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Evaluation of treatments for myofascial pain syndrome and fibromyalgia

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Abstract

Myofascial pain syndrome (MPS) and fibromyalgia (FM) are complex conditions and pose significant challenges to clinicians and patients. This chapter explores available treatments for MPS and FM in the context of pathophysiology, clinical evidence, and experimental support. This information may prove to be helpful in designing individualized treatment for patients with these complex syndromes. New treatments should be critically and carefully evaluated as they appear.

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References and Recommended Reading

  1. Wolfe F, Ross J, Anderson J, et al.: The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995, 38:19–28.

    Article  PubMed  CAS  Google Scholar 

  2. Skootsky SA, Jeager B, Oye RK: Prevalence of myofascial pain in general internal medicine practice. West J Med 1989, 151:157–160.

    PubMed  CAS  Google Scholar 

  3. Fishbain DA, Goldberg M, Meagher BR, et al.: Male and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria. Pain 1986, 26:181–197.

    Article  PubMed  CAS  Google Scholar 

  4. Quintner JL, Cohen ML: Fibromyalgia falls foul of a fallacy. Lancet 1999, 353:1092–1094.

    Article  PubMed  CAS  Google Scholar 

  5. Cohen M, Quintner L: Fibromyalgia syndrome, a problem of tautology. Lancet 1993, 342:906–909.

    Article  PubMed  CAS  Google Scholar 

  6. Bohr TW: Fibromyalgia syndrome and myofascial pain syndrome: Do they exist? Neurol Clin 1995, 13:365–384.

    PubMed  CAS  Google Scholar 

  7. Simons DG, Travell JG, Simons PT: Travell and Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual, vol 1: Upper Half of Body. Baltimore: Williams and Wilkins; 1999. The definitive reference on myofascial pain and TrPs. Worth reading for anyone interested in MPS.

    Google Scholar 

  8. Gerwin R, Shannon S, Hong CZ, et al.: Interrater reliability in myofascial trigger point examination. Pain 1997, 69:65–73.

    Article  PubMed  CAS  Google Scholar 

  9. Hubbard DR, Berkoff GM: Myofascial trigger points show spontaneous needle EMG activity. Spine 1993, 18:1803–1807.

    Article  PubMed  CAS  Google Scholar 

  10. Sato J, Perl ER: Adrenergic excitation of cutaneous pain receptors induced by peripheral nerve injury. Science 1991, 251:1608–1610.

    Article  PubMed  CAS  Google Scholar 

  11. Janig W: The sympathetic nervous system in pain: physiology and pathophysiology. In Pain and the Sympathetic Nervous System. Edited by Stanton-Hicks M. Boston, London: Kluwer Academic Publishers; 1990:17–89.

    Google Scholar 

  12. Birklein F, Schmelz M, Schifter S, et al.: The important role of neuropeptides in complex regional pain syndrome. Neurology 2001, 57:2179–2184.

    PubMed  CAS  Google Scholar 

  13. Mense S, Simons DG, Hoheisel U, et al.: Lesions of rat skeletal muscle after local block of acetylcholinesterase and neuromuscular stimulation. J Appl Physiol 2003, 94:2494–2501.

    Article  PubMed  CAS  Google Scholar 

  14. Rivner MH: The neurophysiology of myofascial pain syndrome. Curr Pain Headache Rep 2001, 5:432–440.

    Article  PubMed  CAS  Google Scholar 

  15. Fischer AA: Treatment of myofascial pain. J Musculoskel Pain 1999, 7:131–142.

    Article  Google Scholar 

  16. Quintner JL, Cohen M: Referred pain of peripheral nerve origin: an alternative to the “myofascial pain” construct. Clin J Pain 1994, 10:243–251. An important paper linking MPS to advances in pain neurophysiology.

    Article  PubMed  CAS  Google Scholar 

  17. Simons DG: Myofascial pain syndrome due to trigger points. In Rehabilitation Medicine. Edited by Goodgold J. St. Louis: C.V. Mosby; 1988:686–723.

    Google Scholar 

  18. Cohen Reis E, Holubkov R: Vapocoolant spray is equally effective as EMLA cream in reducing immunization pain in school-aged children. Pediatrics 1997, 100:E5.

