Oral fluoroquinolones and risk of fibromyalgia

Ganjizadeh-Zavareh, Saeed; Sodhi, Mohit; Spangehl, Tori; Carleton, Bruce; Etminan, Mahyar

doi:10.1111/bcp.13765

Cited by 6 publications

(11 citation statements)

References 15 publications

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“…69 Applying this sort of logic, we may find more factors linking myofibroblasts to myofascial pain. 70–73…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…69 Applying this sort of logic, we may find more factors linking myofibroblasts to myofascial pain. [70][71][72][73] It is unclear where the tipping point between a status quo of movement-sedentarism and a deranged myofibroblast activity is. It is likely multifactorial, but lifestyle seems to be a major factor.…”

Section: Pathophysiological Considerationsmentioning

confidence: 99%

“…4,9,74,79,80 Since MPS is so prevalent, also common overlooked factors in a lifestyle that is not evolution-oriented may be suspected, eg, medications that are shown to both induce myofibroblasts and increase risk of chronic pain conditions. 72,73 Symptomatologic considerations TrPs and myofascial pain, particularly when severe, can cause various symptoms that are not limited to the fascial-muscular-skeletal system. It is suggested that the sympathetic nervous system (SNS) causes TrPs.…”

Section: Pathophysiological Considerationsmentioning

confidence: 99%

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Scoping review and interpretation of Myofascial Pain/Fibromyalgia syndrome: an attempt to assemble a medical puzzle

Plaut

2021

Preprint

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Introduction: Myofascial Pain Syndrome (MPS) is a common overlooked and underdiagnosed condition, and with significant burden. MPS is often dismissed by clinicians while patients remain in pain for years. MPS can evolve into fibromyalgia, however, effective treatments for both are lacking due to absence of a clear mechanism. Many studies focus on central sensitization. Therefore, the purpose of this scoping review is to systematically search cross-disciplinary empirical studies of MPS, focusing on mechanical aspects, and suggest an organic mechanism explaining how it might evolve into fibromyalgia. Hopefully, it will advance our understanding of this disease. Methods: Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro and medrXiv, majority with no time limit. Inclusion/exclusion based on title and abstract, then full text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. PROSPERO yet to adapt registration for scoping reviews. Findings: 734 records included. Fascia can adapt to various states by reversibly changing biomechanical and physical properties. Trigger points, tension, and pain are a hallmark of MPS. Myofibroblasts play a role in sustained myofascial tension. Tension can propagate in fascia, possibly supporting a tensegrity framework. Movement and mechanical interventions treat and prevent MPS, while living sedentarily predisposes to MPS and recurrence. Interpretation: MPS can be seen as a pathological state of imbalance in a natural process; manifesting from the inherent properties of the fascia, triggered by a disrupted biomechanical interplay. MPS might evolve into fibromyalgia through deranged myofibroblasts in connective tissue, or "fascial armoring", which may explain pain, distribution of pain, decreased pressure/pain threshold, and other phenomena eg, occasional complete resolution after surgery. Movement is an underemployed requisite in modern lifestyle. Lifestyle is linked to pain and suffering. The mechanism of needling is suggested to be more mechanical than currently thought. MPS should no longer be overlooked but solidified in the domain of common modern medicine.

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“…69 Applying this sort of logic, we may find more factors linking myofibroblasts to myofascial pain. 70–73…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Pathophysiological Considerationsmentioning

confidence: 99%

Section: Pathophysiological Considerationsmentioning

confidence: 99%

See 2 more Smart Citations

Scoping review and interpretation of Myofascial Pain/Fibromyalgia syndrome: an attempt to assemble a medical puzzle

Plaut

2021

Preprint

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“…As a consequence, "floxed" patients go undiagnosed or misdiagnosed. The majority of their symptoms are still being unjustly attributed to anxiety and depression, or other umbrella-diseases including fibromyalgia [16]. While this is currently a problematic aspect of FQAD, plenty of clinical and laboratory evidence indicates that FQs are strongly associated with cellular toxicity causing specific side effects.…”

Section: Introductionmentioning

confidence: 99%

Fluoroquinolones-Associated Disability: It Is Not All in Your Head

et al. 2021

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Fluoroquinolones (FQs) are a broad class of antibiotics typically prescribed for bacterial infections, including infections for which their use is discouraged. The FDA has proposed the existence of a permanent disability (Fluoroquinolone Associated Disability; FQAD), which is yet to be formally recognized. Previous studies suggest that FQs act as selective GABAA receptor inhibitors, preventing the binding of GABA in the central nervous system. GABA is a key regulator of the vagus nerve, involved in the control of gastrointestinal (GI) function. Indeed, GABA is released from the Nucleus of the Tractus Solitarius (NTS) to the Dorsal Motor Nucleus of the vagus (DMV) to tonically regulate vagal activity. The purpose of this review is to summarize the current knowledge on FQs in the context of the vagus nerve and examine how these drugs could lead to dysregulated signaling to the GI tract. Since there is sufficient evidence to suggest that GABA transmission is hindered by FQs, it is reasonable to postulate that the vagal circuit could be compromised at the NTS-DMV synapse after FQ use, possibly leading to the development of permanent GI disorders in FQAD.

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Risk of fibromyalgia following antibiotic prescriptions: A population‐based case–control study

Armstrong,

Dregan,

Ashworth

et al. 2024

European Journal of Pain

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BackgroundThe health of the gut microbiome is now recognized to be an important component of the gut–brain axis which itself appears to be implicated in pain perception. Antibiotics are known to create dysbiosis in the microbiome, so whether fibromyalgia is more commonly diagnosed after antibiotic prescriptions provides a means of exploring the role of the microbiome in the experience of chronic pain.MethodsA case–control study was carried out using electronic health records collected in the UK's Clinical Practice Research Datalink (CPRD), a comprehensive database of primary care consultations. For each case of diagnosed fibromyalgia, three controls were identified and matched by age, gender and GP practice. The exposure variable was the number and timing of antibiotic prescriptions over previous years. The analysis involved adjusting for a wide range of co‐variates that might be possible confounders.ResultsA total of 44,674 cases of fibromyalgia were identified together with 133,513 controls. After adjusting for co‐variates, it was found that both the total number of prescriptions and their timing was associated with an FM diagnosis. For example, the quartile with the highest number of prescriptions and that with the longest exposure had a greater than three‐fold increase in FM diagnoses (number of prescriptions: odds ratio 3.92; 95% CIs: 3.71–4.13; exposure odds ratio 3.28; CIs: 3.13–3.43). Some antibiotics (such as tetracyclines and metronidazole) seemed to confer greater risk than others.ConclusionsThe results lend support for prior antibiotics being an important risk factor for a diagnosis of FM.SignificanceThis study shows an association between the volume as well as timing of prior antibiotic prescriptions and of a subsequent diagnosis of fibromyalgia in primary care.

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Oral fluoroquinolones and risk of fibromyalgia

Cited by 6 publications

References 15 publications

Scoping review and interpretation of Myofascial Pain/Fibromyalgia syndrome: an attempt to assemble a medical puzzle

Scoping review and interpretation of Myofascial Pain/Fibromyalgia syndrome: an attempt to assemble a medical puzzle

Fluoroquinolones-Associated Disability: It Is Not All in Your Head

Risk of fibromyalgia following antibiotic prescriptions: A population‐based case–control study

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