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Multi-method assessment of experimental & clinical pain in patients with fibromyalgia (FM)

  [ 30 votes ]   [ Discuss This Article ] • October 3, 1994

Experimental measures of responsiveness to painful and non-painful
stimuli as well as measures of typical and present clinical
pain were assessed in 26 female patients with fibromyalgia and
in an equal number of age-matched healthy women. Pressure pain
thresholds, determined by means of a dolorimeter, were lower
in the patients compared to the control subjects both at a
tender point (trapezius) and at a non-tender control point
(inner forearm). The same was true for the heat pain
thresholds, measured using a contact thermode. In contrast,
the pain thresholds for electrocutaneous stimuli were
decreased only at the tender point. The detection thresholds
for non-painful stimuli (warmth, cold and electrical stimuli)
seemed to be less affected in the fibromyalgia patients, with
only the detection threshold for cold being lower at both
sites. Tender points were more sensitive than control points
for mechanical pressure. The reverse was found for the other
modalities which were tested. Although the 3 experimental pain
thresholds showed patterns of either generalized or
site-specific pain hyperresponsiveness, the between-methods
correlations were not very high. While the correlations
between the experimental pain thresholds and the various
measures of clinical pain (Localized Pain Rating, McGill Pain
Questionnaire) in the patients were generally low, there were
significant negative correlations between pressure pain
thresholds at the two sites and the level of present pain
assessed by the Localized Pain Rating. We conclude that a
pattern of pain hyperresponsiveness, generalized across the
site of noxious stimulation and across the physical nature of
the stressor, is associated with fibromyalgia.

Lautenbacher S, Rollman GB, McCain GA

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