Dear Fibromyalgia

Category: Fibromyalgia Pain

A comprehensive look at Fibromyalgia pain, its symptoms, triggers, and effective strategies to manage and alleviate discomfort.

  • Fibromyalgia Increases Pain And Fatigue For Pregnant Women

    Pregnant women with fibromyalgia (FM) experience significant pain, fatigue, and psychological stress, symptoms that are often misdiagnosed or undertreated as a normal part of pregnancy, according to a pilot study by Karen M. Schaefer, D.N.Sc., R.N., assistant professor of nursing at Temple University’s College of Health Professions. Her research, the first to look at the impact of pregnancy on women with FM, was recently presented at the 2006 Association of Women’s Health, Obstetrics and Neonatal Nurses’ convention in Baltimore.

    Fibromyalgia is a chronic condition commonly found in women that causes pain in the muscles and soft tissues of the body. Many sufferers feel weak from fatigue, and the condition, at its worst, can lead to disability.

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    “Until now, there was only anecdotal evidence suggesting that women with FM had a rougher time during pregnancy,” said Schaefer. “This data is the first step toward gathering hard evidence of FM effects on this group and will hopefully help us identify ways to reduce the impact of fibromyalgia during pregnancy.”

    For this study, Schaefer recruited pregnant women with and without FM through an Internet announcement on a fibromyalgia Web site. Study subjects were between the ages of 29 and 31, in their third trimester, with no history of stillbirth and free of chronic illnesses other than FM.

    The women were then mailed a questionnaire about fatigue, depression, pain, and ability to function. A demographic form was also used to assess the number of painful areas in the body as well as age, marital status, education, hours slept, and use of medication.

    Schaefer’s results revealed that pregnant women with fibromyalgia had a hard time functioning, felt more stiff and tired, and experienced pain in more body areas than women without FM.

    “Most women with FM have trouble getting this condition properly diagnosed, let alone knowing where to turn for help once their condition is identified. We need to start looking at how FM affects all areas of these women’s lives and come up with ways to provide as much comfort and support as possible,” she said.

    Schaefer, whose research focuses on women with chronic illness (fibromyalgia, lupus, ovarian cancer) is currently expanding her study to include a larger group of subjects.

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  • Ordinary Touches Multiply Into Severe Pain For Fibromyalgia Patients

    The millions of Americans who suffer from fibromyalgia live with a two-edged sword: excruciating pain, accompanied by the doubts of many who dismiss it as a made-up illness invented by a troubled mind.

    But researchers at the University of Florida and elsewhere are beginning to piece together clues that reveal the physical basis of the puzzling syndrome that causes severe fatigue and aches and has defied easy diagnosis.

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    UF scientists have found an abnormal central nervous system reaction in those with fibromyalgia-the body magnifies ordinary repetitive stimulation into an experience of crippling pain.

    “This is particularly important because it has been unclear if fibromyalgia was just an imagined illness or a real syndrome,” said Dr. Roland Staud, an associate professor of medicine at UF’s College of Medicine who also is affiliated with the UF Brain Institute. “We now have good evidence that shows that it’s not a psychological abnormality, but that there is a neurological abnormality present.”

    Staud, who presented his research findings at the annual meeting of the American College of Rheumatology last November, recently was awarded a National Institutes of Health grant worth nearly $800,000 to continue his studies for the next four years. Donald Price, a UFprofessor of oral and maxillofacial surgery, and Charles Vierck, a UF professor of neuroscience, are collaborating on the research. Their goal is to develop a better understanding of the condition, with an eye toward improving diagnostic tests and treatments.

    An estimated 3.7 million people in the United States – primarily women who are diagnosed during their 30s and 40s – have fibromyalgia, according to the NIH. A chronic illness with no known cure, its cause also is not known. Researchers have theorized that an injury to the central nervous system or an infectious agent might be responsible for triggering it in people who have inherited susceptibility. Symptoms include persistent and widespread musculoskeletal pain, fatigue and tenderness in the neck, spine, shoulders, and hips.

    Staud and colleagues found the central nervous system abnormality by conducting a series of repetitive stimulation tests on people with the syndrome as well as healthy research participants. The tests involved repeatedly placing warm plates on their hands and arms. The healthy participants felt the sensation but did not report it as pain.

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    For those with fibromyalgia, however, the sensation would magnify with each repetition into an experience of crippling and unbearable pain.

