This is a short letter to the director, published in the “Revista clínica española” in 1992 when they still use the word FIBROSITIS instead of the new term fibromyalgia proposed in 1990.
The doctors had the impression that this pathology was underdiagnosed. So they decided to perform a prevalence study. It is a very simple retrospective study. They found 7% of prevalence especially in women between 45 and 65. (They did not study older than 65 years old).
They do not mention anything about etiology.
They say that the HYPERSENSIBLE POINTS were the TRIGGER POINTS.
Some of the “minor criteria” as irritable bowel syndrome are interesting since old studies related the “rheumatic pains” with certain “INDIGESTION PROBLEMS”.
They also insist on the fact that the patients refer “subjective swelling”. (Personal note: These could well be a sign of peripheral nerve slight compression or a consequence of the interfascial tissue tension).
They very briefly mention some therapeutic measures that -they insisted- are of little help.
Notes on the article:
PREVALENCIA DE LA FIBROSITIS (fibromyalgia or myofascial pain)
By F. J. Romero and A. Encinas Sotillos
The authors start their letter by saying that fibrositis; “fibromyalgic syndrome” or “myofascial pain” is a low chronic disorder that does NOT originate complications or incapacitations.
There are NO histological findings.
And it is characterized by chronic musculoskeletal pain areas; with special HYPERSENSIBILITY in the anatomic points known as “trigger points”.
They are patients that come to the doctor referring “pain all over”, they wake up tired, they have morning stiffness and they refer swelling in certain zones that the doctor can not see.
The complementary tests are absolutely normal.
There can be a sleep no-REM disorder.
The diagnosis can be done by the clinical picture.
There are some DIAGNOSTIC CRITERIA showed in table 1.
The treatment is complex since the patients are reticent to treatments.
Usual treatment: “tranquilization, relief of cervical and lumbar fatigue, salicylate and glafenine, tricyclic antidepressant, physiotherapy, local heat, massage, short wave, acupuncture”.
-They did a study in Madrid reviewing 685 patients between 25 and 65 years old.
-357 (52%) women and 328 (48%) men.
They checked the presence of the diagnosed FIBROSITIS in each patient.
In certain suspected patients they did an extra study with physical examination and some blood test with VSG, FR, ASLO, and CPK.
-They found 54 cases of fibrositis (7%), 45 women (83%) and 9 men (16%).
-74% of the cases were between 45 and 65 years old.
They said that there were not many articles about it in Spain and that the syndrome was probably underdiagnosed.
They insist that in certain “rheumatic patients” the doctors should suspect this diagnosis.
They recommend that a better diagnosis could avoid unnecessary tests and specialist derivation.
Published in April 2019 by Marta Cañis Parera
Reference:
Romero Gamuza FJ and Encinas Sotillos A. The prevalence of fibrositis. Revista clínica española. 1992. 190 (5) p 280. ISSN: 0014-2565.
The references from this study:
-Wolfe, Goldenberg.
