CLINICAL RESEARCH POSTER PRESENTATION ABSTRACTS
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Salons 10-12.
THURSDAY, 5:30-6:15 PM
McMakin CR, Gregory WM, Phillips TM.
Cytokine changes with microcurrent treatment of fibromyalgia
associated with cervical spine trauma.
Fibromyalgia and Myofascial Pain Clinic of Portland
cmcmakin@msn.com
PURPOSE: Patients who have fibromyalgia syndrome
(FMS) associated with cervical spine trauma have pain descriptors and
physical examination findings distinct from patients with fibromyalgia
of non traumatic etiology and their pain is typically unresponsive to
narcotics or other palliative measures. This retrospective analysis
of patients receiving microcurrent treatment for fibromyalgia associated
with cervical spine trauma utilizes VAS pain scores as a primary outcome
measure and changes in inflammatory cytokines in a subgroup of the same
patient population to test the hypothesis that microcurrent treatment
produces substantial measurable objective and subjective outcomes.
METHODS: 54 consecutive patients meeting the
ACR diagnostic criteria for fibromyalgia were treated with microamperage
current and two frequencies found through trial and error to be effective
in reducing pain in a clinical setting. Blood samples on a subset of
six patients were analyzed using a recycling immunoaffinity chromatography
system to identify objective changes accompanying subjective pain score
changes.
RESULTS: Five patients did not tolerate treatment.
The remaining 49 patients reported pain reduction on a 10-point visual
analog scale (VAS) from an average baseline score of 7.3±1.2 to 1.3±1.1
with the first treatment. (P< 0.0001). Interleukin-1, Interleukin-6
and substance P levels were all reduced from 330pg/ml to 80pg/ml (p=0.004),
from 239 pg/ml to 76 pg/ml (p=0.0008), and from 180pg/ml to 54pg/ml
(p=0.0001), respectively, in the first 90-minute treatment. Tumor Necrosis
Factor (TNF)-a was reduced from 305 pg/ml to 78 pg/ml (p=0.002). Beta-endorphin
and cortisol both increased from an average of 8.2pg/ml to 71.1pg/ml
(p=0.003), and 14.7 mg/ml to 105.3 mg/ml (p=0.03), respectively. Thirty-one
patients reported symptomatic relief from fibromyalgia following an
average of 8 treatments.
CONCLUSION: When seen in a patient population
refractory to other treatment modalities the reductions in subjective
VAS pain scores in conjunction with significant objective changes in
biological markers for pain and pro-inflammatory cytokines observed
in response to this treatment protocol are important preliminary findings.
Based on the observations reported in this analysis, controlled prospective
clinical studies to evaluate the clinical efficacy of microcurrent treatment
of FMS associated with cervical spine trauma are warranted.
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