    “When a sensation signal reaches the spinal cord, the signal can be omitted, changed, or augmented,” Staud said. “If it is augmented, then something that is innocuous, such as pressure on the skin, can then be perceived as a painful stimulus.”

    Jessica LeMay, one of Staud’s patients, has been battling fibromyalgia since 1993. The 30-year-old Lake City resident said the pain starts in one area and usually spreads, sometimes becoming overwhelming.

    “I imagine if someone had taken a baseball bat and beaten me with it,that’s got to be what it feels like,” she said. “Depending on the day, I’ll just move out of the way if someone tries to touch me.”

    The pain of fibromyalgia often interferes with a person’s working life.

    “These are people who are diagnosed in their productive years. Many have personal or professional problems adjusting to the pain experience,” Staud said. “The illness makes some people feel dysfunctional because they can’t do the activities they once did.”

    The condition can worsen from stress and inadequate sleep, Staud said. Because living with fibromyalgia often causes stress, and pain and makes sleeping difficult, a vicious cycle develops.

    LeMay said many people dismiss her condition, not understanding the “huge difference” between her severe fatigue and a healthy person’s occasional tiredness.

    “When this fatigue would come about, it’s almost like a weight being dropped on you, and you can’t function anymore,” she said.

    LeMay said she is hopeful that Staud’s research will lead to more effective treatment for fibromyalgia patients and better understanding by the general public.

    “In our society, you either get better or you die, and fibromyalgia patients don’t do that,” she said. “We don’t fit in the mold, so people don’t know what to do with us.”

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  • High rate of restless legs syndrome found in adults with fibromyalgia

    High rate of restless legs syndrome found in adults with fibromyalgia

    A study in the Oct. 15 issue of the Journal of Clinical Sleep Medicine found that adults with fibromyalgia had a much higher prevalence and risk of restless legs syndrome than healthy controls. The study suggests that treating RLS may improve sleep and quality of life in people with fibromyalgia.

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    Results show that the prevalence of restless legs syndrome was about 10 times higher in the fibromyalgia group (33 percent) than among controls (3.1 percent). After statistical adjustments for potential confounders such as age, gender, and ethnicity, participants with fibromyalgia were 11 times more likely than controls to have RLS (odds ratio = 11.2). As expected, considerable sleep disruption was reported by participants with fibromyalgia using the Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale. In the fibromyalgia group, these sleep problems were more severe among people who also had RLS.

    “Sleep disruption is common in fibromyalgia, and often difficult to treat,” said contributing author Dr. Nathaniel F. Watson, associate professor of neurology at the University of Washington in Seattle, Wash. “It is apparent from our study that a substantial portion of sleep disruption in fibromyalgia is due to restless legs syndrome.”

    The research team led by Dr. Watson and lead author Dr. Mari Viola-Saltzman of Loyola University Medical Center in Maywood, Ill., studied 172 people with fibromyalgia who had a mean age of 50 years; 93 percent were female. They were compared with 63 healthy controls who had a mean age of 41 years.

    Fibromyalgia was identified by self-report or review of the medical records, and it was confirmed on examination according to published guidelines regarding the presence of pain that is chronic and widespread. The pain was assessed by the subjective report and by objective measurement with a dolorimeter, a spring-loaded gauge that is used to apply standardized rates of pressure to tender points on the arms and legs.

    According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, fibromyalgia can cause significant pain and fatigue. It is estimated to affect 5 million Americans age 18 or older, and between 80 and 90 percent of those diagnosed with fibromyalgia are women. The causes of fibromyalgia remain unknown.

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    Restless legs syndrome was diagnosed using a self-administered, validated questionnaire. RLS is a sleep-related movement disorder that involves an urge to move the legs that are usually accompanied or caused by uncomfortable and unpleasant sensations in the legs. This urge begins or worsens during periods of rest or inactivity, is partially or totally resolved by movement, and worsens or only occurs at night. RLS occurs 1.5 to two times more commonly in women than in men.

    Watson noted that treating restless legs syndrome may be one of the keys to reducing fatigue and improving the quality of life in people with fibromyalgia. RLS often can be successfully treated with a medication such as pramipexole or ropinirole.

    “Since restless legs syndrome is a treatable condition, diagnosing and treating RLS in fibromyalgia patients has the potential to improve their sleep,” Watson said.

