Fibromyalgia and myofascial pain syndrome: diagnostic features


Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

Fibromyalgia and myofascial pain syndrome are the most common causes of chronic musculoskeletal pain in the practice of a neurologist. Fibromyalgia is a syndrome characterized by chronic musculoskeletal pain and the presence of palpable dolorogenic zones, defined as discrete areas of soft tissue, painful when pressed with little effort, indistinguishable from surrounding healthy tissue. At the same time, myofascial pain syndrome is associated with impaired motor and sensory functions and is characterized by the presence of myofascial trigger zones - hyperirritable nodes in skeletal muscle fibers. Currently, the differential diagnosis of these conditions is difficult due to the lack of clear criteria for diagnosis, and, therefore, these diseases are not correctly diagnosed too often. The wrong diagnosis of any of the conditions leads to a number of negative consequences, including unnecessary analyzes and examinations by various specialists, lack of improvement of symptoms, lengthening the time to establish the correct diagnosis, frustration of patients and increasing burden on the health care system as a whole. The article presents modern data on the pathophysiology, criteria for diagnosis and differential diagnosis of these conditions.

Texto integral

Acesso é fechado

Sobre autores

Aleksandr Tkachev

Medical and Diagnostic Center “Medical Institute n.a. Berezin Sergey"; Tkachev Clinic, TMM-Clinic

Email: tkachevclinic@mail.ru
Neurologist

A. Epifanov

Medical and Diagnostic Center “Medical Institute n.a. Berezin Sergey"; Doctor Epifanov Clinic

E. Akarachkova

International Society “Stress Under Control"

A. Smirnova

Medical and Diagnostic Center “Medical Institute n.a. Berezin Sergey"

A. Iljushin

Medical and Diagnostic Center “Medical Institute n.a. Berezin Sergey"

