2009 年 21 巻 3 号 p. 249-255
Fibromyalgia (FM) is a condition characterized by chronic and disabling pain. Since pain is commonly evaluated by a subjective assessment, it is difficult to evaluate the treatment effect objectively. In this report, the treatment outcome was evaluated by an objective assessment of pain in FM patients.
Eight FM patients who fulfilled the American College of Rheumatology criteria for the classification of fibromyalgia participated. The severity of FM was assessed with the Japanese version of the Fibromyalgia Impact Questionnaire (JFIQ). The pain level was evaluated by pain degree, i.e., the magnitude of pain which was quantitatively measured with Pain Vision PS-2100TM, and by visual analog scale (VAS). The treatment procedure involved the injection of a local anesthetic into bilateral lateral pterygoid muscles followed by the insertion of an oral device which restricted horizontal mandibular movements. In three cases, the treatment procedure was repeated and a clinical course was observed for 3-6 months.
Pain degree and VAS were significantly reduced after the monotherapy. There was a significant correlation between pain degree and VAS. Pain degree, VAS and JFIQ were reduced in three cases in the follow-up period, although some fluctuations were observed.
The pain relief procedure for lateral pterygoid muscles exhibited a significant effect on the reduction of systemic pain for temporomandibular disorder patients who fulfilled the classification criteria of FM, and could be considered as a treatment option for FM. It was also suggested that a quantitative measurement method for the magnitude of pain could be valuable for the evaluation of treatments for FM.