Was sind die Kernsymptome des Fibromyalgiesyndroms?

Haüser, Winfried; Zimmer, C.; Felde, E.; Köllner, Volker

doi:10.1007/s00482-007-0602-z

Cited by 102 publications

(22 citation statements)

References 18 publications

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“…No language restrictions were made; 2) types of participants: patients of any age diagnosed with FMS on recognized criteria were included; 3) types of intervention: studies that compared any kind of BT (mineral/thermal water, spa treatment, thalassotherapy, thermotherapy, peloids, natural therapeutic gas) or HT (treatment in plain water with or without exercise) with no treatment or any active treatment. Studies were excluded if BT/HT treatments were not the main intervention or if the intervention in treatment and control group were the same and only the co-therapies differed; and 4) types of outcome: studies assessing at least one symptom-specific outcome of the major FMS symptoms [18], such as pain (for example, tender point count (TPC), visual analog scale (VAS)), fatigue, sleep disturbances, depressive symptoms, health-related quality of life (HRQOL) and/or relevant pain-related psychological issues such as self-efficacy pain and/or objective tests of physical fitness, were included.…”

Section: Methodsmentioning

confidence: 99%

Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials

Naumann

Sadaghiani

2014

Arthritis Res Ther

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IntroductionIn the present systematic review and meta-analysis, we assessed the effectiveness of different forms of balneotherapy (BT) and hydrotherapy (HT) in the management of fibromyalgia syndrome (FMS).MethodsA systematic literature search was conducted through April 2013 (Medline via Pubmed, Cochrane Central Register of Controlled Trials, EMBASE, and CAMBASE). Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model.ResultsMeta-analysis showed moderate-to-strong evidence for a small reduction in pain (SMD −0.42; 95% CI [−0.61, −0.24]; P < 0.00001; I2 = 0%) with regard to HT (8 studies, 462 participants; 3 low-risk studies, 223 participants), and moderate-to-strong evidence for a small improvement in health-related quality of life (HRQOL; 7 studies, 398 participants; 3 low-risk studies, 223 participants) at the end of treatment (SMD −0.40; 95% CI [−0.62, −0.18]; P = 0.0004; I2 = 15%). No effect was seen at the end of treatment for depressive symptoms and tender point count (TPC).BT in mineral/thermal water (5 studies, 177 participants; 3 high-risk and 2 unclear risk studies) showed moderate evidence for a medium-to-large size reduction in pain and TPC at the end of treatment: SMD −0.84; 95% CI [−1.36, −0.31]; P = 0.002; I2 = 63% and SMD −0.83; 95% CI [−1.42, −0.24]; P = 0.006; I2 = 71%. After sensitivity analysis, and excluding one study, the effect size for pain decreased: SMD −0.58; 95% CI [−0.91, −0.26], P = 0.0004; I2 = 0. Moderate evidence is given for a medium improvement of HRQOL (SMD −0.78; 95% CI [−1.13, −0.43]; P < 0.0001; I2 = 0%). A significant effect on depressive symptoms was not found. The improvements for pain could be maintained at follow-up with smaller effects.ConclusionsHigh-quality studies with larger sample sizes are needed to confirm the therapeutic benefit of BT and HT, with focus on long-term results and maintenance of the beneficial effects.

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Section: Methodsmentioning

confidence: 99%

Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials

Naumann

Sadaghiani

2014

Arthritis Res Ther

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“…FMS patients report a wide array of somatic and psychological symptoms, with each contributing to a varying degree of symptom burden and functional disablement [6, 7]. FMS continues to present a challenge for healthcare professionals of various disciplines as well as for patients.…”

Section: Introductionmentioning

confidence: 99%

Classification and Clinical Diagnosis of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines

Fitzcharles

Shir

Ablin

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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Objectives. Fibromyalgia syndrome (FMS), characterized by subjective complaints without physical or biomarker abnormality, courts controversy. Recommendations in recent guidelines addressing classification and diagnosis were examined for consistencies or differences. Methods. Systematic searches from January 2008 to February 2013 of the US-American National Guideline Clearing House, the Scottish Intercollegiate Guidelines Network, Guidelines International Network, and Medline for evidence-based guidelines for the management of FMS were conducted. Results. Three evidence-based interdisciplinary guidelines, independently developed in Canada, Germany, and Israel, recommended that FMS can be clinically diagnosed by a typical cluster of symptoms following a defined evaluation including history, physical examination, and selected laboratory tests, to exclude another somatic disease. Specialist referral is only recommended when some other physical or mental illness is reasonably suspected. The diagnosis can be based on the (modified) preliminary American College of Rheumatology (ACR) 2010 diagnostic criteria. Discussion. Guidelines from three continents showed remarkable consistency regarding the clinical concept of FMS, acknowledging that FMS is neither a distinct rheumatic nor mental disorder, but rather a cluster of symptoms, not explained by another somatic disease. While FMS remains an integral part of rheumatology, it is not an exclusive rheumatic condition and spans a broad range of medical disciplines.

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“…Depressive symptoms are frequently present in FMS patients [1]. To control for possible confounding effects of depression on study results, we additionally investigated a group of ten patients (nine women, one men; median age: 50 years, range 39–75) with monopolar major depression without pain.…”

Section: Methodsmentioning

confidence: 99%

“…Fibromyalgia syndrome (FMS) is a chronic pain condition that is regularly associated with additional symptoms like depressive mood, fatigue, and sleep disturbance [1]. The pathophysiology of pain in FMS is incompletely understood.…”

Section: Introductionmentioning

confidence: 99%

Skin cytokine expression in patients with fibromyalgia syndrome is not different from controls

et al. 2014

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BackgroundFibromyalgia syndrome (FMS) is a chronic pain syndrome of unknown etiology. There is increasing evidence for small nerve fiber impairment in a subgroup of patients with FMS. We investigated whether skin cytokine and delta opioid receptor (DOR) gene expression in FMS patients differs from controls as one potential contributor to small nerve fiber sensitization.MethodsWe investigated skin punch biopsies of 25 FMS patients, ten patients with monopolar depression but no pain, and 35 healthy controls. Biopsies were obtained from the lateral upper thigh and lower calf. Gene expression of the pro-inflammatory cytokines tumor necrosis factor-alpha (TNF), interleukin (IL)-6, and IL-8 and of the anti-inflammatory cytokine IL-10 was analyzed using quantitative real-time PCR and normalizing data to 18sRNA as housekeeping gene. Additionally, we assessed DOR gene expression.ResultsAll cytokines and DOR were detectable in skin samples of FMS patients, patients with depression, and healthy controls without intergroup difference. Also, gene expression was not different in skin of the upper and lower leg within and between the groups and in FMS patient subgroups.ConclusionsSkin cytokine and DOR gene expression does not differ between patients with FMS and controls. Our results do not support a role of the investigated cytokines in sensitization of peripheral nerve fibers as a potential mechanism of small fiber pathology in FMS.

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Was sind die Kernsymptome des Fibromyalgiesyndroms?

Abstract: The key symptoms of FM are chronic widespread pain, non-restorative sleep and subjective disabilities. The frequency of general and extra-musculoskeletal symptoms underlines that FMS is more than just a "pain disorder".

Cited by 102 publications

References 18 publications

Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials

Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials

Classification and Clinical Diagnosis of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines

Skin cytokine expression in patients with fibromyalgia syndrome is not different from controls

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