The Transition of Acute Postoperative Pain to Chronic Pain: An Integrative Overview of Research on Mechanisms

Fibromyalgia is characterized by chronic widespread pain, fatigue, sleep disturbances and functional symptoms. The etiopathogenesis, diagnostic criteria and classification criteria of fibromyalgia are still debated and, consequently, so are the strategies for treating this condition. Fibromyalgia is the third most frequent musculoskeletal condition, and its prevalence increases with age. However, although diagnosis has improved with the evolution of more accurate diagnostic criteria, a considerable proportion of physicians still fail to recognize the syndrome. Many factors contribute to the development of fibromyalgia in a unique manner: genetic predisposition, personal experiences, emotional-cognitive factors, the mind-body relationship and a biopsychological ability to cope with stress. The multiple components of the pathogenesis and maintenance of the condition necessitate a multi-modal treatment approach. Individually tailored treatment is an important consideration, with the increasing recognition that different fibromyalgia subgroups exist with different clinical characteristics. Consequently, although an evidence-based approach to fibromyalgia management is always desirable, the approach of physicians is inevitably empirical, and must have the aim of creating a strong alliance with the patient and formulating shared, realistic treatment goals.

Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment

This study aims to estimate the reliable prevalence of fibromyalgia using meta-analysis method. Available databanks were searched using appropriate keywords. According to the heterogeneity between the results (indicated by Cochrane and I square indices), random- or fixed-effects model was applied to combine the point prevalences. Meta-regression models were used to assess the suspected factors in the heterogeneity. In 65 selected papers, 81 evidences regarding prevalence of fibromyalgia among 3,609,810 subjects from general population and specific groups were investigated. The total prevalences (95% confidence intervals) of fibromyalgia among general population, women, men, patients referring to rheumatology and internal departments, patients with Irritable bowel syndrome (IBS), hemodialysis patients and those with type 2 diabetes mellitus were estimated as of 1.78% (1.65, 1.92), 3.98% (2.80, 5.20), 0.01% (-0.04, 0.06), 15.2% (13.6, 16.90), 12.9% (12.70, 13.10), 6.30% (4.60, 7.90) and 14.80% (11.10, 18.40), respectively. In addition, prevalence of fibromyalgia in specified groups varied from 3.90% in hemodialysis patients to 80% in patients suffering from Behcet syndrome. This meta-analysis showed that prevalence of fibromyalgia in general population was significantly lower than that in populations with some diseases.

Prevalence of fibromyalgia in general population and patients, a systematic review and meta-analysis

Corneal nerves in health and disease.

Dry eye is a common, multifactorial disease currently diagnosed by a combination of symptoms and signs. Its epidemiology and clinical presentation have many similarities with neuropathic pain outside the eye. This review highlights the similarities between dry eye and neuropathic pain, focusing on clinical features, somatosensory function, and underlying pathophysiology. Implications of these similarities on the diagnosis and treatment of dry eye are discussed.

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Neuropathic pain and dry eye

BackgroundFibromyalgia often coexists and overlaps with other syndromes such as chronic fatigue, irritable bowel syndrome, and interstitial cystitis. Chronic stress has been implicated in the pathogenesis of these illnesses. The sympathetic nervous system is a key element of the stress response syst

Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: a review of case-control studies

Small fiber neuropathy in women with fibromyalgia. An in vivo assessment using corneal confocal bio-microscopy.

Isolated cases and small series have described the development of complex regional pain syndrome, postural orthostatic tachycardia, and fibromyalgia after human papillomavirus (HPV) vaccination. These illnesses are difficult to diagnose and have overlapping clinical features. Small fiber neuropathy and dysautonomia may play a major role in the pathogenesis of these entities. We used the following validated questionnaires to appraise the chronic illness that might appear after HPV vaccination: The 2010 American College of Rheumatology Fibromyalgia Diagnostic Criteria, COMPASS 31 dysautonomia questionnaire, and S-LANSS neuropathic pain form. These questionnaires and a “present illness” survey were e-mailed to persons who had the onset of a chronic ailment soon after HPV vaccination. Forty-five filled questionnaires from individuals living in 13 different countries were collected in a month’s period. Mean (±SD) age at vaccination time was 14 ± 5 years. Twenty-nine percent of the cases had immediate (within 24 h) post-vaccination illness onset. The most common presenting complaints were musculoskeletal pain (66 %), fatigue (57 %), headache (57 %), dizziness/vertigo (43 %), and paresthesias/allodynia (36 %). Fifty-three percent of affected individuals fulfill the fibromyalgia criteria. COMPASS-31 score was 43 ± 21, implying advanced autonomic dysfunction. Eighty-three percent of the patients who had ongoing pain displayed S-LANSS values >12, suggesting a neuropathic component in their pain experience. After a mean period of 4.2 ± 2.5 years post-vaccination, 93 % of patients continue to have incapacitating symptoms and remain unable to attend school or work. In conclusion, a disabling syndrome of chronic neuropathic pain, fatigue, and autonomic dysfunction may appear after HPV vaccination.

HPV vaccination syndrome. A questionnaire-based study

F ibromyalgia is a stress-related disorder. Psychological and other types of stressors are frequent fibromyalgia drivers. The coronavirus disease 2019 (COVID-19) pandemic has generated long-lasting widespread heterogeneous stressful events. The pandemic lockdown provides a unique opportunity to study the effect of imposed lifestyle changes on fibromyalgia symptoms. There is no information on the impact of COVID-19 pandemic on the quality of life of patients suffering from fibromyalgia. The objective of this investigation was to assess the effect of COVID-19 pandemic lockdown on fibromyalgia symptoms measured through validated questionnaires.

Effect of COVID-19 Pandemic Lockdown on Fibromyalgia Symptoms.

BackgroundVasovagal syncope is an acute manifestation of autonomic nervous system dysfunction. This type of syncope is often associated with other dysautonomic expressions such as migraine, gastroparesis, or postural tachycardia syndrome. Autonomic nervous system dysfunction has been proposed as a k

Laura-Aline Martínez-Martínez

Papers

Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: a review of case-control studies

Small fiber neuropathy in women with fibromyalgia. An in vivo assessment using corneal confocal bio-microscopy.

HPV vaccination syndrome. A questionnaire-based study

Effect of COVID-19 Pandemic Lockdown on Fibromyalgia Symptoms.

Prevalence of Fibromyalgia in Vasovagal Syncope