    Article  PubMed  CAS  Google Scholar 

  19. Jaeger B, Reeves JL: Quantification of changes in myofascial trigger point sensitivity with the pressure algometer following passive stretch. Pain 1986, 27:203–210.

    Article  PubMed  CAS  Google Scholar 

  20. Hou CR, Tsai LC, Cheng KF, et al.: Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Arch Phys Med Rehabil 2002, 83:1406–1414.

    Article  PubMed  Google Scholar 

  21. Lewit K, Simons DG: Myofascial pain: relief by post-isometric relaxation. Arch Phys Med Rehabil 1984, 65:452–456.

    PubMed  CAS  Google Scholar 

  22. Rosen NB: Physical medicine and rehabilitation approaches to the management of myofascial pain and fibromyalgia syndromes. Baillieres Clin Rheum 1994, 8:881–916.

    Article  CAS  Google Scholar 

  23. McClaflin RR: Myofascial pain syndrome: primary care strategies for early intervention. Postgrad Med 1994, 96:56–59, 63–56, 69–70.

    PubMed  CAS  Google Scholar 

  24. Wright EF, Domenech MA, Fischer JR: Usefulness of posture training for patients with temporomandibular disorders. J Am Dent Assoc 2000, 131:202–210.

    PubMed  CAS  Google Scholar 

  25. Nicolakis P, Erdogmus B, Kopf A, et al.: Effectiveness of exercise therapy in patients with myofascial pain dysfunction syndrome. J Oral Rehab 2002, 29:362–368.

    Article  CAS  Google Scholar 

  26. Cummings TM, White AR: Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil 2001, 82:986–992. Excellent review of trigger point injection.

    Article  PubMed  CAS  Google Scholar 

  27. Borg-Stein J, Stein J: Trigger points and tender points: one and the same? Does injection treatment help? Rheum Dis Clin North Am 1996, 22:305–322.

    Article  PubMed  CAS  Google Scholar 

  28. Lewit K: The needle effect in the relief of myofascial pain. Pain 1979, 6:83–90.

    Article  PubMed  CAS  Google Scholar 

  29. Gunn CC: Intramuscular stimulation (IMS): the technique. http://www.istop.org/html/ims.htm. Accessed July 2003.

  30. Chen JT, Chung KC, Hou CR, et al.: Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots on rabbit skeletal muscle. Am J Phys Med Rehabil 2001, 80:729–735.

    Article  PubMed  CAS  Google Scholar 

  31. Iwama H, Akama Y: The superiority of water-diluted 0.25% to neat 1% lidocaine for trigger-point injections in myofascial pain syndrome: a prospective, randomized, double-blinded trial. Anesth Analg 2000, 91:408–409.

    Article  PubMed  CAS  Google Scholar 

  32. Pere P, Watanabe H, Pitkanen M, et al.: Local myotoxicity of bupivacaine in rabbits after continuous supraclavicular brachial plexus block. Reg Anesth 1993, 18:304–307.

    PubMed  CAS  Google Scholar 

  33. Iwama H, Ohmori S, Kaneko T, et al.: Water-diluted local anesthetic for trigger-point injection in chronic myofascial pain syndrome: evaluation of types of local anesthetic and concentrations in water. Reg Anesth Pain Med 2001, 26:333–336.

    Article  PubMed  CAS  Google Scholar 

  34. Frost FA, Toft B, Aaboe T: [Isotonic saline and methylprednisolone acetate in blockade treatment of myofascial pain: a clinical controlled study]. Ugeskr Laeger 1984, 146:652–654.

    PubMed  CAS  Google Scholar 

  35. Sheean G: Botulinum toxin for the treatment of musculoskeletal pain and spasm. Curr Pain Headache Rep 2002, 6:460–469.

    Article  PubMed  Google Scholar 

  36. Nixdorf DR, Heo G, Major PW: Randomized controlled trial of botulinum toxin A for chronic myogenous orofacial pain. Pain 2002, 99:465–473.

