June 16, 1998

Studies reviewed in this article include:

1. Fibromyalgia and myofascial pain
2. Comparing glutocorticoid injections into the lower jaw of fibromyalgia patients and localized myalgia (pain) patients
3. Treating fibromyalgia with Tramadol

You can find the abstracts of these articles at the PubMed, a listing of research journal articles maintained by the U.S. National Institutes of Health. Authors, titles, publication information and UI number are included at the end of each summary. You can read the abstracts by going to the PubMed website at and inserting the UI number of the article into the search window.

For a reliable, professional explanation of these studies, please consult your own doctor.


Scientists at the University of Toronto compared information about fibromyalgia and myofascial pain of the masticatory muscles (pain in the connective tissues of chewing muscles) to see if they might be related. The intensity of facial pain and its effect on the quality of daily life are very similar in both disorders.

The authors concluded that fibromyalgia is probably a more debilitating disorder than myofascial pain of the masticatory muscles: patients describe the pain of fibromyalgia in stronger terms, and fibro patients also tend to have neurologic and gastrointestinal symptoms. Also, when fibro patients have facial pain, they usually also have pain elsewhere in the body. Body pain in fibro patients is constant and relatively severe, but body pain is only episodic (comes and goes) in myofascial pain patients.

The authors say that the differences in pain patterns suggest that fibromyalgia and myofascial pain are not caused by the same thing. They also note that, in both disorders, patients who have been sick longer do not report more pain than patients who have recently become ill, and this shows that neither disorder is likely to be progressive (continue to get worse the longer you have it).

UI Number: 98273233

Title: "Comorbidity between myofascial pain of the masticatory muscles and fibromyalgia."

Authors: Dao TT, Reynolds WJ, Tenenbaum HC

Published: J Orofac Pain 1997:11(3):232-241


Doesn't that title just sound like fun? Gee, I hope these patients got paid for participating in the study!

Anyway, 25 fibro patients and 25 patients with localized myalgia of the masseter muscle (pain in the lower jaw) were asked to assess their pain on questionnaires, and were given physical exams including tenderness to digital palpation ("Does it hurt when I poke here?"). All the patients were then given an injection of glucocorticoid. The entire process was repeated after 2 weeks, and then again after another 5 weeks. The fibro patients had less pain when being poked than they had before the injection, but no change in their other symptoms; the localized myalgia patients had a general improvement of symptoms as well as less overall pain and less pain when poked.

UI number: 98273235

Title: "Short-term effect of glutocorticoid injection into the superficial masseter muscle of patients with chronic myalgia: a comparison between fibromyalgia and localized myalgia."

Authors: Ernberg M, Hedenberg-Magnusson B, Alstergren P, Kopp S

Published: J Orofac Pain 1997;11(3):249-257.


Researchers at the University of Siena in Italy assembled a group of 12 fibromyalgia patients and gave them injections of either Tramadol or a placebo. Then, a week later, the placebo patients received Tramadol injections and the Tramadol patients received the placebo.

Three of the patients dropped out of the study after the first injections because the side effects were too severe. (One of them had received the placebo, not the Tramadol, so it's unclear what the patient was reacting to.)

After both injections, the patients were asked to rate their pain on a scale, and were also tested for trigger point pain (there they go poking again). There was no change in the trigger point pain, but there was a 20 percent reduction in overall pain after receiving Tramadol; after the placebo injection, there was a 20 percent increase in overall pain. The researchers concluded that more studies should be undertaken to see if Tramadol would work better if it were given over a period of time, rather than just one injection, and to find out more about how Tramadol works in treating fibromyalgia.

UI Number: 98268089

Title: "Tramadol in the fibromyalgia syndrome: a controlled clinical trial versus placebo."

Authors: Biasi G, Manca S, Manganelli S, Marcolongo R

Published: Int J Clin Pharmacol Res 1998:18(1):13-19.

* * * * * * * * * * * * * * * * * * *
Cfsmail is a free e-mail news service for chronic fatigue syndrome, fibromyalgia, and related disorders, symptoms, and issues.
Subscribe at:
Contact the editor at: (If you have trouble subscribing at the OneList website, e-mail me and I'll subscribe you.)
* * * * * * * * * * * * * * * * * * *

Web page design by Bill Jackson, 1998.

Any comments? Send them to Bill Jackson at

Button pointing leftBack to Fibromyalgia Index Page