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Tuesday, 31 May 2016

Most Common Disease of 50plus: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Fibromyalgia - The Delay Diagnosis

Kyle J. Norton (Scholar)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia

                                                      Fibromyalgia

Fibromyalgia, according to the American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia in the newly proposed criteria for the classification of fibromyalgia are 1) widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites(a) as a result in responding to pressure.

                              Delay diagnosis 

Delay diagnosis of fibromyalgia is frequent due to patients difficulties in communicating their symptoms to the physician, causing over one third (35%) delay diagnosis of chronic widespread pain.
According to the King's College London," Patients wait a significant period of time before presenting to a physician, adding to the prolonged time to diagnosis. Patients typically present with a multitude of symptoms, all resulting in a delay in diagnosis and eventual management"(73).
In a questionnaire survey of 1622 physicians in six European countries, Mexico and South Korea including Specialties of primary care physicians (PCPs; n=809) and equal numbers of rheumatologists, neurologists, psychiatrists and pain specialists, 53% of physicians reported difficulty with diagnosing FM, 54% reported their training in FM was inadequate, and 32% considered themselves not knowledgeable about FM(74). The high percentage  of difficult diagnosis and inadequate training may contributed the delay diagnosis and contributing to widespread unnecessary pain and significant impact on quality of life and function to patients with FM(75).
Dr. Clark P and colleagues at the Clinical Epidemiology Unit HIM-Federico Gómez Faculty of Medicine UNAM in the physician survey of fibromyalgia across Latin America and Europe,
said, "Patient and physician perspective concerning FM impact and disruption were often misaligned within the same region. Our observations may be representative of cultural differences in stoicism, expression, beliefs, and attitudes to pain perception and management. Better understanding of these complexities could help targeted educational/training programs incorporating cultural differences, to improve chronic care"(76).

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References
(73) A patient survey of the impact of fibromyalgia and the journey to diagnosis by Choy E1, Perrot S, Leon T, Kaplan J, Petersel D, Ginovker A, Kramer E.(PubMed)
(74) Survey of physician experiences and perceptions about the diagnosis and treatment of fibromyalgia by Perrot S1, Choy E, Petersel D, Ginovker A, Kramer E.(PubMed)
(75) A patient survey of the impact of fibromyalgia and the journey to diagnosis by Choy E1, Perrot S, Leon T, Kaplan J, Petersel D, Ginovker A, Kramer E.(PubMed)
(76) A patient and physician survey of fibromyalgia across Latin America and Europe by Clark P1, Paiva ES, Ginovker A, Salomón PA.(PubMed)