• The Korean Journal of Pain
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• v.36 no.4
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• pp.458-464
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• 2023

Background: Fibromyalgia (FM) is a complex disorder characterized by widespread chronic pain and tenderness in the muscles, ligaments, and soft tissues. It is a chronic pain condition often accompanied by other symptoms and comorbidities. To effectively manage FM, it is crucial to obtain fundamental epidemiological data pertaining to the target population. Therefore, this study was conducted to elucidate the epidemiological characteristics of FM in the Korean population. Methods: Population-based medical data of 51,276,314 subscribers to the National Health Insurance Service of Korea from 2014 to 2018 were used in this study. Results: The overall incidence of FM ranged from 441 (2014) to 541 (2018) cases per 100,000 person-years, with a higher prevalence observed among female patients compared to male patients. The incidence gradually increased until middle age, followed by a decrease. The highest incidence rates were observed in the fifth decade of life for females and the sixth decade of life for males. When categorizing the affected parts of the body, the shoulder region was observed to be the most frequently affected. A comparison of the drug prescriptions based on medical specialty showed that antidepressants were the most commonly prescribed medications. The management of FM leads to consistent increases in medical expenses, regional disparities, and variations in prescription patterns across different medical specialties. Conclusions: The findings of this study will not only contribute to the understanding of FM characteristics but also provide a vital foundation for efficient management of FM in Korea.

• The Journal of Internal Korean Medicine
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• v.45 no.2
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• pp.323-333
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• 2024

Objectives: This case report describes the effect of complex Korean medical treatment on the clinical symptoms of a patient with fibromyalgia syndrome (FMS). Methods: A 60-year-old female woman diagnosed with FMS in 2015 was prescribed Youngsunjaetong-em-hap-Sopunghwalhyeol-tang from 2 May 2023 to 20 June 2023 to reduce excessive sweating and widespread pain. With the same objective, acupuncture, moxibustion, and cupping treatment were administered from 23 May 2023 to 11 June 2023. Changes in excessive sweating and widespread pain were recorded 2 months post-treatment. Results: Treatment with Youngsunjaetong-em-hap-Sopunghwalhyeol-tang led to a considerable improvement in clinical symptoms after 2 months, especially excessive sweating and widespread pain compared to the baseline parameters of the first visit. In addition, no adverse effects, such as liver injury or decreased kidney function, were recorded during the herbal medicine treatment. Conclusion: This case report points to the use of complex Korean medical treatment as a therapeutic option for the management of FMS.

• Investigative Magnetic Resonance Imaging
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• v.18 no.4
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• pp.341-351
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• 2014

Purpose : In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. Materials and Methods: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. Results: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. Conclusion: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.

• The Korean Journal of Physiology and Pharmacology
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• v.21 no.4
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• pp.361-370
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• 2017

Previous reports have suggested that physical and psychological stresses may trigger fibromyalgia (FM). Stress is an important risk factor in the development of depression and memory impairments. Antidepressants have been used to prevent stress-induced abnormal pain sensation. Among various antidepressants, tianeptine has been reported to be able to prevent neurodegeneration due to chronic stress and reverse decreases in hippocampal volume. To assess the possible effect of tianeptine on FM symptoms, we constructed a FM animal model induced by restraint stress with intermittent cold stress. All mice underwent nociceptive assays using electronic von Frey anesthesiometer and Hargreaves equipment. To assess the relationship between tianeptine and expression levels of brain-derived neurotrophic factor (BDNF), cAMP response element-binding protein (CREB), and phosphorylated cAMP response element-binding protein (p-CREB), western blotting and immunohistochemistry analyses were performed. In behavioral analysis, nociception tests showed that pain threshold was significantly decreased in the FM group compared to that in the control group. Western blot and immunohistochemical analyses of medial prefrontal cortex (mPFC) and hippocampus showed downregulation of BDNF and p-CREB proteins in the FM group compared to the control group. However, tianeptine recovered these changes in behavioral tests and protein level. Therefore, this FM animal model might be useful for investigating mechanisms linking BDNF-CREB pathway and pain. Our results suggest that tianeptine might potentially have therapeutic efficacy for FM.

