rojournalРоссийский остеопатический журналRussian Osteopathic Journal2220-09752949-3064All-Russian Public Organization «Russian Osteopathic Association» (ROsA)10.32885/2220-0975-2023-3-124-138rojournal-498Research ArticleОСТЕОПАТИЯ ЗА РУБЕЖОМOSTEOPATHY ABROADЭффективность остеопатического лечения пациентов, страдающих фибромиалгией (обсервационное исследование)Observational study of the effects of an osteopathic treatment for patients with fibromyalgiaЛарошФ.LarocheF.

Франсуаза Ларош , ревматолог Центра исследования и лечения боли и Отделения ревматологии 

75012, Париж, ул. Фобур Сент-Антуан, д. 184 

Françoise Laroche , Rhumatologue au Centre d′Evaluation et de Traitement de la Douleur et Service de Rhumatologie 

184 Rue du Faubourg Saint-Antoine, Paris, 75012

francoise.laroche@sat.aphp.frБелланЭ.BellanE.

Элоди Беллан , остеопат 

94170, Ле Перре-сюр-Марн, ул. Марны, д. 10

Elodie Bellan , Osteopathe 

10 Rue de la Marne, Le Perreux-sur-Marne, 94170

ДолеакМ.DoléacM.

Мари Долеак , остеопат 

94170, Ле Перре-сюр-Марн, ул. Марны, д. 10

Marie Doléac , Osteopathe 

10 Rue de la Marne, Le Perreux-sur-Marne, 94170

МелеР.MesléR.

Робер Меле , остеопат, исследователь 

75019, Париж, ул. Рэн, д. 20

Robert Meslé , Osteopathe, Chercheur 

20, rue du Rhin, Paris, 75019

МартиМ.MartyM.

Марк Марти , ревматолог, статистик Отделения ревматологии 

94010, Кретей, ул. Гюстава Эйфеля, д. 1

Marc Marty , Rhumatologue, Statisticien au Service de Rhumatologie 

1 rue Gustave Eiffel, Créteil, 94010

РостэнС.RostaingS.

Сильви Ростэн , анестезиолог Центра исследования и лечения боли 

75012, Париж, ул. Фобур Сент-Антуан, д. 184

Sylvie Rostaing , Anesthésiste au Centre d′Evaluation et de Traitement de la Douleur 

184 Rue du Faubourg Saint-Antoine, Paris, 75012

Больница Сент-АнтуанФранцияHôpital Saint-AntoineFranceВысшая школа остеопатииФранцияEcole Superieure d′OsteopathieFranceOpen RomeФранцияChercheur Open RomeFranceБольница Анри МондорФранцияHôpital Henri MondorFrance20232209202303124138Copyright © Ларош Ф., Беллан Э., Долеак М., Меле Р., Марти М., Ростэн С., 20232023Ларош Ф., Беллан Э., Долеак М., Меле Р., Марти М., Ростэн С.Laroche F., Bellan E., Doléac M., Meslé R., Marty M., Rostaing S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rojournal.elpub.ru/jour/article/view/498

Цель исследования — оценить влияние остеопатического лечения на основные симптомы фибромиалгии: боль, качество сна, тревожность, депрессию, ухудшение качества жизни. Материалы и методы. Это пилотное открытое проспективное обсервационное исследование включало 13 пациентов, получавших остеопатическое лечение. Исследование проводили в Центре исследования и лечения боли при больнице Сент-Антуан (Париж). Остеопатическое лечение было адаптировано к каждому пациенту без заранее установленного протокола лечения. Курс лечения состоял из шести сеансов с интервалом в 3 нед ±7 дней. Интенсивность симптомов и изменения оценивали перед первым сеансом и после последнего сеанса с помощью следующих опросников для самооценки: QCD, QIF, PSQI, HAD и PGIC. Результаты. Для 13 пациентов (93 % женщины, средний возраст — 51 год) качество жизни (QIF) улучшилось на 34 % — с 73,9±10,2 до 48,7±17,6 (p<0,0001), показатель нарушения сна (PSQI) снизился (то есть сон улучшился) на 25 % — с 13,3±3,3 до 10±3,4 (p=0,003), а также наблюдали уменьшение боли на 38 % — с 58,5±15,7 до 36,2±16,1 (p=0,005) и тревожности на 25 % — с 10,5±4,2 до 7,9±4,5 (p=0,004). Снижение уровня депрессии было незначительным.Заключение. Результаты, полученные в этой когорте, обнадеживают, даже если высокие стандартные отклонения, по-видимому, отражают значительные межиндивидуальные различия. Для подтверждения этих данных необходимо провести рандомизированное контролируемое исследование на большей популяции. 

