Highlights
- •Of chronic pain patients 37% were classified with fibromyalgia (FM).
- •FM patients showed higher levels of clinical and experimental pain sensitivity.
- •A higher proportion of patients classified as FM used opioids.
- •Specificity and sensitivity of the revised American College of Rheumatology-2016 FM criteria is unknown.
Abstract
Fibromyalgia (FM) is a condition with chronic widespread pain and signs of generalized
pain hypersensitivity. FM has previously been classified according to the American
College of Rheumatology-1990 criteria, where the presence of hypersensitivity is estimated
by a tender point examination. Because of the limitations of these classification
criteria, new diagnostic criteria have been proposed, abandoning this examination.
This cross-sectional study investigated the prevalence of FM according to the revised
2016 FM criteria in a large cohort of chronic pain patients. Pain drawings, the FM
Symptom Severity Scale, and questionnaires assessing manifestations of pain, pain-related
disability, and psychological distress were collected from 1,343 patients with chronic
nonmalignant pain referred to a multidisciplinary pain clinic. In addition, assessments
of mechanical and thermal pain sensitivity were performed in 496 of the patients.
Patients fulfilling the FM criteria (n = 498, 37%) reported significantly higher levels
of pain, pain-related disability, psychological distress, and sensitivity to mechanical
and heat stimuli (P < .05). Moreover, the proportion using opioids were significantly higher compared
with patients not fulfilling the criteria (P = .015). Significant associations were found between heat and mechanical pain sensitivity
(P < .001) indicating that patients who showed higher pain sensitivity to mechanical
stimulation also showed higher pain sensitivity to thermal stimulation.
Perspective
More than one-third of patients were classified as FM, and patients classified showed
increased clinical and experimental pain profiles. Because no data were collected
on whether the included patients had a clinical FM diagnosis, future studies validating
the American College of Rheumatology-2016 criteria in a cohort of patients with chronic
nonmalignant pain are warranted.
Key words
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Article info
Publication history
Published online: February 27, 2018
Accepted:
February 14,
2018
Received in revised form:
January 30,
2018
Received:
June 21,
2017
Footnotes
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2018 by the American Pain Society
