(Fibrositis is an old term for back mice)
This is a LETTER sent to the BMJ about the fibrositis controversy. It is written by Francis Bach from London. He DOES NOT agree with Dr. Cyriax’s vision that states that the primary lesion of fibrositis would be articular lesion.
The letter is related to the article from Dr. James Cyriax (July 31, p. 251), where he offers a simple solution to the complex problem of “fibrositis”. (Personal notes: Cyriax was known for his manipulative techniques to manage articular pains).
Cyriax stated that “the symptoms of rheumatic fibrositis coming on for no apparent reason are the result of articular lesions”, and that the treatment is the “reduction of intrarticular lesion by local manipulation”.
Dr. Bach is aware that many people who were diagnosed to be suffering from fibrositis and neuritis in the past were REALLY suffering from symptoms due to INTRA-ARTICULAR lesions, such as prolapsed and fragmented intervertebral disc in the cervical or lumbar regions. Dr. Cyriax has been among those who have impressed this fact on the medical profession.
But Back warns that fibrositis is not related to disc problems. He states that “fibrositis” is used to describe a pain that seems to be located in the SOFT TISSUES and for which there isn’t an obvious cause. In the practice, diagnosis is based on exclusion of other systemic or local disorders. Pain and stiffness are the cardinal symptoms. On examination, the lesion is localized to the DEEP SUBCUTANEOUS tissue, superficial and deep fasciae, aponeurosis, ligaments and capsules of joints, tendons, bursae, periosteum and the sheats of the nerve trunks.
Dr. Bach admits that there was not EVIDENCE that the FIBROUS TISSUE is affected primarily, but he lists a number of cases that by personal experience he knew were related to this clinical entity:
-They knew that sitting in a draught might be followed by stiff neck or lumbago.
-They knew that pain in the shoulder might disappear after the removal of a septic tooth.
-They knew that the industrial worker, the harried young housewife, the plump, the middle-aged ladies frequently suffer from “fibrositis”.
Moreover, Dr. Bach states that many of them KNOW that “the reduction of an intra-articular lesion” (Cyriax’s technique) has not only failed to relieve their symptoms, but has even made them worse.
The author warns “FIBROSITIS IS A PROBLEM IN GENERAL MEDICINE”, but he says that there are authors publishing about it, he mentions a list (like Weddell, Draper, May Wilson, Halliday, Ling, Hench, Stone, Bauwens, Harman, Dykes)
He finishes his letter by saying:
“The problem of fibrositis is complex. To solve it, the biochemist, the geneticist, the pathologist and the clinician will need to work together as a team, probably FOR QUITE A LONG TIME TO COME”.
Published in October 2018 by Marta Cañis Parera
Fibrositis. Francis Bach. London. Aug 21, 1948. Page 399.