Background. The aim of this study is to evaluate the effects of an osteopathic treatment on the main symptoms of Fibromyalgia: pain, quality of sleep, anxiety, depression, deterioration in the quality of life. Methods. This open, prospective and observational pilot study included 13 patients, all of them submitted to an osteopathic treatment. The study took place in the «Centre d′Évluation et de Traitement de la Douleur» (Centre of Evaluation and Treatment of Pain) at the «Saint-Antoine» Hospital in Paris. The osteopathic treatment has been adapted to each patient without pre-established procedure of treatment. Six sessions with three weeks intervals (± seven days). The intensity as well as the impression of alteration of the symptoms has been evaluated before the first and after the last session of treatment with the following auto evaluation forms: QCD, QIF, PSQI, HAD and PGIC. Results. In all 13 patients (women: 92%, middle-aged 51 years), the Quality of Life (QIF) improved with 34% namely from 73,9±10,2 to 48,7±17,6 (p<0.0001). The Sleep score (PSQI) decreased with 25 % i. e. 13,3±3,3 to 10±3,4 (p=0003) as well as Pain that decreased with 38 %, that is from 58,5±15,7 to 36,2±16,1 (p=0,005). Anxiety decreases with 25 %, namely from 10,5±4,2 to 7,9±4,5 (p=0,004).There was no significative diminishing of Depression. Conclusion. The results of this cohort are encouraging even if the high standard deviations seem to be the mirror of important interindividual differences. A controlled, randomized trial with more patients is necessary to confirm these data.

