(181) - The relationship between quantitative sensory testing (qst), mindfulness, fatigue, and pain in fibromyalgia

Abstract

Fibromyalgia (FM) is a chronic pain condition characterized by heightened sensitivity to mechanical (as well as other modalities) stimuli. While on average FM patients display substantial hyperalgesia, inter-patient variability is large, and the degree of hyperalgesia is known to associate with the magnitude of patients' spontaneous daily pain. To date however, little research has investigated the potential moderating effects of patient characteristics on the association between experimental pain and daily clinical pain. The present study used a diary-based micro-longitudinal design to examine this question in fibromyalgia patients. Patients completed baseline measures of mindfulness (FFMQ), followed by daily surveys of fibromyalgia pain, symptoms, and catastrophizing for a period of 7 days. In addition, FM patients underwent Quantitative Sensory Testing measuring Pressure Pain Thresholds (PPTs), measured on the lower leg using cuff algometry. Multilevel modeling (MLM) analyses indicated that high mechanical pain sensitivity was associated with heightened levels of daily pain interference (B = .63, p < .01). In addition, more cuff pain sensitivity was associated with elevated levels of daily fatigue (B = .33, p < .01). Results of a multilevel moderation analysis revealed a significant interaction between cuff pain sensitivity and mindfulness on daily pain interference (B = .04, p < .01) as well as fatigue (B = .02, p < .05). Overall, the findings are congruent with other studies showing that mechanical hyperalgesia is correlated with daily pain and fatigue in FM and these novel results suggest that characteristics of mindfulness may be most effective in reducing pain in patients who suffer from relatively less hyperalgesia.