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Does primary fibromyalgia exist?

K Forslind1, E Fredriksson, O Nived

  • 1Department of Rheumatology, University Hospital, Lund, Sweden.

British Journal of Rheumatology
|October 1, 1990
PubMed
Summary
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Fibromyalgia patients often present with co-occurring psychiatric or thyroid issues. Long-term follow-up revealed no patients met primary fibromyalgia criteria, suggesting complex underlying conditions impacting work capacity.

Area of Science:

  • Rheumatology
  • Pain Medicine
  • Endocrinology

Background:

  • Fibromyalgia is a chronic pain condition often diagnosed in primary care.
  • Co-occurring conditions can complicate diagnosis and management.
  • Longitudinal studies are needed to understand the natural history of fibromyalgia.

Purpose of the Study:

  • To re-examine patients diagnosed with primary fibromyalgia/fibrositis after a 5-year period.
  • To investigate the long-term diagnostic criteria fulfillment and associated comorbidities.
  • To assess functional outcomes and return to work capacity.

Main Methods:

  • Retrospective analysis of 25 consecutive patients with primary fibromyalgia/fibrositis.
  • Follow-up re-examination of 21 patients after 5 years.

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  • Assessment of diagnostic criteria, comorbidities, and work status.

    • Main Results:

    • Fifteen patients initially met fibromyalgia criteria, but none did at follow-up.
    • All patients exhibited psychiatric disturbance or thyroid dysfunction.
    • Neurological diseases, rheumatoid arthritis, and hypothyroidism were noted in non-follow-up patients.
    • Manual labor women were over-represented.
    • Physiotherapy showed beneficial effects.
    • No patient returned to full-time work.

    Conclusions:

    • Primary fibromyalgia may not be a stable diagnosis, often associated with psychiatric or thyroid dysfunction.
    • Complex comorbidities significantly impact patient prognosis and return to work.
    • Further research into the etiology and management of fibromyalgia comorbidities is warranted.