Highlights
- •Quantitative sensory testing studies show strongly abnormal cold pain thresholds.
- •Many observational meteorological studies are methodologically flawed.
- •The influence of temperature on spontaneous pain intensity in FMS remains unclear.
- •Temperature-sensitive subgroups are emerging in fibromyalgia syndrome.
- •Future research should focus on phenotyping these temperature-sensitive subgroups.
Abstract
Fibromyalgia syndrome (FMS) is a chronic widespread pain condition of unknown aetiology.
The role of temperature in FMS pain has not been reviewed systematically. The goal
of this study was to review the influences of temperature on pain in FMS, from meteorological
and quantitative sensory testing (QST) studies.
The review was registered with Prospero: ID-CRD42020167687, and followed PRISMA guidance.
Databases interrogated were: MEDLINE (via OVID), EMBASE, PubMed, Web of Science, ScienceDirect,
CINAHL, and ProQuest (Feb’20). Exclusion criteria were: age <18, animal studies, non-English,
and noncontrolled articles.
Thirteen studies pertaining to ambient temperature and FMS pain were identified; 9
of these found no uniform relationship. Thirty-five QST studies were identified, 17
of which assessed cold pain thresholds (CPTs). All studies showed numerically reduced
CPTs in patients, ranging from 10.9°C to 26.3°C versus 5.9°C to 13.5°C in controls;
this was statistically significant in 14/17. Other thermal thresholds were often abnormal.
We conclude that the literature provides consistent evidence for an abnormal sensitization
of FMS patients’ temperature-sensation systems. Additional work is required to elucidate
the factors that determine why a subgroup of patients perceive low ambient temperatures
as painful, and to characterize that group.
Perspective
Patients often report increased pain with changes in ambient temperature; even disabling,
extreme temperature sensitivity in winter. Understanding this phenomenon may help
clinicians provide reassurance and advice to patients and may guide research into
the everyday impact of such hypersensitivity, whilst directing future work into the
pathophysiology of FMS.
Key words
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Article info
Publication history
Published online: January 06, 2021
Footnotes
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflicts of interest: The authors have no conflicts of interest to disclose.
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© 2021 by United States Association for the Study of Pain, Inc.
