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Phenobarbital-induced fibromyalgia (FM) as the cause of bilateral shoulder pain

  [ 76 votes ]   [ Discuss This Article ]
www.ProHealth.com • August 4, 1995


A female swimming instructor was seen with chronic bilateral
shoulder pain and loss of range of motion. Intensive physical
therapy significantly improved the range of motion but did not
alleviate the pain. Osteopathic manipulative treatment
produced no further improvement in pain or function. Results
of laboratory tests were all within normal limits. Four months
after the initial consultation, the patient, who was taking
medication for tonic/clonic seizures, recalled that her
symptoms began after her anticonvulsant medication was
switched from hydantoin sodium to phenobarbital. Therefore,
phenobarbital-induced fibromyalgia was diagnosed. In 4 months,
pain had completely disappeared. The authors discuss several
theories regarding the cause of fibromyalgia and the mechanism
of action of phenobarbital, including its relationship to
sleep disturbance, a probable contributor to pain and
dysfunction in the patient described.

Goldman SI, Krings MS




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