The relation between neuromuscular control and pain intensity in fibromyalgia

Fibromyalgia patients are shown to have a different neuromuscular control (differential activation) than healthy persons. Before clinical trials can be initiated, the relation between differential activations and pain intensity among fibromyalgia patients needs to be investigated. Twenty-seven fibromyalgia patients performed 3 min bilateral shoulder elevations with different loads (0-4 kg) with a high-density surface electromyographical (EMG) grid placed on the upper trapezius. Differential activation was quantified by the power spectral median frequency of the difference in EMG amplitude between the cranial and caudal parts of the upper trapezius. The average duration of the differential activation was described by the inverse of the median frequency of the differential activations. The relation between frequency and duration of differential activations as an average of the 4 loads and pain intensity the same day prior to the experiment was explored by Pearson's correlation coefficients. A strong negative relation between frequency of differential activations and pain intensity (R=-0.67, p<0.001) and a strong positive association between duration of differential activations and pain intensity (R=0.66, p<0.001) were found. The significant association between frequency and duration of differential activations and pain intensity among the fibromyalgia patients indicates a relation between this neuromuscular control pattern and pain intensity. This finding support initiation of clinical trials for investigating effects on pain intensity of modifying differential activations among fibromyalgia patients.