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A. Casas-Barragan1, M. Correa-Rodríguez2, R.M. Tapia-Haro1, F. Molina3, S. Toledano-Moreno1, M.E. Aguilar-Ferrándiz1
1University of Granada (UGR), Spain, Department of Physical Therapy, Faculty of Health Sciences, Granada, Spain, 2University of Granada (UGR), Spain, Department of Nursing, Faculty of Health Sciences, Granada, Spain, 3University of Jaén (UJA), Spain, Department of Health Science, Jaén, Spain
Background: Fibromyalgia (FM) is a syndrome characterized by chronic widespread musculoskeletal pain accompanied by a set of symptoms such as fatigue, hyperalgesia, stiffness, sleep disturbances, and cognitive impairments. Although the pathogenesis of FMS remains unknown, new researches highlight the existence of blood microcirculation alterations by changes in the innervation to the arteriovenous anastomoses (AVAs) located at hypothenar eminence of the hands. The excessive sympathetic innervation of hand´s AVAs could cause an insufficient shunt arterial blood flow to the musculoskeletal deep tissue, thereby explaining the pain, tenderness, sleep deficits, and general symptoms in FM patients.
Purpose: To analyse the peripheral vascular blood flow at skin surface of the hypothenar eminence of the hands and its relationship to clinical features in a population of women diagnosed with FM.
Methods: Thirty women diagnosed with FM and thirty healthy women were enrolled in this observational case-control study. Hypothenar eminence temperature of both hands was recorded by infrared thermography camera (FLIR Systems, INC., USA). We used the Spanish version of the Revised Fibromyalgia Impact Questionnaire (FIQ-R), the Spanish version of the Pittsburgh Quality of Sleep Questionnaire Index (PSQI), and Beck Anxiety Inventory (BAI) to assess the degree of FM symptoms. On the other hand, each participant signed informed consent and completed some structured questionnaires in order to obtain the demographic data.
Results: Significant differences were found for hypothenar eminence temperature, the PSQI, and anxiety between FM women and healthy controls (P≤0.001). The mean of the total score of FIQ-R was 71.27±16.08 in FM patients. Linear analysis regression revealed significant associations between hypothenar eminence temperature of both hands and sleeping medication assessed by the PSQI (β=-0.242, 95%CI= -0.471, -0.013, p=0.039) after adjustment for age, menopause status, and body mass index in FM women. No significant associations were found for healthy women.
Conclusion(s): Our findings showed that women with FM present an association between the use of night medication to sleep and hypothenar eminence temperature of the hands. However, further longitudinal studies are necessary to clarify the contribution of AVAs to the capillary circulation regarding changes in the temperature of the hypothenar eminence skin of the hands and its relationship to FM symptoms.
Implications: The results of this study provide a new perspective on the relationship between vascular abnormalities and clinical features in the Fibromyalgia syndrome. Infrared thermography protocol can be used by physiotherapists, offering a technique non-invasive, practical, and simple to apply that it provides a good relationship between peripheral blood flow variations and thermal properties of the cutaneous tissue.
Funding, acknowledgements: this research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors
Keywords: fibromyalgia, thermography, symptoms
Topic: Musculoskeletal
Did this work require ethics approval? Yes
Institution: University Hospital of Granada
Committee: Ethics Committee of the University Hospital of Granada
Ethics number: 1797-N-17
All authors, affiliations and abstracts have been published as submitted.