    Article  PubMed  CAS  Google Scholar 

  37. Porta M: A comparative trial of botulinum toxin type A and methylprednisolone for the treatment of myofascial pain syndrome and pain from chronic muscle spasm. Pain 2000, 85:101–105.

    Article  PubMed  CAS  Google Scholar 

  38. Freund BJ, Schwartz M: Treatment of chronic cervicalassociated headache with botulinum toxin A: a pilot study. Headache 2000, 40:231–236.

    Article  PubMed  CAS  Google Scholar 

  39. Rollnik JD, Tanneberger O, Schubert M, et al.: Treatment of tension-type headache with botulinum toxin type A: a doubleblind, placebo-controlled study. Headache 2000, 40:300–305.

    Article  PubMed  CAS  Google Scholar 

  40. Harkins JD, Mundy GD, Stanley SD, et al.: Lack of local anesthetic efficacy of Sarapin in the abaxial sesamoid block model. J Vet Pharmacol Ther 1997, 20:229–232.

    Article  PubMed  CAS  Google Scholar 

  41. Gerwin RD, Dommerholt J: Treatment of myofascial pain syndromes. In Pain Management: A Practical Guide for Clinicians. Edited by Weiner RS. Boca Raton, FL: CRC Press; 1998:217–229.

    Google Scholar 

  42. Chaitow L: Positional release techniques in the treatment of muscle and joint dysfunction. Clinical Bulletin of Myofascial Therapy 1998, 3:25–35.

    Article  Google Scholar 

  43. Harris RE, Clauw DJ: The use of complementary medical therapies in the management of myofascial pain disorders. Curr Pain Headache Rep 2002, 6:370–374.

    Article  PubMed  CAS  Google Scholar 

  44. Hanten WP, Olson SL, Butts NL, et al.: Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points. Phys Ther 2000, 80:997–1003.

    PubMed  CAS  Google Scholar 

  45. Bendtsen L, Jensen R: Amitriptyline reduces myofascial tenderness in patients with chronic tension-type headache. Cephalalgia 2000, 20:603–610.

    Article  PubMed  CAS  Google Scholar 

  46. Fishbain DA, Cutler RB, Rosomoff HL, et al.: Clonazepam open clinical treatment trial for myofascial syndrome associated chronic pain. Pain Med 2000, 1:332–339.

    Article  PubMed  CAS  Google Scholar 

  47. Harkins S, Linford J, Cohen J, et al.: Administration of clonazepam in the treatment of TMD and associated myofascial pain: a double-blind pilot study. J Craniomandib Disord 1991, 5:179–186.

    PubMed  CAS  Google Scholar 

  48. Mathias BJ, Dillingham TR, Zeigler DN, et al.: Topical capsaicin for chronic neck pain: a pilot study. Am J Phys Med Rehabil 1995, 74:39–44.

    PubMed  CAS  Google Scholar 

  49. Gallardo F, Molgo J, Miyazaki C, et al.: Carisoprodol in the treatment of myofascial pain-dysfunction syndrome. J Oral Surg 1975, 33:655–658.

    PubMed  CAS  Google Scholar 

  50. Lehmann JF, de Lateur BJ: Diathermy and superficial heat, laser, and cold therapy. In Krusen’s Handbook of Physical Medicine and Rehabilitation. Edited by Kottke FJ, Lehmann JF. Philadelphia: W.B. Saunders; 1990:283–367.

    Google Scholar 

  51. Esposito CJ, Veal SJ, Farman AG: Alleviation of myofascial pain with ultrasonic therapy. J Prosthet Dent 1984, 51:106–108.

    PubMed  CAS  Google Scholar 

  52. Gam AN, Warming S, Larsen LH, et al.: Treatment of myofascial trigger points with ultrasound combined with massage and exercise: a randomized controlled trial. Pain 1998, 77:73–79.

    Article  PubMed  CAS  Google Scholar 

  53. Basford JR: Physical agents. In Rehabilitation Medicine: Principles and Practice. Edited by DeLisa JA. Philadelphia: J.B. Lippincott; 1993:404–424.

    Google Scholar 

  54. Marchand S, Charest J, Li JX, et al.: Is TENS purely a placebo effect: a controlled study on chronic low back pain. Pain 1993, 54:99–106.

