Objectives The objective of the study was to evaluate the natural course of fibromyalgia syndrome (FS) and to reveal if FS was not only the mask of another somatic disease.
Methods A questionnaire concerning the present health state was sent to 177 patients with FS diagnosed between 1991 and 1997. One hundred fifteen answers were received. Thirty three patients (28,7%) had no pain. In 19 (16,5%) cases the same intensity of pain and other subjective symptoms were noted. Majority of patients- 63 (54,8%) assessed their complaints as more intensive. Clinical and basic laboratory examinations were performed in 86 FS women, aged 39–70. They were asked about their present pain status, other complaints, mental status and their understanding of the matter of FS. Moreover, in all cases the FIQ answers were obtained. In some cases additional tests were performed (X-rays, Schrimer?s test, ANA, RF).
Results At examination only 5 patients (5,8%) had no pain in musculoskeletal system and felt very well; in the remaining 81 patients the features of active FS were noted. 43 patients (50%) described the pain as ?awful” and ?terrible?, in 32 cases (37,2%) the pain was great or even insufferable. Less than 11 tender points (TPs) in 11 patients (12,8%), however in these patients other manifestations of FS were present (sleep disturbances, fatigue, ancillary symptoms). In the remaining 70 patients all ACR criteria for diagnosis of FS were still present.
Four patients (4,7%) fulfilled criteria for diagnosis of Sjögren’s Syndrome (SS); ocular and oral dryness appeared later than widespread pain. There were no features of other connective tissue diseases in the remaining 82 patients. At examination other musculosceletal disorders were observed in some cases: gonarthrosis (4 patients- 4,7%), coxarthrosis (6 patients- 7%), carpal tunnel syndrome (21 patients- 24,4%), enthesopathy (15 patients- 17,4%). The majority of FS patients (61- 70,9%) still felt suspicion of severe somatic disease and were anxious about the future; 44 patients (51,2%) believed, that careful hospital examination is necessary.
Conclusion FS remains active in most patients several years after the first diagnosis. The majority of patients feel poor or even worse, the remission of FS is uncommonly achieved and the results of treatment are still unsatisfactory. No serious chronic diseases were observed in those patients. The results confirm the high usefulness of ACR 1990 FS criteria in everyday clinical practice. In a few cases FS can be associated with subclinical course of SS.
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