D. Archakov

Tkachev Clinic, TMM-Clinic

Bibliografia

  1. Кадырова Л.Р., Акарачкова Е.С., Керимова К.С. и др. Мультидисциплинарный подход к пациенту с хронической болью. РМЖ. 2018;7:28-32.
  2. Голубенко Е.О., Силина Е.В., Орлова А.С. Персонифицированный подход в лечении болевых синдромов. Современная наука: актуальные проблемы теории и практики. Серия: Естественные и технические науки. 2017;7-8:107-12.
  3. Hawker G.A. The assessment of musculoskeletal pain. Clin Exp Rheumatol. 2017;35(Suppl. 107, 5):8-12.
  4. Данилов А.Б. Фибромиалгия: диагностика и лечение (обзор). Поликлиника. 2016;4(3):18-
  5. Skaer T.L., Kwong WJ. illness perceptions and burden of disease in fibromyalgia. Expert Rev Pharmacoecon Outcomes Res. 2017;17(1):9-15. Doi: https://doi.org/10.1080/14737167.2017.) 270207.
  6. Borg-Stein J., laccarino M.A. Myofascial pain syndrome treatments. Phys Med Rehabil Clin N. Am. 2014; 25(2):357-74. Doi: https://doi. org/10.1016/j.pmr. 2014.01.012.
  7. Rivers W.E., Garrigues D., Graciosa J., et al. Signs and symptoms of myofascial pain: An international survey of pain management providers and proposed preliminary set of diagnostic criteria. Pain Med. 2015; 16(9): 1794-805. Doi: https://doi. org/10.1111/pme.12780.
  8. Queiroz L.P. Worldwide epidemiology of fibromyalgia. Curr Pain Headache Rep. 2013;17(8):356. Doi: https://doi.org/10.1007/ s11916-013-0356-5.
  9. Vincent A., Lahr B.D., Wolfe F., et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthr Care Res. 2013;65(5):786-92. Doi: https://doi. org/10.1002/acr.21896.
  10. Wolfe F., Smythe H.A., Yunus M.B., et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthr Rheum. 1990;33(2):160-72.
  11. Wolfe F., Clauw D.J., Fitzcharles M.A., et al. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. J. Rheumatol. 2011;38(6):1113-22. Doi: https://doi.org/10.3899/jrheum.100594.
  12. Курушина О.В., Барулин А.Е., Данилов А.Б. Миофасциальный болевой синдром. РМЖ. 2015;23(30):22-6.
  13. Money S. Pathophysiology of Trigger Points in Myofascial Pain Syndrome. J. Pain Palliat Care Pharmacother. 2017;31(2):158-59. Doi: https:// doi.org/10.1080/15360288.2017.1298688.
  14. Saxena A., Chansoria M., Tomar G., Kumar A. Myofascial pain syndrome: an overview. J. Pain Palliat Care Pharmacother. 2015;29(1):16-21. Doi: https://doi.org/10.3109/15360288.2014.9 97853.
  15. Simons D.G., Travell J.G., Simons L.S. Myofascial pain and dysfunction: The trigger point manual (2nd ed.). Baltimore, MD: Williams &Wilkins, 1999.
  16. Bourgaize S., Newton G., Kumbhare D., Srbely J. A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management. J. Can Chiropr Assoc. 2018;62(1):26-41.
  17. Gerwin R.D. Diagnosing fibromyalgia and myofascial pain syndrome: a guide. J. Fam Pract. 2013;62(12, Suppl. 1):19-25.
  18. Perle S.M. Tender points/fibromyalgia vs. trigger points/myofascial pain syndrome: a need for clarity in terminology and differential diagnosis. J. Manipulative Physiol Ther. 1996;19(2):146-47.
  19. Myburgh C., Larsen A.H., Hartvigsen J. A systematic, critical review of manual palpation for identifying myofascial trigger points: evidence and clinical significance. Arch Phys Med Rehabil. 2008;89(6): 1169-76. Doi: https://doi. org/10.1016/j.apmr.2007.12.033.
  20. Tough E.A., White A.R., Richards S., Campbell J. Variability of criteria used to diagnose myofascial trigger point pain syndrome-evidence from a review of the literature. Clin J. Pain. 2007;23(3):278-86. Doi: https://doi. org/10.1097/ajp.0b013e31802fda7c
  21. Gerwin R.D. Diagnosis of myofascial pain syndrome. Phys Med Rehabil Clin N Am. 2014;25(2):341 55. Doi: https://doi.org/10.1007/978-3-642-05468-6_2
  22. Sabour S. Methodological Issues on the Accuracy and Precision of Clinical Examination in the Diagnosis of Myofascial Pain Syndrome. Pain Med. 2018;19(12):2573. Doi: https://doi. org/10.1093/pm/pny100.
  23. Shah J.P., Danoff J.V., Desai M.J., et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil. 2008;89(1):16-23. Doi: https://doi. org/10.1016/j.apmr.2007.10.018.
  24. Rickards L.D. The effectiveness of non-invasive treatments for active myofascial trigger point pain: A systematic review of the literature. Int J. Osteopath Med. 2006;9(4):120-36. Doi: https:// doi.org/10.1016/j.ijosm.2006.07.007.
  25. Latremoliere A., Woolf C. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J. Pain. 2009;10(9):895-926. Doi: https://doi.org/10.1016/j.jpain.2009.06.012.
  26. Hong C.Z. New trends in myofascial pain syndrome. Zhonghua Yi Xue Za Zhi (Taipei). 2002;65(11):501-12.
