Friday, 20 Jul 2018

You are here

Fibromyalgia Diagnosed by Two Simple Tests

Researchers from the Oregon Health Science Center have reported that fibromyalgia can be distinguished from chronic pain by primary care providers (PCPs) who employ two simple screening tests: BP cuff-evoked pain and a single patient question, and pain induced by pinching the Achilles tendon. 

They analyzed 352 patients (age 50 yrs;  70% female) from 2 primary care practices during routine visits. The group included 52 patients (15%) diagnosed with FM, 108 (31%) with chronic pain and 192 who had neither pain nor FM (54%). They tested  patient by applying to digital pressure at 10 body locations, BP cuff-evoked pain, and a single question, “I have a persistent deep aching over most of my body” (0–10).

FM patients endorsed the single deep ache question substantially more than those with chronic pain but without FM (7.4 ± 2.9 vs 3.2 ± 3.4; P < .0001) and demonstrated lower BP-evoked pressure pain (132.6 mmHg ±45.5 vs 169.2 mmHg ±48.0, P < 0.0001).

Using multivariate logistic regressions, the BP cuff-evoked pain became non-significant and the only useful screening tests were (1) pain on pinching the Achilles tendon at 4 kg/pressure over 4 seconds, and (2) and positive endorsement of the question “I have a persistent deep aching over most of my body”.

The diagnosis of FM is often overlooked in primary care. These 2 simple questions can heighten the awareness of the highly prevalent FM populatoin that exists; leading to earlier recognition and better treatment. 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Unsafe Practices with Ambien Use

Ambien (zolpidem) is the most widely used prescription hypnotic sedative since its introduction in 1992 and is currently the fourth most frequently prescribed psychiatric drug (2013). Recent US Food and Drug Administration Drug Safety Communications suggest limitations on use to reduce adverse effects. A study of the Medical Expenditures Survey in 2015 revealed that over 3.8 million adults reported using one or more prescriptions for zolpidem.

Weight Loss Lessens Knee Pain in Obese

Obese knee osteoarthritis (OA) patients who lose > 20% of their weight were in significantly less pain, had better function and improved quality of life. 

Blacks Suffer When Pain is Poorly Defined

Racial discrimination was a key feature at a 2-day summit on pain management and the opioid crisis, hosted by the National Institutes of Health on Thursday and Friday.

Asheley Cockrell Skinner, PhD, of the Duke Clinical Research Institute in Durham, North Carolina, provided a broad overview of racial bias in opioid prescribing.

Prescription Drug Monitoring Programs Fail to Deter Opiate Abuse

A systematic review of prescription drug monitoring programs (PDMPs), advocated in the president's Prescription Drug Abuse Prevention Plan, fails to show evidence of efficacy in preventing nonfatal and fatal overdoses.

Measures of Opioid Misuse Predict Future Opioid Overdose and Death

The current issue of Annals of Internal Medicine examines patterns of potential opioid misuse that are associated with subsequent adverse outcomes nationally.

Researchers analyzed a 5% sample of Medicare beneficiaries who had an opioid prescription, without a cancer diagnosis.  Specifically the sought to correlate a diagnosis of opioid overdose with other measures of opioid misuse including: