A group of common nonspecific illnesses characterized by pain, tenderness, and stiffness of the joints, muscles, joint capsules, and adjacent structures.

The term myaliga indicates simple muscular pain, in contract to myositis, which is due to inflammation of the muscle tissues. Fibrositis is a similar inflammation of the fibrous connective tissue components of muscles, joints, tendons, ligament, and other 'white' connective tissues.

Various combinations of these conditions may occur together as "simple rheumatism." Any of the fibromuscular tissues may be involved, but those of the low back (lumbago), neck (toricollis), shoulders, thorax (pleurodynia), and thighs (aches and "charleyhourses") are especially affected. There is no specific histologic entity.

Etiology

The conditions may be brought on or intensified by trauma, exposure to dampness or cold, and occasionally by a systemic, usually rheumatic, disorder. A virus infection or sometimes toxemia from a remote bacterial infection may be causative, through this is unproved. Some cases may be of psychogenic or psycholphysiologic origin; symptoms can be exacerbated by environmental or emotional stress.

Symptoms, Signs, and Diagnosis

Onset of pain frequently is sudden; the pain is aggravate by movement. Tenderness may be present, perhaps localized in a few small 'trigger' zones or nodules. There may be local muscle spasm, though it cannot be regularly demonstrated by electromyography. Fever is not characteristic and only occurs when there is a provoking systemic condition. Diagnosis is by exclusion of other systemic diseases (e.g. early onset of RA, polymyositis, polymyalgia rheumatica, or other connective tissue disease), and (most difficult of all) of psychogenic muscle pain and spasm.

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FIBROSITIS

The term fibrositis is used to refer to secondary symptoms set up in muscles and joints by certain specific diseases. Although the condition is painful, there are now various forms of relief.

Fibrositis is a rather vague term. Some doctors use it to cover any ache in the soft tissue of the body and many patients, in turn, tell their doctor that they have fibrositis when they simply mean pain in a muscle.

Most doctors today, however, use the word fibrositis to describe a group of conditions where there is pain and tenderness in the soft tissue, usually in the muscle or around the joints, which occurs as more or less secondary to another, more specific disease.

Causes:

There are three principal causes which account for nearly all cases of fibrositis. The first of these is arthritis. Not only does arthritis deform joints and therefore place differing stresses on surrounding muscles and ligaments, but it often causes chronically inflamed bone to protrude into the muscles close to the affected joint. It is the combination of these two effects that causes muscle ache, spasm and tenderness.

This is why many patients with arthritis complain not only of pain in the affected joint but also of pain in the surrounding muscle, which they correctly call fibrositis.

Secondly, the discs between the vertebrae of the spine are a frequent cause of trouble, especially if a disc is out of position, as in a slipped disc. When an abnormally placed disc presses on a nerve in the spinal cord or intrudes into surrounding muscle, this frequently causes pain and spasm in the affected area of the back.

Thirdly, where a muscle has suffered damage or a ligament is stretched and strained, the pain in the area is referred to as fibrositis.

Whatever the condition causing fibrositis, it is frequently made worse by cold and damp.

Symptoms and treatment:

The sudden onset of pain in a muscle of the neck, back, arms, thigh or calf is typical of fibrositis. The sufferer complains of pain when moving and tenderness when the affected place is touched.

The doctor will be able to detect areas of muscular spasm, often with tightly knotted muscles in a constant contraction.

Having identified the fibrositis, the doctor will want to find and treat the underlying cause. Fibrositis caused by arthritis improves with anti-arthritic treatment, and that caused by disc conditions may improve with manipulation either by a doctor or by an osteopath or physiotherapist.

Anti-inflammatory and painkilling drugs can help considerably, especially if an attack of fibrositis is treated promptly. In severe cases where pain is unbearable, an injection of local anaesthetic, such as procaine, may be given. However, the relief may only be temporary.

In most cases, massage by a physiotherapist will relieve the muscle spasm and work out the knots and tense areas. Resting the affected par and applying heat can also bring relief.