    According to the authors, the cross-sectional nature of the study did not allow for an examination of causality. However, several aspects of the two syndromes suggest a logical overlap. Both disorders involve sensory abnormalities, and similar pathophysiology of the system that regulates the neurotransmitter dopamine has been proposed for both syndromes. Furthermore, restless legs syndrome may be induced by antidepressants, which are a common treatment for pain and depression in fibromyalgia. Also, exercise has been shown to improve the symptoms of both syndromes.

    The study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health and by the National Fibromyalgia Research Association.

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  • Study probes obesity link to fibromyalgia

    Study probes obesity link to fibromyalgia

    Afflicting up to 5 percent of the U.S. population, mostly women, fibromyalgia is characterized by widespread pain and a range of function problems. A new study in The Journal of Pain reports there is a close association between obesity and disability in fibromyalgia patients.

    The purpose of the study, conducted by University of Utah researchers, was to evaluate the relationship between fibromyalgia and obesity. They hypothesized that obesity significantly adds to the disease and disability burden of the condition. Two hundred fifteen fibromyalgia patients were evaluated in the study and given several physical tests to measure strength, flexibility, range of motion, and strength. Heart rates and sleep quality also were assessed.

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    The authors reported that consistent with previous studies, obesity is common among those with fibromyalgia. Half the study sample was obese and an additional thirty percent were overweight. Also consistent with previous findings, obese patients in this study showed increased pain sensitivity, which was more pronounced in lower body areas. The obese patients also had impaired flexibility in the lower body and reduced strength.

    The study concluded that obesity is a common comorbidity of fibromyalgia that may compromise clinical outcomes. The adverse impact of obesity is evidenced by hyperalgesia, disability, impaired quality of life, and sleep problems. The authors also noted that recent evidence suggests weight loss improves fibromyalgia symptoms, perhaps resulting from patients adopting healthier lifestyles and taking more positive attitudes toward symptom management, and overall quality of life.

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  • Immediate treatment can alleviate future back problems

    Immediate treatment by a physiotherapist, bypassing a waiting list, can reduce problems with recurring low back pain, reveals a thesis from the University of Gothenburg, Sweden.

    Many people suffer from low back pain, and most get better. However, those who suffer from long-term pain can find that their work, everyday, and leisure activities are limited to varying degrees. Given that long-term pain often requires extensive treatment, it is important that the pain be treated at an early stage.

    “I wanted to find out whether patients‘ low back pain could be alleviated in the long run if primary care clinics could offer examinations and treatment by a physiotherapist without any delay in the form of a doctor’s referral or waiting list,” says Lena Nordeman, a registered physiotherapist, and researcher at the Sahlgrenska Academy.

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    As part of her thesis, she, therefore, carried out a study in a same-day appointment model with the option of going straight to a physiotherapist, with or without a referral from a doctor. The effect of receiving an examination and treatment within 48 hours was subsequently evaluated compared to being on a waiting list for four weeks before receiving the same treatment.

    60 patients with low back pain for 3-12 weeks took part in the study, which was carried out in primary health care in Södra Älvsborg, south-west Sweden.

    “We saw that both groups improved after the treatment ended. The group that had been given early access to an examination and individualized treatment maintained their improvement after six months, while the group that had been held on a waiting list were more likely to suffer from recurring back pain,” says Nordeman, who draws the conclusion that early examination and treatment by a physiotherapist as soon as a patient asks for care could be important for reducing low back pain in the long term.

    Her thesis also included an investigation of 130 women who had suffered from low back pain for more than three months and who among others had undertaken a walk test. A follow-up after two years revealed that the walk test was a good predictor of both future ability to work and limitations in everyday activities.

    It is recommended that patients with long-term widespread pain or fibromyalgia be given education and a physical exercise program to help alleviate their symptoms. Nordeman’s thesis also looked at which patients benefit most from this treatment. 166 patients with widespread pain or fibromyalgia from Gothenburg, Uddevalla, and Alingsås were randomly divided into two groups, the first of which was given a six-session education program and 20-week pool exercise program supervised by a physiotherapist, while the second was given just the education program.

    “We saw that the group that received both the education and the physical exercise program showed the greatest improvement in perceived health and that patients with moderate symptoms benefitted most from exercise,” says Nordeman.

    Low back pain

    Low back pain affects up to 80% of people of working age at some time in their lives, though most will recover. Low back pain can be recurring, and some people will continue to suffer from some degree of pain. In 85-90% of cases, the pain cannot be attributed to a specific illness or injury.

