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MusculoskeletalPain
Dan S.
Frances
Heffez Y.-K.
Daniel
Leung G.
Thomas
Malone J.
I. Jon
Romano
David
Russell
Donald G.
Saul
Seibel
Anil Kumar Jain, BSc, MD, Co-Editor, is affiliated with the Ottawa Hospital, Ottawa,
BruceM.Carruthers,MD,CM,FRCP[C],Co-
ON, Canada.
Marjorie I. van de Sande, BEd, Grad Dip Ed, is Consensus Coordinator, Director of Education,
Editor,isSpecialistinInternalMedicine,Saanichton,BC,Canada.
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TheFibromyalgiaSyndrome:
AClinicalCaseDefinition
forPractitioners
TheJournalofMusculoskeletalPain Monographic
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TheFibromyalgiaSyndrome:AClinicalCaseDefinitionforPractitioners, edited by I. Jon Russell, MD, PhD (Vol. 11, No. 4, 2003).
Establishesanexpertconsensustowardaworkingcasedefinitionoffibromyalgiasyndromeandaworkingguidetoits
managementforphysiciansinCanada.
InternationalMYOPAINSocietyMYOPAIN01:Abstractsfromthe5thWorldCongressonMyofascialPainandFibromyalgia,
Portland,Oregon,USA,September9September13,2001(Vol. 9, Suppl. #5, 2001)
MYOPAIN98:Abstractsfromthe4thWorldCongressonMyofascialPainandFibromyalgia,SilviMarina[TE],ITALY,August
24August27,1998, edited by Leonardo Vecchiet, MD, and Maria Adele Giamberardino, MD (Vol. 6, Supp. #2,
1998).
TheNeuroscienceandEndocrinologyofFibromyalgia, edited by Stanley R. Pillemer, MD (Vol. 6, No. 3, 1998).Irecommendthis
booktoallhealthcareproviderswhowanttoofferthemostuptodatetherapyfortheirpatientswithfibromyalgia.[David
Borestein,MD,ClinicalProfessorofMedicine,TheGeorgeWashingtonUniversityMedicalCenter,ArthritisandRheumatism]
MusclePainSyndromesandFibromyalgia:PressureAlgometryforQuantificationofDiagnosisandTreatmentOutcome, edited by
Andrew A. Fischer, MD, PhD (Vol. 6, No. 1, 1998).Shouldhelpresearchersindevelopingnewandexpandedstudiesforthe
appropriateroleofpressurealgometry.[MartinGrabois,MD,ProfessorandChairman,PhysicalMedicineandRehabilitation,
BaylorCollegeofMedicine,Houston,Texas]
MusculoskeletalPainEmanatingfromtheHeadandNeck:CurrentConceptsinDiagnosis,Management,andCostContainment,
edited by Murray E. Allen, MD (Vol. 4, No. 4, 1996).Excitingbecauseitcontainsadistillationofrecentresearchthatisofvalue
toallwhotreatandservethosewithwhiplashrelatedinjuries.[NationalAssociationofRehabilitationProfessionalsinthe
PrivateSector]
ClinicalOverviewandPathogenesisoftheFibromyalgiaSyndrome,MyofascialPainSyndrome,andOtherPainSyndromes, edited
by I. Jon Russell, MD, PhD (Vol. 4, No. 1/2, 1996).ThefeaturedspeakersattheMYOPAIN95ThirdWorldCongressarehere
distilledintoananthologythatrepresentsastateoftheartinfibromyalgiasyndromeandmyofascialpainsyndromefromthat
conference.
MYOPAIN95:Abstractsfromthe3rdWorldCongressonMyofascialPainandFibromyalgia,SanAntonio,Texas,USA,July
30August3,1995, edited by I. Jon Russell, MD, PhD (Vol. 3, Supp. #1, 1995).Anexcellentresourcethatallowsphysicians,
dentists,researchers,andothersworkinginthisfieldtoaccesskeyinformationaspresentedbyspecialistsworldwidewhowork
withandresearchchronicmusclepain.
