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Quantifying pain threshold and quality of life of fibromyalgia patients

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Abstract

The most typical symptom of fibromyalgia (FM) is diffuse pain, and pain at specific points—tender points—is crucial for its diagnosis. By comparing healthy individuals and FM patients, this study was aimed at assessing pain and quality of life of Brazilian females with FM, while seeking for a correlation between pain threshold and quality of life. A total of 178 women were evaluated: 124 were FM patients and 54 were healthy women. Pain threshold at tender points was quantified by dolorimetry, and diffuse pain by means of the visual analogue scale (VAS); the Fibromyalgia Impact Questionnaire (FIQ) was used to evaluate quality of life. Statistical treatment of the data allowed for proposing two indexes: a pain threshold index (PT) and a quality of life one (QOL). PT is the lowest value among all pain thresholds measured at the 18 tender points; QOL is the mean of responses to the FIQ and VAS. Both indexes were tested and showed significant differences between the test and control groups. By pairing pain threshold values of each tender point in the test and control groups, it was found that the most sensitive points matched between the two groups, that is, the most sensitive anatomic spots in a healthy individual are also likely to be the most sensitive points in a person with FM. This suggests that a stimulus that provokes slight discomfort to a healthy person may produce more pain in FM patients—which may bear implications for FM clinical treatment. In this sample of Brazilian women, FM patients had both lower pain threshold and worse quality of life than healthy women.

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References

  1. Wolfe F (1997) The relation between tender points and fibromyalgia symptom variables: evidence that fibromyalgia is not a discrete disorder in the clinic. Ann Rheum Dis 56:268–271

    Google Scholar 

  2. Croft P, Schollum J, Silman A (1994) Population study of tender point count and pain as evidence of fibromyalgia. BMJ 309:696–699

    Google Scholar 

  3. Caidahl K, Lurie M, Bake B, Johansson G, Wettweqvist H (1989) Dyspnea in chronic primary fibromyalgia. J Intern Med 226:265–270

    Google Scholar 

  4. Lurie M, Caidahl K, Johansson G, Bake B (1990) Respiratory function in chronic primary fibromyalgia. Scand J Med 22:151–155

    Google Scholar 

  5. Weiss DJ, Kreck T, Aalbert RK (1998) Dyspnea resulting from fibromyalgia. Chest 113:246–249

    Google Scholar 

  6. Wolfe F, Aarflot T, Bruusgaard D, Henriksson KG, Littlejohn G, Moldofsky H, Raspe H, Vaeroy H (1995) Fibromyalgia and disability. Scand J Rheumatol 24:112–118

    Google Scholar 

  7. Henriksson C, Burckhardt C (1996) Impact of fibromyalgia on everyday life: a study of women in the USA and Sweden. Disabil Rehabil 18:241–248

    Google Scholar 

  8. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Franklin CM, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT, McCain GA, Reynolds J, Romano TJ, Russel JI, Sheon RP (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis Rheum 33:160–172

    CAS  PubMed  Google Scholar 

  9. Revill SI, Robinson JO, Rosen M, Hogg IJ (1976) The reliability of a linear analogue for evaluating pain. Anaesthesia 31:1191–1198

    Google Scholar 

  10. Huskisson EC (1974) Measurement of pain. Lancet 9:1127–1131

    Google Scholar 

  11. Rydén O, Lindal E, Udén A, Hansson SB (1985) Differentiation of back pain patients using a pain questionnaire. Scand J Rehab Med 17:155–161

    Google Scholar 

  12. Melzack R (1983) The McGill pain questionnaire. In: Melzack R (ed) Pain measurement and assessment. Raven Press, New York, pp 41–47

    Google Scholar 

  13. Russell IJ (1998) Advances in fibromyalgia: possible role for central neurochemicals. Am J Med Sci 315:377–384

    Google Scholar 

  14. Fischer AA (1987) Pressure algometry over normal muscle. Standard values, validity and reproducibility of pressure threshold. Pain 30:115–126

    Article  CAS  PubMed  Google Scholar 

  15. Tunks E, McCain GA, Hart LE, Teasell RW, Goldsmith CH, Rollman GB, McDermid AJ, DeShane PJ (1995) The reliability of examination for tenderness in patients with myofascial pain, chronic fibromyalgia and controls. J Rheumatol 22:944–952

    Google Scholar 

  16. Jacobs JWG, Geenen R, Van der Heide A, Rasker JJ, Bijlsma JWJ (1995) Are tender points assessed by manual palpation in fibromyalgia reliable? An investigation into the variance of tender point scores. Scand J Rheumatol 24:243–247

    Google Scholar 

  17. Bonica JJ (1990) History and pain concepts and therapies. In: Bonica JJ (ed) The management of pain. Lea & Febiger, Philadelphia, pp 2–17

    Google Scholar 

  18. Burckhardt CS, Clark SR, Bennett RM (1991) The fibromyalgia impact questionnaire: development and validation. J Rheumatol 18:728–733

    CAS  PubMed  Google Scholar 

  19. Gottfried N (1991) Introduction to statistics: the nonparametric way. Springer, Berlin Heidelberg New York

    Google Scholar 

  20. Djikers M (1999) Measuring quality of life. Am J Phys Med Rehabil 78:286–300

    Google Scholar 

  21. American Physical Therapy Association (2001) Guide to physical therapist practice. Phys Ther 81:27–33

    Google Scholar 

  22. Wolfe F, Anderson J, Harkness D, Bennett RM, Caro XJ, Goldenberg DL, Russell IJ, Yunus MB (1997) A prospective, longitudinal, multicenter study of service utilization and costs in fibromyalgia. Arthritis Rheum 40:1560–1570

