Comparison of pain threshold, health and functional status of females with fibromyalgia and multiple sclerosis: a pilot study

Abstract

Objectives. Fibromyalgia (FM) and multiple sclerosis (MS) are known to cause disability and have an impact on physical functioning, social functioning, and emotional well-being of affected individuals. The aim of this study was to compare pressure pain threshold, health and functional status in females with FM and MS who were ambulatory. Methods. Control point scores (CPS), total myalgic scores (TMS; using an algometer), tender point (TP) counts, and chronic widespread pain were assessed in females with FM and MS and in healthy age-matched female controls. The Fibromyalgia Impact Questionnaire (FIQ), and the Nottingham Health Profile were performed. The Kurtzke Expanded Disability Status Scale (EDSS) was used to estimate the disability status of persons with MS. Results. Fibromyalgia patients have significantly lower CPS and TMS than MS patients and controls. Multiple sclerosis patients had similar CPS but significantly lower TMS compared to controls. Tender point counts were significantly higher in FM than MS patients and controls. Patients with MS had a higher numbers of TPs with respect to controls. Chronic widespread pain was reported by only three patients with MS and these patients did not meet FM criteria for tender point counts. Fibromyalgia patients had significantly lower FIQ-first item scores than MS patients. FM patients had higher NHP section scores in pain, social isolation, emotional reaction, sleep and energy, but similar physical mobility compared to MS patients. In MS patients energy and physical mobility dimension of NHP and FIQ-first item scores correlated with EDSS (r=0.42, P=0.047, r=0.83, P=0.001, and r=0.62, P=0.001, respectively). Conclusion. This cross-sectional study warrants further research comparing FM and MS, which share a lot of clinical and psychosocial features or may coexist. Chronic pain and related fatigue, social and emotional reactions and disability seem to be important components in FM, so taking care of these components, in other words a biopsychosocial model, may improve disease outcome and quality of life not only in FM but also in MS.

Health-related quality of life in chronic fatigue syndrome: Predictors of physical functioning and psychological distress

“…These conditions show some clinical similarities to CFS including symptom profiles (debilitating fatigue, muscular pain, sleep difficulties and other pathophysiological disturbance), and highly variable and unpredictable disease courses, with significant resulting functional disability and psychological distress (Komaroff et al, 1996;Ozgocmen, Kaya, Gulkesen, Bulut, & Ardicoglu, 2006;Patarca-Montero, 2001).…”

Clinical perspective on pain in multiple sclerosis

“…45 The Pain Interference Scale of the Brief Pain Inventory, the Graded Chronic Pain Disability Score, 41,47 and the PES are validated for MS. 48 The Pain Interference Scale of the Brief Pain Inventory includes several components and seems sufficiently comprehensive to evaluate the interference of pain in MS. Algometer (evaluating thermal and pressure pain thresholds) usage in studies is scarce. 29,49,50 Several studies assessed co-existing sensory complaints of MS pain by Quantitative Sensory Testing (evaluating perception of vibration, touch, warm, cold, and heat pain). 18,25 In order to discriminate neuropathic pain and nociceptive pain, neurophysiological tests are recommended to use, such as somatosensory evoked potentials and laser evoked potentials.…”

Bone mass and bone turnover in premenopausal women with fibromyalgia syndrome

“…A total of 50 premenopausal women with low back pain who met 1990 and 2010 American College of Rheumatology (ACR) criteria for the classification of FMS [18,19] and 50 premenopausal female control patients with degenerative disc disease were enrolled. The study was approved by the local ethics committee and written informed consent forms were obtained from all participants.…”