    Article  PubMed  CAS  Google Scholar 

  55. Kruger LR, van der Linden WJ, Cleaton-Jones PE: Transcutaneous electrical nerve stimulation in the treatment of myofascial pain dysfunction. S Afr J Surg 1998, 36:35–38.

    PubMed  CAS  Google Scholar 

  56. Flor H, Birbaumer N: Comparison of the efficacy of electromyographic biofeedback, cognitive-behavioral therapy, and conservative medical interventions in the treatment of chronic musculoskeletal pain. J Consult Clin Psychol 1993, 61:653–658.

    Article  PubMed  CAS  Google Scholar 

  57. Winocur E, Gavish A, Emodi-Perlman A, et al.: Hypnorelaxation as treatment for myofascial pain disorder: a comparative study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002, 93:429–434.

    PubMed  Google Scholar 

  58. Loeser JD: John J. Bonica 1917–1994. Emma B. Bonica 1915–1994. Pain 1994, 59:1–3.

    Article  PubMed  CAS  Google Scholar 

  59. Auleciems LM: Myofascial pain syndrome: a multidisciplinary approach. Nurse Pract 1995, 20:18, 21–22, 24–28.

    Article  PubMed  CAS  Google Scholar 

  60. Krabak BJ, Borg-Stein J, Oas JA: Chronic cervical myofascial pain syndrome: improvement in dizziness and pain with a multidisciplinary rehabilitation program: a pilot study. J Back Musculoskel Rehab 2000, 15:83–87.

    Google Scholar 

  61. Heikkila H, Heikkila E, Eisemann M: Predictive factors for the outcome of a multidisciplinary pain rehabilitation program on sick-leave and life satisfaction in patients with whiplash trauma and other myofascial pain: a follow-up study. Clin Rehabil 1998, 12:487–496.

    Article  PubMed  CAS  Google Scholar 

  62. Gil IA, Barbosa CM, Pedro VM, et al.: Multidisciplinary approach to chronic pain from myofascial pain dysfunction syndrome: a 4-year experience at a Brazilian center. Cranio 1998, 16:17–25.

    PubMed  CAS  Google Scholar 

  63. Hong CZ: Myofascial trigger points: pathophysiology and correlation with acupuncture points. Acupunct Med 2000, 18:41–47.

    Article  Google Scholar 

  64. Ceccherelli F, Rigoni MT, Gagliardi G, et al.: Comparison of superficial and deep acupuncture in the treatment of lumbar myofascial pain: a double-blind, randomized, controlled study. Clin J Pain 2002, 18:149–153.

    Article  PubMed  Google Scholar 

  65. Ceccherelli F, Bordin M, Gagliardi G, et al.: Comparison between superficial and deep acupuncture in the treatment of the shoulder’s myofascial pain: a randomized and controlled study. Acupunct Electrother Res 2001, 26:229–238.

    Google Scholar 

  66. Birch S, Jamison RN: Controlled trial of Japanese acupuncture for chronic myofascial neck pain: assessment of specific and nonspecific effects of treatment. Clin J Pain 1998, 14:248–255.

    Article  PubMed  CAS  Google Scholar 

  67. Myers CD, White A, Heft MW: A review of complementary and alternative medicine use for treating chronic facial pain. J Am Dent Assoc 2002, 133:1189–1196.

    PubMed  Google Scholar 

  68. Anonymous: NIH Consensus Conference: Acupuncture. JAMA 1998, 280:1518–1524.

  69. Wolfe F, Smythe H, Yunus M, et al.: The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum 1990, 33:160–172. Paper defining the diagnostic criteria for FM.

    Article  PubMed  CAS  Google Scholar 

  70. Starz TW, Sinclair JD, Turk DC: Putting the finger on fibromyalgia: the manual tender point survey. J Musculoskel Pain 1997, 14:61–67. Describes the standardized technique for tender point examination without special instrumentation.

    Google Scholar 

  71. Wolfe F, Anderson J, Harkness D, et al.: Health status and disease severity in fibromyalgia: results of a six-center longitudinal study. Arthritis Rheum 1997, 40:1571–1579.