  27. Hocking M.J.L. Exploring the central modulation hypothesis: Do ancient memory mechanisms underlie the pathophysiology of trigger points? Topical collection on myofascial pain. Curr Pain Headache Rep. 2013;17(7):347. Doi: https://doi. org/10.1007/s11916-013-0347-6.
  28. Srbely J.Z., Dickey J.P., Lee D., et al. Dry needle stimulation of myofascial trigger points evokes segmental antinociceptive effects. J. Rehabil. Med. 2010;42(5):463-68. Doi: https://doi. org/10.2340/16501977-0535.
  29. Wolfe F., Brahler E., Hinz A., et al. Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: Results from a survey of the general population. Arth Care Res (Hoboken). 2013;65(5):777-85. Doi: https://doi.org/10.1002/acr.21931.
  30. Wolfe F., Clauw D.J., Fitzcharles M.A., et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arth. Care Res. 2010;62(5):600-10. Doi: https://doi. org/10.1002/acr.20140.
  31. Woolf C.J., Salter M.W. Neuronal plasticity: increasing the gain in pain. Science. 2000;288(5472):1765-69. Doi: https://doi. org/10.1126/science.288.5472.1765.
  32. Woolf C.J. Central sensitization: Implications for the diagnosis and treatment of pain. Pain. 2011;152(3):2-15. Doi: https://doi. org/10.1016/j.pain.2010.09.030.
  33. Russell I.J., Vaeroy H., Javors M., et al. Cerebrospinal fluid biogenic amine metabolites in fibromyalgia/ fibrositis syndrome and rheumatoid arthritis. Arth Rheum. 1992;35(5):550-56. Doi: https://doi. org/10.1002/art.1780350509.
  34. Woolf C.J. Pain: moving from symptom control toward mechanism-specific pharmacologic management. Ann Intern Med. 2004;140(6):441 51. Doi: https://doi.org/10.7326/0003-4819-140-8-200404200-00010
  35. Eich W., Bar K.J., Bernateck M., et al. Definition, classification, clinical diagnosis and prognosis of fibromyalgia syndrome: Updated guidelines 2017 and overview of systematic review articles. Schmerz. 2017;31(3):231-38. Doi: https://doi. org/10.1007/s00482-017-0200-7.
  36. Tunks E., McCain G.A., Hart L.E., et al. The reliability of examination for tenderness in patients with myofascial pain, chronic fibromyalgia and controls. J. Rheum. 1995;22(5):944-52.
  37. Al-Shenqiti A.M., Oldham J.A. Test-retest reliability of myofascial trigger point detection in patients with rotator cuff tendonitis. Clin Rehabil. 2005; 19(5):482-8 7. Doi: https://doi. org/10.1191/0269215505cr791oa.
  38. Боровая Т.В., Захаренко А.Г., Силивончик Н.Н. и др. Фибромиалгия. Вопросы диагностики и лечения. Вопросы организации и информатизации здравоохранения. 2016;(Suppl.):64-7
  39. Lucas N., Macaskill P., Irwig L., et al. Reliability of physical examination for diagnosis of myofascial trigger points: a systematic review of the literature. Clin J. Pain. 2009;25(1):80-9. Doi: https://doi. org/10.1097/ajp.0b013e31817e13b6.
  40. Tough E.A., White A.R., Richards S., et al. Variability of criteria used to diagnose myofascial trigger point pain syndrome-evidence from a review of the literature. Clin J. Pain. 2007;23(3):278-86. Doi: https://doi.org/10.1097/ ajp.0b013e31802fda7c.
  41. Myburgh C., Larsen A.H., Hartvigsen J. A systematic, critical review of manual palpation for identifying myofascial trigger points: Evidence and clinical significance. Arch Phys Med Rehabil. 2008;89(6):1169-76. Doi: https://doi. org/10.1016/j.apmr.2007.12.033.
  42. Sciotti V.M., Mittak V.L., DiMarco L., et al. Clinical precision of myofascial trigger point location in the trapezius muscle. Pain. 2001;93(3):259-66. Doi: https://doi.org/10.1016/s0304-3959(01)00325-6.
  43. Dommerholt J., Bron C., Franssen J. Myofascial trigger points: an evidence-informed review. J. Man Manip Ther. 2006;14(4):203-21. Doi: https:// doi.org/10.1179/106698106790819991.
  44. Dommerholt J., Gerwin R.D. A critical evaluation of Quintner et al: missing the point. J. Bodyw Mov Ther 2015;19(2):193-204. Doi: https:// doi.org/10.1016/j.jbmt.2015.01.009.
  45. Ge H.Y., Nie H., Madeleine P., et al. Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome. Pain. 2009;147(1-3):233-40. Doi: https://doi.org/10.1016/s1090-380K09) 60508-5.
  46. Quintner J.L., Bove G.M., Cohen M.L. A critical evaluation of the trigger point phenomenon. Rheum. (Oxford). 2015;54(3):392-99. Doi: https://doi.org/10.1093/rheumatology/kev095.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar

Declaração de direitos autorais © Bionika Media, 2019

Este site utiliza cookies

Ao continuar usando nosso site, você concorda com o procedimento de cookies que mantêm o site funcionando normalmente.

Informação sobre cookies