Fibromyalgia,ChronicFatigueSyndrome,andRepetitiveStrainInjury:CurrentConceptsinDiagnosis,Management,Disability,
andHealthEconomics, edited by Andrew Chalmers, MD, Geoffrey Owen Littlejohn, MD, Irving Salit, MD, and Frederick
MD (Vol. 3, No. 2, 1995).Theinformationandoriginalresearchpresentedisrelevantandusefulforunderstandingsomeofthe
Wolfe,
globalresearchbeingconductedonthesedisorders....Itwouldbemostusefulasanadditiontoascientific/medicallibrary.
[AnnalsofPharmacotherapy]
TheFibromyalgiaSyndrome:CurrentResearchandFutureDirectionsinEpidemiology,Pathogenesis,andTreatment, edited by
Stanley R. Pillemer, MD (Vol. 2, No. 3, 1994).Thishighlyinformativeandwellreferencedtextisrecommendedtobothstudents
andpractitioners.[AnnalsofPharmacotherapy]
MusculoskeletalPain,MyofascialPainSyndrome,andtheFibromyalgiaSyndrome:ProceedingsfromtheSecondWorldCongress
onMyofascialPainandFibromyalgia, edited by Sren Jacobsen, MD, Bente Danneskiold-Samse, MD, PhD, and Birger
MD,
Lund,PhD (Vol. 1, No. 3/4, 1993).Packedwithstateoftheartinformation....Animportantcontributiontoourunderstanding
ofmyofascialpainsyndrome,fibromyalgia,andmusculoskeletalpain,andwillbeusefultobothpatientsandhealthcare
providers.[Lifeline[NationalChronicPainOutreachAssociation]]
TheFibromyalgiaSyndrome:
AClinicalCaseDefinition
forPractitioners
Journal of Musculoskeletal
Pain Volume 11,
Number 4
I.JONRUSSELL,MD,PhD,TheUniversityofTexasHealthScienceCenter,SanAntonio,TX,USA
FOUNDINGASSISTANTEDITOR[19932002]
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TheFibromyalgiaSyndrome:
AClinicalCaseDefinition
forPractitioners
Journal of Musculoskeletal
Pain Volume 11,
Number 4
CONTENTS
ARTICLE
RESEARCH IDEAS
ERRATUM
In theJournalofMusculoskeletalPain, volume 11, issue 3, an error occurred in the article
paring Patients
entitled Com-with Fibromyalgia Chronic Low Back Pain Participating in an Outpatient
ioral Treatment Program by Carol Wells-Federman, Paul Arnstein, and Margaret Caudill-
Cognitive-Behav-
affiliation The
Slosberg. of Carol Wells-Federman should be read as: Carol Wells-Federman, MEd, APRN,
Senior Lecturer, Simmons College, Boston, MA
BC, is Adjunct
The Haworth Press sincerely regrets this error and any inconvenience it
02115.
may have caused.
instructions for authors
1 MANUSCRIPTS.Manuscripts or letters for publication should be submitted in triplicate to:
) PhD, Editor,JournalofMusculoskeletalPain, Department of Medicine, University of Texas Health
I.JonRussell,MD,
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Science
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BRIEFRESEARCHREPORTS. Definition. Short papers containing descriptions of original research, reports of clinical
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lpain.
The abstract [page 2] should be no more than 100 words long, double-spaced, and divided into four sections
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The manuscript should not exceed 15 double-spaced pages [not including tables, figure legends,
and figures].Definition. Report of one or more patients that contributes information to the body of knowledge
7) CASEREPORTS.
musculoskeletal pain through in-depth observations, laboratory findings or pathogenic
regarding
mechanisms.
The abstract [page 2] should be double-spaced, no more than 100 words long, and divided into three sections
following bolded
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The manuscript should not exceed 15 double-spaced pages [not including tables, figure legends, and figures].
tainThey should
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8) references.
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The abstract [page
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The manuscript should not exceed eight double-spacedpages [not includingtables, figure legends, and figures].
