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Updated!Reading Room: Fibromyalgia

This page is provided as a resource of reading materials on FM that have been published on the internet. This includes links to documents, book reviews, editorials, and abstracts. If you would like us to add a link to another site or reprint articles at this site, please contact us through our on-line form or by sending an email message to

Selected articles that were posted to the Co-Cure list have been reprinted on the Articles and Posts page.

Fibromyalgia Reading Room Topics

Central Agencies Disability IssuesMeetings/Conferences

Articles from Central Agencies

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) - Questions and Answers About Fibromyalgia.

"Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple tender points. 'Tender points' refers to tenderness that occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips. People with this syndrome may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and other symptoms."

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Disability Issues

Illness and Your Job: An Introduction

By Michele Bloomquist
WebMD Columnist

When you are diagnosed with a chronic illness every aspect of your life is affected - your health, your relationships, your activities. One area often hit hard is your job. Suddenly the health plan handbook that you barely skimmed when you were hired becomes the one of most important books in your life. How to deal with the blow illness brings to your work life will be the subject of this monthly column.

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Research Initiatives of The American Fibromyalgia Syndrome Association, Inc.

Aging, Cognition and Fibromyalgia
Denise C. Park, Ph.D.
Professor of Psychology and Senior Research Scientist
Institute for Social Research, University of Michigan

Leslie J. Crofford, M.D.
Assistant Professor of Internal Medicine
Department of Internal Medicine, University of Michigan.

Research Team
Jennifer M. Glass, Ph.D.
Postdoctoral Fellow
Alcohol Research Center and Institute for Social Research, University of Michigan

Overview of Research

Fibromyalgia (FM) is a rheumatic disorder characterized by the presence of widespread musculoskeletal pain and the presence of tender points. Other symptoms, including fatigue, sleep disturbance, and neuropsychological complaints contribute significantly to the morbidity associated with FM. One of the most prominent complaints in patients with FM is impaired cognitive ability. The notion that cognitive deficits are fundamental to FM has some credibility, as there is growing evidence that there are subtle but important cognitive deficits associated with Chronic Fatigue Syndrome (CFS), a related disorder, that cannot be explained by psychiatric symptoms (e.g. depression). It is possible that cognitive defects in FM patients could result from single or multiple central nervous system perturbations associated with FM.

Present Research

In this research, we will correlate cognitive function of FM patients with measures of neuroendocrine function. A basic thesis advanced is that FM patients may have both cognitive and neuroendocrine function similar to that of control subjects who are 20 to 30 years older. Indeed, cognitive testing in patients with CFS reveals changes similar to those seen in subjects of advanced chronological age. In two experiments, FM patients will be compared to age and education matched controls, as well as to education matched older adults. Neuroendocrine function will be measured as well, as will depression, pain, fatigue, and beliefs about memory function. This approach permits us to determine whether there are differences in cognitive function of fibromyalgia patients from others, and whether cognitive aging is a good model for understanding the cognitive effects of FM. In addition, and perhaps more importantly, the integration of a cognitive approach with a neuroendocrine approach will allow us to determine what mechanisms account for the cognitive differences - neurochemical, psychiatric, or experienced pain and fatigue. Knowing the mechanisms underlying observed cognitive deficits has important implications for treatment of the disorder as well as for understanding its etiology.

Increased concentrations of nerve growth factor in cerebrospinal fluid of patients with fibromyalgia.
Authors: Giovengo SL, Russell IJ, Larson AA
Department of Veterinary Pathobiology, University of Minnesota, St. Paul 55108, USA.
Journal of Rheumatology 1999 Jul;26(7):1564-9
NLM citations: PMID: 10405946, UI: 99334418

The authors measured the concentrations of nerve growth factor (NGF) in the cerebrospinal fluid (CSF) of "patients with primary fibromyalgia syndrome (FM), fibromyalgia associated with other secondary conditions (SFM), patients with other painful conditions but lacking fibromyalgia (OTHER), and healthy controls." They found that the mean concentration of NGF measured in patients with FM was significantly increased (41.8 12.7 pg/ml) compared to controls (9.1 4.1 pg/ml), but with large variability. The other groups of patients did not have elevated levels compared to controls, suggesting that "a central mechanism, involving abnormalities in neuropeptides such as NGF, may be a factor in the pathogenesis of FM."

