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Widespread pain: is an improved classification possible?

G J MacFarlane1, P R Croft, J Schollum

  • 1ARC Epidemiology Research Unit, University of Manchester, UK.

The Journal of Rheumatology
|September 1, 1996
PubMed
Summary
This summary is machine-generated.

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A revised definition for widespread pain identifies individuals with greater psychological distress, fatigue, and sleep issues. This new definition is more suitable for epidemiological studies than the current American College of Rheumatology (ACR) criteria.

Area of Science:

  • Rheumatology
  • Epidemiology
  • Pain Medicine

Background:

  • The American College of Rheumatology (ACR) classification for widespread pain, used clinically for fibromyalgia screening, may lack face validity for epidemiological studies.
  • Existing definitions might not accurately capture the full extent or impact of widespread pain.

Purpose of the Study:

  • To develop a more coherent definition of widespread pain for epidemiological research.
  • To compare the performance of a new definition against the ACR definition in identifying individuals with significant morbidity.

Main Methods:

  • 172 subjects from a community-based pain study were categorized using the ACR definition and a new, more stringent definition requiring diffuse limb pain.
  • Clinical and psychological measures were recorded, and associations between pain status and these variables were assessed.

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Main Results:

  • Individuals meeting the new widespread pain definition showed significantly higher scores on the General Health Questionnaire, Health and Fatigue Questionnaire, and sleep problem assessments.
  • These individuals also had more tender points compared to those meeting only the ACR definition.
  • Morbidity in those meeting only the ACR definition resembled that of individuals with regional pain.

Conclusions:

  • A redefined concept of widespread pain identifies a cohort with greater psychological disturbance, fatigue, sleep problems, and tender points.
  • This revised definition may be more appropriate and valid for use in epidemiological studies investigating widespread pain.