2nd Department of Physical Medicine and Rehabilitation, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey.
Pain Med. 2012 Feb;13(2):270-80. doi: 10.1111/j.1526-4637.2011.01300.x. Epub 2012 Jan 5.
The objective of this study was to evaluate the effects of coexisting fibromyalgia syndrome (FS) on pain intensity, disability, and treatment outcome in patients with chronic lateral epicondylitis (LE).
Seventy-eight patients with chronic unilateral LE and 30 healthy subjects were included. Patients were classified into two groups: group 1 consisted of 46 LE alone patients, while group 2 consisted of 32 LE plus FS patients. A pain questionnaire was used to determine the subjective pain and disability. Pressure pain threshold (PPT) on the lateral epicondyles, isometric hand grip strength (IHGS), lateral pinch grip strength (LPGS), and tender point examinations of groups were performed. A mixture of methylprednisolone and prilocaine was injected 1 cm distal to the lateral epicondyle. All measurements were repeated 2 weeks and 3 months after injection.
Compared with healthy subjects, both patient groups had significantly increased pain and disability scores and decreased IHGS, LPGS, and PPT values (P < 0.001). Compared with the LE alone group, pain and disability scores were significantly higher (P < 0.01), and PPT, IHGS, and LPGS values were significantly lower in LE plus FS group (P < 0.05). Pain questionnaire scores of the LE alone and LE plus FS patients showed statistically significant decrease, and IHGS, LPGS, and PPTs showed statistically significant increase at the second week (P < 0.01) and at the third month (P < 0.001) after injection. Improvements in the LE plus FS group were poorer than FS alone group at both second week and third month after injection.
Coexisting FS may increase the pain intensity and disability, and negatively affect the treatment outcome in patients with chronic LE.
本研究旨在评估共存纤维肌痛综合征（FS）对慢性肱骨外上髁炎（LE）患者疼痛强度、残疾和治疗效果的影响。
纳入 78 例单侧慢性 LE 患者和 30 名健康对照者。患者分为两组：第 1 组（n=46）为单纯 LE 患者，第 2 组（n=32）为 LE 合并 FS 患者。采用疼痛问卷评估主观疼痛和残疾程度。测量外侧上髁处的压力疼痛阈值（PPT）、等长手握力（IHGS）、侧捏握力（LPGS）和触痛点。在外侧上髁远端 1cm 处混合注射甲基强的松龙和普鲁卡因。所有测量均在注射后 2 周和 3 个月重复。
与健康对照组相比，两组患者的疼痛和残疾评分均显著升高，IHGS、LPGS 和 PPT 值均显著降低（P<0.001）。与单纯 LE 组相比，LE 合并 FS 组的疼痛和残疾评分显著升高（P<0.01），PPT、IHGS 和 LPGS 值显著降低（P<0.05）。单纯 LE 和 LE 合并 FS 患者的疼痛问卷评分在注射后第 2 周和第 3 个月均有统计学显著下降，IHGS、LPGS 和 PPT 均有统计学显著升高（P<0.01）。LE 合并 FS 组在注射后第 2 周和第 3 个月的改善均差于 FS 单纯组。
共存 FS 可能会增加慢性 LE 患者的疼痛强度和残疾程度，并对治疗效果产生负面影响。
