[The course and topography of pain in generalized tendomyopathies]

The generalized tendomyopathy (fibromyalgia) is characterized by the characteristic picture of multilocular pain symptoms, severe pressure-type pain in the tendon insertions and muscles, vitality deficiency, sleep disturbance and other vegetative disorders as well as functional complaints and is often also characterized by an altered psychological condition. Nevertheless, the disease is often not recognized, resulting in extensive superfluous diagnostic procedures and sometimes invasive and useless therapeutic measures. The disorder develops on average in the 37th year of life and initially affects, mostly monolocular, the cervical and lumbar region. The further course of the disease is progressive or recurrent and extends over years, often over decades. The patients' quality of life is markedly impaired and in many cases they are no longer able to carry out their occupational and household work. The socioeconomic significance of the generalized tendomyopathy probably exceeds that of chronic polyarthritis. One problem is the still poor therapeutic possibilities and also the assessment of the treatment. It is, therefore, of great importance to follow the course of the disease and the pain course via hand measurement methods, so as to enable the evaluation of new, but also known therapies. Measuring instruments, which record the intensity and the topography of the pain, such as dolorimetry and the pain score, will be presented and discussed. One of the newest possibilities is the computerized recording of the current symptoms, which is made by the patient himself by means of an electronic pain diary.