• The Journal of Internal Korean Medicine
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• v.40 no.2
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• pp.192-200
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• 2019

Introduction: The aim of this study is to report the effect of traditional Korean medical treatment on fibromyalgia. Case presentation: A patient with fibromyalgia was treated with acupuncture, pharmacopuncture (Bee venom, Hwangryunhaedok-tang), cupping therapy, moxibustion therapy and herbal medicine for 37 days. To reduce the patient's symptoms, we provided herbal medicine three times a day, as well as acupuncture, pharmacopuncture, cupping therapy and moxibustion therapy once a day for 37 days. To evaluate the results of this treatment, we used the Numeral Rating Scale (NRS), Score of Sleeping Quality (SSQ) and Fibromyalgia Impact Questionnaire (FIQ). After treatment, the patient showed that pain was reduced, the score of NRS was improved, FIQ improved from 91 to 69 and SSQ improved from 3 to 1. No adverse reaction was noted. Conclusion: According to the result, traditional Korean medical treatment can be effective and safe for the treatment of fibromyalgia.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.27-35
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• 1999

Background: Fibromyalgia is a common syndrome of musculoskeletal pain and fatigue. Lacking distinctive histological or laboratory abnormality in diagnosis, it has often been considered a form of "psychogenic rheumatism". Fibromyalgia causes much distress to the affected patients and often frustrates physicians, who are unable to start rational therapy on any logical disease pathology. Methods: Growth hormone is essential for muscular homeostasis. In the present study, the notion that the stage-4 sleep anomaly typically seen in the fibromyalgia syndrome may disrupt growth hormone secretion was tested. Because growth hormone has a very short half-life, serum levels of somatomedin C were measured; somatomedin C is the major mediator of growth hormone's anabolic actions and is a prerequisite for normal muscle homeostasis. Serum levels of somatomedin C using acid-extraction procedure and two-site immunoradiome-tric assay (IRMA) and number of tender points were measured in 27 female patients with fibromyalgia from 40 to 60 years old and 27 healthy controls. Results: There were no differences in the concentration of somatomedin C between fibromyalgia patients and controls ($mean{\pm}SD$: $178.3{\pm}75.5$ ng/ml versus $166.3{\pm}76.6$ ng/ml; p=0.55). And there were no correlations between number of tender point and serum somatomedin C level by linear regression analysis. Conclusions: These findings did not support that there is a distinctive disruption of the growth hormone-somatomedin C neuroendocrine axis in a fibromyalgia syndrome. But we can not discard the hypothesis that disturbed sleep predispose to muscle pain.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.99-107
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• 2020

Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fatigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmental factors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacological and non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyalgia than in the general population ; moreover, the association between fibromyalgia and certain psychopathologies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.

• Journal of Oriental Neuropsychiatry
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• v.34 no.2
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• pp.95-113
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• 2023

Objectives: To review studies evaluating effects of acupuncture on pain and depressive symptoms in fibromyalgia. Methods: Quantitative evidences (RCTs) were systematically reviewed. Literature were searched for a combination of fibromyalgia and depression (The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, medline (via PubMed), Kmbase, KISS, ScienceON, OASIS, CiNii, CNKI). Quantitative research findings were critically appraised by Cochrane risk of bias (RoB) tool and pooled. Meta-analysis was then conducted using Review Manager (RevMan) 5.4. Results: Eighteen studies were selected. American College of Rheumatology (ACR) classification criteria for Fibromyalgia Syndrome was most frequently used as diagnostic criteria for fibromyalgia. As for outcome measurement, Hamilton Rating Scale for Depression (HAMD), Visual Analog Scale (VAS), and Total Effective Rate (TER) were used most commonly. Meta-analysis of ten studies revealed that both Depression and VAS scores of the Acupuncture+Western Medicine group were significantly lower than those of Western Medicine group (Depression: SMD, -0.94, 95% CI, -1.17 to -0.70; VAS: MD, -1.51, 95% CI, -1.83 to -1.19). Also, TERs of both Acupuncture group and Acupuncture+Western Acupuncture+Western Medicine group were significantly higher than those of the Western Medicine group (OR: 2.38, 95% CI: 1.29 to 4.41; and OR: 7.40, 95% CI: 3.41 to 16.07). There was no significant difference in Depression or VAS score between the Acupuncture Group and the Western Medicine Group. Conclusions: Acupuncture might be an effective option for pain and depressive symptoms of fibromyalgia when it is combined with Western Medicine treatment. For more accurate results, more types of Korean medicine treatment should be conducted.

• Herbal Formula Science
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• v.20 no.1
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• pp.149-158
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• 2012

Objectives : The purpose of this study is to evaluate the effect of oriental medical combined treatment on the fibromyalgia syndrome patient. Methods : Oriental medical combined treatment was administered during 3 weeks at 2 times admissions. The improvement of clinical symptom was evaluated by VAS(visual analogue scale), SF-MPQ(short form-McGill pain questionnarie) and PRS(pain rating scale), change of tender points. Results : After treatment, the patient's VAS score was reduced to 3-5, 4-5 point. First admission, there is no observable change in the SF-MPQ. But, Second admission, SF-MPQ score was reduced from 16 to 6. The PRS score was reduced from 72 to 24, from 75 to 48 respectively. Tender points was reduced generally. Conclusions : Oriental medical combined treatment for the fibromyalgia syndrome patient was effective. Although this case presented valuable result, further research is encouraged to confirm the effectiveness of this treatment with large number of patient.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.2
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• pp.55-66
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• 2017

