Which symptoms best distinguish fibromyalgia patients from those with other chronic pain disorders?

Abstract

Rationale, aims and objectives: The primary purpose of this study was to test both classic and novel FM pain and non-pain symptoms to determine their practical efficacy in aiding clinicians to distinguish FM pain from other chronic pain disorders.Methods: 158 pain patients from two primary care clinics were evaluated with history, physical exam, chart review, and a questionnaire containing 26 exploratory symptoms (10 from the Symptom Impact Questionnaire (SIQR) and 16 from the FM literature)). The symptoms were rated on a 0-10 VAS for severity by those patients reporting pain over the past week. Somers' D and mean severity differences between FM and chronic pain patients without FM were used to rank the discriminatory and diagnostic contributions of symptoms.Results: Fifty patients (14.2%) carried a chart diagnosis of FM, 108 (30.7%) had pain but not FM, and 192 (54.5%) who had neither pain nor FM. Comparing means between the two pain groups, the 5 best differentiating symptoms (all, P < .0001) were: a persistent deep aching over most of my body, poor balance (7.4 vs 3.1), environmental sensitivity (6.8 vs 3.0), tenderness to touch (6.8 vs 3.6) and pain after exercise (8.1 vs 4.1). Notably, VAS pain though significantly higher for FM was least discriminatory (6.5 vs 5.1, P < .001). The five best symptoms generated a ROC = 0.85 and Somers' D = 0.69, an accuracy of 81%, and an odd's ratio of 14.4. Conclusions:Our results herein suggest that clinicians may be well-served to consider symptoms in addition to those contained in current diagnostic criteria when recognizing FM in their chronic pain patients.

Knowledge, Attitude, and Practice Regarding Fibromyalgia Among Primary Care Physicians in Tabuk, Saudi Arabia

“…It has been evident that the subjective character of symptoms, the absence of a diagnostic test, and the modest response to treatments remain challenges for treating healthcare professionals in standard clinical practice [ 9 ]. As well, the presence of several somatic complaints confounds the condition, and the diagnosis of FM is frequently overlooked [ 21 ]. Definitely, a well-informed physician and good communication with the patients could reliably reach valid FM diagnoses [ 22 ].…”

Fibromyalgia: one year in review 2023

“…Accordingly, another study has found that the descriptors of central sensitivity-related pain differ from those of disease activity-related pain (35). Two recent studies (36,37) have investigated the differentiation of FM from other chronic pain disorders or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which is also very co-morbid. The first evaluated 158 pain patients attending two primary care clinics, and found that five symptoms best distinguished FM from other chronic pain disorders: persistent deep aching over the body, poor balance, environmental sensitivity, tenderness to touch, and pain after exercise.…”

IL-1 Mediates Chronic Stress-Induced Hyperalgesia Accompanied by Microglia and Astroglia Morphological Changes in Pain-Related Brain Regions in Mice

“…As far as fibromyalgia’s etiology is undiscovered, the disease does not have a well-established animal model that mimics all the signs and symptoms of the complex illness. Patients with fibromyalgia have, in addition to their spontaneous widespread pain, disproportionally increased pain in response to painful stimuli (“mechanical hyperalgesia”) [ 10 , 11 , 12 ].…”