We have seen much controversy among many people - both within and between groups of patients and medics - about pain, fibromyalgia and autoimmune thyroid disease. Denial of a link between thyroid and pain seems to be a common feature.
So it is interesting to see this strong, unequivocal statement in the first paper:
Autoimmune thyroid disease is the most prevalent autoimmune disorder, affecting about 10 % of the population, and is a recognized cause of fibromyalgia and chronic widespread pain.
July 2014, Volume 33, Issue 7, pp 885-891
Date: 18 Jan 2014
Fibromyalgia and chronic widespread pain in autoimmune thyroid disease
Clement E. Tagoe
Department of Geriatrics, Albert Einstein College of Medicine, Bronx, NY, USA, firstname.lastname@example.org.
Fibromyalgia and chronic widespread pain syndromes are among the commonest diseases seen in rheumatology practice. Despite advances in the management of these conditions, they remain significant causes of morbidity and disability. Autoimmune thyroid disease is the most prevalent autoimmune disorder, affecting about 10 % of the population, and is a recognized cause of fibromyalgia and chronic widespread pain. Recent reports are shedding light on the mechanisms of pain generation in autoimmune thyroid disease-associated pain syndromes including the role of inflammatory mediators, small-fiber polyneuropathy, and central sensitization. The gradual elucidation of these pain pathways is allowing the rational use of pharmacotherapy in the management of chronic widespread pain in autoimmune thyroid disease. This review looks at the current understanding of the prevalence of pain syndromes in autoimmune thyroid disease, their likely causes, present appreciation of the pathogenesis of chronic widespread pain, and how our knowledge can be used to find lasting and effective treatments for the pain syndromes associated with autoimmune thyroid disease.
Only abstract available without payment.
If you click on the Look Inside on the magazine icon at the above link, you can see the first two full pages. Which is a little bit better but not enough.
Pain Research and Treatment
Volume 2012 (2012), Article ID 426130, 17 pages
Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment
Enrico Bellato,1 Eleonora Marini,1 Filippo Castoldi,1 Nicola Barbasetti,1 Lorenzo Mattei,1 Davide Edoardo Bonasia,2 and Davide Blonna1
Received 28 June 2012; Revised 9 September 2012; Accepted 12 September 2012
Academic Editor: Jonathan O. Dostrovsky
Fibromyalgia syndrome is mainly characterized by pain, fatigue, and sleep disruption. The etiology of fibromyalgia is still unclear: if central sensitization is considered to be the main mechanism involved, then many other factors, genetic, immunological, and hormonal, may play an important role. The diagnosis is typically clinical (there are no laboratory abnormalities) and the physician must concentrate on pain and on its features. Additional symptoms (e.g., Raynaud’s phenomenon, irritable bowel disease, and heat and cold intolerance) can be associated with this condition. A careful differential diagnosis is mandatory: fibromyalgia is not a diagnosis of exclusion. Since 1990, diagnosis has been principally based on the two major diagnostic criteria defined by the ACR. Recently, new criteria have been proposed. The main goals of the treatment are to alleviate pain, increase restorative sleep, and improve physical function. A multidisciplinary approach is optimal. While most nonsteroidal anti-inflammatory drugs and opioids have limited benefit, an important role is played by antidepressants and neuromodulating antiepileptics: currently duloxetine (NNT for a 30% pain reduction 7.2), milnacipran (NNT 19), and pregabalin (NNT 8.6) are the only drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. In addition, nonpharmacological treatments should be associated with drug therapy.
Full paper available in multiple formats.