Abstract
Fibromyalgia is a common disease with a high economic burden. The etiology of this disease remains unclear, as there are no specific abnormalities on clinical or technical examinations. Evidence suggests that central pain sensitization at the brain pain matrix might be involved. Understanding the pain characteristics of this disease is of importance both for diagnosis and treatment. The authors present their findings of pain characteristics in a Belgium population of fibromyalgia patients. Data of 65 patients (57 male and 8 female patients) were analyzed in this study (mean age 46.86, SD = +8.79). Patients filled out the following questionnaires: visual analogue scale, fibromyalgia impact questionnaire, pain-catastrophizing scale, pain vigilance and awareness questionnaire, modified fatigue impact scale, the Beck depression inventory, the short form 36 and the Dutch shortened profile of mood states. Statistical analysis was performed making use of a factor analysis and a hierarchical cluster analysis. We were able to define pain characteristics in this group of patients. The reciprocal effects of mood and fatigue on pain experience could be identified within the data, catastrophizing scores show a high correlation with overall life quality and pain experience. We have performed a cluster analysis on the fibromyalgia patients, based on the four main principal components defining the overall disease burden. Mood explained most of the variance in symptoms, followed by mental health state, fatigue, and catastrophizing. Three clusters of patients could be revealed by these components. Clusters: 1 high scores on mood disorders, pain, and decreased mental health, 2 high scores on fatigue and physical health, and 3 a mixture of these two groups. This data suggest that different subgroups of fibromyalgia patients could be identified and based on that, treatment strategies and results might be adapted.
Similar content being viewed by others
References
van Hecke O, Torrance N, Smith BH (2013) Chronic pain epidemiology and its clinical relevance. Br J Anaesth 111(1):13–18. doi:10.1093/bja/aet123
Bushnell MC, Ceko M, Low LA (2013) Cognitive and emotional control of pain and its disruption in chronic pain. Nat Rev Neurosci 14(7):502–511. doi:10.1038/nrn3516
Cortelli P, Giannini G, Favoni V, Cevoli S, Pierangeli G (2013) Nociception and autonomic nervous system. Neurol Sci Off J Ital Neurol Soc Ital Soc Clin Neurophysiol 34(Suppl 1):S41–S46. doi:10.1007/s10072-013-1391-z
Gureje O (2007) Psychiatric aspects of pain. Curr Opin Psychiatry 20(1):42–46. doi:10.1097/YCO.0b013e328010ddf4
Gureje O (2008) Comorbidity of pain and anxiety disorders. Curr Psychiatry Rep 10(4):318–322
Demyttenaere K, Bruffaerts R, Lee S, Posada-Villa J, Kovess V, Angermeyer MC, Levinson D, de Girolamo G, Nakane H, Mneimneh Z, Lara C, de Graaf R, Scott KM, Gureje O, Stein DJ, Haro JM, Bromet EJ, Kessler RC, Alonso J, Von Korff M (2007) Mental disorders among persons with chronic back or neck pain: results from the World Mental Health Surveys. Pain 129(3):332–342. doi:10.1016/j.pain.2007.01.022
De Ridder D, Elgoyhen AB, Romo R, Langguth B (2011) Phantom percepts: tinnitus and pain as persisting aversive memory networks. Proc Natl Acad Sci U S A 108(20):8075–8080. doi:10.1073/pnas.1018466108
Maletic V, Raison CL (2009) Neurobiology of depression, fibromyalgia and neuropathic pain. Front Biosci 14:5291–5338
Edwards RR, Bingham CO 3rd, Bathon J, Haythornthwaite JA (2006) Catastrophizing and pain in arthritis, fibromyalgia, and other rheumatic diseases. Arthritis Rheum 55(2):325–332. doi:10.1002/art.21865
Weissman-Fogel I, Sprecher E, Pud D (2008) Effects of catastrophizing on pain perception and pain modulation. Exp Brain Res Exp Hirnforsch Exp Cerebrale 186(1):79–85. doi:10.1007/s00221-007-1206-7
Rhudy JL, France CR, Bartley EJ, Williams AE, McCabe KM, Russell JL (2009) Does pain catastrophizing moderate the relationship between spinal nociceptive processes and pain sensitivity? J Pain Off J Am Pain Soc 10(8):860–869. doi:10.1016/j.jpain.2009.02.005
Wolfe F, Hauser W (2011) Fibromyalgia diagnosis and diagnostic criteria. Ann Med 43(7):495–502. doi:10.3109/07853890.2011.595734
Queiroz LP (2013) Worldwide epidemiology of fibromyalgia. Curr Pain Headache Rep 17(8):356. doi:10.1007/s11916-013-0356-5
Berger A, Sadosky A, Dukes EM, Edelsberg J, Zlateva G, Oster G (2010) Patterns of healthcare utilization and cost in patients with newly diagnosed fibromyalgia. Am J Manage Care 16(5 Suppl):S126–S137
