Pressure pain endurance in women with fibromyalgia

BACKGROUND AND OBJECTIVES:Fibromyalgia syndrome is a chronic condition causing spontaneous widespread pain associated with hypersensitivity. This study aimed at investigating the pressure pain endurance in women with fibromyalgia syndrome to determine the range of painful stimulation that an individual with fibromyalgia syndrome can resist acceptably.METHODS:We conducted an observational, descriptive, crosssectional study with 60 subjects (51.23±8 years), who met the American College of Rheumatology/1990 (ACR) criteria for fibromyalgia syndrome, and 42 healthy volunteers (48.33±9 years) as the control group. Algometry was performed to record pressure pain detection threshold and pressure pain tolerance, and fibromyalgia impact questionnaire was used to determine the impact of fibromyalgia syndrome. Pressure pain endurance was calculated as the arithmetic difference between pressure pain tolerance and pressure pain detection threshold.RESULTS:A significant difference in fibromyalgia impact questionnaire (p<0.0001), pressure pain detection threshold, and pressure pain tolerance (p<0.0001) was found between both groups. Furthermore, a significant difference in pressure pain endurance (p<0.0001) for each of the 18 points identified by ACR was noted between both groups, with the highest range of physical stimulation observed in the control group. A correlation between pressure pain endurance and pressure pain detection threshold (r=0.8334; p<0.0001) and pressure pain tolerance (r=0.8387; p< 0.0001) was observed in the fibromyalgia syndrome group.CONCLUSION:Pressure pain endurance of the fibromyalgia syndrome group was extremely lower, when compared with that of healthy controls, and may be used as an additional component to measure the disturbance in pain perception and to determine the range of painful stimulation that an individual with fibromyalgia syndrome can acceptably resist.

背景与目的：纤维肌痛综合征（Fibromyalgia syndrome）是一类以自发性广泛疼痛伴痛觉超敏为特征的慢性疾病。本研究旨在探讨纤维肌痛综合征女性患者的压力痛耐力，以明确该类患者可耐受的疼痛刺激范围。
研究方法：本研究为观察性描述性横断面研究，共纳入60名符合1990年美国风湿病学会（American College of Rheumatology, ACR）纤维肌痛综合征诊断标准的受试者（年龄51.23±8岁），以及42名健康志愿者作为对照组（年龄48.33±9岁）。采用压力测痛法（Algometry）记录压力痛觉阈值与压力痛觉耐受力，并使用纤维肌痛影响问卷（fibromyalgia impact questionnaire）评估纤维肌痛综合征的疾病影响程度。压力痛耐力通过压力痛觉耐受力与压力痛觉阈值的算术差值计算得到。
研究结果：两组受试者在纤维肌痛影响问卷评分、压力痛觉阈值及压力痛觉耐受力方面均存在显著差异（p<0.0001）。此外，美国风湿病学会划定的18个压痛点的压力痛耐力在两组间均存在显著差异（p<0.0001），对照组可承受的物理刺激范围最大。在纤维肌痛综合征组中，压力痛耐力与压力痛觉阈值（r=0.8334; p<0.0001）及压力痛觉耐受力（r=0.8387; p<0.0001）均呈显著正相关。
研究结论：与健康对照组相比，纤维肌痛综合征组的压力痛耐力显著降低，该指标可作为评估痛觉感知异常的补充指标，用于明确纤维肌痛综合征患者可耐受的疼痛刺激范围。