Preliminary validation of the Michigan Body Map

Brummett, Chad M.; Bakshi, Rishi; Goesling, Jenna; Leung, Daniel A.; Moser, Stephanie; Zollars, Jennifer; Williams, David A.; Clauw, Daniel J.; Hassett, Afton L.

doi:10.1097/j.pain.0000000000000506

Cited by 119 publications

(86 citation statements)

References 24 publications

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“…Furthermore, appraise the type of pain (localised or generalised) and whether referral is needed to a pain specialist to evaluate the type of pain, current treatment or current medication (safe use, interactions with other medication, side effects). Generalised pain can be recognised in a clinical interview and by the use of a pain manikin such as the Michigan body map 63. Use validated questionnaires to assess the potential presence of neuropathic pain 62 64–66…”

Section: Resultsmentioning

confidence: 99%

EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis

et al. 2018

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Pain is the predominant symptom for people with inflammatory arthritis (IA) and osteoarthritis (OA) mandating the development of evidence-based recommendations for the health professional's approach to pain management. A multidisciplinary task force including professionals and patient representatives conducted a systematic literature review of systematic reviews to evaluate evidence regarding effects on pain of multiple treatment modalities. Overarching principles and recommendations regarding assessment and pain treatment were specified on the basis of reviewed evidence and expert opinion. From 2914 review studies initially identified, 186 met inclusion criteria. The task force emphasised the importance for the health professional to adopt a patient-centred framework within a biopsychosocial perspective, to have sufficient knowledge of IA and OA pathogenesis, and to be able to differentiate localised and generalised pain. Treatment is guided by scientific evidence and the assessment of patient needs, preferences and priorities; pain characteristics; previous and ongoing pain treatments; inflammation and joint damage; and psychological and other pain-related factors. Pain treatment options typically include education complemented by physical activity and exercise, orthotics, psychological and social interventions, sleep hygiene education, weight management, pharmacological and joint-specific treatment options, or interdisciplinary pain management. Effects on pain were most uniformly positive for physical activity and exercise interventions, and for psychological interventions. Effects on pain for educational interventions, orthotics, weight management and multidisciplinary treatment were shown for particular disease groups. Underpinned by available systematic reviews and meta-analyses, these recommendations enable health professionals to provide knowledgeable pain-management support for people with IA and OA.

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Section: Resultsmentioning

confidence: 99%

EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis

et al. 2018

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“…To our knowledge, this is the first study to compare treatment response in patients with multiple painful sites with the response in patients with isolated CLBP. We used the MBM, a recently validated graphic tool that allows patients to identify up to 35 different painful sites 25. The MBM has been used primarily in studies of fibromyalgia,25 and the Japanese trial included in this analysis was among the first to use the MBM in patients with CLBP 14.…”

Section: Discussionmentioning

confidence: 99%

“…This analysis included an assessment of the relationship between the number of painful body sites (assessed using the Michigan Body Map25 [MBM]) and the response to duloxetine, assessed in the Japanese trial 14. The MBM is a graphic tool that allows patients to self-report where they experience pain in up to 35 distinct body sites, and its validity and reliability have been demonstrated in a series of 5 studies involving 402 patients with widespread pain due to fibromyalgia 25…”

Section: Introductionmentioning

confidence: 99%

Duloxetine 60 mg for chronic low back pain: post hoc responder analysis of double-blind, placebo-controlled trials

