Thursday, 26 Apr 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

NSAIDs and Acetaminophen Preferred Over Opioids for Dental Pain

A systematic review in the Journal of the American Dental Association evaluated the safety and efficacy of analgesics and foundp opioids less effective than nonsteroidal anti-inflammatory drugs (NSAIDs) alone or in combination with acetaminophen when treating dental pain.

Lancet Tackles the Global Challenge of Low Back Pain

Lancet has several reports on low back pain (LBP) as a major problem worldwide, largely because of the aging population.

Low back pain is the leading cause of disability worldwide.

Cannabis Laws Lessen the Opioid Crisis

Three reports from JAMA Internal Medicine demonstrate favorable trends with less opioid use when cannabis became legal.

Tai Chi Eases Fibromyalgia Pain

The mind-body practice of tai chi was as effective or better than currently recommended aerobic exercise for fibromyalgia, a randomized controlled trial demonstrated.

Opioid Overdoses Jump 30% in 2017

The CDC released new information yesterday showing that emergency department (ED) visits for opioid overdoses rose 30% in the US from July 2016 through September 2017; in addition, those with an overdose are more likely to a repeat overdose.

The data was presented as part of a new CDC “Vital Signs” report which describes recent trends in healthcare - with this report addressing opioid overdoses using emergency department data.