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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.