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Abstract Number: 2075

The Lumbar Spine in Fibromyalgia

Robert S. Katz1, Alexandra Small2 and Anthony Farkasch3, 1Rush Medical College, Chicago, IL, 2University of Illinois College of Medicine, Chicago, IL, 3Rheumatology Associates, Chicago, IL

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: fibromyalgia, radiography and spine involvement

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Session Information

Session Title: Fibromyalgia, Soft Tissue Disorders, Regional and Specific Clinical Pain Syndromes: Research Focus

Session Type: Abstract Submissions (ACR)

Background/Purpose: Radiographs of the lumbar spine appear normal in fibromyalgia.  However, a previous study (ArthRheum50:134, 2004) found a reduced lordotic curve in the cervical spine of patients with fibromyalgia.  We measured the Cobb angle on radiographs of the lumbar spine in patients with fibromyalgia and other rheumatic disease patients.

Methods:  Fibromyalgia patients meeting the 2010 ACR criteria with a complaint of back pain, and patients with other rheumatic disease disorders who had back pain (osteoarthritis, spinal stenosis, degenerative joint disease, herniated disc and other forms of lumbar radiculopathy, and ankylosing spondylitis) were evaluated for lumbar spine straightening using the Cobb angle of lateral lumbar spine radiographs.

The Cobb angle was measured by drawing a line parallel to the superior portion to L1 and another line parallel to the inferior portion to L5 and measuring the angle where the two lines intersect.

Results:   The number of fibromyalgia patients studied was 148 and the number of non-fibromyalgia patients with back pain but not fibromyalgia was 59. The mean ages were 45.4 years for fibromyalgia patients and the mean age for the non-fibromyalgia patients 52.5 years. In the fibromyalgia group there were 136 females, and 12 males; and in the non-fibromyalgia group w back pain, who served as controls, there were 46 females, and 13 males.

The mean Cobb angle in the fibromyalgia patients was 14.0 degrees, and the mean Cobb angle in the rheumatic disease controls with back pain was 20.9 degrees.

Conclusion: FMS patients have a straight lumbar spine. We propose that increased muscle tension may be the cause of the reduced Cobb angle in these patients.  Fibromyalgia patients have widespread pain over large muscle groups, muscle tenderness, and also have straight cervical spines and straight lumbar spines, by measuring  the Cobb angle. It is quite possible that much of the pain experienced by fibromyalgia patients relates to increased muscle tension.


Disclosure:

R. S. Katz,
None;

A. Small,
None;

A. Farkasch,
None.

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