    Article  PubMed  CAS  Google Scholar 

  72. Wolfe F, Anderson J, Harkness D, et al.: The work and disability status of persons with fibromyalgia [abstract]. J Musculoskel Pain 1995, 3:155.

    Article  Google Scholar 

  73. Marchand S, Arsenault P: Fibromyalgic pain: the possible role of a deficit of diffuse noxious inhibitory contro (DNIC). In American Pain Society Annual Meeting 1999. Fort Lauderdale, FL: American Pain Society; October, 1999. First report of disordered descending pain modulation in FM.

    Google Scholar 

  74. Staud R, Robinson ME, Vierck CJ, Jr., et al.: Diffuse noxious inhibitory controls (DNIC) attenuate temporal summation of second pain in normal males but not in normal females or fibromyalgia patients. Pain 2003, 101:167–174.

    Article  PubMed  Google Scholar 

  75. Russell I, Orr M, Littman B, et al.: Elevated cerebrospinal fluid levels of substance P in patients with the fibromyalgia syndrome. Arthritis Rheum 1994, 37:1593–1601.

    Article  PubMed  CAS  Google Scholar 

  76. Mountz J, Bradley L, Modell J, et al.: Fibromyalgia in women: abnormalities of regional cerebral blood flow in the thalamus and caudate nucleus are associated with low pain threshold levels. Arthritis Rheum 1995, 38:926–938. First report of abnormalities on functional brain imaging in FM.

    Article  PubMed  CAS  Google Scholar 

  77. Neeck G, Crofford LJ: Neuroendocrine perturbations in fibromyalgia and chronic fatigue syndrome. Rheum Dis Clin North Am 2000, 26:989–1002. Excellent summary of this important research topic.

    Article  PubMed  CAS  Google Scholar 

  78. Crofford LJ: Neuroendocrine abnormalities in fibromyalgia and related disorders. Am J Med Sci 1998, 315:359–366.

    Article  PubMed  CAS  Google Scholar 

  79. Bou-Holaigah I, Calkins H, Flynn J, et al.: Provocation of hypotension and pain during upright tilt table testing in adults with fibromyalgia. Clin Exp Rheum 1997, 15:239–246.

    CAS  Google Scholar 

  80. Visuri T, Lindholm H, Lindqvist A, et al.: Cardiovascular functional disorder in primary fibromyalgia: a noninvasive study in 17 young men. Arthritis Care Res 1992, 5:210–215.

    Article  PubMed  CAS  Google Scholar 

  81. Martinez-Lavin M: The autonomic nervous system and fibromyalgia. J Musculoskel Pain 2002, 10:221–228.

    Article  Google Scholar 

  82. Moldofsky H, Scarisbrick P, England R, et al.: Musculoskeletal symptoms and non-REM sleep disturbance in patients with “fibrositis syndrome” and healthy subjects. Psychosom Med 1975, 37:341–351.

    PubMed  CAS  Google Scholar 

  83. Jessee E, Owen D Jr, Sagar K: The benign hypermobile joint syndrome. Arthritis Rheum 1980, 23:1053–1056.

    Article  PubMed  CAS  Google Scholar 

  84. Karaaslan Y, Haznedaroglu S, Ozturk M: Joint hypermobility and primary fibromyalgia: a clinical enigma. J Rheumatol 2000, 27:1774–1776. Discussion of the linkage between FM and hypermobility.

    PubMed  CAS  Google Scholar 

  85. Goldman J: Hypermobility and deconditioning: important links to fibromyalgia/fibrositis. South Med J 1991, 84:1192–1196.

    Article  PubMed  CAS  Google Scholar 

  86. Fitzcharles MA: Is hypermobility a factor in fibromyalgia? J Rheumatol 2000, 27:1587–1589.

    PubMed  CAS  Google Scholar 

  87. Russek LN: Hypermobility syndrome. Phys Ther 1999, 79:591–599.

    PubMed  CAS  Google Scholar 

  88. Clark S, Burckhardt CS, Campbell S: Fitness characteristics and perceived exertion in women with fibromyalgia. J Musculoskel Pain 1993, 1:193–197.

