Monday, 25 Mar 2019

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

New Sleep Medicine Guidelines for Obstructive Sleep Apnea

The American Academy of Sleep Medicine (AASM) has established new guidelines for the evaluation and treatment of sleep-disordered breathing in adults, specifically guiding the use of positive airway pressure (PAP) in the treatment of obstructive sleep apnea (OSA) in adults. 

Pain Drives the Use of Medical Marijuana

A report from the University of Michigan examined state-wide medical marijuana showing most of it is used for chronic pain.

The authors include Kevin Boehnke, Ph.D., Daniel J. Clauw, M.D., Rebecca L. Haffajee, Ph.D., and Saurav Gangopadhyay, M.P.H. undertook this investigation to to assess why people are using cannabis medically. 

Compounded Pain Creams - Expensive Placebos?

The Annals of Internal Medicine reports that the growth and use of compounded pain creams is unwarranted as they were no better than placebo in a randomized controlled trial, suggesting their higher costs are unjustifiable compared to other topical commercially available agents (lidocaine, diclofenac, capsaicin, etc.). (Citation source: https://buff.ly/2BkTj58)

Opioids Double Rates of Suicides and Overdoses

An article in the New England Journal of Medicine reports that the rates of suicide and drug overdoses has doubled in the last 17 years, and that opioids are largely to blame.

Using data from the Centers for Disease Control and Prevention databases, researchers show that the sheer number of deaths from suicides and unintentional overdoses together rose from 41,364 in the year 2000 to 110,749 in 2017.

Cryotherapy Never FDA Approved

Another injury related to whole body cryotherapy (WBC) has been reported by practitioners in Philadelphia, serving as yet another warning of WBC's potential to cause serious adverse effects.