Alev¹,

Fujikoshi²,

Yoshikawa³

et al. 2017

JPR

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IntroductionDuloxetine has demonstrated efficacy in chronic low back pain (CLBP). We examined the predictors of response to duloxetine for CLBP.Patients and methodsThis was a post hoc analysis of pooled data from 4 double-blind, ran-domized, placebo-controlled trials of duloxetine (60 mg/day for 12–14 weeks) in adult patients with CLBP. Primary outcome was proportion of patients with ≥30% reduction in Brief Pain Inventory (BPI) average pain (“pain reduction”) at 12–14 weeks. The proportion of patients with ≥30% and ≥50% (secondary outcome) pain reduction in duloxetine and placebo groups was compared. Variables for responder analyses were early improvement (≥15% pain reduction at Week 2), sex, age, baseline BPI average pain score, duration of CLBP, and number of painful body sites according to the Michigan Body Map (≥2 vs 1 [isolated CLBP]; 1 trial); relative risk (RR) and 95% confidence interval (CI) were calculated.ResultsCompared with placebo (n = 653), a greater proportion of duloxetine-treated patients (n = 642) achieved ≥30% (59.7% vs 47.8%; P < 0.001) and ≥50% pain reduction (48.6% vs 35.1%; P < 0.001). Among duloxetine-treated patients, early improvement was associated with greater likelihood of ≥30% (RR [95% CI], 2.91 [2.30–3.67]) or ≥50% (3.24 [2.44–4.31]) pain reduction. Women were slightly more likely than men to achieve ≥30% (RR [95% CI], 1.14 [1.00–1.30]) or ≥50% (1.17 [0.99–1.38]) pain reduction. Response rates were similar between age, CLBP duration, and baseline BPI average pain score subgroups. Patients with ≥2 painful sites were more likely to respond to duloxetine 60 mg relative to placebo than patients with isolated CLBP (RR, duloxetine vs placebo [95% CI]: ≥30% reduction, ≥2 painful sites 1.40 [1.18–1.66], isolated CLBP 1.07 [0.78–1.48]; ≥50% reduction, ≥2 painful sites 1.51 [1.20–1.89], isolated CLBP 1.23 [0.81–1.88]).ConclusionEarly pain reduction was indicative of overall response. Patients with multiple painful sites had more benefit from duloxetine than patients with isolated CLBP.

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“…The survey version of these criteria, designed for clinical and epidemiological research, is entirely patient self‐report, and can be administered on a single piece of paper (Wolfe et al., ). Our group uses the Michigan Body Map (Brummett, Bakshi et al., ) to assess the Widespread Pain Index (up to 19 body areas each counted as 1 point), as well as the Symptom Severity Index that queries the presence and severity of fatigue, sleep disturbances, memory difficulties (each scored 0–3 for presence and severity), as well as irritable bowel, headaches, and mood problems (1 point each; total Symptom Severity Index Score = 0–12; Figure ). The Widespread Pain Index and Symptom Severity Index are combined for a total FM score of 0–31.…”

Section: The Concept Of Central Sensitization As a Continuum—rather Tmentioning

confidence: 99%

“…The 2011 Survey Criteria for Fibromyalgia (Wolfe et al., ) using the Michigan Body Map (Brummett, Bakshi et al., )…”

Section: The Concept Of Central Sensitization As a Continuum—rather Tmentioning

confidence: 99%

The neurobiology of central sensitization

Harte

Harris

Clauw

2018

J Appl Biobehavioral Res

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262

274

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Central sensitization refers to the amplification of pain by central nervous system mechanisms. Classically described as a consequence of ongoing nociceptive input, it is increasingly recognized that central sensitization also occurs independent of peripheral injury or inflammation. Features of central sensitization have been identified in nearly all chronic pain conditions, and it is considered the primary underlying cause of pain in conditions such as fibromyalgia. Central sensitization is characterized in these conditions by widespread pain and multisite hyperalgesia/ allodynia. Co-occurring symptoms include fatigue, mood and cognitive problems, sleep disturbances, and multisensory hypersensitivity. Individuals with central sensitization often report previous exposure to psychosocial or physical stressors, and a higher personal lifetime and family history of pain, with the latter findings supported by genetic studies. Neuroimaging studies of central sensitization show evidence of: changes in brain gray matter in pain processing regions; neurochemical imbalances; and altered resting brain-network connectivity between pronociceptive and antinociceptive brain areas. Immune system abnormalities have also been demonstrated in individuals with central sensitization. The recognition of central sensitization, andwhether it is being driven by ongoing nociceptive input or it is occurring in the absence of a peripheral driver, is critical for effective pain management.

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Preliminary validation of the Michigan Body Map

Cited by 119 publications

References 24 publications

EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis

EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis

Duloxetine 60 mg for chronic low back pain: post hoc responder analysis of double-blind, placebo-controlled trials

The neurobiology of central sensitization

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