обсервационное исследованиеостеопатическое лечениефибромиалгияobservational studyosteopathic treatmentfibromyalgiaReferencesLaroche F. Actualités de la fibromyalgie Fibromyalgia syndrome: What′s new in 2009? Rev. Rhumat. 2009; 76: 529–536.Laroche F. Actualités de la fibromyalgie Fibromyalgia syndrome: What′s new in 2009? Rev. Rhumat. 2009; 76: 529–536.Bodin L. La fibromyalgie et le syndrome de fatigue chronique. Paris: Editions du Dauphin; 2009. 238 p.Bodin L. La fibromyalgie et le syndrome de fatigue chronique. Paris: Editions du Dauphin; 2009. 238 p.Blotman F., Boulenger J. P., Capdevielle D., Thomas E. La fibro myalgie. L′observ. Mouvem. 2003; 9: 2.Blotman F., Boulenger J. P., Capdevielle D., Thomas E. La fibro myalgie. L′observ. Mouvem. 2003; 9: 2.Carville S. F., Arendt-Nielsen S., Bliddal H., Blotman F., Branco J. C., Buskila D. et al. Eular evidence-based recommandations for management of fibromyalgia syndrome. Ann. Rheum. Dis. 2008; 67: 536–541.Carville S. F., Arendt-Nielsen S., Bliddal H., Blotman F., Branco J. C., Buskila D. et al. Eular evidence-based recommandations for management of fibromyalgia syndrome. Ann. Rheum. Dis. 2008; 67: 536–541.Häuser W., Thieme K., Turk D. C. Guidelines on the management of fibromyalgia syndrome — A systematic review. Europ. J. Pain. 2010: 14; 5–10.Häuser W., Thieme K., Turk D. C. Guidelines on the management of fibromyalgia syndrome — A systematic review. Europ. J. Pain. 2010: 14; 5–10.Paul I. K. Fibromyalgie. Arch. Pédiat. 2006; 13: 544–555.Paul I. K. Fibromyalgie. Arch. Pédiat. 2006; 13: 544–555.Wolfe F., Smythe H. A., Yunus M. B., Bennet R. M., Bombardier C., Goldenberg D. L. et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthr. and Rheum. 1990; 33: 160–172.Wolfe F., Smythe H. A., Yunus M. B., Bennet R. M., Bombardier C., Goldenberg D. L. et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthr. and Rheum. 1990; 33: 160–172.Fitzcharles M. A., Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology. 2003: 42–263.Fitzcharles M. A., Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology. 2003: 42–263.Menkès C. J., Godeau P. La fibromyalgie. Bull. Acad. Natle Méd. 2007; 191: 143–148.Menkès C. J., Godeau P. La fibromyalgie. Bull. Acad. Natle Méd. 2007; 191: 143–148.Wolfe F., Clauw D. J., Fitzcharles M. A., Goldenberg D. L., Katz R. S., Mease P. et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthr. Care Res. 2010; 62 (5): 600–610.Wolfe F., Clauw D. J., Fitzcharles M. A., Goldenberg D. L., Katz R. S., Mease P. et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthr. Care Res. 2010; 62 (5): 600–610.Adler G. K., Geenen R. Hypothalamic-pituitary-adrenal and autonomic nervous system functioning in fibromyalgia. Rheum. Dis. clin. N. Amer. 2005; 31: 187–202.Adler G. K., Geenen R. Hypothalamic-pituitary-adrenal and autonomic nervous system functioning in fibromyalgia. Rheum. Dis. clin. N. Amer. 2005; 31: 187–202.Mc Lean S. A., Williams D. A., Harris R. E., Kop W. J., Groner K. H., Ambrose K. et al. Momentary relationship between cortisol secretion and symptoms in patients with fibromyalgia. Arthr. and Rheum. 2005; 52: 3660–3669.Mc Lean S. A., Williams D. A., Harris R. E., Kop W. J., Groner K. H., Ambrose K. et al. Momentary relationship between cortisol secretion and symptoms in patients with fibromyalgia. Arthr. and Rheum. 2005; 52: 3660–3669.Arnold L. M., Hudson J. I., Hess E. V., Ware A. E., Fritz D. A., Auchenbach M. B. et al. Family study of fibromyalgia. Arthr. and Rheum. 2004; 50 (3): 944–952.Arnold L. M., Hudson J. I., Hess E. V., Ware A. E., Fritz D. A., Auchenbach M. B. et al. Family study of fibromyalgia. Arthr. and Rheum. 2004; 50 (3): 944–952.Offenbaecher M., Bondy B., De Jonge S., Glatzeder K., Krüger M., Schoeps P. et al. Possible association of fibromyalgia with a polymorphisme in serotonin transporter gene regulatory R region. Arthr. and Rheum. 2004; 50: 944–952.Offenbaecher M., Bondy B., De Jonge S., Glatzeder K., Krüger M., Schoeps P. et al. Possible association of fibromyalgia with a polymorphisme in serotonin transporter gene regulatory R region. Arthr. and Rheum. 