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Fibromyalgia: generalized pain intolerance and manifold symptom reporting
L G Quimby1, S R Block, G M Gratwick
1Department of Psychology, University of Maine, Orono.
The Journal of Rheumatology
|August 1, 1988
Summary
Fibromyalgia diagnosis may not be distinct from generalized nonarticular rheumatism. Tender points reflect general pain sensitivity, not localized pathology, suggesting fibromyalgia may be an artifact of physician assessment.
Area of Science:
- Rheumatology
- Pain Medicine
- Psychosomatic Medicine
Background:
- Current diagnostic criteria for fibromyalgia are under scrutiny.
- Generalized nonarticular rheumatism encompasses various musculoskeletal conditions.
- Distinguishing fibromyalgia from other rheumatic conditions is clinically relevant.
Purpose of the Study:
- To evaluate the validity of current fibromyalgia diagnostic criteria.
- To compare pain sensitivity and psychological profiles in fibromyalgia versus other generalized nonarticular rheumatism.
- To investigate whether fibromyalgia represents a distinct clinical entity.
Main Methods:
- Assessed pain tolerance at tender and control points using a pressure algometer.
- Administered 6 psychological self-report measures.
- Studied 125 patients with generalized nonarticular rheumatism, rheumatoid arthritis, or osteoarthritis.
Main Results:
- Fibromyalgia symptom criteria did not correlate with tender point count in generalized nonarticular rheumatism.
- Lower generalized pressure pain tolerance was the sole differentiator for fibromyalgia.
- Patients with generalized nonarticular rheumatism reported higher frequencies of symptoms like headaches and functional bowel syndrome.
Conclusions:
- Fibromyalgia may not be physically or psychologically distinct from generalized nonarticular rheumatism, apart from tender points.
- Tender points indicate general pressure pain sensitivity, not localized pathology.
- Fibromyalgia as a separate entity might be an artifact of clinical evaluation and patient reporting.
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