    CAS  PubMed  Google Scholar 

  23. Skevington SM (1995) Psychology of pain. Wiley, Chichester

    Google Scholar 

  24. Clark WC, Clark SB (1980) Pain responses in Nepalese porters. Science 209:410–412

    Google Scholar 

  25. Haun MVA, Ferraz MB, Pollak DF (1999) Validação dos critérios do Colégio Americano de Reumatologia (1990) para classificação da fibromialgia, em uma população brasileira. Rev Bras Reumatol 39:221–230

    Google Scholar 

  26. Forseth KØ, Gran JT (1992) The prevalence of fibromyalgia among women aged 20–49 years in Arenal, Norway. Scand J Rheumatol 21:74–78

    Google Scholar 

  27. Nishikai M (1992) Fibromyalgia in Japanese. J Rheumatol 19:110–114

    Google Scholar 

  28. Prescott E, Kjøller M, Jacobsen PM, Danneskiold-Samsøe B, Kamper-Jørgensen F (1993) Fibromyalgia in the adult Danish population: I. A prevalence study. Scand J Rheumatol 22:233–235

    Google Scholar 

  29. Gracely RH, Petzke F, Wolf JM, Clauw DJ (2002) Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia. Arthritis Rheum 46:1333–1343

    Google Scholar 

  30. Russel IJ (1998) Advances in fibromyalgia: possible role for central neurochemicals. Am J Med Sci 315:377–384

    Google Scholar 

  31. Mountz JM, Bradley LA, Alarcón GS (1998) Abnormal functional activity of the central nervous system in fibromyalgia syndrome. Am J Med Sci 315:385–396

    Google Scholar 

  32. Weigent DA, Bradley LA, Blalock E, Alarcón GS (1998) Current concepts in the pathophysiology of abnormal pain perception in fibromyalgia. Am J Med Sci 315:405–412

    Google Scholar 

  33. Crofford LJ (1998) Neuroendocrine abnormalities in fibromyalgia and related disorders. Am J Med Sci 315:359–366

    Google Scholar 

  34. Bonica JJ (1990) Definitions and taxonomy of pain. In: Bonica JJ (ed) The management of pain. Lea & Febiger, Philadelphia, pp 18–22

    Google Scholar 

  35. Clark SR, Jones KD, Burckhardt CS, Bennett R (2001) Exercise for patients with fibromyalgia: risks versus benefits. Curr Rheumatol 3:135–140

    Google Scholar 

  36. Jentoft ES, Kvalvik AG, Mengshoel AM (2001) Effects of pool-based and land-based aerobic exercise on women with fibromyalgia/chronic widespread muscle pain. Arthritis Care Res 45:42–47

    Google Scholar 

  37. Ramsay C, Moreland J, Ho M, Joyce S, Walker S, Pullar T (2000) An observer-blinded comparison of supervised and unsupervised aerobic exercise regimens in fibromyalgia. Rheumatology 39:501–505

    Google Scholar 

  38. Meiworm L, Jakob E, Walker UA, Peter HH, Keul J (2000) Patients with fibromyalgia benefit from aerobic endurance exercise. Clin Rheumatol 19:253–257

    Google Scholar 

  39. Offenbacher M, Stucki G (2000) Physical therapy in the treatment of fibromyalgia. Scand J Rheumatol 29:78–85

    Google Scholar 

  40. Nichols DS, Glenn TM (1994) Effects of aerobic exercise on pain perception, affect, and level of disability in individuals with fibromyalgia. Phys Ther 74:327–332

    Google Scholar 

  41. Mengshoel AM, Komnaes HB, Forre O (1992) The effects of 20 weeks of physical fitness training in female patients with fibromyalgia. Clin Exp Rheumatol 10:345–349

    Google Scholar 

  42. Mengshoel AM, Vollestad NK, Forre O (1995) Pain and fatigue induced by exercise in fibromyalgia patients and sedentary healthy subjects. Clin Exp Rheumatol 13:477–482

    Google Scholar 

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Authors and Affiliations

  1. Department of Physical, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânia 51, Cidade Universitária, São Paulo, 05360-160, Brazil

    A. P. Marques

  2. Department of Physical Therapy, Methodist University, São Paulo, Brazil

    E. A. G. Ferreira

  3. Department of Physical Therapy, FIEO University, São Paulo, Brazil

    L. A. Matsutani

  4. Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil

    C. A. B. Pereira

  5. School of Medicine, University of São Paulo, São Paulo, Brazil

    A. Assumpção

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  1. A. P. Marques
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  2. E. A. G. Ferreira
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  3. L. A. Matsutani
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  4. C. A. B. Pereira
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Correspondence to A. P. Marques.

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Marques, A.P., Ferreira, E.A.G., Matsutani, L.A. et al. Quantifying pain threshold and quality of life of fibromyalgia patients. Clin Rheumatol 24, 266–271 (2005). https://doi.org/10.1007/s10067-004-1003-7

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  • DOI: https://doi.org/10.1007/s10067-004-1003-7

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