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  • Young people report worse fibromyalgia than older patients

    It may seem counterintuitive, but young and middle-aged fibromyalgia patients report worse symptoms and poorer quality of life than older patients, a Mayo Clinic study shows. Fibromyalgia most often strikes women. It is characterized by widespread musculoskeletal pain with fatigue, sleep, memory, and mood issues. The research, one of several Mayo studies being presented at the American College of Rheumatology annual meeting, suggests the disorder plays out differently among different age groups.

    Researchers studied 978 fibromyalgia patients and divided them into three age groups: those 39 or younger, those 50 to 59, and those 60 or older. The younger and middle-aged patients were likelier to be employed, unmarried, and smokers and have a higher education level, lower body mass index, more abuse history, and a shorter duration of fibromyalgia symptoms than older patients.

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    “Among the three age groups of young, middle-aged, and older, symptom severity and quality of life differ,” says senior author Terry Oh, M.D., a physical medicine and rehabilitation physician at Mayo Clinic in Rochester, Minn. The study’s findings were surprising because the quality of life and physical health are considered to be negatively associated with age, Dr. Oh says.

    Dr. Oh notes that women in all three groups with fibromyalgia reported a lower quality of life than average U.S. women and that the difference between their physical health and that of the average woman was more significant than mental health differences, particularly in young patients.

    In other studies, Mayo researchers found:

    *About 7 percent of fibromyalgia patients had inflammatory rheumatic conditions, and in general, those fibromyalgia patients didn’t do as well with treatment as those without rheumatic diseases.

    *Fibromyalgia patients may also have skin-related symptoms such as excessive sweating or burning or other sensations.

    *Obese patients with polymyalgia rheumatica have more pain and disability than other polymyalgia rheumatic patients. They also tend to need higher doses of glucocorticoids.

    *Rheumatoid arthritis patient experiences and symptoms do not always reflect what medical literature shows when it comes to pain, morning stiffness, the relationship between swelling and damage, and what worsens or improves symptoms.

    *Hospitalization is a significant risk factor for gout flares in people already diagnosed with gout.

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  • Lady Gaga: When people doubt

    Lady Gaga: When people doubt

    I use the word ‘suffer’ not for pity, or attention, and have been disappointed to see people online suggest that I’m being dramatic, making this up, or playing the victim to get out of touring. If you knew me, you would know this couldn’t be further from the truth

    It isn’t at all surprising to me that people have suggested to Lady Gaga that she is being dramatic, making her pain up, or playing the victim.

    Everyone with chronic pain has faced this exact same sort of stigma before. It is pervasive with fibromyalgia.

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    I want to say ‘Try it on for size, see how it fits. Hell, give it a decade or two and come back to me. Tell me how it feels.’ But I wouldn’t want anyone to endure this pain. Not ever. But it seems chronic pain is a member’s only club. The true depth of the experience is extremely hard to explain to people. And there will be those that doubt it is a valid experience. That you are in as much pain as you say. That you are in pain at all. That, surely, you exaggerate it.

    You see, the main lesson we learn early on in coping is to try and function with pain and the fatigue of fibromyalgia. Generally, we learn this the hard way. We push through the pain. We do not pace. We do not pay attention to our limits. We want to keep our lives as IS. So we push through it. So perhaps the impact isn’t seen by the outside observer yet. This causes a great deal more pain. So we begin to seek some sort of resolution.

    But there isn’t any resolution. So we seek some sort of reduction. But there aren’t any easy answers there. But meanwhile, we are still pushing through the pain. And this stress builds and builds until we cannot do that anymore. Generally, a lot of us learn the hard way we have to pace. We have to slow down. We have to pay attention to those newly imposed limitations.

    I learned this twice. Because that is how I roll.

    Nevertheless, the impact is seen in our lives then. People do not see the chiropractor, acupuncture, or massage therapy appointments. Doctor appointments and specialist appointments. Diets. Supplements. Exercise. And every other thing we try and do. But when it begins to start to cancel plans and affect work… they begin to notice.

    You are always canceling plans

    How is it you did that one day, but couldn’t the next? You are just lazy. You are just exaggerating the pain.

    You just don’t want to work.

    The judgments begin. All the while you feel guilty for not being who you Were. And struggle to maintain the semblance of a life you had. May be struggling to hold onto your career, working in general or dealing with the sudden loss of work. Not being able to work is something that is difficult to deal with financially, in regards to self-worth and guilt wise. All this takes adjustments. And people Judge.

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    What they have no comprehension of is the level of pain, fatigue, poor concentration and other symptoms of illness one has to endure and try to function with on a daily basis. When you are developing a treatment plan, it can be pretty much impossible to function. Unmanaged pain is extremely difficult to cope with. And it may never be managed well.

