Introduction:

The chronic non-rheumatic musculoskeletal pain affects 20 % of the world population, with an upward trend. Currently, its treatment is only symptomatic, poorly efficient and onerous. The aim of this study was to characterize the disease researched as fibromyofascial pain, of an initially relapsing-remitting evolution, and then, migratory, progressive and persistent. Resistant to symptomatic treatment. The etiological hypothesis is that this disease is produced by the impregnation of the monosodium urate in the connective tissue of the musculoskeletal system and soft connective tissue; similarly to the physiopathology of gout but without inflammation. Expressing only pain, and in some cases, edema. Therefore, the hypothesis states that an oral treatment for gout will be effective. The intervention consists of applying this treatment to the sample -regardless of the uricemia of each patient- and calculate its effect in decreasing pain and other health problems.

Material and methods:

An individual follow-up study was held for one year of a 49-patient cohort, who attended, at random and voluntarily, for the period of one year, to an integral medicine center, presenting pain according to the definition of the case. The design is a dynamic, prospective, randomized, quasi-experimental, with no control group, cohort study. Two groups are formed: 1) patients previously studied and treated with NSAIDs, analgesics, corticoids, physiotherapy or alternative treatment; and 2) patients who had not been either diagnosed or treated previously. Treatment: Low-Purine Diet, colchicine and allopurinol, via oral and, eventually, transdermic lidocaine for some persistent trigger point. The use of other analgesic treatments was absolutely excluded. Variables that compose and characterize the syndrome in study were determined. Recovery rates and recovery probabilities were evaluated for each time interval, studied through a descriptive analysis of recovery, and also through a survival analysis.

Results:

From the initial sample of 53 people, 4 of them quit the treatment on the first day because of intolerance to medicines. As a result, the sample was formed by 49 patients, who continued with the treatment and individual control for 1 year. In this group, 17 are male (34.7 %) and 32 are female (65.3 %); 58.5 years old in average (SD = 15.07); length of disease: 0 to 27 years, means: 4.08 years (DT = 5.23). The characteristics of the disease were obtained by identifying and evaluating the frequency distribution of symptoms and signs of the whole group in the sample. The etiological hypothesis was obtained in a previous semiological and clinical comparative study, in which the monosodium urate was characterized as the etiological agent, that this is an insoluble salt, which stimulates the nocipropioreceptors, without causing inflammation. Treatment: colchicine: 1.5 to 0,5 mg/day, for 2 months at most each dose, remission guaranteed: 0.5 mg/week. Allopurinol: 300 mg/day until remission, and then, 100 mg/day. By the end of the year of treatment and follow-up for each patient, all of them achieved 100 % of recovery, in a median time of 2 months, which was evaluated with a survival analysis. The compliance with the treatment was 92.45 %. 24.5 % presented tolerable adverse reactions: Allopurinol: mucous dryness (1), urinary and vaginal burning (1) erectile dysfunction (1). Colchicine: gastric intolerance (2), persistent diarrhea (4), vomit (1), headache (1), nausea (1).

Conclusion:

The semiological-clinical characterization of the syndrome of fibromyofascial pain was sensitive enough to establish the diagnosis. The etiological hypothesis allowed to select a curative treatment for all the patients effectively treated.

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