Review of the Epidemiology and Criteria of Fibromyalgia and Myofascial Pain Syndromes:

Abstract

Objectives: To review epidemiologic methodology and concepts in the study of fibromyaliga and myofascial pain syndromes. To identify studies of the prevalence and relative frequency of fibromyalgia and myofascial pain in community and clinic populations. To compare etiologic mechanisms and concepts of classical diseases versus dysfunctional syndromes. To draw analgies between irritable bowl syndrome [IBS] and fibromyalgia syndrome [FMS] with respect to the reationale for patient subgrouping in order to achieve improved classification schema. Findings: Prevalences of fibromyalgia in community populations differ widely, i.e., from about 1% to 10%. Differences may be due to variations in age, sex, occupation, socioeconomic status and other personal factors, but are more likely due to differences in criteria or other methodology used. The classical epidemiologic concept of agent, host and environmental causes of disease does not apply well to dysfunctional syndromes, e.g., FMS or myofascial pain syndrome [MPS]. These syndromes are more complex, etiologically than the classical diseases, have multifactorial illness dynamics and considerable individualized variability. Conclusions: Population surveys with standardized definitions [e.g., the 1990 American College of Rheumatology criteria for fibromyalgia] promise to identify importnat overall demographic and socio-environmental risk factors in FMS and MPS. However, more specific analytical studies of risk factors are also needed. These will require further patent subgroupings which can better reflect personalized illness dynamics. Improved conceptual models of dysfunctional disorders need to be developed. Integrated systems research approaches [e.g., force field analysis] can accommodate the complex host dynamics, i.e., somatic, emotional and behavioral mechanisms, and potential risk factors in the environment.

KEYWORDS:

• Fibromyalgia syndrome
• myofascial pain syndrome
• epidemiology
• etiology
• dysfunction