    That is the thing with chronic pain. Not everyone’s pain can be managed to a level they can function well enough to work or do the sort of things society expects of them. Some people can have moderately managed pain and they can function at a better capacity some of the time. And there are those with well-managed pain. But it is still pain. It is still very difficult to deal with. There are still very bad days, moderate days and then there are good days. It is very unpredictable.

    Oddly enough they think we exaggerate when we also learn to mask the pain in order to function in society as we do. We are rather stoic given the level of pain we are in. We have exceptional pain tolerances we develop from dealing with it all the time. We have ‘baseline’ pain that we find ‘normal’ or ‘good days’ and I will guarantee the average person wouldn’t find that ‘normal’ at all.

    And we have moderate pain that even Then we are still going at it… but not doing Quite as well. And we have brutal pain that would have the average person in the ER, and certainly, it is the sort that causes us to be non-functional. So do not judge us for non-functional days. Not to mention there are decades of worse pain sometimes. Times when pain management isn’t working. And it is relentless then. But we get through it.

    I think it is a great thing that Lady Gaga is out there sharing the truth about chronic pain and fibromyalgia. But with that truth comes the very true fact of the stigma we all experience. It is a great thing she is pointing it out as well. When your pain isn’t managed it will manage you, and you need to take the time to deal with it. She has no one to answer to for that. Most people will completely understand that. Those that don’t are the ones that we all deal with in our lives and why awareness is so very important in the first place.

    But I will say this:

    Just because you cannot see my pain doesn’t mean I have to validate its existence to you. Believe it. Or don’t. I don’t care. I still have to live and cope with it whether you do or don’t. What it does mean is that if you don’t… you will not be a person I will value in my life. If you do not believe in a fundamental experience that defines my existence and how I live in this world, then I have very little use for you.

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    For More Information Related to Fibromyalgia Visit below sites:

    References:

    Fibromyalgia Contact Us Directly

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    Official Fibromyalgia Blogs

    Click here to Get the latest Chronic illness Updates

    Fibromyalgia Stores

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  • Lady Gaga and fibromyalgia

    Lady Gaga has opened up about having Fibromyalgia and is going to be candid about it in her documentary. Fibromyalgia is a syndrome that needs this sort of representation. Someone visible is seen to be struggling with it and getting extensive treatment to manage the pain. It isn’t the sort of syndrome that gets much attention. So I am proud of her for putting that out there. And those of us who advocate for awareness are glad to see someone putting her story out there to a broad audience in such away.

    Pain Network News article goes into some of the treatments she is using from massage to ‘sitting in an infrared sauna wrapped in an emergency blanket‘ and alternating between cold (ice baths) and hot treatments. As well as Gyrotonic Workout,

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    That is the thing for Fibromyalgia that she demonstrates well. We have to find our own treatments that work for us. And sometimes that takes a long time. And sometimes you have to think of new things to try. But when you find your path it can help you manage the pain and help you cope.

    I do only a few basic things for FM a) exercise b) magnesium– Epsom salt baths, magnesium oil, or magnesium in liquid form. c) Oska Pulse and d) slow-release tramadol called Silvia and e) FibroCane supplements. For pain anyway. And that is what works for me.

    Also, Rhodiola for fatigue, because fatigue is another major issue all on its own. And B12 for fatigue as well.

    And then a sleeping pill for sleep. Because my sleep is horrendous.

    And just pacing and moderation, as we all know, go a long way. Staying within those limits.

    I am glad to see we have some star power willing to share her struggles though. And also discuss how she lives and works with her condition. Because having it is one thing, coping another and we have lives to live. We have to find ways to manage the pain, fatigue, sleep dysfunction, and cognitive issues somehow. It will be interesting to see what she says in her documentary and how much awareness it brings to fibromyalgia as a syndrome. We need the awareness for sure.

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    For More Information Related to Fibromyalgia Visit below sites:

    References:

    Fibromyalgia Contact Us Directly

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    Official Fibromyalgia Blogs

    Click here to Get the latest Chronic illness Updates

    Fibromyalgia Stores

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  • Long-term study on fibromyalgia severity

    I came across an interesting long-term study in Finland on Fibromyalgia spanning 26 years published in the journal of Clinical Rheumatology. The severity of symptoms persists for decades in a fibromyalgia-a 26-year follow-up study.