2004; 50: 944–952.Price D. D., Staur R. Neurobiology of fibromyalgia syndrome. J. Rheum. 2005; 32 (75): 22–28.Price D. D., Staur R. Neurobiology of fibromyalgia syndrome. J. Rheum. 2005; 32 (75): 22–28.Mountz J. M., Bradley L. A., Modell J. G. et al. Fibromyalgia in women. Abnormalities of regional cerebral blood fl ow in the thalamus and the caudate nucleus are associated with low pain threshold levels. Arthr. and Rheum. 1995; 38 (7): 926–938.Mountz J. M., Bradley L. A., Modell J. G. et al. Fibromyalgia in women. Abnormalities of regional cerebral blood fl ow in the thalamus and the caudate nucleus are associated with low pain threshold levels. Arthr. and Rheum. 1995; 38 (7): 926–938.Bennett R. M., Jones J., Turk D. C., Russell I. J., Matallana L. An internet survey of 2596 people with fibromyalgia. BMC Musculoskelet Disord. 2007; 8: 27.Bennett R. M., Jones J., Turk D. C., Russell I. J., Matallana L. An internet survey of 2596 people with fibromyalgia. BMC Musculoskelet Disord. 2007; 8: 27.Häuser W., Bernardy K., Üceyler N., Sommer C. Treatment of Fibromyalgia Syndrome With Antidepressants. A Metaanalysis. J.A.M.A. 2009; 301 (2): 198–209.Häuser W., Bernardy K., Üceyler N., Sommer C. Treatment of Fibromyalgia Syndrome With Antidepressants. A Metaanalysis. J.A.M.A. 2009; 301 (2): 198–209.Baranowsky J., Klose P., Musial F., Haeuser W., Dobos G., Langhorst J. Qualitative systemic review of randomized contolled trials on complementary and alternative medicine treatments in fibromyalgia. Rheum. Int. 2009; 30: 1–21.Baranowsky J., Klose P., Musial F., Haeuser W., Dobos G., Langhorst J. Qualitative systemic review of randomized contolled trials on complementary and alternative medicine treatments in fibromyalgia. Rheum. Int. 2009; 30: 1–21.Itoh K., Kitakoji H. Effects of acupuncture to treat fibromyalgia: a preliminary randomised controlled trial. Chinese Med. 2010; 5: 11.Itoh K., Kitakoji H. Effects of acupuncture to treat fibromyalgia: a preliminary randomised controlled trial. Chinese Med. 2010; 5: 11.Harris R. E., Tian X., Williams D. A., Tian T. X., Cupps T. R., Petzke F. et al. Treatment of fibromyalgia with formula acupuncture: investigation of needle placement, needle stimulation, and treatment frequency. J. Altern. Complement Me. 2005; 11: 663–671.Harris R. E., Tian X., Williams D. A., Tian T. X., Cupps T. R., Petzke F. et al. Treatment of fibromyalgia with formula acupuncture: investigation of needle placement, needle stimulation, and treatment frequency. J. Altern. Complement Me. 2005; 11: 663–671.Martin D. P., Sletten C. D., Williams B. A., Berger I. H. Improvement in fibromyalgia symptoms with acupuncture : results of a randomized controlled trial. Mayo Clin. Proc. 2006; 81: 749–757.Martin D. P., Sletten C. D., Williams B. A., Berger I. H. Improvement in fibromyalgia symptoms with acupuncture : results of a randomized controlled trial. Mayo Clin. Proc. 2006; 81: 749–757.Martin-Sanchez E., Torralba E., Diaz-Dominguez E., Barriga A., Martin J. L. Efficacy of acupuncture for the treatment of fibromyalgia: systematic review and meta-analysis of randomized trials. Open Rheum. J. 2009; 3: 25–29.Martin-Sanchez E., Torralba E., Diaz-Dominguez E., Barriga A., Martin J. L. Efficacy of acupuncture for the treatment of fibromyalgia: systematic review and meta-analysis of randomized trials. Open Rheum. J. 2009; 3: 25–29.Sim J., Adams N. Systematic review of randomized controlled trials of non pharmacological interventions in fibromyalgia. Clin. J. Pain. 2002; 18 (5): 324–336.Sim J., Adams N. Systematic review of randomized controlled trials of non pharmacological interventions in fibromyalgia. Clin. J. Pain. 2002; 18 (5): 324–336.Morley S. RCTs of psychological treatments for chronic pain: progress and challenges. Pain. 2006; 121: 171–172.Morley S. RCTs of psychological treatments for chronic pain: progress and challenges. Pain. 2006; 121: 171–172.Bendaya S., Le Breton F., Gahlouz F., Aymard C. Approche pluridisciplinaire de la fibromyalgie. Lettre méd. physiq. réadaptat. 