The London Fibromyalgia Epidemiology Study: the prevalence of fibromyalgia syndrome in London, Ontario.
Authors: White KP, Speechley M, Harth M, Ostbye T
Department of Medicine, University of Western Ontario, London, Canada.
Journal of Rheumatology 1999 Jul;26(7):1570-6
NLM citations: PMID: 10405947, UI: 99334419

A study of non-institutionalized adults in London, Ontario found that FM is a common musculoskeletal disorder among Canadian adults, especially among women and persons of lower socioeconomic status. Female sex, middle age, less education, lower household income, being divorced, and being disabled were found to be associated with increased odds of having FM.

The London Fibromyalgia Epidemiology Study: comparing the demographic and clinical characteristics in 100 random community cases of fibromyalgia versus controls.
Authors: White KP, Speechley M, Harth M, Ostbye T
Department of Medicine, University of Western Ontario, London, Canada.
Journal of Rheumatology 1999 Jul;26(7):1577-85
NLM citations: PMID: 10405948, UI: 99334420

The authors found that in the general population, adults who meet the 1990 American College of Rheumatology definition of FM appear to have distinct features compared to those with chronic widespread pain who do not meet criteria.

Effects of selective slow wave sleep disruption on musculoskeletal pain and fatigue in middle aged women.
Authors: Lentz MJ, Landis CA, Rothermel J, Shaver JL
Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle 98195-7266, USA.
Journal of Rheumatology 1999 Jul;26(7):1586-92
NLM citations: PMID: 10405949, UI: 99334421

The authors attempted to determine whether disrupted slow wave sleep (SWS) would evoke musculoskeletal pain, fatigue, and an alpha electroencephalograph (EEG) sleep pattern and concluded that disrupted sleep is probably an important factor in the pathophysiology of symptoms in fibromyalgia.

A survey of outcome measurement procedures in routine rheumatology outpatient practice in Australia.
Authors: Bellamy N, Muirden KD, Brooks PM, Barraclough D, Tellus MM, Campbell J
Department of Medicine, University of Western Ontario, London, Canada.
Journal of Rheumatology 1999 Jul;26(7):1593-9
NLM citations: PMID: 10405950, UI: 99334422

Special FMS Issue of Zeitschrift fur Rheumatologie

The German rheumatology journal "Zeitschrift fur Rheumatologie" has released a special supplement comprised of articles concerning fibromyalgia: 1998, Volume 57, Supplement 2.

Article abstracts can be read in either English or German.

Substance P, 5-hydroxyindole acetic acid and tryptophan in FMS

Relationship of substance P, 5-hydroxyindole acetic acid and tryptophan in serum of fibromyalgia patients.
Schwarz MJ, Spath M, Muller-Bardorff H, Pongratz DE, Bondy B, Ackenheil M
Psychiatric Hospital, University of Munich, Germany.
NLM citations: PMID: 10025591, UI: 99148458
Neurosci Lett 1999 Jan 15;259(3):196-8

The authors discuss their findings that there is systemic involvement of 5-hydroxyindole acetic acid and substance P in fibromylagia.

London (Ontario, Canada) Fibromyalgia Epidemiology Study

Comparing self-reported function and work disability in 100 community cases of fibromyalgia syndrome versus controls in London, Ontario: the London Fibromyalgia Epidemiology Study.

Arthritis Rheum 1999 Jan;42(1):76-83
White KP, Speechley M, Harth M, Ostbye T
University of Western Ontario, London, Canada.