    There has been this sort of rumor that fibromyalgia improves with the time that I have heard several times and so this study is interesting. Also, there is the question of whether we can go into remission or not. Either way, we all want to know what FM will be like in the future. We know it isn’t progressive but we worry it will worsen with age.

    It started with 56 patients in 1986 who were given a base questionnaire. 42 of these fulfilled the criteria for FM at that time.

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    Then 26 later 36 of the patients were located again. and 28 of these filled out another questionnaire. So we are looking basically at the study of these 28 individuals. Nine of the questions on the new questionnaire were identical to the old one, including questions on the quality of life and changes in symptoms.

    • Three individuals (11%) had recovered from fibromyalgia. (this is a fascinating number here. Makes you want to dig a little into the reasons for their recovery.)
    • 23% reported the remission we hear about, having had one or several symptomless periods lasting at least 1 year. This does suggest that remission is indeed possible.
    • In others (n=25), all symptoms aside from pain showed a slight deterioration. So we might see a slight slide in symptoms.
    • Despite aging and the FM, functional levels remained the same over time. This is a key one. Functionality, despite aging, remained consistent.
    • The actual amount of symptoms reported didn’t change much (10.8 (SD 2.9) vs. 11.1 (SD 4.1), p = 0.75). Symptom changes can lead to a lot of problems, but it looks like over time we do not change overly in them. 
    • Insomnia showed the most significant increase. I wouldn’t say this is much of a surprise since it is a difficult one to manage.
    • Exercise didn’t have a significant influence on the changes in the measured parameters. But the 3 recovered individuals did an exercise on a regular basis. And they speculate since 21 of 24 (who answered the question on exercise) did exercise it might be why functionality was consistent over time. Most of the participants did exercise and this could be then a key to treatment and functionality. A study of those who do not compare to those who do long-term would be interesting.

    Symptoms of FM have persisted in most patients for decades without significant deterioration of self-reported functional ability. About one-fourth of patients had experienced long symptomless periods during their illness. Three patients (11%) reported that they have healed from FM. study 

    We can conclude in the long-term symptoms will remain but there can be extended periods of remission. And that perhaps exercise helps us maintain our current level of functionality over time. This is a positive study for long-term outlook really. At the very least it says things remain consistent over time, not worse.

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    Official Fibromyalgia Blogs

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  • Fibromyalgia assessments

    So it looks like some clinicians have some uncertainty when it comes to diagnosing Fibromyalgia. Remember the criteria for tender points are no longer used.

    Data from the U.S., Europe, and Asia report that approximately half of providers admit uncertainty in confidently making a diagnosis of [fibromyalgia]. Diagnosing [fibromyalgia] more promptly should reduce unnecessary tests, specialty referrals, health care costs, and patient anxiety,” Kim D. Jones, Ph.D., FNP, FAAN, from Oregon Health and Science University School of Nursing and School of Medicine, and colleagues wrote.

    “Based on our clinical experience, we surmise that clinicians need a simple screening test that can be performed as part of the routine evaluation in all patients with persistent pain complaints.”

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    The study recommends adding two things to help with assessments.

    • Asking whether they have deep, persistent, aching pain all over their body. Widespread pain criteria.
    • And see if there is a pain when the Achilles tendon is pinched for 4 seconds.

    The study involved 52 patients with FM, 108 with chronic pain but not FM, and 192 without pain or FM. They used three measures: BP cuff-evoking pain, digital palpation-evoked pain, and a question about persistent deep aching. Patients were looked at for tenderness to digital pressure at 10 spots and BP cuff-evoked pain and then asked to rate their deep persistent aching widespread pain on a 1-10 scale.

    More FM patients answered the questions about persistent deep aching compared to the chronic pain subjects. They had higher bilateral digital evoked tenderness and BP cuff-evoked pain. (But the cuff-evoked pain became non-significant when researchers did multivariate logistic regressions).

    The analysis demonstrated pinching the Achilles tendon for more than 4 seconds and a positive answer to the deep aching question did provide a beneficial screening test that indicated a probable diagnosis of fibromyalgia.

    “We are recommending two simple assessments to be added to the routine evaluation of any chronic pain patient. We envisage these assessments be used as a screening instrument, not a diagnostic test, with a definitive diagnosis of [fibromyalgia] being reserved for later,” Jones and colleagues wrote. “By raising a provider’s index of suspicion, patients may be spared a lengthy cycling through the medical system before receiving a diagnosis of [fibromyalgia] and beginning treatment.”

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