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Pressure points, history of trauma cited among key issues in onset, diagnosis of fibromyalgia
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Health-related quality of life, tender points and fatigue continue to be key issues in the clinical assessment of patients with fibromyalgia, according to researchers in Spain who noted most patients reported a psychologically stressful event prior to their onset of symptoms and 31% reported a physical event as a trigger.
Researchers identified 79 women with fibromyalgia who had a mean age of 46.2 years and matched them to local women without the disease. Most patients in both groups were Caucasian and from the Galicia region in Spain. Patients were assessed with the American College of Rheumatology (ACR) 1990 criteria, the Spanish version of the Fibromyalgia Impact Questionnaire, Beck Depression Inventory, Pittsburgh Sleep Quality Index and pain on a VAS. In addition, 18 tender points defined by the ACR were evaluated using an algometer. Key associated symptoms and comorbid conditions were also recorded.
Analysis showed 77.5% of patients reported a psychologically stressful event prior to the onset of symptoms, and 31% reported a physical episode that was perceived to a trigger of the syndrome. A family history of fibromyalgia was reported by 31.4% of patients.
Patients differed from control participants by marital status, work status and level of education, but not by occupation. Level of education was significantly correlated with several symptoms and domains.
A lower mean pressure pain threshold was reported by patients with fibromyalgia compared to the control group. One healthy participant reported more than 11 tender points, and eight patients with fibromyalgia had fewer than 11 tender points. However, the differences between both groups were statistically significant.
Patients with fibromyalgia were likely to be polysymptomatic, and all reported some symptoms at the time of study. Quality of life, vitality, fatigue, VAS, physical role and physical body scores were significantly worse for patients with fibromyalgia. Anxiety, insomnia, depression and loss of memory were commonly reported by patients compared to healthy participants. Other symptoms more commonly reported by patients included frequent urination, digestive problems, menstrual cramps and sensitivity to environmental agents. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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