    Article  Google Scholar 

  89. McCain G, Bell D, Mai F, et al.: A controlled study of a supervised cardiovascular fitness training program on the manifestations of primary fibromyalgia. Arthritis Rheum 1988, 31:1135–1141.

    Article  PubMed  CAS  Google Scholar 

  90. Richards SC, Scott DL: Prescribed exercise in people with fibromyalgia: parallel group randomised controlled trial. BMJ 2002, 325:185.

    Article  PubMed  Google Scholar 

  91. Jones KD, Burckhardt CS, Clark SR, et al.: A randomized controlled trial of muscle strengthening versus flexibility training in fibromyalgia. J Rheumatol 2002, 29:1041–1048.

    PubMed  Google Scholar 

  92. Forseth KO, Gran JT: Management of fibromyalgia: What are the best treatment choices? Drugs 2002, 62:577–592.

    Article  CAS  Google Scholar 

  93. Busch A, Schachter CL, Peloso PM, et al.: Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev 2002, 3:CD003786.

    PubMed  Google Scholar 

  94. Sim J, Adams N: Systematic review of randomized controlled trials of nonpharmacological interventions for fibromyalgia. Clin J Pain 2002, 18:324–336. Comprehensive review of this important treatment topic.

    Article  PubMed  Google Scholar 

  95. Mannerkorpi K, Nyberg B, Ahlmen M, et al.: Pool exercise combined with an education program for patients with fibromyalgia syndrome: a prospective, randomized study. J Rheumatol 2000, 27:2473–2481.

    PubMed  CAS  Google Scholar 

  96. Mannerkorpi K, Ahlmen M, Ekdahl C: Six- and 24-month follow-up of pool exercise therapy and education for patients with fibromyalgia. Scand J Rheumatol 2002, 31:306–310.

    Article  PubMed  Google Scholar 

  97. Jones KD, Clark SR: Individualizing the exercise prescription for persons with fibromyalgia. Rheum Dis Clin North Am 2002, 28:419–436.

    Article  PubMed  Google Scholar 

  98. Hong CZ, Hsueh TC: Difference in pain relief after trigger point injections in myofascial pain patients with and without fibromyalgia. Arch Phys Med Rehabil 1996, 77:1161–1166.

    Article  PubMed  CAS  Google Scholar 

  99. Reddy SS, Yunus MB, Inanici F, et al.: Tender point injections are beneficial in fibromyalgia syndrome: a descriptive, open study. J Musculoskel Pain 2000, 8:7–18.

    Article  Google Scholar 

  100. Goldenberg D, Felson D, Dinerman H: A randomized controlled trial of amitriptyline and naproxen in the treatment of patients with fibromyalgia. Arthritis Rheum 1986, 29:1371–1377.

    Article  PubMed  CAS  Google Scholar 

  101. Carette S, McCain GA, Bell DA, et al.: Evaluation of amitriptyline in primary fibrositis: a double-blind, placebocontrolled study. Arthritis Rheum 1986, 29:655–659.

    Article  PubMed  CAS  Google Scholar 

  102. Arnold LM, Keck PE Jr, Welge JA: Antidepressant treatment of fibromyalgia: a meta-analysis and review. Psychosomatics 2000, 41:104–113.

    Article  PubMed  CAS  Google Scholar 

  103. Arnold LM, Hess EV, Hudson JI, et al.: A randomized, placebocontrolled, double-blind, flexible-dose study of fluoxetine in the treatment of women with fibromyalgia. Am J Med 2002, 112:191–197.

    Article  PubMed  CAS  Google Scholar 

  104. Wolfe F, Cathey MA, Hawley DJ: A double-blind placebo controlled trial of fluoxetine in fibromyalgia. Scand J Rheumatol 1994, 23:255–259.

    PubMed  CAS  Google Scholar 

  105. Zijlstra T, Barendregt P, VandeLaar M: Venlafaxine in fibromyalgia: results of a randomized, placebo-controlled, double-blind trial. Arthritis Rheum 2002, 46:S105.

    Google Scholar 

  106. Sorensen J, Bengtsson A, Ahlner J, et al.: Fibromyalgia: Are there different mechanisms in the processing of pain? A double blind crossover comparison of analgesic drugs. J Rheumatol 1997, 24:1615–1621.

