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

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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