@umdnj.edu
NLM Citation: PMID: 11889658
AIMS: To determine the impact of myofascial face pain (MFP) on dietary intake of
selected nutrients.
METHODS: Sixty-one MFP women meeting the criteria for the myofascial subtype of
temporomandibular disorders completed a 4-day daily food intake diary, as well
as self-report of pain severity, pain interference with eating, and depressive
symptomatology. Nutrient intake for the MFP women was compared with a
demographically-equivalent sample of community women participating in the
federally-sponsored Continuing Survey of Food Intakes by Individuals (CFSII).
Within the MFP sample, multiple linear regression analysis was used to test
whether dietary fiber intake reduction was most likely due to pain adaptation,
or to depressive symptomatology or associated appetite reduction.
RESULTS: Only the subgroup of MFP patients with above-average pain severity
showed reduced dietary fiber intake compared with the community sample. MFP
patients did not differ from the community sample on other nutrient intake
measures (i.e., total calories, protein, fat, carbohydrates and dietary fiber,
calcium, and iron). Within the MFP sample, pain severity was significantly
associated with reduced dietary fiber intake. This relationship persisted, after
controlling for depressive symptomatology, appetite, and total calories.
CONCLUSION: Myofascial face pain patients with more severe pain intensity are
likely to reduce their intake of dietary fiber. This is likely due to an effort
to decrease masticatory activity to avoid exacerbating facial pain. Since low
dietary fiber, especially in combination with commonly prescribed medications
for MFP, increases the risk of constipation and may exacerbate comorbid medical
conditions, clinicians should recommend alternative dietary fiber sources for
MFP patients.
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9) Resource - Information on reactive hypoglycemia There is a certain type of
hypoglycemia, or low blood sugar, that accompanies many cases of Fibromyalgia
Syndrome and Chronic Myofascial Pain. This is not the same as the fasting
hypoglycemia that shows up on the glucose tolerance test. Reactive hypoglycemia
usually occurs two to three hours after a high carbohydrate meal,
overstimulating insulin release, which triggers an adrenalin response.
Check it out:
http://www.immunesupport.com/library/bulletinarticle.cfm?ID=3498&EM=032702&PROD=n081
AOL users: <a href="http://www.immunesupport.com/library/bulletinarticle.cfm?ID=3498&EM=032702&PROD=n081">Read
it here</a>
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10) Abstract - Randomised trial of acupuncture compared with conventional
massage and "sham" laser acupuncture for treatment of chronic neck pain.
Irnich, D., N. Behrens, et al. (2001).
Bmj 322(7302): 1574-8.
OBJECTIVES: To compare the efficacy of acupuncture and conventional massage for
the treatment of chronic neck pain. DESIGN: Prospective, randomised, placebo
controlled trial. Setting: Three outpatient departments in Germany.
PARTICIPANTS: 177 patients aged 18-85 years with chronic neck pain.
Interventions: Patients were randomly allocated to five treatments over three
weeks with acupuncture (56), massage (60), or "sham" laser acupuncture (61).
MAIN OUTCOME MEASURES: Primary outcome measure: maximum pain related to motion
(visual analogue scale) irrespective of direction of movement one week after
treatment. Secondary outcome measures: range of motion (3D ultrasound real time
motion analyser), pain related to movement in six directions (visual analogue
scale), pressure pain threshold (pressure algometer), changes of spontaneous
pain, motion related pain, global complaints (seven point scale), and quality of
life (SF-36). Assessments were performed before, during, and one week and three
months after treatment. Patients' beliefs in treatment were assessed. RESULTS:
One week after five treatments the acupuncture group showed a significantly
greater improvement in motion related pain compared with massage (difference
24.22 (95% confidence interval 16.5 to 31.9), P=0.0052) but not compared with
sham laser (17.28 (10.0 to 24.6), P=0.327). Differences between acupuncture and
massage or sham laser were greater in the subgroup who had had pain for longer
than five years (n=75) and in patients with myofascial pain syndrome (n=129).
The acupuncture group had the best results in most secondary outcome measures.
There were no differences in patients' beliefs in treatment.
CONCLUSIONS: Acupuncture is an effective short term treatment for patients with
chronic neck pain, but there is only limited evidence for long term effects
after five treatments.
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11) Article - FMS sufferer's story
I am Marie Dabrowski, and this is my story. We all need help with our chronic
pain. The doctors are ignoring us for fear, they want to keep their license; I
can't blame them. So, I forgo my own privacy to ask for help for all of us who
are suffering
Here's the story by Damien Cave (senior writer for Salon.com):
http://salon.com/mwt/feature/2002/04/04/no_relief/index.html
AOL users: <a href="http://salon.com/mwt/feature/2002/04/04/no_relief/index.html">Read
it here</a>
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