2007; 23(2): 97–102.Bendaya S., Le Breton F., Gahlouz F., Aymard C. Approche pluridisciplinaire de la fibromyalgie. Lettre méd. physiq. réadaptat. 2007; 23(2): 97–102.Laroche F., Jammet L., Aguerre C., Coichard C. G., Rostaing-Rigattieri S., Perrot S. Effet des thérapies cognitives et comportementales associées aux exercices sur la qualité de vie de la fibromyalgie. Rev. Rhum. 2007; 74: 1039–1208.Laroche F., Jammet L., Aguerre C., Coichard C. G., Rostaing-Rigattieri S., Perrot S. Effet des thérapies cognitives et comportementales associées aux exercices sur la qualité de vie de la fibromyalgie. Rev. Rhum. 2007; 74: 1039–1208.Bernardy K., Füber N., Köllner V., Häuser W. Efficacy of cognitive-behavioral therapies in fibromyalgia syndrome — a systematic review and metaanalysis of randomized controlled trials. J. Rheum. 2010; 37(10): 1991–2005.Bernardy K., Füber N., Köllner V., Häuser W. Efficacy of cognitive-behavioral therapies in fibromyalgia syndrome — a systematic review and metaanalysis of randomized controlled trials. J. Rheum. 2010; 37(10): 1991–2005.Panton L. B., Figueroa A., Kingsley J. D., Hornbuckle L., Wilson J., St John N. et al. Effects of resistance training and chiropractic treatment in women with fibromyalgia. J. Altern. Compl. Med. 2009; 15 (3): 321–328.Panton L. B., Figueroa A., Kingsley J. D., Hornbuckle L., Wilson J., St John N. et al. Effects of resistance training and chiropractic treatment in women with fibromyalgia. J. Altern. Compl. Med. 2009; 15 (3): 321–328.Ernst E. Chiropractic treatment for fibromyalgia: a systematic review. Clin. Rheum. 2009; 28 (10): 1175–1178.Ernst E. Chiropractic treatment for fibromyalgia: a systematic review. Clin. Rheum. 2009; 28 (10): 1175–1178.Dardzinski J. A., Ostrov B. E., Hamann L. S. Myofascial pain unresponsive to standart treatment: successful use of strain and counterstrain technique with physical thérapie. J. clin. Rheum. 2000; 6 (4): 169–174.Dardzinski J. A., Ostrov B. E., Hamann L. S. Myofascial pain unresponsive to standart treatment: successful use of strain and counterstrain technique with physical thérapie. J. clin. Rheum. 2000; 6 (4): 169–174.Gamber R. G., Shores J. H., Russo D. P., Jimenez C., Rubin B. R. Osteopathic Manipulative Treatment in conjonction with medication relieves pain associated with fibromyalgia syndrome: result of a randomized clinical pilot project. JAOA. 2002; 102: 321–325.Gamber R. G., Shores J. H., Russo D. P., Jimenez C., Rubin B. R. Osteopathic Manipulative Treatment in conjonction with medication relieves pain associated with fibromyalgia syndrome: result of a randomized clinical pilot project. JAOA. 2002; 102: 321–325.Matarán-Peñarrocha G. A., Castro-Sánchez A. M., Carballo García G., Moreno-Lorenzo C., Parrón Carreño T., Onieva Zafra M. D. Infl uence of Craniosacral Therapy on Anxiety, Depression and Quality of Life in Patients with Fibromyalgia. Evidence-Based Complementary and Alternative Medicine. 2011. Article ID 178769. doi: 10.1093/ecam/nep125.Matarán-Peñarrocha G. A., Castro-Sánchez A. M., Carballo García G., Moreno-Lorenzo C., Parrón Carreño T., Onieva Zafra M. D. Infl uence of Craniosacral Therapy on Anxiety, Depression and Quality of Life in Patients with Fibromyalgia. Evidence-Based Complementary and Alternative Medicine. 2011. Article ID 178769. doi: 10.1093/ecam/nep125.Castro-Sánchez A. M., Matarán-Peñarrocha G. A., Granero-Molina J., Aguilera-Manrique G., Quesada-Rubio J. M., MorenoLorenzo C. Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evidence-Based Complementary and Alternative Medicine. 2011. Article ID 561753. doi: 10.1155/2011/561753Castro-Sánchez A. M., Matarán-Peñarrocha G. A., Granero-Molina J., Aguilera-Manrique G., Quesada-Rubio J. M., MorenoLorenzo C. Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evidence-Based Complementary and Alternative Medicine. 2011. Article ID 561753. doi: 10.1155/2011/561753Perrot S. Des médicaments pour traiter la fibromyalgie? Rev. Rhum. 2003; 70 (4): 340–345.Perrot S. Des médicaments pour traiter la fibromyalgie? Rev. Rhum. 2003; 70 (4): 340–345.Burckhardt C. S., Clark S. R., Bennet R. M. The fibromyalgia impact questionnaire: development and validation. J. Rheum. 