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JournalArticles
1. Turk DC, Rudy TE, Steig RL: The disability determination dilemma: Toward a multiaxial solution. Pain 34: 217-
229, 1988.
2.CulpepperRC,WilliamsRG,MeasePJ,KoepsellTD,KobayashiJM:Naturalhistoryofeosinophilia-myalgiasyndrome.Ann
Int Med 115: 437-442,
1991.
JournalSupplements
3. Felson DT: Epidemiologic research in fibromyalgia. J Rheumatol 16 (Suppl 19): 7-11,
1989.
BookSource
4. Travell JG, Simons DG: Myofascial Pain and Dysfunction:The TriggerPoint Manual. Williams & Wilkins, Baltimore,
pp. 1983,
431-
439.
ContributiontoBook
5.CanosoJJ:Fibromyalgiaandbursitis.TextbookofInternalMedicine.EditedbyWNKelley.JBLippincott,Philadelphia,1989,
pp. 1040-
1042.
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ABOUTTHEEDITOR
ANNOUNCE
MYOPAIN04
SIXTHWORLDCONGRESSONMYOFASCIALPAINANDFIBROMYALGIA
MUNICH,GERMANY
JULY1822,2004
InternationalMYOPAINSociety[IMS]OfficersandBoard:
President: Robert M. Bennett, MD,
VicePresident: Dieter Pongratz, Prof Dr med,
USA
Secretary/Treasurer: Robert D. Gerwin, MD,
Germany
BoardChair: Leonardo Vecchiet, MD,
USA
BoardMembers: Bente
Italy Danneskiold-Samse, MD, PhD,
James R. Fricton, DDS, MS,
Denmark
I. Jon Russell, MD, PhD,
USA
Jack
USA H. Scott, BS,
Administrator: Barbara Runnels, MEd,
USA
USA
CongressProgramCommittee
ProgramChair: Dieter Pongratz, Prof Dr med,
CongressCoChair: Siegfried Mense, Prof Dr med,
Germany
LocalArrangements: Michael
GermanySpaeth, MD,
Members: Robert Bennett, MD,
Germany
Leslie J. Crofford, MD,
USA
Salvatore
USA DiMauro, MD,
Chang-Zern Hong, MD,
USA
Frederick W. Miller, MD, PhD,
Taiwan
I.
USAJon Russell, MD, PhD,
David G. Simons, MD,
USA
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Prefac
Backe:to the
Future
Romano TJ, Russell IJ, Sheon RP: The American 6. Russell IJ: Proposed study to develop and
lege
Col- of Rheumatology 1990 Criteria for the a clinical
validate case definition for the fibromyalgia
tionofFibromyalgia.ArthritisRheum33:160-
Classifica- applicable to the community practice setting.
syndrome
4. Wolfe F: Stop using the American
172,1990. Pain 11(4):109-111,
J Musculoske
Rheumatology
College of Criteria in the clinic. J 7. White KP: Developing and validating a
2003.
1671-1672,30(8):
Rheumatol case definition for the fibromyalgia syndrome
clinical
5. Yunus MB, Masi AT, Aldag JC: Preliminary
2003. clinical
for use practice.
in J Musculoske Pain 11(4):117-
teria
cri-for primary fibromyalgia syndrome (PFS): 118,8.RaphaelKG:
2003. Proposed methodsfor
variate analysis of a consecutive series of
Multi- clinical case definition
validation of a of the fibromyalgia
pain patients, and normal subjects. Clin Exp
PFS, other Musculoske
syndrome. J Pain 11(4):113-115,
7:63-69,
Rheumatol 2003.
1989.
