Articles from prior issues of The Advocate

September/October, 2000

Fibromyalgia: A Painful Subject
by Tamara Kastanas, Missouri DDS

RHEUMATOLOGIST, DR. PAUL KATZENSTEIN, GAVE a presentation on fibromyalgia and myofascial pain. Patients with fibromyalgia describe sleep quality as poor. Their sleep is most often disturbed at Stage 3 and Stage 4, when sleep is more deep and most restful and restoring to the body. Lack of quality sleep contributes to their awareness of pain. He stated that the people who suffer from fibromyalgia have lower sensory and pain thresholds. The term, fibromyalgia, is the label used for people who have chronic and diffuse widespread pain. It is a Syndrome-one that is based on a set of acceptable symptoms and signs. There is not a highly effective treatment for fibromyalgia as of yet. Ultram is often prescribed as it is non-addictive but is somewhat effective in handling the pain. The criteria for establishing fibromyalgia is to have pain in 11 of 18 tender points by digital palpation with an appropriate 4kg force application. Four experts on fibromyalgia have written articles/books on this condition: Drs. Don Goldenberg, Fred Wolfe, Robert Bennet, Muhammed Yunner and Alfonso Masa. These books/articles could be of help to the Disability Examiner in adjudication of these cases.

Dr. Katzenstein also discussed myofascial pain, which has more locations in the body with clear findings without clear significance. Myofascial pain often responds to OT/PT, but like fibromyalgia, there is no effective treatment as the symptoms remain stable over the years.