File
Barbero M.1, Fernández-de-las-Peñas C.2,3, Palacios-Ceña M.2,3, Cescon C.1, Deborah F.4
1University of Applied Sciences and Arts of Southern Switzerland, Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, Manno, Switzerland, 2Universidad Rey Juan Carlos, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Alcorcón, Spain, 3Universidad Rey Juan Carlos, Cátedra de Investigación y Docencia en Fisioterapia, Terapia Manual y Punción Seca, Madrid, Spain, 4University of Birmingham, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, Birmingham, United Kingdom
Background: Fibromyalgia (FMS) is a chronic rheumatic condition that affects around 2-3% of adults worldwide. Patients with FMS experience widespread chronic pain, tender points, fatigue and a number of other disabling symptoms. Diagnosing FMS may be difficult as the symptoms vary considerably and can mimic other conditions, such as multiple sclerosis, rheumatoid arthritis, and lupus. Pain drawings (PD) performed on body charts are usually completed by patients during the clinical assessment. PDs provide clinicians with an estimation of the pain location and its extent. Yet, investigations of pain extent and pain location using PDs in people with FMS are almost non-existent.
Purpose: To investigate pain extent and pain location, extracted from PDs, in women with FMS. Additionally, the association between pain extent and pain intensity was explored.
Methods: Thirty women with FMS without other comorbid conditions participated. All patients completed two PDs: one on a body chart with a dorsal view of the body and one with a ventral view. Patients were also asked to rate their current level of pain, the worst, and the lowest level of pain experienced over the preceding week on a numerical rating scale (0-10). All PDs were then digitalized and pain extent and pain location were defined for each patient. Using a customized software, pain extent was computed as a percentage of the total body chart area and pain frequency maps were obtained by superimposing the PDs from all participants. Spearmans correlation coefficients were used to assess the relationship between pain extent and pain intensity.
Results: Pain extent was 16.2% ± 3.4% across the entire group of women with FMS, 13% ± 46% for the ventral aspect of the body and 19% ± 6.5% for the dorsal aspect. The pain frequency maps showed that most patients reported pain in the neck, shoulder, low back, elbow, and knee regions. The pain pattern was widespread and composed by multiple regional pain areas. Higher values of pain extent were associated with a higher pain intensity (dorsal area: rs=0.461, P=0.010; total area: rs=0.593, P=0.001).
Conclusion(s): Pain extent and location were explored in woman with FMS and this study is the first to generate pain frequency maps in people with FMS. The results reveled the most commonly affected sites and showed that people that report higher pain intensity also showed larger pain extent.
Implications: Pain drawings can be used in the clinical evaluation of patients with FMS and pain frequency maps may assist clinicians in diagnosing FMS.
Funding acknowledgements: N/A
Topic: Rheumatology
Ethics approval: Approved by the local Ethics Committee (URJC 08-30-2014)
All authors, affiliations and abstracts have been published as submitted.
