Fibromyalgia: An Environmental Scan

Table of Contents

2.0 INTRODUCTION

When constructing an understanding of chronic pain, it is important to focus on the overlapping nature of the presenting characteristics, symptomology, treatments and co-existing or co-morbid conditions among the numerous syndromes classified as Chronic Pain (CP). The spectrum of chronic pain disorders may be classified into distinct categories: 1) those that are systemic in nature in that they affect the whole body e.g., fibromyalgia and 2) regional chronic pain disorders such as irritable bowel syndrome (IBS) and migraine headaches (D. J Clauw and Crofford 2003).

2.1 Project Background

The purpose of the report titled: Chronic Pain Environmental Scan: An In-Depth View of Fibromyalgia prepared for the Jesse & Julie Rasch Foundation by dmgroup is to provide significant information required to establish a formidable and successful endowment fund.  The summary of the environmental scan presents highlights and pertinent information for use in making major strategic and informative decisions in establishing resource support within the area of chronic pain. The report is a summary on the ‘state of affairs’ of chronic pain with an in-depth focus on fibromyalgia from an epidemiological, clinical, research and resource perspective.  This report in no way represents an exhaustive presentation of all information available regarding the various chronic pain syndromes that exist, nor is it a  systematic literature review of fibromyalgia, rather selected information deemed important for the Jesse & Julie Rasch Foundation is included. A full methodological description and a detailed documentation of research processes are included for future reference.

In establishing the endowment fund in the area of chronic pain, the project to date consists of two distinct parts. One, the background information for the Jesse & Julie Rasch Foundation to use in making crucial decisions regarding the endowment is a culmination of information from the academic literature, gray literature, pertinent organizations associated with chronic pain and numerous specific syndrome affiliates, funding and granting information along with other electronic information sources that all provided an overview of the environment where research, clinical activity, programming and information exists surrounding chronic pain.
Following the environmental scan summary, the second part of the report (Section 4.0) presents a discussion surrounding items for the Jesse & Julie Rasch Foundation to be aware of in the area of research for chronic pain, specific funding recommendations and the identification of where gaps are in resources all arising from the environmental scan and key informant interviews to date.
The project is organized by providing an overview of chronic pain followed by an in-depth discussion of one chronic pain syndrome, namely fibromyalgia.
The report consists of:

  1. A summary of an environmental scan inclusive of academic literature, gray literature, relevant organizations, electronic information sources and key informant interviews completed to date
  1. A comprehensive resource of electronic sources and organizations relevant to chronic pain syndromes in general along with certain specific sources for fibromyalgia and other chronic pain disorders such as myofascial pain, chronic fatigue syndrome, irritable bowel syndrome and systemic lupus erythematosus are provided.
  1. List of key informants and contact information
  1. Recommendations for areas of research, identified areas of resource needs along with items to reflect on in the area of chronic pain while establishing an endowment fund

2.2 State of Affairs: Chronic Pain

Chronic pain (CP) is accounted for by a number of different syndromes and develops over time. CP is considered when pain persists three months or more. Specifically, fibromyalgia is a poorly-understood chronic pain syndrome, is characterized by widespread musculoskeletal pain, nonrestorative sleep, fatigue and psychological distress with specific regions of localized tenderness. This syndrome is considered one of several ‘central’ pain syndromes that are common in the general population (Dadabhoy, D., and Daniel J. Clauw 2006). The etiology of many chronic pain disorders (CPD) remains unknown although researchers are beginning to understand for example, how the central nervous system and subsequent physiological augmentations play a role in pain experience. In addition, numerous triggers such as a trauma are known events associated with the development of fibromyalgia. In the case of other CPD, such as chronic fatigue syndrome (CFS) the role of viruses are currently under investigation.  Estimates suggest that globally up to 20% of people suffer with chronic pain (H Breivik et al. 2005). Issues surrounding the role of genetics associated with CPD, complexities of diagnosis, challenges of complex treatment requirements and importantly increased quality of life require further investigation and understanding to reduce the morbidity and burden of illness individuals suffer from due to various chronic pain disorders.