Perrot S, Schaefer C, Knight T, Hufstader M, Chandran AB, Zlateva G (2012) Societal and individual burden of illness among fibromyalgia patients in France: association between disease severity and OMERACT core domains. BMC Musculoskelet Disord 13:22. doi:10.1186/1471-2474-13-22
Arnold LM, Clauw DJ, McCarberg BH, Fibro Collaborative (2011) Improving the recognition and diagnosis of fibromyalgia. Mayo Clin Proc Mayo Clin 86(5):457–464. doi:10.4065/mcp.2010.0738
Bennett R (2005) The fibromyalgia impact questionnaire (FIQ): a review of its development, current version, operating characteristics and uses. Clin Exp Rheumatol 23(5 Suppl 39):S154–S162
Osman A, Barrios FX, Kopper BA, Hauptmann W, Jones J, O’Neill E (1997) Factor structure, reliability, and validity of the pain catastrophizing scale. J Behav Med 20(6):589–605
McCracken LM (1997) ‘Attention’ to pain in persons with chronic pain: a behavioural approach. Behav Ther 28:271–284
Fisk JD, Ritvo PG, Ross L, Haase DA, Marrie TJ, Schlech WF (1994) Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clin Infect Dis Off Publ Infect Dis Soc Am 18(Suppl 1):S79–S83
Richter P, Werner J, Heerlein A, Kraus A, Sauer H (1998) On the validity of the Beck depression inventory. A review. Psychopathology 31(3):160–168
Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30(6):473–483
McNair DM, Lorr M, Droppleman LF (1971) Manual for the profile of mood states. Educational and Industrial Testing Service, San Diego
McNair D, Lorr M, Droppleman LF (1986) Manual for the profile of mood states. Educational and Industrial Testing Service, San Diego
Buskila D, Neumann L, Sibirski D, Shvartzman P (1997) Awareness of diagnostic and clinical features of fibromyalgia among family physicians. Fam Pract 14(3):238–241
Salaffi F, Sarzi-Puttini P (2012) Old and new criteria for the classification and diagnosis of fibromyalgia: comparison and evaluation. Clin Exp Rheumatol 30(6 Suppl 74):3–9
Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P et al (1990) The American college of rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33(2):160–172
Yunus MB (2002) Gender differences in fibromyalgia and other related syndromes. J Gend Specif Med JGSM Off J Partnership Women’s Health C 5(2):42–47
Yunus MB (2001) The role of gender in fibromyalgia syndrome. Curr Rheumatol Rep 3(2):128–134
Homann D, Stefanello JM, Goes SM, Breda CA, Paiva Edos S, Leite N (2012) Stress perception and depressive symptoms: functionality and impact on the quality of life of women with fibromyalgia. Rev Bras Reumatol 52(3):319–330
Campbell CM, McCauley L, Bounds SC, Mathur VA, Conn L, Simango M, Edwards RR, Fontaine KR (2012) Changes in pain catastrophizing predict later changes in fibromyalgia clinical and experimental pain report: cross-lagged panel analyses of dispositional and situational catastrophizing. Arthritis Res Ther 14(5):R231. doi:10.1186/ar4073
Sanchez AI, Martinez MP, Miro E, Medina A (2011) Predictors of the pain perception and self-efficacy for pain control in patients with fibromyalgia. Span J Psychol 14(1):366–373
Sawamoto N, Honda M, Okada T, Hanakawa T, Kanda M, Fukuyama H, Konishi J, Shibasaki H (2000) Expectation of pain enhances responses to nonpainful somatosensory stimulation in the anterior cingulate cortex and parietal operculum/posterior insula: an event-related functional magnetic resonance imaging study. J Neurosci Off J Soc Neurosci 20(19):7438–7445
Woolf CJ (2011) Central sensitization: implications for the diagnosis and treatment of pain. Pain 152(3 Suppl):S2–S15. doi:10.1016/j.pain.2010.09.030
Phillips K, Clauw DJ (2011) Central pain mechanisms in chronic pain states—maybe it is all in their head. Best practice & research. Clin Rheumatol 25(2):141–154. doi:10.1016/j.berh.2011.02.005
de Souza JB, Goffaux P, Julien N, Potvin S, Charest J, Marchand S (2009) Fibromyalgia subgroups: profiling distinct subgroups using the fibromyalgia impact questionnaire. A preliminary study. Rheumatol Int 29(5):509–515. doi:10.1007/s00296-008-0722-5
Camerlain M, Myhal G (2009) Are we profiling patients with fibromyalgia? Pain Res Manag J Can Pain Soc J Soc Can Pour le Traitement de la Douleur 14(3):238
Conflict of interest
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Plazier, M., Ost, J., Stassijns, G. et al. Pain characteristics in fibromyalgia: understanding the multiple dimensions of pain. Clin Rheumatol 34, 775–783 (2015). https://doi.org/10.1007/s10067-014-2736-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-014-2736-6