Abstract
Fibromyalgia syndrome (FMS) is a highly prevalent, chronic musculoskeletal condition characterized by widespread pain and evoked pain at tender points. This study evaluated various aspects of body awareness in a sample of 14 women with FMS and 13 healthy controls, such as plasticity of the body schema, body esteem, and interoceptive awareness. To this end, the Rubber Hand Illusion (RHI), the Body Esteem Scale (BES), and the Body Perception Questionnaire (BPQ) were used, respectively. Consistent with increased plasticity of the body schema, FMS patients scored higher, with large or very large effect sizes, across all three domains evaluated in the RHI paradigm, namely proprioceptive drift and perceived ownership and motor control over the rubber hand. Scores on all items addressed by the BES were consistently lower among FMS subjects (2.52, SEM .19 vs 3.89, SEM .16, respectively, p < .01, Cohen’s d = .38-.66). In the FMS sample, BES scores assigned to most painful regions also were lower than those assigned to the remaining body sites (1.58, SEM .19 vs 2.87, SEM .18, respectively, p < .01). Significantly higher scores (p < .01, Cohen’s d = .51-.87) were found in the FMS sample across awareness (3.57 SEM .15 vs 1.87 SEM .11), stress response (3.76 SEM .11 vs 1.78 SEM .11), autonomic nervous system reactivity (2.59 SEM .17 vs 1.35 SEM .07), and stress style 2 (2.73 SEM .27 vs 1.13 SEM .04) subscales of the BPQ. Intensity of ongoing clinical pain was found to be strongly correlated with interoceptive awareness (r = .75, p = .002). The results suggest a disturbed embodiment in FMS, characterized by instability of the body schema, negatively biased cognitions regarding one’s own body, and increased vigilance to internal bodily cues. These manifestations may be interpreted as related with the inability of incoming sensory inputs to adequately update negatively biased off-line somatorepresentations stored as long-term memory.
Highlights
Fibromyalgia syndrome (FMS) is a chronic musculoskeletal condition characterized by widespread pain and evoked pain at tender points [1,2]
In patients presenting with complex regional pain syndrome (CRPS), for example, mental representation of movement of the painful body part has been found to be slower [19,20], and visuospatial perception and laterality recognition may be impaired [21,22]
In order to gain insight into embodied pain in FMS, the current study explored various fundamental aspects of body awareness such as plasticity of the body schema, body image and interoceptive awareness
Summary
Fibromyalgia syndrome (FMS) is a chronic musculoskeletal condition characterized by widespread pain and evoked pain at tender points [1,2]. In patients presenting with complex regional pain syndrome (CRPS), for example, mental representation of movement of the painful body part has been found to be slower [19,20], and visuospatial perception and laterality recognition may be impaired [21,22]. Patients with this condition often present with altered motor performance, including limited range of motion, weakness or dystonia [23,24,25,26]. Such relationship has been confirmed by direct correlations between poor body image and severity of the clinical status and ongoing pain [35]
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