Fibrositis

Abstract

Abstract. Fibrositis—muscular or nonarticular rheumatism—is a controversial diagnosis; nevertheless it represents a real entity, whether primary or secondary. The outstanding symptoms are pain and stiffness. Objective findings are “trigger areas” and indurations. The most common sites are the soft tissues of the neck, shoulder, elbow, carpal tunnel, palms (Dupuytren's contracture) and low back, but sometimes the syndrome is generalized. Therapy for each type is outlined. The immediate treatment usually includes the administration of analgesics, immobilization of the affected area, and infiltration of the trigger points with procaine and adrenocortical steroids. Physical therapy (heat, massage and described exercises) is indispensable.

History of fibromyalgia: Past to present

“…He properly noted that men have more localized symptoms (pain) and signs (tender points) given that recent data have shown that men have fewer pain symptom sites and tender points than women [59,60]. Traut [57] discredits Stockman's [32] histologic observations, stating that such findings "had little substantiation." His important contribution was to bring into focus the systemic features of FMS (eg, fatigue, poor sleep, headache, and colitis).…”

“…The next important paper was by Traut [57] of the University of Illinois whose description of fibrositis in 1968 is fairly similar to the one used today. Traut [57] described female gender almost exclusively, generalized aching and stiffness, aching all over, fatigue, headaches, colitis, poor sleep, being "worry worts," and tender points on physical examination.…”

“…Using a diagram, he demonstrated the common sites of tender point locations (eg, occipital muscles, paraspinal muscles, and the origin of the gluteus muscle at the posterior iliac crest). Traut [57] described generalized pain, but also regional ones including carpal tunnel syndrome and Dupuytren's contracture. He further recognized the importance of mind-body interaction in fibrositis.…”

“…First use of the term fibrositis Copeman [55] 1945 First controlled study showing that fibrositic nodules are as frequent in patients with FMS as in control subjects Traut [57] 1968 First near-modern description of FMS with systemic features Smythe [61••] 1972 First modern description of FMS with widespread pain and multiple tender points at specified sites, along with a set of working criteria that stimulated clinical interest and research Moldofsky [62••] 1975 First EEG sleep study showing a disturbance of non-rapid eye movement sleep by an intrusion Hench [21] 1976 First use of the term fibromyalgia Smythe [63] 1977 Brought into focus the importance of sleep with sleep EEG findings and suggested a revised set of criteria for FMS that generated further interest in research Yunus [ [74] 1984 First report of a high prevalence of FMS in rheumatoid arthritis Yunus [72] 1985 First description of juvenile FMS by a controlled study Carette [104], Goldenberg [105] 1986…”

“…Traut [57] described female gender almost exclusively, generalized aching and stiffness, aching all over, fatigue, headaches, colitis, poor sleep, being "worry worts," and tender points on physical examination. Using a diagram, he demonstrated the common sites of tender point locations (eg, occipital muscles, paraspinal muscles, and the origin of the gluteus muscle at the posterior iliac crest).…”