Aspects of fibromyalgia (FM) in the general population: sex, pain threshold, & FM symptoms

OBJECTIVE. To investigate relationships between sex, pain threshold
and fibromyalgia (FM) symptoms in the general population.

METHODS. Data were obtained from a randomized populations
survey of 3,006 persons in Wichita, KS and a subsample of 391
who completed a detailed interview and had an examination.
Tender point counts, dolorimetry scores, clinical and
psychological variables were measured.

RESULTS. Dolorimetry
scores were 2.04 kg/cm (1.42-2.66) lower in women than men,
and women were almost 10 times more likely to have 11 tender
points [OR 9.6 (2.00-46.3)] than men. Women are also more
likely to have FM symptoms than men: "Pain all over," [OR 3.94
(1.34-11.38)], sleep disturbance [OR 3.06 (1.45-6.46)],
fatigue [OR 4.52 (2.03-10.09)], and irritable bowel syndrome
[OR 5.23 (1.83-14.96)]. Tender point counts are more
correlated with FM symptoms than dolorimetry scores.

CONCLUSION. Symptoms of FM are correlated with pain threshold
in the general population, but tender point counts correlate
better than dolorimetry. These 2 measures of pain threshold
assay different but overlapping factors. Pain threshold is
lower in women; and women have more FM symptoms. Decreased
pain threshold correlates with all of the symptoms of FM, even
in those who do not meet criteria for the syndrome. This
suggests that decreased pain threshold, as measured by the
tender point counts, is an intrinsically important aspect of
patient distress, regardless of the extent and kind of
concomitant disease; and that much can be learned about
patients by employing this examination.

Wolfe F, Ross K, Anderson J, Russell IJ

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