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A 5.5 year prospective study of self-reported musculoskeletal pain & of fibromyalgia (FM) in a female population: significance & natural history

  [ 17 votes ]   [ Discuss This Article ]
www.ProHealth.com • February 15, 1999


In order to investigate the significance and outcome of
self-reported pain and fibromyalgia (FM) in a female
population, 214 women with initially self-reported pain were
interviewed and examined in 1990 and 1995. In 1990 the sample
was categorised into four pain status groups: 46 individuals
(21%) with nonchronic (recurrent) pain, 69 (32%) with chronic
regional pain 42 (20%) with chronic multifocal pain and 57
with chronic widespread pain (CWP). The last group comprised
39 (18%) women with FM, fulfilling the American College of
Rheumatology 1990 criteria. The frequency of tender points,
associated symptoms called historical variables and
individuals with low education increased statistically
significantly with increasing pain status. In 1995, 48 women
had non- chronic pain (23%), 46 (21%) chronic regional pain,
39 (18%) chronic multifocal pain and 81 (38%) CWP; of these,
71 (33%) had FM. Eleven of the 39 women initially with FM no
longer fulfilled the criteria. The risk of developing CWP
among the 157 individuals with initially a lower pain status
was statistically higher in women with chronic multifocal pain
than in women with less pain extension. Self-reported pain
constitutes a continuum of pain severity and thus of clinical
and social significance. The overall outcome was poor with an
increase of individuals with CWP and FM. The prognosis of
chronic multifocal pain, CWP and FM was especially poor. About
half of the women with non- chronic pain or chronic regional
pain did not deteriorate. However, because the process of
developing FM started with localised pain in most cases,
self-reported pain of any severity confers a risk for
developing FM. Identifying possible risk factors for FM are at
present under study and will be presented separately in
another report.

Forseth KO, Forre O, Gran JT




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