May 2011 References   Devin J. Starlanyl   for http://www.sover.net/~devstar

Arnold LM, Clauw DJ, McCarberg BH. 2011. Improving the Recognition and Diagnosis of Fibromyalgia. Mayo Clin Proc. 86(5):457-464. “Fibromyalgia (FM) is a chronic widespread pain disorder often seen in primary care practices. Advances in the understanding of FM pathophysiology and clinical presentation have improved the recognition and diagnosis of FM in clinical practice. Fibromyalgia is a clinical diagnosis based on signs and symptoms and is appropriate for primary care practitioners to make. The hallmark symptoms used to identify FM are chronic widespread pain, fatigue, and sleep disturbances. Awareness of common mimics of FM and comorbid disorders will increase confidence in establishing a diagnosis of FM.”

Azadeh H, Dehghani M, Zarezadeh A. 2010. Incidence of trapezius myofascial trigger points in patients with the possible carpal tunnel syndrome. J Res Med Sci. 15(5):250-255. “The findings of this study imply the significant correlation between occurrence of CTS (carpal tunnel syndrome) and MTP (myofascial trigger points) suggested that clinicians consider the probability of existence of MTP in patients referred for diagnosis of CTS.” 

Beauchet O, Annweiler C, Verghese J et al. 2011. Biology of gait control: Vitamin D involvement. Neurology. [Apr 6 Epub ahead of print]. “Low levels of vitamin D may be associated with disturbed gait control.”

Fiz J, Duran M, Capella D et al. 2011. Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life. PLoS One. 6(4):e18440. “The use of cannabis was associated with beneficial effects on some FM symptoms. Further studies on the usefulness of cannabinoids in FM patients as well as cannabinoid system involvement in the pathophysiology of this condition are warranted.”

Ge HY, Arendt-Nielsen L. 2011. Latent myofascial trigger points. Curr Pain Headache Rep May 11 [Epub ahead of print] The treatment of latent TrPs may improve function, decrease sensitivity to pain, prevent the activation of those TrPs, and, if caught in time, may prevent the development of myofascial pain syndrome.

Giamberardino MA, Affaitati G, Fabrizio A et al. 2011. Effects of Treatment of Myofascial Trigger Points on the Pain of Fibromyalgia. Curr Pain Headache Rep. [May 5 Epub ahead of print]. “FMS is mainly rooted in the central nervous system, while TrPs have a peripheral origin. However, the nociceptive impulses from TrPs may have significant impact on symptoms of FMS, probably by enhancing the level of central sensitization typical of this condition. Several attempts have been made to assess the effects of treatment of co-occurring TrPs in FMS. We report the outcomes of these studies showing that local extinction of TrPs in patients with fibromyalgia produces significant relief of FMS pain. Though further studies are needed, these findings suggest that assessment and treatment of concurrent TrPs in FMS should be systematically performed before any specific fibromyalgia therapy is undertaken.”

Guan H, Koceja DM. 2011. Effects of long-term tai chi practice on balance and h-reflex characteristics. Am J Chin Med. 39(2):251-260. “The findings of this study support the positive effects of Tai Chi exercise on balance control under different conditions.”

Hauser W, Kuhn-Becker H, von Wilmoswky H et al. 2011. Demographic and clinical features of patients with fibromyalgia syndrome of different settings: a gender comparison. Gend Med. 8(2):116-125. “A total of 1023 patients (885 female, 138 male) were included in the analysis..... We found no relevant gender differences in the clinical picture of FMS. The assumption of well-established gender differences in the clinical picture of FMS could not be supported.”

Jimenez-Sanchez S, Jimenez-Garcia R, Hernandez-Barrera V et al. 2011. Invalidating musculoskeletal pain is associated with psychological distress and drug consumption: a Spanish population case-control study. J Musculoskel Pain. 19(2):76-86. “The IMP (invalidating musculoskeletal pain) subjects showed two times more probability of presenting psychological distress compared to those without pain. Women with IMP had more probability of suffering from psychological distress than men. Finally, psychological distress was related to a greater consumption of tranquilizers.”  Educating care providers and companions of peopel with TrPs is a key to their psychological health.

