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Counter irritation test in primary fibromyalgia (FM)

  [ 20 votes ]   [ Discuss This Article ] • December 3, 1994

In primary fibromyalgia the main symptom is diffuse pain
predominating at tender points which are sensitive to
palpation. The aim of this study was to compare the effects on
the amplitude of the nociceptive flexion reflex of the lower
limb (RIII reflex) of applying painful pressure to the tender
points with the effects of the same pressure applied to other
points of the body or to the same part of the body in control
subjects. This method was chosen because previous studies have
shown that it was possible to activate the diffuse noxious
inhibitory system using a "counter-irritation" stimulation.
Our study was carried out on 18 fibromyalgic patients and on
12 control subjects. During the counter-irritation procedure,
consisting of applying pressure with a mechanical dolorimeter
to tender points, a clear cut and significant decrease in the
amplitude of the RIII response was observed in 6 patients. In
conclusion, in view of the subjective nature of the criteria
used at present to diagnose primary fibromyalgia, we would
like to suggest that a positive counter-irritation test be
adopted as a further obligatory criterion, since it has been
clearly established that the diffuse noxious inhibitory
control responsible for the decrease in the RIII amplitude can
be activated only when the subjects undergo intense
nociceptive stimulation.

Guieu R, Serratrice G, Pouget J

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