Friday, 14 Dec 2018

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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

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