Johanson E, Brumagne S, Janssens L et al. 2011. The effect of acute back muscle fatigue on postural control strategy in people with and without recurrent low back pain.  Eur Spine J. [May 1 Epub ahead of print]. “...these findings suggest that impaired back muscle function, as a result of acute muscle fatigue or pain, may lead to an inability to adapt postural control strategies to the prevailing conditions.”  When we are hurt or fatigued, we are less able to control our gross motor function and posture, and more likely to be injured.

Loretan S, Duvoisin B, Scolozzi P. 2011. Unusual fatal petrositis presenting as myofascial pain and dysfunction of the temporal muscle. Quintessence Int. 42(5):419-422. “Petrositis is a rare and severe complication of acute otitis media and mastoiditis.... We report here the unusual case of an 86-year-old man who presented with a handicapping myofascial pain and dysfunction syndrome of the right temporal muscle as a heralding manifestation of an unusual form of petrositis. The patient progressively developed a retropharyngeal abscess, a right sphenoid sinusitis, and fatal meningitis..... This case demonstrated that (1) myofascial pain and dysfunction syndrome that does not respond to conventional treatments may suggest an unusual etiology and warrant further medical investigations and a detailed medical history and that (2) petrositis can manifest itself with atypical clinical symptoms and radiologic signs.”      

Nicolaidis C. 2011. Police Officer, Deal-Maker, or Health Care Provider? Moving to a Patient-Centered Framework for Chronic Opioid Management. Pain Med. [May 3 Epub ahead of print].

 “How we frame our thoughts about chronic opioid therapy greatly influences our ability to practice patient-centered care. Even providers who strive to be nonjudgmental may approach clinical decision-making about opioids by considering if the pain is real or they can trust the patient. Not only does this framework potentially lead to poor or unshared decision-making, it likely adds to provider and patient discomfort by placing the provider in the position of a police officer or a judge. Similarly, providers often find themselves making deals with patients using a positional bargaining approach. Even if a compromise is reached, this framework can potentially inadvertently weaken the therapeutic relationship by encouraging the idea that the patient and provider have opposing goals. Reframing the issue can allow the provider to be in a more therapeutic role. As recommended in the American Pain Society/American Academy of Pain Medicine guidelines, providers should decide whether the benefits of opioid therapy are likely to outweigh the harms for a specific patient (or sometimes, for society) at a specific time. This article discusses how providers can use a benefit-to-harm framework to make and communicate decisions about the initiation, continuation, and discontinuation of opioids for managing chronic nonmalignant pain. Such an approach focuses decisions and discussions on judging the treatment, not the patient. It allows the provider and the patient to ally together and make shared decisions regarding a common goal. Moving to a risk-benefit framework may allow providers to provide more patient-centered care, while also increasing provider and patient comfort with adequately monitoring for harm.”

Park CH, Huh BK, Lee SH et al. 2011. Efficacy of oblique fluoroscopic approach for stellate ganglion block. J Musculoskel Pain. 19(2):101-104. “The C7 oblique approach SGB (stellate ganglion block) showed the same SGB effects compared with the C7 anterior approach SGB, and did not cause hoarseness. We concluded that the C7 oblique approach SGB may be a beneficial method for patients.”  Spinal pathology is a frequent perpetuating factor for TrPs in CMP.  It is good to have the safest options for controlling spinal pain. DJS]

Williams DA, Clauw DJ, Glass JM. 2011. Perceived cognitive dysfunction in fibromyalgia syndrome. J Musculoskel Pain. 19(2):66-75. “In general, perceived dyscognition in FMS was most strongly associated with fatigue and mood. Pain was uniquely associated with perceived language deficits, and sleep was uniquely associated with aspects of  dyscognition involving memory. Somewhat unexpected, pain was not related to attention or concentration….These data suggest that perceived dyscognition is a multi-faceted clinical concern in individuals with FMS. When assessed, dyscognition should reflect the multi-dimensionality of the symptom in order to be valid. Treatments aimed at dyscognition should similarly consider the importance of addressing multiple types of dyscognition in order to be considered effective.” Many tests that measure cognitive dysfunction in patients with FM do not have the specific sensitivity required.