Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls

Occupational musculoskeletal stress and disorders of the neck and shoulder: a review of possible pathophysiology

Disorders and complaints in the neck and shoulder regions are common among industrial workers and are often attributed to occupational musculoskeletal stress. The possible pathophysiological mechanism of occupational stress on the neck and shoulders is reviewed. A mechanical origin for cervical disc degeneration and osteoarthrosis is reported for a few occupational groups. However, a mechanical origin for osteoarthrosis is debatable. A work posture involving elevated arms may accelerate degeneration of shoulder tendons through impairment of circulation due to static tension and humeral compression against the coracoacromial arch. Furthermore, work tasks with repetitive arm movements may evoke shoulder tendinitis or tendo-vaginitis, probably due to friction. Three possible routes to neck-shoulder muscular pain are discussed; mechanical failure, local ischemia and energy metabolism disturbance.

Clinical characteristics of fibrositis. I. A "blinded," controlled study of symptoms and tender points

Twenty-two patients with fibrositis, selected from a general medical outpatient population by a screening questionnaire and subsequent evaluation, were compared with age-, sex-, and clinic-matched patients without fibrositis. Although there was a high prevalence of musculoskeletal complaints in both groups, the fibrositis patients had a uniform constellation of symptoms, including axial pain, severe aching and stiffness, morning fatigue, and modulation by specific factors. They also had a higher incidence of tension headache and irritable bowel syndrome. The use of a dolorimeter demonstrated that fibrositis patients had many more areas of localized tenderness than control patients, but also that fibrositis patients did not have diffusely diminished pain threshold and tolerance. Using the criteria of this study, fibrositis appears to be a common and readily definable syndrome within the spectrum of soft tissue rheumatism.