1991; 18 (5): 728–733.Burckhardt C. S., Clark S. R., Bennet R. M. The fibromyalgia impact questionnaire: development and validation. J. Rheum. 1991; 18 (5): 728–733.Perrot S., Dumond D., Guillemin F., Pouchot J., Coste J. Quality of life in women with fibromyalgia syndrome: validation of the QIF, the French version of the fibromyalgia impact questionnaire. J. Rheum. 2003; 30: 1054–1059.Perrot S., Dumond D., Guillemin F., Pouchot J., Coste J. Quality of life in women with fibromyalgia syndrome: validation of the QIF, the French version of the fibromyalgia impact questionnaire. J. Rheum. 2003; 30: 1054–1059.Zigmond A. S., Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiat. Scand. 1983; 67: 361–370.Zigmond A. S., Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiat. Scand. 1983; 67: 361–370.Agence Nationale d′Accréditation et d′Évaluation en Santé. Évaluation et suivide la douleur chronique chez l′adulte en médecine ambulatoire. ANAES: 1999. 124 p.Agence Nationale d′Accréditation et d′Évaluation en Santé. Évaluation et suivide la douleur chronique chez l′adulte en médecine ambulatoire. ANAES: 1999. 124 p.Buysse D. J., Reynolds C. F., Monk T. H., Berman S. R., Kupfer D. J. The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric research and practice. Psychiat. Res. 1989; 28 (2): 193–213.Buysse D. J., Reynolds C. F., Monk T. H., Berman S. R., Kupfer D. J. The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric research and practice. Psychiat. Res. 1989; 28 (2): 193–213.Hurst H., Bolton J. Assessing the clinical significance of change scores recorded on subjective outcome measures. J. manipul. Physiol. Ther. 2004; 27: 26–33.Hurst H., Bolton J. Assessing the clinical significance of change scores recorded on subjective outcome measures. J. manipul. Physiol. Ther. 2004; 27: 26–33.Branco J. C., Zachrisson O., Perrot S., Mainguy Y. Multinational Coordinator Study Group. A European multicenter randomized double-blind placebo-controlled monotherapy clinical trial of milnacipran in treatment of fibromyalgia. J. Rheum. 2010; 37: 851–859.Branco J. C., Zachrisson O., Perrot S., Mainguy Y. Multinational Coordinator Study Group. A European multicenter randomized double-blind placebo-controlled monotherapy clinical trial of milnacipran in treatment of fibromyalgia. J. Rheum. 2010; 37: 851–859.Morillas-Arques P., Rodriguez-Lopez C. M., Molina-Barea R., Rico-Villademoros F., Calandre E. P. Trazodone for the treatment of fibromyalgia: an open-label, 12-week study. BMC Musculoskelet. Disord. 2010; 11: 204.Morillas-Arques P., Rodriguez-Lopez C. M., Molina-Barea R., Rico-Villademoros F., Calandre E. P. Trazodone for the treatment of fibromyalgia: an open-label, 12-week study. BMC Musculoskelet. Disord. 2010; 11: 204.Wang C., Schmid C. H., Rones R., Kalish R., Yinh J., Goldenberg D. L. et al. A randomized trial of tai chi for fibromyalgia. New Engl. J. Med. 2010; 363: 743–754.Wang C., Schmid C. H., Rones R., Kalish R., Yinh J., Goldenberg D. L. et al. A randomized trial of tai chi for fibromyalgia. New Engl. J. Med. 2010; 363: 743–754.Choy E., Perrot S., Leon T., Kaplan J., Petersel D., Ginovker A. A patient survey of the impact of fibromyalgia and the journey to diagnosis. BMC Hlth Serv. Res. 2010; 10: 102.Choy E., Perrot S., Leon T., Kaplan J., Petersel D., Ginovker A. A patient survey of the impact of fibromyalgia and the journey to diagnosis. BMC Hlth Serv. Res. 2010; 10: 102.Goldenberg D. L., Clauw D. J., Palmer R. H., Mease P., Chen W., Gendreau M. Durability of Therapeutic Response to Milnacipran Treatment for Fibromyalgia. Results of a Randomized, Double-Blind, Monotherapy 6-Month Extension Study. Pain Med. 2010; 11 (2): 180–194.Goldenberg D. L., Clauw D. J., Palmer R. H., Mease P., Chen W., Gendreau M. Durability of Therapeutic Response to Milnacipran Treatment for Fibromyalgia. Results of a Randomized, Double-Blind, Monotherapy 6-Month Extension Study. Pain Med. 2010; 11 (2): 180–194.

The authors declare that there are no conflicts of interest present.