Editorial
s Introductio
Canadian
n: Consensus
on Fibromyalgia
Document
Syndrome
The National ME/FM Action Network the stipulations was that at least one
ada] spearheaded the drive for the
[Can- of the panel must be nominated by
member
ment of an expert consensus
develop- five
eachstakeholder
of the groups of
would include
document, whicha clinical definition, versities,
government, uni- industry, and
clinicians,
and treatment protocols, and a
diagnostic There were to be at least ten
advocacy.
pertinent research
discussion of for the panel, fouron
members ofthe
whom could come from
drome [FMS].Syn-
Fibromyalgia As increasing numbers of Canada. The members of the panel
outside
patients
of FMS asked about knowledgeable either
must be practicing MDs, actively
it quickly became clear that there
doctors, diagnosing
treating and/orFMS, or MDs or PhDs
for more
was a neededucation about FMS among clinical research
involved in of the illness. The
care practitioners.
primary The Network sent to provide
focus was the generalist with a
questionnaire
out a to doctors across tion thatdefini-
clinical addressed a broader
what items
Canada asking would be most helpful in pathogenesis of the illness, as well as
spectrum of the
them with
assisting their FMS patients. The diagnostic and treatment protocols.
provide
concurred
physicians that a clinical definition, as would have autonomy over their
The panel
diagnostic
well as and treatment protocols, docume
prime consensus
were of nt.The expert medical subcommittee
The National ME/FM Action Network
importance. Canada selected an expert consensus
of Health
approached
then two clinicians
FMS, which
panel for consisted of thirteen
experienced
knowledgeable in FMS,
and Dr. Anil Jain of This thirteen-member consensus
members.
and Dr. Bruce Carruthers of British
Ontario
who agreed to co-author a draft ceived
panel hada total
re- of forty-six
Columbia, included numerous
Lydia Neilson, President of the
document. nominations, which nominations from
FM ActionME/Network, met with the stakeholder group. The members of
each
National
Alan Rock, then Minister of Health, to sensus
the con-panel represented clinicians,
Honourable
cuss the results of the doctors
dis- medical
university faculty, and researchers in
draft document.
survey and the The Honourable Alan FMS. Collectively,
the area of they had diagnosed
responded
Rock by stating the draft clinical treated
and/or more than twenty thousand
tion was
defini- a milestone in the fight tient pa-
FMS
complex
against this tragic
and s. Health Canada planned for a
Health Canada set up an expert
condition. Workshop
Consensus to be held on March 30 to
subcommittee,
medical which established the 2001.1,All members of the expert
April
of Reference
Terms for the consensus panel were sent the draft document,
consensus
panel. One of which
[Haworth co-indexing entry note]: Introduction: Canadian Consensus Document on Fibromyalgia Syndrome. Jain, Anil
Carruthers, and Marjorie
Kumar, Bruce M. I. van de Sande. Co-published simultaneously inJournalofMusculoskeletalPain [The Haworth Medical
printofTheHaworthPress,Inc.]Vol.11,No.4,2003,pp.1-2;and:TheFibromyalgiaSyndrome:AClinicalCaseDefinitionforPractitioners
Press, an im-
[ed: I. Jon Russell] TheHaworth Medical Press, an imprint of TheHaworth Press, Inc., 2003, pp.1-2. Single or multiple copies
available
of for aare
this article fee from The Haworth Document Delivery Service [1-800-HAWORTH, 9:00 a.m. - 5:00 p.m. [EST]. E-mail
docdelivery@haworthpress.c
address:
om].
http://www.haworthpress.com/we
2003b/JMP
by The Haworth Press, Inc. All rights
Digital Object Identifer:
reserved. 1
10.1300/J094v11n04_01
2 THEFIBROMYALGIASYNDROME:ACLINICALCASEDEFINITIONFORPRACTITIONERS
MarjorieI.vandeSande,BEd,GradDipEd
ConsensusCoordinator
DirectorofEducation
NationalME/FMActionNetwork
AnilKumarJain
BruceM.Carruthers
MarjorieI.vandeSande
ARTICLE
Fibromyalgia
Canadian Clinical Working Case Definition,
Syndrome:
and Treatment ProtocolsA Consensus
Diagnostic
Jain et Document
Anil Kumar
al. Bruce
Jain M.
Marjorie I. van de
Carruthers
Stephen
Sande R.
C. C. Stuart
Barron
James V.
Donaldson
Emerson
Dunne
Gingrich