• The Korean Journal of Pain
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• v.29 no.3
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• pp.172-178
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• 2016

Background: This study was designed to assess serum vitamin D status (25-OHD) in the fibromyalgia (FM) patients and to compare it with a healthy control group. It also aimed to investigate the correlation of serum vitamin D level with FM symptom severity and invalidation experiences. Methods: A total of 74 consecutive patients with FM and 68 healthy control participants were enrolled. The eligible FM patients completed the Illness Invalidation Inventory (3*I), the Revised Fibromyalgia Impact Questionnaire (FIQR) and a short-form health survey (SF-12). Venous blood samples were drawn from all participants to evaluate serum 25-OHD levels. Mann-Whitney tests and multiple logistic regression analyses were performed and Spearman's correlations were calculated. Results: 88.4% of FM patients had low levels of serum 25-OHD. FM patients had significantly higher level of serum 25-OHD than the control group ($17.24{\pm}13.50$ and $9.91{\pm}6.47$ respectively, P = 0.0001). There were no significant correlations between serum 25-OHD levels and the clinical measures of disease impact, invalidation dimensions, and health status. Multiple logistic regression analyses revealed that an increased discounting of the disease by the patient's spouse was associated with a 4-fold increased risk for vitamin D deficiency (OR = 4.36; 95% CI, 0.95-19.87, P = 0.05). Conclusions: This study showed that although high rates of vitamin D insufficiency or deficiency were seen among FM patients and healthy non-FM participants, but it seems there was no intrinsic association between FM and vitamin D deficiency. Addressing of invalidation experience especially by the patient's spouse is important in management of FM.

• Korean Journal of Psychosomatic Medicine
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• v.15 no.1
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• pp.44-50
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• 2007

Objectives: previous studies have suggested the possible predisposing personality in fibromyalgia(FM). The aim of this study is to investigate the personality traits in female patients with FM compared to healthy female controls using the Temperament and Character Inventory(TCI) and furthermore, to evaluate the personality traits affecting the severity of the symptoms of FM. Methods Forty female patients with FM and 40 healthy female controls were examined using the TCI and the Hamilton depression rating scale. The FM patients were also evaluated the severity of the symptoms of FM using the fibromyalgia impact questionnaire(FIQ). Results : ANCOVA with age and depression levels as covariates showed that the FM patients scored significantly higher on the harm avoidance(F=2.187, p=0.047) and lower on the self-directedness(F=4.551, p=0.036) than the healthy controls. The FIQ scores showed positive correlation with the harm avoidance scores in the FM patients when adjusting for age and depression level(R=0.399, p=0.013) Multiple linear regression models revealed that the harm avoidance scores would affect the FIQ scores in FM patients(95% Cl=0.004-1.942, p=0.049). Conclusions : These results suggest that the female FM patients have distinctive temperament and character dimensions compared to the healthy female controls. Moreover, the harm avoidance may be the predictive personality to affect the severity of the symptoms of female FM patients.

• Clinics in Shoulder and Elbow
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• v.6 no.1
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• pp.1-7
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• 2003

Myofascial pain이나 filbrbomyalgia 등에 의한 만성 견관절통증은 보존적 치료로 치료적인 효과를 기대할 수 있는 질환이며, 수술적 치료가 필요한 다른 질환과의 감별을 요한다. 만성적인 견관절 동통의 치료는 증상의 원인과 악화요인을 확인하고 실질적으로 도움이 될 수 있는 적절한 치료법을, 단계적으로 적용하는 것이 효과적이며. 환자와 teamwork을 형성하여, 환자가 병증에 대해 충분히 이해하고 안심할 수 있도록 도와주는 것이 무엇보다 중요하다.

• CELLMED
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• v.12 no.3
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• pp.14.1-14.2
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• 2022