    PubMed  CAS  Google Scholar 

  107. Backonja M, Beydoun A, Edwards KR, et al.: Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 1998, 280:1831–1836.

    Article  PubMed  CAS  Google Scholar 

  108. Russell IJ, Kamin M: Efficacy of tramadol in treatment of pain in fibromyalgia. J Clin Rheumatol 2000, 6:250–257.

    Article  PubMed  Google Scholar 

  109. Biasi G, et al.: Tramadol in the fibromyalgia syndrome: a controlled clinical trial versus placebo. Int J Clin Pharmacol Res 1998, 18:13–19.

    PubMed  CAS  Google Scholar 

  110. Gardner JS, Blough D, Drinkard CR, et al.: Tramadol and seizures: a surveillance study in a managed care population. Pharmacotherapy 2000, 20:1423–1431.

    Article  PubMed  CAS  Google Scholar 

  111. Freye E, Levy J: Acute abstinence syndrome following abrupt cessation of long-term use of tramadol (Ultram): a case study. Eur J Pain 2000, 4:307–311.

    Article  PubMed  CAS  Google Scholar 

  112. Mason PJ, Morris VA, Balcezak TJ: Serotonin syndrome: presentation of two cases and review of the literature. Medicine 2000, 79:201–209.

    Article  PubMed  CAS  Google Scholar 

  113. McKenzie R, O’Fallon A, Dale J, et al.: Low-dose hydrocortisone for treatment of chronic fatigue syndrome: a randomized, controlled trial. JAMA 1998, 280:1061–1066.

    Article  PubMed  CAS  Google Scholar 

  114. Bennett RM: Adult growth hormone deficiency in patients with fibromyalgia. Curr Rheumatol Reports 2002, 4:306–312.

    Article  Google Scholar 

  115. Bennett RM, Clark SC, Walczyk J: A randomized, doubleblind, placebo-controlled study of growth hormone in the treatment of fibromyalgia. Am J Med 1998, 104:227–231.

    Article  PubMed  CAS  Google Scholar 

  116. Hakkinen K, Pakarinen A, Hannonen P, et al.: Effects of strength training on muscle strength, cross-sectional area, maximal electromyographic activity, and serum hormones in premenopausal women with fibromyalgia. J Rheumatol 2002, 29:1287–1295.

    PubMed  Google Scholar 

  117. Amand RP: The Use Of Uricosuric Agents in Fibromyalgia: Information For Physicians. http://www.guaidoc.com/ Research_Urico.htm. Accessed September 9, 2003.

  118. Bennett RM, deGarmo P, Clark S: A one-year double-blind, placebo-controlled study of guaifenesin in fibromyalgia. Presented at the American College of Rheumatology Annual Meeting: Orlando; October 18–22,1996.

  119. Offenbacher M, Stucki G: Physical therapy in the treatment of fibromyalgia. Scand J Rheumatol 2000, 113:78–85.

    CAS  Google Scholar 

  120. Rossy LA, Buckelew SP, Dorr N, et al.: A meta-analysis of fibromyalgia treatment interventions. Ann Behav Med 1999, 21:180–191.

    Article  PubMed  CAS  Google Scholar 

  121. Burckhardt CS: Nonpharmacologic management strategies in fibromyalgia. Rheum Dis Clin North Am 2002, 28:291–304.

    Article  PubMed  Google Scholar 

  122. Turk DC, Okifuji A, Sinclair JD, et al.: Interdisciplinary treatment for fibromyalgia syndrome: clinical and statistical significance. Arthritis Care Res 1998, 11:186–195.

    Article  PubMed  CAS  Google Scholar 

  123. Mason LW, Goolkasian P, McCain GA: Evaluation of a multimodal treatment program for fibromyalgia. J Behav Med 1998, 21:163–178.

    Article  PubMed  CAS  Google Scholar 

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Rudin, N.J. Evaluation of treatments for myofascial pain syndrome and fibromyalgia. Current Science Inc 7, 433–442 (2003). https://doi.org/10.1007/s11916-003-0059-4

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