This study concludes that "FMS commonly results in loss of function and work disability."

Increased 24-hour urinary cortisol excretion: FMS vs. PTSD

Increased 24-hour urinary cortisol excretion in patients with post-traumatic stress disorder and patients with major depression, but not in patients with fibromyalgia.
Maes M, Lin A, Bonaccorso S, van Hunsel F, Van Gastel A, Delmeire L, Biondi M, Bosmans E, Kenis G, Scharpe S
Clinical Research Center for Mental Health, Antwerp, Belgium.
Acta Psychiatr Scand 1998 Oct;98(4):328-35
NLM citations: PMID: 9821456, UI: 99038897

The authors used 24-hour urinary cortisol excretion to assess changes in the baseline activity of the hypothalamic-pituitary-adrenal (HPA) axis in patients with FMS, depression, and post-traumatic stress disorder. They found increased 24-h UC excretion in patients with PTSD comparable to that in patients with major depression, whereas in fibromyalgia no significant changes in 24-h UC were found.

"Elevated levels of hyaluronic acid in the sera of women with fibromyalgia."
J Rheumatol 1997 Nov;24(11):2221-2224 Yaron I, Buskila D, Shirazi I, Neumann L, Elkayam O, Paran D, Yaron M

CONCLUSION: HA serum levels in women with FM were significantly elevated compared to healthy controls and patients with RA. This observation suggests that FM is associated with a biochemical abnormality and that serum HA could be a laboratory marker for its diagnosis.

"Fibromyalgia in hepatitis C virus infection. Another infectious disease relationship."
Arch Intern Med 1997 Nov 24;157(21):2497-2500
Buskila D, Shnaider A, Neumann L, Zilberman D, Hilzenrat N, Sikuler E

CONCLUSIONS: A high prevalence of FS was observed in patients infected with HCV, especially women. Recognizing FS in patients with HCV will prevent misinterpretation of FS symptoms as part of the liver disease and will enable the physician to reassure the patient about these symptoms and to alleviate them.

"Influenza A Virus: A Possible Precipitating Factor in Fibromyalgia?"
Allen N. Tyler, M.D., N.D., D.C.

"Fibromyalgia and Myofacial pain" Chronic Musculoskeletal Pain, A.L Shaw, M.D.

"Fibromyalgia: The Muscle Pain Epidemic - Is it ME by Another Name?" Leon Chaitow N.D., D.O., MRO, Senior Lecturer, University of Westminster.

"In marked contrast to the time it has taken for research into ME and CFS to emerge there has over the past few years been an explosion in the medical literature featuring Fibromyalgia Syndrome (FMS)."
"The more the condition has been researched (FMS that is) the more obvious it has become that there is a vast overlap between it and ME/CFS."
"Both CFS(ME) and FMS often seem to begin after an infection or a severe trauma (physical or emotional) , and as indicated above the symptoms are very similar. The only obvious difference seems to be that for some people the fatigue element is the most dominant while for others the muscular pain symptoms are greatest (and for an unfortunate few both are markedly present)."

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"Chronic Fatigue, Fibromyalgia, and Autoimmune Thyroid Disease". The Mining Company.
Also see Miscellaneous Articles for other Thyroid Disease articles.

"While HAIT is known to be an autoimmune illness, researchers are beginning to believe that there is a strong autoimmune component to CFS and FMS as well. Ultimately, the three diseases may, in fact, be found to be varying manifestations of the same underlying autoimmune problems."

Fibromyalgia: Ten Strategies for Maintaining a Positive Attitude
by Deborah A. Barrett, Ph.D., with links to other essays by the same author.

"Patient Information - Fibromyalgia" American College of Rheumatology

"A Physician's Guide to Fibromyalgia Syndrome" by David A. Nye MD.

The British Journal of Rheumatology.

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International Fibromyalgia Conference, May 19-21, 2000, Los Angeles

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