Currently, a 70-year-old woman started suffering from S.I joint pain from 1973 and had severe pain in the S.I joint, wrist, and elbow from 1975 to 1977, and was diagnosed with spinal tuberculosis at a general hospital. From 1978 to 1987, she suffered from chronic fatigue and insomnia, and since January 1, 1988, she was unable to get up while lying down, suffering from whole body joint, muscle pain, and fibromyalgia. In May 1989, she was also diagnosed with ankylosing spondylitis through genetic testing at the Catholic St. Mary's Hospital Rheumatology Department in Korea, and was treated with sulfasalazine, analgesic, and immunosuppressant, methotrexate, for 12 years until 1999, but none of the drugs eliminated the pain. She was hospitalized and discharged repeatedly, and continued to receive salt water poultice and exercise therapy at home, but was unable to move at all. In 2000, after biologic treatment with Remicade injection (Remsima®), she was able to walk and move, and after that, she was continuously prescribed biologics. From 2015 to 2019, Enbrel® (Etanercept) injection was prescribed once a week, but the symptoms such as severe pain (joint and muscle, fibromyalgia), scleroderma, Sjogren's syndrome (dryness of eyes, nose and mouth), difficulty swallowing, chronic fatigue, and stiff body appeared. Around January 2018, hepatic indicators were high and lymphocytes became enlarged. However, most serious injuries were highly improved after the OCNT combination therapy using active phytonutrients, anthocyanin-fucoidan nanocomplex. Therefore, for patients with such experiences, OCNT treatment is proposed as an alternative.

• Journal of Life Science
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• v.20 no.4
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• pp.496-502
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• 2010

The acidic saline animal model of pain has been suggested to mimic fibromyalgia (FM). Oligomeric proanthocyanidin complexes (OPC) from grape seeds are known to act as an antioxidant. We studied the effects of OPC on the pain threshold in the acidic saline animal model of pain. The left gastrocnemius muscle was injected with $100\;{\mu}l$ of saline at pH 4.0 under brief isoflurane anesthesia on days 0 and 5. Control rats (n=5) received identical injections of physiological saline (pH 7.2) on the same schedule. Rats (n=10) with acidic saline injection were separated into two study subgroups. After measurement of pre-drug pain thresholds, rats were injected intraperitoneally with either saline or OPC 300 mg/kg. Paw withdrawal thresholds to pressure were again measured 60 min after intraperitoneal injection. Nociceptive thresholds were measured with a Dynamic Plantar Aesthesiometer by applying an increasing pressure to right or left hind paw until the rat withdrew the paw. Compared to baseline (day 0), acid injections produced mechanical hyper-responsiveness on day 7 (pre-drug) in these rats [p<0.05]. A potent antihyperalgesic effect was observed when rats were injected intraperitoneally with OPC 300 mg/kg [injected paw, p=0.001; contralateral paw, p=0.002]. OPC treatment decreased the expression of acid sensing ion channel 3 in the brain motor cortex area on immunohistochemical staining when OPC 300 mg/kg was administered intraperitoneally in the animal model of FM pain [p<0.05]. Further research is required to determine the efficacy of OPC treatments in FM pain in humans.

• The Korean Journal of Pain
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• v.29 no.4
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• pp.249-254
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• 2016

Background: This study aimed to investigate the effect of strenuous exercise on ${\beta}$-endorphine (${\beta}$-END) level in fibromyalgia (FM) patients compared to healthy subjects. Methods: We enrolled 30 FM patients and 15 healthy individuals. All study participants underwent a treadmill exercise test using modified Bruce protocol (M.Bruce). The goal of the test was achieving at least 70% of the predicted maximal heart rate (HRMax). The serum levels of ${\beta}$-END were measured before and after the exercise program. Measurements were done while heart rate was at least 70% of its predicted maximum. Results: The mean ${\pm}$ the standard deviation (SD) of exercise duration in the FM and control groups were $24.26{\pm}5.29$ and $29.06{\pm}3.26$ minutes, respectively, indicating a shorter time to achieve the goal heart rate in FM patients (P < 0.003). Most FM patients attained 70% HRMax at lower stages (stage 2 and 3) of M.Bruce compared to the control group (70% versus 6.6%, respectively; P < 0.0001). Compared to healthy subjects, FM patients had lower serum ${\beta}$-END levels both in baseline and post-exercise status ($Mean{\pm}SD$: $122.07{\pm}28.56{\mu}g/ml$ and $246.55{\pm}29.57{\mu}g/ml$ in the control group versus $90.12{\pm}20.91{\mu}g/ml$ and $179.80{\pm}28.57{\mu}g/ml$ in FM patients, respectively; P < 0.001). Conclusions: We found that FM patients had lower levels of ${\beta}$-END in both basal and post-exercise status. Exercise increased serum the ${\beta}$-END level in both groups but the average increase in ${\beta}$-END in FM patients was significantly lower than in the control group.