Objectives This study aimed to review studies in Korean medicine for fibromyalgia syndrome (FMS). Methods We conducted search across 3 electronic databases (Korean traditional knowledge portal, RISS, Oasis) to find studies for FMS in Korean medicine. Studies of Korean medicine for FMS were included and analysed. Results 15 studies were included. 2 studies were reviews and 13 studies were case reports. Total numbers of patients in case studies were 15. In case studies, acupuncture (100%), herbal medicine (76.9%), Korean physical therapy (69.2%), pharmacopuncture (53.8%), Chuna (46.1%) and moxibustion (30.7%) etc. were used. BL23 in acupuncture and CV12 in moxibustion were most frequently used. Gamisoyo-san in herbal medicine and visual analogue scale (VAS) in outcome measure were most frequently used. Conclusions This systematic review found encouraging but limited evidence of Korean medicine for FMS. I expect various trials such as randomized clinical trial or animal experimentation and more case reports. And systemic review for FMS in other national journals is needed.

• Journal of muscle and joint health
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• v.5 no.2
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• pp.191-205
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• 1998

This study was conducted to identify the relations between the factors influencing syndrome and physical disability of fibromyalgia patients. The subjects of this study were 125 outpatients selected at H. Rheumatism clinic from February to July in 1997, The Collected data were analyzed by Frequency, Pearson correlation using SPSS Windows and Path analysis using LISREL 7.16. The results were as follows. 1. General characteristics of subjects About 2/3 of subjects were over 40years of age and most of them were graduated from high school. The Christian were over a half (54.0%) of subjects. 2. Correlation between Family support, knowledge, Self-efficacy, Syndrome and physical disability. As knowledge was positively related to self-efficacy(r=.306), the family support was positively related to self-efficacy(r=.217), and family support was negatively to syndrome. Self-efficacy showed negative relation with syndrome and Physical disability. Syndrome as physical disability represent positive relation. Therefore all hypotheses were supported. 3. Causal relations between research variables. Family support influenced on syndrome, as syndrome on physical activity, as well as knowledge on self-efficacy & physical disability. The model also showed a good fit to the data[$X^2$=1.21 df=1(p=.546), GFI=.996, AGFI=.971, RMSR=.023]. 4. Correlation between symptoms of Fibromyalyia. Having analyzed the relations between tender point, pain, stiffness, functional disturbance, sleep disturbance, depression, fatigue, anxiety, the results were as follows ; All relations show statistically positive correlation, which means close relationship between symptoms, except between pain and depression, pain and anxiety. As a result, symptoms of Fibromyalgia had close relation. Therefore, these were common, rather than individual symptoms. This syndrome influenced on physical disability, and self-efficacy on the both, as knowledge on self-efficacy. In conclusion, to improve syndrome relief and physical disability of fibromyalgia, nursing interventions such as education, self-efficacy increasing stratagy, and family counseling are needed.

• The Korean Journal of Pain
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• v.31 no.3
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• pp.147-154
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• 2018

Fibromyalgia (FM) is a contested illness with ill-defined boundaries. There is no clearly defined cut-point that separates FM from non-FM. Diagnosis of FM has been faced with several challenges that occur, including patients' health care-seeking behavior, symptoms recognition, and FM labeling by physicians. This review focuses on important but less visible factors that have a profound influence on under- or over-diagnosis of FM. FM shows different phenotypes and disease expression in patients and even in one patient over time. Psychosocial and cultural factors seem to be a contemporary ferment in FM which play a major role in physician diagnosis even more than having severe symptom levels in FM patients. Although the FM criteria are the only current methods which can be used for classification of FM patients in surveys, research, and clinical settings, there are several key pieces missing in the fibromyalgia diagnostic puzzle, such as invalidation, psychosocial factors, and heterogeneous disease expression. Regarding the complex nature of FM, as well as the arbitrary and illusory constructs of the existing FM criteria, FM diagnosis frequently fails to provide a clinical diagnosis fit to reality. A physicians' judgment, obtained in real communicative environments with patients, beyond the existing constructional scores, seems the only reliable way for more valid diagnoses. It plays a pivotal role in the meaning and conceptualization of symptoms and psychosocial factors, making diagnoses and labeling of FM. It is better to see FM as a whole, not as a medical specialty or constructional scores.

• Korean Journal of Acupuncture
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• v.37 no.1
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• pp.46-53
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• 2020

Objectives : The purpose of this study was to report the effects of Korean medicine therapy on patients with fibromyalgia syndrome. Methods : In this study, we used Korean medicine treatments, including acupuncture, bee venom therapy, chuna manual therapy, and others, to treat hospitalized patients diagnosed with fibromyalgia syndrome. Improvements in clinical symptoms were evaluated using a numeric rating scale (NRS), the short form McGill Pain Questionnaire (SF-MPQ), and changes in the number of tender points. Results : After Korean medicine treatment, the NRS scores reduced from 10 to 7 (Patient 1) and from 10 to 5 (Patient 2). The SF-MPQ scores decreased from 33 to 26 (Patient 1) and from 25 to 18 (Patient 2). The number of tender points reduced from 18 to 15 (Patient 1) and from 12 to 11 (Patient 2). Conclusions : In both patients, the NRS scores, SF-MPQ scores, and number of tender points significantly improved. The results suggest that Korean medicine treatments, including acupuncture, bee venom therapy, chuna manual therapy, and others, may be effective for treating fibromyalgia syndrome.

• Journal of muscle and joint health
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• v.5 no.1
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• pp.39-56
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• 1998

This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.